Syllabus

Master of Science in Applied Nutrition

APN 786 – Nutrition Assessment and Application in a Clinical Setting Lab (Fall B 2023)

Credits - 1

Description

In the dietetics focus lab series, MSAN students in the dietetics focus will conduct Supervised Experiential Learning (SEL) hours. In the lab series, Faculty and Preceptors will assess competencies. Students will work to demonstrate professional skills and values in all interactions with their site preceptors, CPS faculty and staff, their peers and community members. Through reflective writing exercises, students will self-assess their skills, behaviors and attitudes. Topics such as clinical skills, communication skills, leadership and management skills, professionalism, conflict resolution, teamwork and integrity will be explored. Cases and real-world examples will be used to facilitate discussions. Students are responsible for working with the Assistant Director, Graduate Program in Applied Nutrition to arrange acceptable Preceptors and SEL sites before signing up for the course.

Materials

Learning Objectives and Outcomes

Supervised Experiential Learning

The Accreditation Council for Education in Nutrition and Dietetics (ACEND) released the Future Education Model Accreditation Standards for Graduate Degree Programs (GP) in nutrition and dietetics. These accreditation standards integrate didactic coursework with supervised experiential learning in a competency-based curriculum designed to prepare nutrition and dietetics practitioners for future practice.

Competencies and Performance Indicators:

Unit 1: Foundational Knowledge: Applies foundational sciences to food and nutrition knowledge to meet the needs of individuals, groups, and organizations.

1.1 Applies an understanding of environmental, molecular factors (e.g. genes, proteins, metabolites), and food in the development and management of disease.

• • 1.1.4 Demonstrates an understanding of research techniques and processes used to study the relationship between molecules (e.g., genes, proteins, metabolites) and microbes with disease states. (K)

1.8 Applies knowledge of pharmacology to recommend, prescribe and administer medical nutrition therapy.

• • 1.8.3 Identifies potential drug and food interactions based on physiological responses to pharmacological agents and takes appropriate actions. (S)

Unit 2: Client/Patient Services: Applies and integrates client/patient-centered principles and competent nutrition and dietetics practice to ensure positive outcomes. 

2.1 Applies a framework to assess, develop, implement and evaluate products, programs and services.

• • 2.1.1 Conducts or coordinates an assessment of the environment, competitive landscape and stakeholder opinions to identify and evaluate data needed to make decisions regarding nutritional products, programs and services. (D)
  • 2.1.2 Designs nutritional products, programs or services that promote consumer nutritional health, dimensions of wellness and lifestyle management. (D)
  • 2.1.3 Creates a work plan or project plan to implement nutritional programs and services or launch products. (D)
  • 2.1.4 Conducts an evaluation of a product, program or service by analyzing reasons for variance from expected outcomes and implements new strategies as appropriate. (D) 

2.3 Nutrition Assessment

• • 2.3.1 Selects and implements nutrition assessment tools for individuals, groups or populations. (D)
  • 2.3.2 Interviews client/patient to collect subjective information considering the determinants of health. (D)
  • 2.3.3 Conducts a nutrition focused physical exam. (D)
  • 2.3.4 Takes a food and nutrition related medical history. (D)
  • 2.3.5 Assesses physical activity and history of physical activity. (D)
  • 2.3.6 Collects, assesses and interprets anthropometric measures and body composition.
  • 2.3.7 Orders, collects and interprets biochemical tests. (D)
  • 2.3.8 Analyzes diagnostic test results relevant to nutrition (e g. diagnostic imaging related to fluoroscopy, swallowing evaluation, enteral feeding tube placement). (D)
  • 2.3.9 Identifies signs and symptoms of nutrient deficiencies or excesses. (D)
  • 2.3.10 Determines barriers that might influence a client/patient’s nutritional status. (D)
  • 2.3.11 Determines accuracy and currency of nutrition assessment data. (D)
  • 2.3.12 Identifies patient appropriate validated formula and performs calculations to determine nutritional requirements. (D)

Diagnosis

• • 2.3.13 Analyzes and synthesizes nutrition assessment data to inform nutrition diagnosis(es) and nutritional plan of care. (D)
  • 2.3.14 Devises PES (problem, etiology and sign symptom) statement and outlines reasons for professional opinion cause and contributing factors. (D)
  • 2.3.15 Prioritizes the nutrition diagnosis(es). (D)

Intervention

• • 2.3.16 Develops an individualized plan of care that addresses nutritional care needs diagnosis and client/patient nutrition goals in collaboration with the client/patient and team members. (D)
  • 2.3.17 Orders nutrition prescriptions to address nutritional goals. (D)
  • 2.3.18 Implements the nutrition plan of care or nutrition intervention with the client/patient and other team members. (D)

Monitoring/Evaluation

• • 2.3.19 Monitors and evaluates impact of nutrition intervention on the nutrition diagnosis. (D)
  • 2.3.20 Develops and applies nutrition care outcome indicators to measure nutrition intervention. (D)
  • 2.3.21 Assesses client/patient’s compliance with nutrition intervention. (D)
  • 2.3.22 Identifies barriers to meeting client/patient’s nutrition goals and makes recommendations to modify the nutrition plan of care or nutrition intervention, and communicates changes to client/patient and others. (D)
  • 2.3.23 Summarizes impact of nutrition interventions on client/patient’s nutrition outcomes, considering client/patient-centered care. (D)
  • 2.3.24 Identifies, analyzes and communicates reasons for deviation from expected nutrition outcomes. (D)
  • 2.3.25 Evaluates the availability of services to support access to nutrition care and to help meet client/patient nutrition goals. (D)

Documentation

• • 2.3.26 Documents all elements of the nutrition care process following professional standards and organizational policies. (D)
  • 2.3.27 Demonstrates coding and billing procedures to obtain payment for nutrition services under alternate health care payment models. (D)

2.4 Implements or coordinates nutritional interventions for individuals, groups or populations.

Medical Nutrition Therapy

• • 2.4.1 Manages medical nutrition therapy for clients/patients. (D)
  • 2.4.2 Applies and integrates understanding of foundational sciences to manage medical nutrition therapy, diet and disease management. (D)
  • 2.4.3 Applies foundational science knowledge and medical nutrition therapy principles to establish, order, manage and evaluate the need for nutrition support when prescribing and administering nutritional oral, enteral and parenteral diets. (D)
  • 2.4.4 Considers and applies all relevant factors when recommending the use of oral nutritional supplements. (D)
  • 2.4.5 Refers/transfers care to relevant professionals when client/patient needs or required interventions are beyond personal competence or professional scope of practice. (D)

Education

• • 2.4.7 Assesses audience’s readiness to learn and identifies barriers to learning. (D)
  • 2.4.8 Develops or modifies nutrition education materials or delivery methods to meet the needs of the audience. (D)
  • 2.4.9 Develops and provides evidence-informed nutritional wellness and therapeutic diet education to a variety of audiences. (D)
  • 2.4.10 Translates basic to advanced food and nutrition science knowledge into understandable language tailored to the audience. (D)
  • 2.4.11 Communicates complex nutrition information to broad and diverse audiences. (D)
  • 2.4.12 Evaluates effectiveness of nutrition education and makes modifications as required. (D)

 Unit 5: Leadership, Business, Management and Organization: Demonstrates leadership, business and management principles to guide practice and achieve operational goals.

5.1 Demonstrates leadership skills to guide practice.

• • 5.1.2 Demonstrates understanding of social cues and team dynamics. (K)
  • 5.1.3 Communicates at the appropriate level and understands emotions and emotional situations. (D)
  • 5.1.4 Develops conversational and interpersonal skills. (D)
  • 5.1.5 Reflects on situations and critically evaluates outcomes and possible alternate courses of action. (D)
  • 5.1.6 Understands the mentoring role and practices mentoring and precepting others. (D)

Required Clinical Learning Experiences

• Required Clinical Learning Experiences 3.3 Perform routine health screening assessments including measuring blood pressure, conducting waived point-of-care laboratory testing (such as blood glucose or cholesterol), recommending and/or initiating nutrition-related pharmacotherapy plans (such as modifications to bowel regimens, carbohydrate to insulin ratio, B12 or iron supplementation).
• Required Clinical Learning Experiences 3.4 Provide instruction to clients/patients for self-monitoring blood glucose considering diabetes medication and medical nutrition therapy plan.
• Required Clinical Learning Experiences 3.5 Explain the steps involved and observe the placement of nasogastric or nasoenteric feeding tubes; if available, assist in the process of placing nasogastric or nasoenteric feeding tubes.
• Required Clinical Learning Experiences 3.6 Conduct a swallow screen and refer to the appropriate health care professional for full swallow evaluation when needed.

Professional Behavior Statement

 

Course Expectations

A student enrolled in the College of Professional Studies is expected to demonstrate professional behavior and conduct by:

• Behaving in a responsible, reliable and dependable manner — e.g. to manage time well; be on time for assignments, meetings, and appointments; to plan ahead and to follow through with commitments; to cooperate with person(s) in charge of programs; and to take responsibility for absences or missed assignments.
• Demonstrating personal integrity, honesty, and self-discipline – e.g. to be consistent and truthful, to show appropriate personal control, to take on tasks that he/she can manage; to be honest in reports and self-evaluations.
• Projecting a professional image in manner, interpersonal relationships, and writings, including social media, that is consistent with the profession’s accepted contemporary standards.
• Recognizing his/her personal limitations and biases, whether they are intellectual, physical or emotional; to strive to correct them (e.g. overcome negative behaviors such as procrastination); to learn to be a team member; to adapt to new situations; and to avoid discriminatory conduct or speech.
• Demonstrating the professional and emotional maturity to manage tensions and conflicts which occur among professional, personal, and family responsibilities. e.g. to meet with supposed antagonists to resolve misunderstandings; to get needed help from faculty, student support, tutors, learning assistance professionals and other qualified persons; to show ability to prioritize appropriately one’s personal, professional, and academic expectations and activities; to accept decisions of persons of authority at the CPS and UNE as well as in the professional environment.
• Demonstrating the ability to exercise sound judgment and to function under pressure – e.g. to request help when needed and to avoid endangering others; to remain focused on the task at hand; to remember that as a student he/she represents CPS to the greater community at large.
• Demonstrating the ability to self-assess, to continually learn and to learn from mistakes and failures and to heed admonitions and warnings from faculty and administrators (or their staff representatives) of CPS and from preceptors – e.g. to be responsive to feedback and constructive criticism regarding professional behavior and attitude; and, to understand the seriousness of academic and disciplinary warnings.
• Demonstrating compassion and respect toward others – e.g. to be respectful of others; to work cooperatively with differences and diversity in personalities and in cultural backgrounds as well as with differences in social and in economic status; and, to respect the privacy, confidentiality and individual choice of others.
• Demonstrating respectful behavior at all times toward the faculty, staff, and students.
• Respecting individuals from diverse backgrounds as a part of a university education. Prejudices against individuals because of race, ethnic or cultural background, gender, disability or other personal characteristics will not be tolerated.
• Displaying mature judgment and abiding by the reasonable decisions communicated by faculty and staff. Profane language or disrespectful behavior by students is unacceptable. Misunderstandings, changes in curricula or mistakes in administrative aspects of the program will occur from time to time. Appropriate mechanisms exist to communicate 30 student concerns about the operation of the college through the program administration, faculty members, and college administrators.
• These standards are taken very seriously and evaluated regularly. Failure to abide by these standards may result in academic warning, prescribed or proscribed actions, probation, or dismissal from the student’s program.

Assignments

In this course, you will be completing Supervised Experiential Learning (SEL) hours in a clinical setting. You will be interacting with professionals of many different disciplines and begin meeting and interacting with patients. Presenting as a professional student will be paramount to your success at all supervised experiential learning sites.

You will be responsible for completing site reflections, submitting a log of your SEL hours, and submitting your evaluation(s) of your preceptor(s) at the end of each SEL experience. You will also submit an overall course reflection for your ePortfolio at the end of the course.

SEL Site Reflections: In this course, you will submit two written reflections (representing 45 hours each) of your experiences and observations at your site placements.

Required Clinical Learning Experiences: You will complete two required RCLE activities (RCLE 3.3 Waived Point of Care Lab Testing and RCLE 3.6 Swallow Screen), with the option of participating in additional clinical learning activities. 

Student Evaluation of Preceptors: As you complete your arranged SEL, you will submit an evaluation of each preceptor at each site. For each one completed, you will send a copy to the MSAN Dietetics-Focus Program Director. In addition, you will also receive a copy which you will upload to your course.

Preceptor Evaluation of Students (Competency Assessment): Your preceptors will be completing the competency evaluation form for your SEL experiences. The preceptors will receive a link to the online evaluation form and it will be submitted directly to the MSAN Dietetics-Focus Program Director. 

Final Lab Course Reflections and ePortfolio: In week 8, you will review your SEL reflections and write a paper reflecting on the overall course experience. This will be included as part of the final capstone assessment, the ePortfolio. 

Sample activities and projects for SEL Sites:

Create culturally appropriate handout to educate the target population. Conduct educational session for target population. Attend staff meeting and present projects involved in at facility Create brochure on community services available to clients in a diverse population. Participate in health fairs. Participate in program management. Enter quality data for clients in QA system; Analyze data collected; Perform program evaluation. Participate in a Journal Club presentation.

Provide a current research article to an MD to support care plan. Conduct an in-service presentation to RD staff. Communicate with medical professionals (i.e., MD, RN, SLP, OT, PT, SW) regarding nutrition care plans for patients. Conduct in-service for employees. Attend interdisciplinary patient care rounds or d/c planning meetings Demonstrate application of motivational interviewing. Update or develop patient education material. Perform patient education. Utilize electronic medical record to chart for patient care.

Grading Policy

Your grade in this course will be determined by the following criteria:

Grade Breakdown

Supervised Experiential Learning hours and Preceptor Evaluation of Student (Competency Assessment) - 7 weeks	70
Supervised Experiential Learning hours reflection (2 @ 6 points each)	12
Required Clinical Learning Experiences (2 @ 1 point each)	2
Professionalism Statement Agreement (Syllabus Agreement)	1
Student Evaluation of Preceptor(s)	5
Final Lab Reflection (submitted to ePortfolio)	10
Total	100

Grade Scale

Grade	Points Grade	Point Average (GPA)
A	94 – 100%	4.00
A-	90 – 93%	3.75
B+	87 – 89%	3.50
B	84 – 86%	3.00
B-	80 – 83%	2.75
C+	77 – 79%	2.50
C	74 – 76%	2.00
C-	70 – 73%	1.75
D	64 – 69%	1.00
F	00 – 63%	0.00

SEL Lab Grading Scale

Number	Grade
5	94 – 100%
4	87 – 93%
3	80 – 86%
2	40 – 79%
1	0 – 39%