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A marketing model: applications for dietetic professionals.

Traditionally, dietitians have communicated the availability of their services to the "public at large." The expectation was that the public would respond favorably to nutrition programs simply because there was a consumer need for them. Recently, however, both societal and consumer needs have changed dramatically, making old communication strategies ineffective and obsolete. The marketing discipline has provided a new model and new decision-making tools for many health professionals to use to more effectively make their services known to multiple consumer groups. This article provides one such model as applied to the dietetic profession. The model explores a definition of the business of dietetics, how to conduct an analysis of the environment, and, finally, the use of both in the choice of new target markets. Further, the model discusses the major components of developing a marketing strategy that will help the practitioner to be competitive in the marketplace. Presented are strategies for defining and re-evaluating the mission of the profession, for using future trends to identify new markets and roles for the profession, and for developing services that make the profession more competitive by better meeting the needs of the consumer.

Advertising↗

Nutritional risk screening: development of a standardized protocol using dietetic technicians.

The development of a standardized screening mechanism for identifying patients in compromised nutritional status is beneficial for prompt initiation of nutrition care. A pilot screening study was conducted at St. Luke's Episcopal Hospital over a 3-month period to determine the prevalence of patients meeting defined nutritional risk criteria. Dietetic technicians screened each nursing unit once, in random order, until the entire hospital had been screened. Results indicated that one-third of the 225 patients screened were at nutritional risk. From those results, a standardized screening protocol and charting form were developed. The current screening procedure includes the original pilot study parameters of height, weight, albumin, diagnosis, and type of nutritional support, as well as additional parameters. Dietetic technicians also collect data on weight changes, appetite status, number of surgical procedures, and length of hospital stay. Criteria are listed under a severe risk or a moderate risk category. Patients meeting one severe or two moderate risk criteria are considered at nutritional risk. Recent data verify that more than one-third of patients screened are at nutritional risk. Through the utilization of technical support personnel, the standardized protocol has helped to identify patients who meet nutritional risk criteria.

Aged↗

The effectiveness of a short curriculum unit in death education for dietetic students.

Dietetic educators are concerned with preparing their students to interact effectively with seriously/terminally ill patients in clinical settings. In this study, a short death education curriculum unit including multi-media teaching materials was designed, implemented, and evaluated. The subjects were 47 junior students enrolled in three coordinated programs. Instruments were adopted or adapted to assess the following items: knowledge of the grief process, personality traits of empathy and dogmatism, fear of death, fear of interacting with the dying, attitudes toward working with terminally ill clients as part of the professional role of dietitians, and clinical performance. Scores for the traits of empathy and dogmatism were negatively related, and students with a higher degree of religious conviction had lower death fear scores. Although no significant changes were found in any of the attitude scores after the curriculum unit, most students indicated that the unit made them feel more comfortable about working with the seriously ill. Students and faculty recommended that death education be included for dietetic students.

Adult↗

Professional dietetic education in the U.S. Historical notes.

Since its founding in 1917, The American Dietetic Association has been concerned with the development and improvement of educational programs for the professional dietitian. This article traces the evolution of professional dietetic educational programs from its beginning in the early cooking schools in the nineteenth century through the development of educational standards, the requirement for training beyond the bachelor's degree, and the establishment of academic requirements. The continued importance of educating the professional dietitian is evidenced by the inclusion of academic requirements as a prerequisite to membership in the Association.

Curriculum↗

Perception of competency attainment in foodservice management: academic Plan IV vs. dietetic internship.

A national survey of 487 dietetic interns (61%), 63 internship directors (76%), and 68 Plan IV representatives (45%) utilized ADA entry-level role responsibilities in foodservice systems management. Student respondents rated perceived competence at the start and near completion of the internship. Program directors rated expected competence at the start of the internship. The three groups differed significantly on mean responses, with interns' ratings lowest and Plan IV representatives' ratings highest. Interns' mean ratings suggested that work experience just prior to starting an internship increased competence somewhat, regardless of type of work. Work during college was not included in the analysis. Interns' mean ratings also suggested that competence peaked some weeks before internship completion. Level of competence averaged about 6 on a scale of 0 to 7 at that time. Starting competence averaged about 2.5 to 3, indicating that Plan IV contribution is substantial but internship experience is essential for entry-level performance. Foodservice systems management competence levels compare very favorably with those previously reported for clinical dietetics.

Dietetics↗

A structured approach to clinical education in a dietetic curriculum.

The successful integration of clinical and didactic elements to achieve a well coordinated clinical education program is a complex, ongoing task in undergraduate dietetics education, involving both educational and managerial considerations. One effort to achieve improvements in these two areas was the development of a structured learning experience recently field tested with undergraduate dietetics students and clinical dietitians during clinical rotations. The structured experience defined roles, responsibilities, and activities for students, clinical dietitians, and course instructors and included scheduled review meetings attended by all participants. It was implemented with nine students during pediatric rotations. At the end of the course, students completed a standardized course evaluation form to assess course content, educational strategies, and effectiveness. They also rated the structured rotation, unstructured rotations, and their "ideal" rotation on 16 instructional factors. Clinical dietitians were interviewed by the course coordinator to elicit reactions and commitment to future participation. When it was compared with the traditional, non-structured approach utilized in surgery, gastroenterology, obesity/diabetes, and cardiovascular disease rotations, the structured learning experience received superior evaluations by participating students and dietitians. Correlations between ratings of structured, non-structured, and "ideal" approaches indicated directions for further educational and managerial improvements.

Curriculum↗

Analysis of the Journal of The American Dietetic Association, 1967 to 1983.

Analysis of the Journal of The American Dietetic Association was undertaken for 1967 to 1983 to determine whether there were changes that might have resulted from the report of the 1972 Study Commission on Dietetics. The study analyzed such factors as the number of original articles, educational background of authors and Journal advisory board members, abstracting of other Journal articles, indexing, citation analysis, and impact factor of the Journal. Study results show increased educational qualifications of authors and advisory board members, more original articles, more efficient indexing, and greater citation frequency.

Abstracting and Indexing↗

Dietetics at work in the workplace: academia and industry cooperate in a blood pressure program.

Here is one approach to the challenge of preparing dietetic students for a rapidly changing health care system. Hypertension screening and control are the focus of a cooperative project conducted at the Saginaw-Detroit plants of General Motors Corporation by students of the Medical Dietetics Program at Wayne State University, Detroit. The project reflects implementation, over a 3-year period, of the General Motors Blood Pressure Program. A model is presented for involving students in a health-oriented program at a work site. Effectiveness of student follow-up and counseling is demonstrated in a research component involving noncompliant hypertensive employees. Outcomes of cooperative efforts include: (a) development of guidelines for management of a hypertension monitoring program involving students, (b) support for an industrial medical staff in mounting a new program, (c) extension of faculty capabilities through plant medical staff, (d) baseline data for calculating cost-benefit of a monitoring program, and (e) achievement of superior blood pressure control in comparison with other industrial programs.

Blood Pressure Determination↗

Auditing dietetic services: first of a series.

Dietetic audits may be used to assess quality of care or to evaluate the efficiency of a food service. Problems can be clearly identified through an audit, and solutions can be found to improve service and nutritional care. An audit also provides a basis for dietitian accountability. In this first of a series of four articles on dietetic audits, the authors describe the basic auditing process.

Dietary Services↗

Future applications of the microcomputer in dietetics.

The microcomputer has potential in both clinical and educational aspects of dietetics. Computer-assisted learning (CAL) applications may be of value to students, to newly qualified staff and to patients needing to understand the background of their disorders. The most widely developed use of the computer at present is in dietary analysis, but other areas of CAL may be fruitful, particularly tutorial and simulation programs. An appreciable amount of work has been carried out exploring the patient-computer interface, and dietitians may wish to make greater use of patient interview and counselling systems in the future. The microcomputer could have value in setting up data files for recording patient and nutritional information. In addition, there are opportunities for increasing the use of computers in the general administration of a dietetics department. The microcomputer is therefore capable of having a marked effect on the future work of the dietitian, with a variety of avenues showing potential for further investigation.

Computer-Assisted Instruction↗

Teaching noncognitive skills to dietetic students: a model.

The purpose of this article is to present a model for a course that teaches noncognitive skills to dietetic students in a workshop format. The course was developed by the Department of Nutrition and Medical Dietetics in consultation with the Counseling Service at the University of Illinois at Chicago. The behavior change project and dietary compliance workshop serve as the unifying focus of the course. Also stressed are the dietitian's role as a change agent, personality-type differences, and videotape feedback on interviewing and counseling. Attention to the varying roles of change agents helps students see the dietitian as a potentially powerful instrument of change. Discussing differences in personality types leads to a realization that there is more than one appropriate way to approach professional activities. The activities on dietary compliance and behavior change integrate all other aspects of the course by examining the multiple factors that affect whether clients change eating behaviors.

Behavior Therapy↗

Hospital dietetics and food service in developing countries: III. Bangladesh.

A survey of 11 hospitals in Bangladesh revealed that most heads of hospital food service had little or no training in nutrition and dietetics, hospital diets were usually inadequate, therapeutic diets were seldom used, and kitchen sanitation was poor. However, in three hospitals in which the heads of food service had some education in nutrition, conditions were markedly better. Even though the results of this survey suggest that major improvements are needed in hospital food service and dietetics in Bangladesh, extensive training programs are probably unrealistic because of the limited economic base of the country. Short-term inservice training programs could result in marked improvement in the quality of food service, sanitation, and the use of therapeutic diets.

Bangladesh↗

A computer-managed instruction system applied to dietetic education.

The emergence of competency-based programs in dietetic education has introduced the need for a systematic method of managing student performance information. A computer-managed instruction system which performs many of the routine clerical tasks usually assumed by instructors is being utilized in Emory University's Dietetic Internship Program. Preliminary use of the system indicates that it was well received by both instructors and students. Its most obvious benefits were the immediate feedback on performance and decreased demands on faculty time for evaluation and record-keeping processes.

Computer-Assisted Instruction↗

Automated hospital information system functions for dietetics.

Utilization of computer technology in health care is expanding, and managers need information regarding existing automated functions when making decisions relative to system design or acquisition. The Automated Hospital Information System (AHIS) Component Catalog, compiled by the Health Services Research Center/Health Care Technology Center (HSRC/HCTC) at the University of Missouri-Columbia, describes the features of software packages offered by vendors and utilized in hospitals. On the basis of an analysis of the contents of the Catalog relative to automated functions for dietetic departments, charge capturing and diet change notification were the functions used most frequently in hospitals. Although a stores inventory was not included as a component offered by any of the responding vendors, 23 of the hospital systems described in the catalog included a stores inventory component. Menu planning and meal scheduling were functions which were both available from vendors and utilized in hospitals. The nutrient analysis function was implemented in some of the larger hospitals. The information in the Catalog reflects the availability and adoption of automated hospital information system components for dietetic functions.

Dietetics↗

Performance of task functions by A.D.A. dietetic technicians.

To meet the professional demands of their positions, dietitians must delegate less demanding responsibilities and routine tasks to educationally qualified dietetic technicians. This research was conducted to determine the degree to which A.D.A. qualified dietetic technicians were performing identified tasks.

Data Collection↗

Implementation and evaluation of a competency-based dietetic program.

To assure that graduates of coordinated undergraduate programs have attained required entry-level competencies, dietetic educators need to assess, guide, and account for the progress of students and analyze their own effectiveness. A model has been developed to assist educators in attaining accountability in a competency-based dietetic program. Required competencies and sub-competencies are defined.

Clinical Competence↗

Twenty-four-carat dietetic practice for the eighties. 17th Lenna Frances Cooper Memorial Lecture.

The author considers trends established in the seventies and, on that basis, makes predictions for the future. The question: "What are the essential, critical-to-survival aspects of the services dietitians provide?" is asked. The findings and recommendations of the Study Commission on Dietetics, formed under the joint auspices of The American Dietetic Association and the Kellogg Foundation, are discussed. The need not just to respond to but to anticipate change is stressed.

Attitude to Health↗

[Dietetics in 16th-century cookbooks].

Throughout the ages, dietetics has been an important part of medicine, but for many centuries it included far more than nutrition alone. Nevertheless, this was the part that physicians studied most. Not only did they prescribe some victuals as materia medica, but even the way to cook them played a part: in other words, the first 'culinary' recipes were written by physicians, without any distinction amidst purely medical prescriptions. On the other hand, we find compilations of "medical" cooking recipes, the first cookery books, written by physicians. We know about such lost examples dating from as early as the 5th century BC. In the Low Countries, even in the 16th century these cookery books are mostly written by physicians. Their dietetics still leans on Galen's humoral doctrine and remains restricted to knowledge about food. From that moment the word acquires the restricted meaning it has nowadays.

Books↗