Dietetic traineeships. IV. Role of the Alabama Dietetic Association in developing dietetic traineeships.
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Alabama↗
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Goals of the lifetime education of the dietitian. Committee on Goals of Education for Dietetics, Dietetic Internship Council, the American Dietetic Association.
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Communication↗
A new look at the profession of dietetics. Final report of the American Dietetic Association Foundation 1984 Study Commission on Dietetics: Summary and recommendations.
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Accreditation↗
The American Dietetic Association Standards of Professional Practice for dietetics professionals.
The Standards of Professional Practice reflect changing market trends, transitions in the work environment, and expectations of the public. The 6 professional standards encompass the key characteristics of the dietetics profession. ADA's mission to serve the public is supported when each dietetics professional applies the 6 Standards of Professional Practice and evaluates the quality of services he or she provides. The standards belong to each and every dietetics professional. They are scheduled for periodic review and revision as the needs of the dietetics profession change. Throughout their careers, dietetics professionals will be called on to contribute to the continuous improvement of these standards and the dietetics profession. It is the responsibility of each individual practitioner to evaluate practice and maintain competence as well as to evaluate the professional standards and contribute to the advancement of the dietetics profession. The Standards of Professional Practice should be adopted by all dietetics professionals to ensure that they will continue to be recognized by the public as the most valued and credible sources of food and nutrition information.
Dietetics↗
Perceptions of competency attainment in community dietetics: academic Plan IV vs. dietetic internship.
A national survey of Plan IV representatives, internship directors, and dietetic interns was conducted to determine the perceived level of competence in community dietetics upon completion of academic coursework. Interns also rated their perceived competence in community dietetics near the end of internships. All major and specific responsibilities from the ADA Role Delineation and Verification for Entry-Level Positions in Community Dietetics were included in the survey questionnaire. Completed questionnaires were received from 447 dietetic interns (60%), 47 internship directors (57%), and 59 Plan IV representatives (39%). Highly significant differences were found among the three groups, with Plan IV representatives' expectations highest and students' lowest. Work experience prior to internship affected mean ratings on selected responsibilities. Unlike the results of the previous studies in clinical dietetics and foodservice systems management, the ratings in community dietetics did not reach their highest until the last month of the internship. Findings from all three areas of dietetic practice suggest that students' perceived competence is considerably lower upon completion of Plan IV than after completion of an internship, indicating need for defined work experience. Different teaching techniques, i.e., lecture vs. hands-on, could be related to different ratings of perceived competence within and between practice areas.
Competency-Based Education↗
Involving dietetic students and interns in dietetic association activities.
The St. Louis Dietetic Association's Division of Educators accepted the challenge of increasing the area dietetic students' and interns' awareness of and involvement in the local dietetic association. The phases of the project were: A student representative from each dietetic program was appointed to the St. Louis Dietetic Association's Executive Board and Division of Educators. The St. Louis Dietetic Association Student Information Flyer described the activities, divisions, and committees and invited student participation in the St. Louis Dietetic Association. An "Introduction to the St. Louis Dietetic Association" meeting was held at the beginning of the academic year to explain the association and invite student participation. Student involvement in the association increased as a result of those efforts. This is a fairly simple scheme that can be readily adapted by other associations. It offers an excellent technique for increasing student awareness and involvement in the professional association in a manner which is personally meaningful, practical, and voluntary.
Dietetics↗
The development and evaluation of Student Training, Education and Practice for Dietetics CD-ROM: a computer-assisted instruction programme for dietetic students.
The Student Training, Education and Practice for Dietetics (STEP-DIET) CD-ROM was developed at the University of Surrey to prepare dietetic students for the practical dietetic training component of their Nutrition/Dietetics degree. This study aimed to evaluate student response to the programme and its effectiveness as a teaching tool, based on the evaluation framework of D.L. Kirkpatrick (Evaluating a Course, 2nd edn. London, Kogan Page). Quantitative and qualitative methodologies were employed, with 41 dietetic students, separated by year group, completing questionnaires and taking part in six focus groups, at the University of Surrey. Student attitudes towards the instruction method and the STEP-DIET programme itself were investigated, in conjunction with their perceived learning achievements. Students rated the programme highly in terms of design and content, however, there was a reluctance to accept computer-assisted instruction (CAI) as a sole teaching method. A number of learning achievements relevant to dietetic practice were reported including a perceived increase in ability to conduct a dietetic interview and an increased understanding of the management of Type 2 diabetes. In general students reacted positively to the STEP-DIET programme and it was perceived by students to be effective in preparing them for the practical component of their dietetic training.
Attitude to Computers↗
Staffing patterns in hospital clinical dietetics and nutrition support: a survey conducted by the Dietitians in Nutrition Support dietetic practice group.
The Dietitians in Nutrition Support dietetic practice group of The American Dietetic Association administered a questionnaire to evaluate changes in nutrition support services provided to hospitalized patients and home patients in 1989 and compared the results with results of a survey administered in 1986. The 1986 survey documented an increase in tube feeding to inpatients during 1984 to 1986 and greater dietitian staffing in tertiary care hospitals than in primary care hospitals and in larger hospitals in 1986. The 1989 questionnaire was mailed to clinical nutrition managers from a nationwide random sample of 1,000 hospitals from American Hospital Association members; 271 responses were received. Full-time equivalent (FTE) registered dietitians (RDs)--including clinical RDs, nutrition support service RDs, and clinical nutrition managers--decreased 11% from 1986 to 1989. FTE dietetic technicians decreased 22%. The number of FTE nutrition support service RDs and clinical nutrition managers decreased significantly (P less than .05). The mean number of FTE clinical dietitians per 100 beds decreased from 1.4 to 1.0 from 1986 to 1989. These decreases in dietetics staffing occurred despite an overall increase in total hospital FTE staff of 2.9%. Reported daily provision of nutrition support modalities to inpatients was 3.5% for parenteral nutrition, 4.9% for enteral tube feeding, and 9.6% for oral supplements. Decreased dietetics staffing was accompanied by other factors that negatively affect productivity (and therefore ability to provide adequate patient care), including inadequate delegation of technical tasks to dietetic technicians, limited availability of secretarial and computer support, and minimal provision of pocket pagers. These trends may be evidence of inadequacy of dietetics staffing to meet the needs of the US population for nutrition care.
Dietary Services↗
Minority interns' experiences during their dietetics education and their recommendations for increasing diversity in dietetics: findings from structured interviews.
Diversity among racial minorities and males has remained limited in the dietetics field. Structured interviews with eleven minority interns were conducted to assess their experiences throughout their dietetics education and to examine their perceptions of the dietetics profession. General themes were reported. Dietetics was not the first career choice for six interns. Work and volunteer experience were perceived as the most influential factors in their selection for a dietetic internship. Some perceived being the only minority in an internship program and the lack of minorities on internship selection committees as problems. Increasing minority dietitians' visibility at career days and early recruitment of students were suggested as ways to increase diversity within the profession. Resources such as the Building Our Future Mentor Program Tool Kit should be utilized to establish mentoring programs for students and to enhance diversity efforts in dietetics.
Career Choice↗
Benefits of training dietetics students in preprofessional practice programs: a comparison with dietetic internships.
OBJECTIVE: To conduct a nationwide study on the opinions of dietitian preceptors regarding the intangible benefits to hospitals and medical centers of training dietetics students in approved preprofessional practice programs (AP4s) and to compare the findings with a similar survey of dietetic internships. DESIGN: A questionnaire was adapted from a 1990 study of preceptors in dietetic internships to investigate the benefits of training dietetics students in AP4s. SAMPLE: Program directors and dietitians who supervise and teach students in the 117 preprofessional programs approved by The American Dietetic Association were sent pretested questionnaires. Responses to the survey were received from 312 dietitians who supervise students in 74 practice programs. STATISTICAL ANALYSIS: Descriptive statistics were used to calculate frequency of response. t Tests were used to compare mean differences between the opinions of preceptors in AP4s and internships. Analysis of variance and Scheffe post-hoc test were used to determine the demographic characteristics related to the dietitians' opinions of benefits. RESULTS: Strongest agreement (agree to strongly agree) was found for three items: sense of satisfaction from seeing students develop as professionals (4.34); belief that teaching students makes the job more interesting (4.17); and real sense of achievement in working with students (4.05). Significant differences were found between the groups on six items and, in all but one instance, the internship preceptors were more in agreement with the statements on intangible benefits than the AP4 preceptors. APPLICATIONS/CONCLUSIONS: The preceptors generally agreed that intangible benefits exist for departments that are AP4 sites and the professionals that work in them. As programs develop from AP4s into accredited internships, examination of intangible and monetary benefits may affect the continuation of dietetics training programs.
Cost-Benefit Analysis↗
From the Canadian Dietetic Association. Concept of dietetic practice and framework for undergraduate education for the 21st century.
Rapid change and marked diversity are expected to characterize the 21st century. If dietitians are to serve as change facilitators in this environment they will have to demonstrate greater flexibility and creativity, practise critical analysis and problem solving and employ creative thinking. Although provision of quality nutrition care will remain the unique contribution of dietitians, practitioners in the future will require a greater understanding of the impact of social, economic and political systems on food availability and food consumption and, in turn, health and well-being. Critical to the future practice of dietetics will be a greater understanding of research methodology, computer technology, quality improvement processes and risk management, principles governing learning and behaviour, personnel management and organizational behaviour, family and group dynamics, interpersonal communication and their application to dietetic practice. The Canadian Dietetic Association recently adopted a framework for the development of baccalaureate programs in dietetics designed to enable the dietetic practitioner to continue to make a unique contribution in the 21st century. The framework allows individual institutions the freedom and flexibility to plan programs that are compatible with their philosophy and organizational structure. In addition, it is predicted on the principle that a career in dietetics entails a lifetime commitment to education, of which the baccalaureate program is only the beginning.
Canada↗
Perceptions of competency attainment in clinical dietetics: academic Plan IV vs. dietetic internships.
A national survey of all Plan IV representatives and dietetic internship directors in programs with a general or clinical emphasis was conducted to determine the level of competence in clinical dietetics expected of Plan IV graduates. Dietetic interns were asked to rate themselves on competency attainment at the beginning and near the end of the internship. The ADA's Role Delineation Study for Entry-level Personnel in Clinical Dietetics was used as the basis for the survey questionnaire. Completed questionnaires were returned by 137 Plan IV representatives (54%), 71 dietetic internship directors (75%), and 530 dietetic interns (62%). Highly significant differences were found among the three groups. Plan IV representatives had higher expectations of students than internship directors. Interns consistently rated their competency levels for all responsibilities below those indicated by either group of directors. All three groups indicated that students were better prepared for client-focus responsibilities than for professional or organizational-level responsibilities. Interns' self-ratings suggested that similar amounts of learning occurred in each of the three areas during the internship. Nutrition-related work experience immediately prior to the internship influenced students' perceived competency level at the beginning of the internship, but differences between those students and the ones with other or no work experience were overcome as students neared the end of their internships. For most major responsibilities, the students' perceived levels of competence did not change after the first few months of the internship.
Analysis of Variance↗
[From empirical 'dietetics' to rational dietetics].
From the outset, the terms 'dietetics' and 'diet' applied in their general acceptance to all the measures, whether or not alimentary, that can provide optimal living conditions for both the healthy and the diseased. In that meaning they are synonymous with hygiene or way of life. In their more restricted acceptance, which will be used henceforth, the terms apply to the choice of food and beverages which promotes or restores health of normal and sick people. In its most restricted meaning, the term 'diet' is confined to the nutrition of the sick, consisting either in a more or less drastic limitation of food intake, or in the prescription of specific foods. Due to the absence of scientific knowledge concerning the processes of life in general, and in particular concerning the physiology of the digestive system and the metabolism, the 'dietetic' rules and principles were governed until the middle of the nineteenth century by empiricism with a strong background of intuition, tradition, magic and religion. In his continuous struggle for life, man has been confronted with the dramatic consequences of the ingestion of toxic and spoiled food. Nausea, vomiting, diarrhea, cramps and eventually death have soon been linked with the ingestion of particular food, although the symptoms were attributed to supernatural forces. Intuitively and later by laws and prohibition, the use of certain foods was to be avoided or was forbidden. Moreover, with the development of cultures and civilizations food and food intake have acquired -besides their vital necessity-social and often magic-religious values which sometimes resulted in food taboos. In most civilizations these taboos have particulars in common: they are mainly directed against food of animal origin, more against meat than fish and particularly against red meat, which is being considered as symbol of strength and power and as endowed with exciting and stimulatory properties. The meat taboos are selective for some animals or parts of an animal, but what is allowed in some cultures is forbidden in others. More or less severe and long lasting abstinence from food or fasting was also self-inflicted or imposed to individuals or whole populations by religion, sometimes seemingly on hygienic grounds but in most cases without any logic reason. Since the earliest time, diets take-together with other dietetic measures-a prevailing place in the treatment of the sick and sickness. Most alimentary prescriptions are based on a more or less drastic restriction of food and - particularly in the seventeenth century with the iatrochemical school - also of fluids. The restrictions were not only quantitative, but also qualitative with restriction of meat consumption-particularly of red meat-and the prescription of more or less diluted decoctions of barley (infusions) or broth. The numerous works on 'dietetics' published-thanks to the development of printing-from the seventeenth on through the nineteenth century concern mainly the description of foodstuffs and beverages available at the time, and of the ways of preparing them. They also provide indications concerning the way these foodstuffs can improve health and/or list which of them can be prescribed or must be avoided in the treatment of the sick and of specific diseases. Some of these 'dietetical' prescriptions and maxims seem perfectly valid from a scientific and therapeutical point of view, - at least according to our actual knowledge - however, many are totally ineffective or are ridiculous and even dangerous. Except for the "dietetical" measures imposed by public hygiene or by religion to everyone, most of the dieteticotherapeutical prescriptions (food restrictions, clysters, purgation, bleeding) involved only the small fraction of the population that could afford medical assistance. The common people - the majority - could afford neither medical help, nor food abuse - except for an occasional feast - and had only access to a limited quantity and choi
Diet↗
Dietetic specialization: opinions of directors of departments of dietetics.
The need for specialists in dietetic practice was studied by surveying a stratified, random sample of 750 directors of departments of dietetics from nonfederal, general medical-surgical hospitals with more than 75 beds. The response rate was 72%. The majority of respondents were directors who considered themselves generalists. Five demographic variables used in data analysis were hospital size, education level, registration status, years of experience, and perception of practice as generalist or specialist. Student's t-test and analysis of variance were the principal methods of statistical analysis. Results indicated that respondents supported dietetic specialization; however, they emphasized the value of undergraduate generalist preparation as enhancing job performance and preventing fragmentation of the profession. Respondents indicated that specialization should follow professional work experience and additional education. Respondents stressed that The American Dietetic Association should be responsible for determining the process of dietetic specialization. Education level was the variable most likely to affect response. Respondents with education beyond the baccalaureate level were more likely than those with only a bachelor's degree to agree that specialization should occur after professional experience and at the graduate level.
Analysis of Variance↗
Position of the American Dietetic Association: dietetics professionals can implement practices to conserve natural resources and protect the environment. (Previously titled "natural resource conservation and waste management").
It is the position of the American Dietetic Association to encourage environmentally responsible practices that conserve natural resources, minimize the quantity of waste that is generated, and have the least adverse affect on the health of all living organisms and the environment. All components of the food system, from farmer to consumer, are affected by the availability and cost of energy and the availability and quality of water. Outdoor and indoor air quality significantly impacts the health of all living organisms. Decisions that dietetics professionals make as practitioners and consumers can affect the quantity and type of solid waste generated. The demand for natural resources should be evaluated when selecting the most cost-effective, environmentally sensitive approach to the management of solid waste. Special precautions are needed when using and disposing of hazardous and medical waste to protect the safety of our clients and employees. This position paper provides information and resources for dietetics professionals for addressing the complexity of the environmental issue presented. Conservation strategies are identified that dietetics professionals can use in their worksites and at home. These conservation practices may reduce cost and decrease the environmental impact we have on our communities and the world.
Air Pollution↗
Reading skills of dietetic interns and readability of dietetics literature.
OBJECTIVE: To assess and compare reading skills of dietetic interns with reading levels of internship references. DESIGN: A standardized reading test, the Nelson-Denny Reading Test, measured reading skills of entering dietetic interns over 7 years. A computerized readability program assessed the readability of references. SETTING: Dietetic internships in university and Veterans Affairs hospitals. SUBJECTS: Of 194 entering interns, 178 (92%) were included and 16 (89%) were omitted. MAIN OUTCOME MEASURES: Nelson-Denny percentile and grade equivalent scores for vocabulary, comprehension, and total. The Fog Index identified reference reading-grade levels. STATISTICAL ANALYSES PERFORMED: Descriptive statistics and analysis of variance. RESULTS: Interns from the two programs did not differ significantly on Nelson-Denny Reading Test scores or in application grade point average. Percentile means and standard deviations were 54.7 +/- 23.8 for vocabulary, 51.2 +/- 25.0 for comprehension, 52.9 +/- 23.9 for total, and 41.6 +/- 24.7 for reading rate. Nearly 20% (33 of 178) of interns read significantly below expected grade level. The fog Index assigned reference grade levels from 6.98 to 21.63 years. CONCLUSIONS: The majority of dietetic interns have strong reading skills and read within the references' reading levels. A minority may experience difficulties reading assignments. Preinternship reading skills assessment could lead to greater success in reading professional literature.
Adult↗
Position of the American Dietetic Association: the role of dietetics professionals in health promotion and disease prevention.
In the United States, the leading determinants of morbidity and mortality are rooted in behavioral choices related to eating habits, exercise, tobacco, alcohol consumption, and stress reduction. Scientific data consistently provide evidence that diet plays an important role in health promotion and disease prevention. Healthy eating habits--coupled with other healthful lifestyle behaviors--have the potential to reduce the risk of chronic disease. Health care typically assumes a curative or treatment role in the United States. However, dietetics professionals are shaping an alternate view of health, which includes developing healthy public policies, creating safe and supportive environments, building communities and coalitions, and reorienting health services to include health promotion as a primary approach to delivering health care. Individual-level approaches, such as counseling and group education, have been employed most often in modifying health behaviors. However, population-level approaches that affect availability of or access to healthy foods, opportunities for physical activity, and other healthy lifestyle determinants also are important. Dietetics professionals have pivotal roles in both individual- and population-level approaches.
Dietetics↗
Position of the American Dietetic Association and the Canadian Dietetic Association: nutrition for physical fitness and athletic performance for adults.
The importance of diet and healthful food choices in optimizing health status, fitness levels, and athletic performance has been recognized by both participants and professionals. There continues to be a need for the interpretation of new research findings in this fast-growing discipline and for the dissemination of nutrition information and training techniques for a broad spectrum of individuals involved in various forms of physical activity. The registered dietitian who has specialized in exercise physiology and sports nutrition has the knowledge and counseling skills to act as the provider of this nutrition information. Additional information may be obtained in the Sports Nutrition Manual, 2nd edition, published by The American Dietetic Association and the Sports and Cardiovascular Nutrition dietetic practice group as well as in Sport Nutrition for the Athletes of Canada, published by the Sport Nutrition Advisory Committee of the Sports Medicine and Science Council of Canada.
Adolescent↗