Academy of Nutrition and Dietetics: Revised 2021 Standards of Professional Performance for Registered Dietitian Nutritionists (Competent, Proficient, and Expert) in Management of Food and Nutrition Systems

Cultural Humility: How Foodservice and/or Management Educators are Preparing Dietetics Students

BACKGROUND

In order to provide sufficient care to all patients, dietitians must understand and practice cultural humility in the workplace. Dietetic programs are now required to incorporate cultural humility training into their curriculum. The purpose of this study was to identify how dietetics foodservice and/or management educators are addressing cultural humility education in foodservice and/or management courses and understand their attitudes towards teaching cultural humility.

METHODS

A survey containing both qualitative and quantitative questions was utilized for this study. The study description and survey link were sent to 549 dietetic program directors who then forwarded the link to foodservice management educators in their programs. A total of 89 directors responded and nine were excluded for a final sample of 80 and a response rate of 14.6%. Descriptive statistics were calculated using Statistical Package for Social Sciences (SPSS). The qualitative data were then coded into themes using conventional content analysis.

RESULTS

Respondents were from 35 states, one territory, and 73 universities/colleges. Majority were white (n = 71, 91.0%), female (n = 65, 82.3%), and taught in Didactic Program in Dietetics (DPD) programs (n = 55, 66.3%). Most educators (n = 78) indicated that cultural humility has a place in foodservice and/or management education; however, they felt that it is best learned through real-life work settings. Three themes from qualitative responses were: 1) Assignments and techniques employed to address cultural humility in foodservice/management curriculum, 2) Barriers and challenges faced by foodservice/management educators in addressing cultural humility, 3) Pedagogical resources utilized and desired to educate both educators and students on cultural humility.

CONCLUSIONS

Foodservice and management educators should continue to highlight cultural humility in their course content and seek out resources to help them in their efforts.

Completion of a Nutrition-Focused Physical Exam with hospitalized adults and pediatric patients: Secondary analysis of a prospective cohort study

BACKGROUND

Nutrition-Focused Physical Exam (NFPE) feasibility is not well-studied. We describe registered dietitian nutritionist (RDN)-reported NFPE completion for hospitalized adult and pediatric patients overall and by assessment parameters.

METHODS

Trained RDNs systematically conducted NFPEs for hospitalized adult and pediatric patients during the Academy of Nutrition and Dietetics and American Society for Parenteral and Enteral Nutrition Indicators to diagnose Malnutrition multisite cohort study (ClinicalTrials.gov: NCT03928548). RDNs reported their ability to evaluate assessment sites for subcutaneous fat and muscle loss, fluid accumulation, and micronutrient status and to complete handgrip strength (adults and children ≥6 years) and mid-upper arm circumference measurements (children). RDNs noted if they could complete the full NFPE; if not, they noted challenges. We descriptively summarized results and used multilevel logistic regression models to examine relationships between patient characteristics and NFPE completion.

RESULTS

RDNs from 39 adult and 29 pediatric US hospitals conducted NFPEs for 327 adults and 214 children aged 1 month to 17.9 years. RDNs reported completing the examination for 44% (n = 145) of adults and 15% (n = 33) of children. They successfully evaluated 25 of 27 and 19 of 26 unique NFPE components in >80% of adults and children, respectively. Common reasons the full NFPE was not completed were limited mobility in adults and patient refusal in children. RDNs had lower odds of completing NFPEs in adults with lower vs higher education levels or higher vs lower nutrition complexity and in younger vs older children.

CONCLUSION

RDNs evaluated NFPE components for a high proportion (>80%) of hospitalized patients.

Culinary Medicine or Culinary Nutrition? Defining Terms for Use in Education and Practice

Examination of how terms such as culinary nutrition, culinary nutrition science, culinary medicine, culinary nutrition professional, culinary nutrition intervention, culinary nutrition activity, and culinary nutrition competency are used in practice, and the creation of consensus definitions will promote the consistent use of these terms across work areas and disciplines. Thirty leading practitioners, academics, and researchers in the fields of food and nutrition across Australia, the United States, Canada, United Kingdom, Europe, and Asia were approached by investigators via email to submit definitions of key terms using a Qualtrics survey link. Further participants were reached through snowball recruitment. Initial emails were sent in October and November 2021 with subsequent reminders between November 2021 and March 2022. Two researchers undertook content analysis of the text answers for each of the terms and generated definitions for discussion and consensus. Thirty-seven participants commenced the survey and twenty-three submitted one or more definitions. Agreed definitions fell into two categories: practice concepts and practitioners. Further discussion amongst investigators led to the creation of a visual map to demonstrate the interrelationship of terms. Culinary nutrition science underpins, and interprofessional collaboration characterizes practice in this area, however, further work is needed to define competencies and model best practice.

Academy of Nutrition and Dietetics: Revised 2022 Standards of Practice and Standards of Professional Performance for Registered Dietitian Nutritionists (Competent, Proficient, and Expert) in Adult Weight Management

A person's weight is an anthropometric measure factored into assessing health risk, not a measure of worth, ability, or overall health. Adult weight management is a spectrum of life-long care services available for persons whose goals can be achieved through evidence-based, weight-related interventions and intersects most practice areas of nutrition. The adult weight management Registered Dietitian Nutritionist (RDN) is responsible for providing a psychologically safe, accessible, and respectful setting and empowering care to those seeking nutrition services. This requires the RDN to act as an advocate by proactively seeking to identify personal and external weight biases, understanding the impact of those predispositions, and acknowledging how weight-related prejudices are intricately connected with systems that impact nutrition both inside and outside of health care. Increases in average weight influence potentially counterproductive discussions about judgment, an individual's body, and relationship with health. RDNs are equipped to provide dynamic care and be on the forefront of implementing weight-inclusive built environments, policies, and person-centered communications to minimize harm and maximize benefit for the individual and society. The authors, Weight Management Dietetic Practice Group, and the Academy of Nutrition and Dietetics Quality Management Committee revised the Standards of Practice (SOP) and Standards of Professional Performance (SOPP) for RDNs in Adult Weight Management to update established criteria of competent practice, further define core values, and set direction for future areas of opportunity. The adult weight management SOP and SOPP are complementary tools intended for RDNs to benchmark and identify progressive routes and goals for professional advancement.