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American
Society for Clinical Nutrition (ASCN)
ASCN Standing Committees
The Committee on Professional Nutrition Education monitors national events
affecting nutrition education, reports on these events, and makes
recommendations to further the society's goals in promoting undergraduate and
graduate nutrition education. The committee interacts with the American Board
of Nutrition (ABN) and other relevant groups to develop criteria for nutrition
training programs and to set standards for evaluating such programs. A list of
clinical nutrition training programs is compiled with criteria for evaluating
them. The committee includes liaisons from the American Dental Association,
the American Medical Association, and the American Medical Student
Association.
Nutrition Topics Essential in a Medical School
Curriculum in Priority Order
(Adapted from: Weinsier RL et al. Am J Clin nutr 1989;50:707-12)
| Ranking |
Topic |
| 1 |
Obesity
Diet, hyperlipidemia, and atherosclerosis
Lipids (including cholesterol)
Diet and Diabetes
Pregnancy, lactation
Water, electrolytes, and acid-base balance
Major minerals |
| 2 |
Carbohydrates, fiber
Vitamins
Proteins and amino acids
Cell growth, infancy, adolescence
Nutrition and immunity |
| 3 |
Nutritional assessment and support;
hospital malnutrition
Nutrition in surgery, trauma, and infection
Diet and hypertension
Body weight, body composition and energy balance
Geriatrics
Nutrition and cancer
The gastrointestinal tract: an overview of function
Criteria of an adequate diet
Nutrition in diseases of the oral cavity and gastrointestinal tract
Hormonal control of nutrient metabolism |
| 4 |
Nutritional anemias
Drug-nutrient interactions
Trace minerals
Nutrition and alcohol, other substance abuse |
American
Board of Nutrition
Purpose
The American Board of Nutrition (ABN) is an independent credentialing
organization which was established in 1948. It certifies Specialists in
Clinical Nutrition and Human Nutrition. The purpose of the American Board of
Nutrition is to establish standards for the qualification of persons as
Specialists in the fields of Clinical Nutrition and Human Nutrition, and to
certify as such those persons who comply with the standards.
ABN Certification Exam Topic Priorities
The ABN has established the following general outline to guide the ABN
Examination Committee in the preparation of the ABN certification
examinations. …the prioritization of topics is outlined below to assist you
in your preparation for this section of the examination. That is, the highest
priority topics generally have the largest number of test items.
Priority Level 1
Body Weight, Body Composition,
Energy Metabolism
Proteins and Amino Acids
Carbohydrates and Fiber
Vitamins
Major Minerals
Nutritional Assessment and Support
Priority Level 2
Gastrointestinal Tract Function
Lipids
Trace Minerals
Pregnancy and Lactation
Growth and Development
Stress, Immunity, AIDS
Hyperlipidemia, Coronary Artery Disease
Diabetes Mellitus
Obesity
Priority Level 3
Geriatrics
Gastrointestinal Disease
Priority Level 4
Water, Electrolytes, Acid-Base Balance
Dietary Goals, RDA's
Cancer
Alcohol, Other Substance Abuse
Nutritional Anemias |
Priority Level 5
Hormonal Control of Nutrient Metab.
Hypertension
Priority Level 6
Food Fads, Health Food Trends, Vegetarianism
Diet & Allergy
Eating Disorders
Priority Level 7
World Food Supply, Hunger
Food Contamination
Effects of Food Processing on Nutritional Values of Foods
Chemical Additives in Foods
Exercise and Environmental Stress
Renal Disease
Inborn Errors of Metabolism
Skeletal & Connective Tissue Disorders
Neurological Disorders
Handicapped Conditions & Rehabilitation
Drug-Nutrient Interactions
Priority Level 8
General Aspects of Nutrition
Hunger & Satiety
Other Endocrine Disorders
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American
College of Nutrition
Objectives
To enhance knowledge of nutrition and metabolism and the application of
such knowledge to the maintenance of health and the treatment of disease.
To provide an organization which encompasses the
needs of professionals from all disciplines with a common interest in
nutrition.
To provide a forum where an interchange of views,
professional and educational experiences, and research results in the general
field of nutrition which may be conducted in an atmosphere of professional
congeniality.
To encourage the incorporation of a strong, clearly
defined nutrition teaching module in the curriculum of all medical schools and
to encourage the inclusion of nutritional education in medical post graduate
training.
To promote educational programs at all levels and
provide advocacy support for non MD nutrition professionals.
Certification
Board for Nutrition Specialists (CBNS)
The CBNS is the only organization providing voluntary
certification to all professional nutritionists with advanced training in
nutrition science. In addition to nutritionists at the doctoral level, the
CBNS offers certification to registered dietitians, pharmacists, nurses and
other health professionals with graduate degrees in nutrition with significant
experience as professional nutritionists.
American
Society for Parenteral and Enteral Nutrition
ASPEN established the National Board of Nutrition
Support Certification, Incorporated (NBNSC) in 1984 as an independent
credentialing board to administer certification programs in specialized
nutrition support. The NBNSC certification program is designed to: establish
the body of knowledge necessary for certification, test through written
examination the common body of knowledge necessary to deliver parenteral or
enteral nutrition support, recognize specialty knowledge by granting
certification to successful candidates, and promote continual professional
development of individuals delivering nutrition services. The NBNSC currently
has available certification programs for nurses, physicians, and dietitians.
The
NBNSC, Incorporated Website
Mission Statement (from website document)
To promote the enhanced delivery of safe and effective nutritional care
through the certification of qualified clinicians practicing nutrition
support.
Objectives
Recognizing formally those individuals who meet eligibility requirements of
the National Board of Nutrition Support Certification and pass the
Certification Examination for Nutrition Support Physicians.
Encouraging continued professional growth in the
practice of nutrition support.
Establishing and measuring the level of knowledge
required for certification of physicians practicing nutrition support.
Providing a standard of specialty knowledge deemed
appropriate for physicians practicing nutrition support; thereby assisting the
employer, public, and members of the health professions in the assessment of
physicians practicing nutrition support.
Content Outline of the Examination for Nutrition Support
Physicians is:
- Nutrition assessment and reassessment - 20%
- Therapeutic plan - 35%
- Implementation -15%
- Patient monitoring and evaluation - 25%
American
Dietetics Association
Position of The American Dietetic Association:
Nutrition education for health care professionals.
(Adapted from Website: http://www.eatright.org/)
POSITION STATEMENT (annotated from website document)
It is the position of The American Dietetic Association that nutrition
education is an essential component of the curricula for the majority of
health care professionals. Curricula should include nutrition principles and
identification of nutrition risk factors for appropriate and timely referral
to a qualified dietetics professional for comprehensive nutrition services.
Nutrition education in the curricula of various
programs of health professions should be commensurate with the nutrition
competencies essential for such professionals to carry out their roles in the
health management of clients (1-9). …the Society of Teachers of Family
Medicine strongly supports the inclusion of nutrition in the curriculum for
family physicians (10). …current professional literature provides
suggestions on nutrition education for a variety of health professions, such
as nursing (including midwives), dentistry, physical therapy, medicine
(including physician assistants), and home health aides (1-9).
RECOMMENDATIONS FOR NUTRITON CURRICULA
The Table provides a suggested listing of screening, assessment, education,
counseling, and referral responsibilities for health care professionals
Practitioners' responsibilities drive the educational curriculum. The content
of the curriculum to achieve the skills listed in the Table varies by
category. Curricula for primary care providers need to be more extensive
because these providers diagnose nutrition disorders, prescribe diets, and
provide preliminary counseling on specific nutrition needs. The focus of such
curricula should be to provide skill development to enable primary care
providers to improve the nutritional health of the public through early
recognition of the need for medical nutrition therapy, suitable direct
education or basic counseling, and appropriate referral to qualified dietetics
professionals. Since the early 1950s, numerous reports on the status and
importance of nutrition in medical education have been published. However,
competition for curriculum time has limited the implementation of nutrition
courses in medical education. Recently, several foundations and government
agencies have funded model programs to promote the integration of
comprehensive nutrition education into the medical curriculum (6,11,12). Rock
(13), for example, has proposed content for a residency program
SUMMARY
The curriculum needs for teaching nutrition in health care professional
education programs are determined on the basis of the nutrition services that
future practitioners will provide within the scope of their practice. The
shift in health care to earlier intervention and increased ambulatory care
services makes it necessary that health practitioners be able to identify
nutrition risk and recognize when it is necessary to refer a patient to a
registered dietitian for medical nutrition therapy and intervention. The
majority of health care providers need initial and continual lifelong learning
about comprehensive nutrition services to enhance the nutritional health of
the public. The nutrition-related skills required by various health care
providers need to be identified and a curriculum specific to the type of care
provided needs to be developed. The competencies expected of health care
professionals will continue to evolve, but a foundation for quality
entry-level and continuing nutrition education should be developed for all
health practitioners.
Table
Aspects of nutrition care that health care practitioner education
programs should include, by amount of patient education responsibility.
(Adapted from Website: http://www.eatright.org/) |
| |
Nutrition
education responsibilities |
| Aspect of nutrition care |
Minimala |
Limitedb |
Broadc |
Extensived |
| Screen for nutrition risk |
X |
X |
X |
X |
| Assess nutritional health |
|
|
|
|
| Reinforce message of the importance of
nutrition to health |
X |
X |
X |
X |
| Reinforce that nutrient needs differ by
person and at different points throughout the lifespan |
|
|
X |
X |
| Educate about public health Nutrition
guidelines and the use of nutrition as a complementary therapy |
|
|
X |
X |
| Prescribe diets, including enteral and
parenteral nutrition |
|
|
|
X |
| Counsel on specific nutrition needs |
|
|
|
X |
| Educate on nutrition principles that
relate closely to a specific discipline |
|
|
X |
X |
| Refer to a registered dietitian for
in-depth nutrition evaluation or counseling |
|
|
X |
X |
a Includes practitioners with
beyond-high-school certificates such as home health aides and patient care
assistants.
b Includes practitioners with a
limited role in patient education such as diagnostic imaging professionals and
vascular technologists.
c Includes practitioners with a
large role in patient education such as physical and occupational therapists,
nurses, and respiratory therapists.
d Includes primary care
providers such as family practitioners, internal medicine physicians,
obstetricians and pediatricians, midwives, nurse practitioners, and physician
assistants and medical specialists such as cardiologists, oncologists,
nephrologists, and surgeons.
References
- Fitz P. Nutrition education of health care
professionals and paraprofessionals. Top Clin Nutr. 1997;12:1-3.
- Weigley E. Nutrition in baccalaureate nursing education
and beginning clinical nursing practice. Top Clin Nutr. 1997;12:8-14.
- Morse W. Incorporating nutrition in a baccalaureate
nursing curriculum: one school's experience. Top Clin Nutr. 1997;12:15-22.
- Touger-Decker R, Gilbride J. Nutrition education of
dental students and professionals. Top Clin Nutr. 1997;12:23-32.
- Nelson L, Smith B, Hunter A. Nutrition knowledge of
acute care physical therapists. Top Clin Nutr. 1997;12:33-41.
- Hark L. One program's experience in nutrition education
of medical students. Top Clin Nutr. 1997;12:42-48.
- O'Sullivan-Maillet J, Fixelle R, Thornton J. What
physician assistants should know about nutrition. Top Clin Nutr.
1997;12:49-57.
- Kolasa K, Zinn B, Moss, N. Nutrition education of
nurse-midwives: one example. Top Clin Nutr. 1997;12:58-62.
- Patenaude J. Home health aide training: an opportunity
for dietitians. Top Clin Nutr. 1997;12:69-75.
- Greenspan J, Path FR. Current and future prospects for
oral health science and technology. J Dental Educ. 1995;59:149-167.
- Rock C. Nutrition education in the clinical setting:
educating the physician and resident. Top Clin Nutr. 1995;10:49-57.
- Center for the Health Professions at the University of
California. Core Curricula Workshop Proceedings. San Francisco, Calif:
Bureau of Health Professions Conference Proceedings; January 7-8, 1995.
- Position of The American Dietetic Association: oral
health and nutrition. J Am Diet Assoc. 1996;96:184-189.
- Center for the Health Professions at the University of
California. Core Curricula Workshop Proceedings. San Francisco, Calif:
Bureau of Health Professions Conference Proceedings; January 7-8, 1995.
ADA Position adopted by the House of Delegates on
October 26, 1997. This position is in effect until December 31, 2003. The
American Dietetic Association authorizes republication of the position
statement/support paper, in its entirety, provided full and proper credit is
given. Requests to use portions of the position must be directed to ADA
Headquarters at 800/877-1600, ext 4896 or holler@eatright.org
(Adapted by ACN with ADA permission: Position
of the American Dietetic Association: Nutrition-essential component of medical
education. J Amer Diet Assoc 1994;94:555-7..)
The
Medical Physiology Curriculum Objectives Project
This is a joint project of The American Physiological
Society and the Association of Chairs of Departments of Physiology. The
project is being headed by Dr. Robert G. Carroll, Professor, Department of
Physiology, East Carolina University School of Medicine, Dr. L. Gabriel Navar,
Professor and Chair, Department of Physiology, Tulane University School of
Medicine, and Dr. Mordecai P. Blaustein, Professor and Chair, Department of
Physiology, University of Maryland School of Medicine.
Overview (adapted form website http://www.the-aps.org/education/MedPhysObj/medcor.htm)
As medical and other professional schools in the
health sciences continue to modify their curricula, a variety of approaches
are being utilized to teach the students. These widely diversified approaches
range from the traditional and systematic course in physiology and
neuroscience to those in which there is not an identifiable course in
physiology. While a systematic presentation of physiological concepts under
the direction of physiology faculty continues to be the most efficient way to
ensure appropriate depth and breadth, physiologically related topics are often
spread out over several courses. It is, nevertheless, essential that all
medical and health professional students receive sufficient exposure to the
physiological concepts that provide the foundations needed for further studies
in pharmacology, pathology, physiology, and medicine. The mechanisms of
deranged function can not be appreciated without an in-depth understanding of
basic biophysical and physiological mechanisms. The purpose of developing
these core competency criteria is to provide guidelines for the breadth and
depth of knowledge in the physiological principles and concepts that are
considered minimal and essential for further progress in understanding
mechanisms of disease and body defenses. Regardless of the specific didactic
or educational approach used by any given institution, that institution must
develop mechanisms to assure that the students are being inculcated with these
basic principles and concepts at an appropriate depth of understanding. The
development of these core learning objectives will allow all programs to
determine if their students are achieving at least this basic level of
understanding.
| Section 1
| Section 2 | Section
4 | Section 5 |
| Preface | The
White Paper
| Committee
Members |
Return To Contents Page
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