Olivia Bennett Wood

Computer-Assisted Instruction Improves Clinical Reasoning Skills of Dietetics Students

OBJECTIVE The effects of a computer-assisted instruction (CAI) tutorial program on learning clinical reasoning skills were compared in undergraduate dietetics students. DESIGN A drill-and-practice program to control for time on task, and tutorial program, and a simulation program, as the test vehicle, were developed. The tutorial and simulation programs presented data on a patient with cardiovascular disease. SETTING Subjects were tested in 30 undergraduate dietetics programs. SUBJECTS Participants were 413 undergraduate diet therapy students enrolled in a coordinated program in dietetics (CPD) or a didactic program in dietetics (DPD). INTERVENTION After completion of lectures on cardiovascular disease, subjects were given the drill-and-practice program plus a simulation test (group 1), the tutorial plus a simulation test (group 2), or the simulation test only (group 3). MAIN OUTCOME MEASURES Scores on the simulation test were compared. Variables included type of CAI, dietetics program, year in school, computer experience, and experience using a medical chart. Mastery of objectives related to lower- and higher-level clinical reasoning skills introduced in the tutorial program was computed. STATISTICAL ANALYSIS One-way analysis of variance and Student-Newman Keuls tests were conducted to determine any differences among the three groups. Reliability was determined using the Kuder-Richardson Formula 20. RESULTS The reliability coefficient of the stimulation test was 0.93. Group 2 higher on the simulation test than group 1 or group 3. As a group, the CPD students scored higher than the DPD students. When CPD and DPD students were divided into the three experimental groups, there was no significant difference between the CPD and DPD student simulation scores. Group 2 mastered all objectives for lower-level reasoning skills and the higher-level decision-making objective better than groups 1 and 3. APPLICATIONS/CONCLUSIONS A computer tutorial program enhanced clinical reasoning skills in undergraduate dietetics students. This type of program could be used to supplement many topics taught in diet therapy and provide DPD students with experimental learning before their clinical intern practicums.

Computer-Based Simulations Enhance Clinical Experience of Dietetics Interns

OBJECTIVE To determine the impact of computer-based simulations on the performance of dietetics interns in initial clinical rotations. DESIGN Interns used either a simulation program (Care Planning Simulation System CPSS[) or a computer-based tutorial (Nutrition Care Planning Tutorial NCPT[) during their orientation. Performance of these interns on nutrition care skills was evaluated during their initial clinical rotations. SUBJECTS/SETTING Participants were 108 dietetics interns from 8 different programs. Each internship had at least 8 interns, and none of the internships awarded a graduate degree. INTERVENTION Subjects in the experimental group completed nutrition assessment and care planning activities for 3 simulated patients. Subjects in the control group completed a tutorial on assessment and care planning. MAIN OUTCOME MEASURES Likert scale ratings of 31 behaviors were recorded by clinical preceptors. Behavior statements were grouped into 8 categories and average ratings for each category were determined. STATISTICAL ANALYSIS Repeated-measures analysis of variance and linear regression were used to compare performance ratings between groups. RESULTS There were no differences in overall evaluations of the simulation and tutorial groups for the 8-week period. Interns who started clinical rotations immediately after orientation (CPSS-I and NCPT-I groups) were rated lower in all categories than those who began their clinical rotations later (CPSS-D and NCPT-D groups). Maturation and acquisition of general skills likely influenced ratings of interns with delayed clinical rotations. For most categories of behavior the rate of improvement in rating scores was greatest for interns who used CPSS. APPLICATIONS Computer-based simulations are a promising supplement to current techniques in didactic instruction and may be useful in both didactic and practice settings. Computer-based simulations can provide more varied practice experiences to didactic students and interns in preparation for more skilled entry-level positions in dietetics.

Drug therapy for obesity: an update.

As a method of losing weight and maintaining weight loss, calorie-restricted diets are proving ineffective and counterproductive. The best candidates for drug therapy for obesity include patients with comorbidities that can be decreased with weight loss and those at risk for obesity-related comorbidities. The central nervous system properties of the amphetamines have led to chemical alterations of the original molecule in the hope of creating an appetite-suppressant drug without the potential for abuse. Studies demonstrate that serotonergic drugs can induce weight loss in the short term. Patients using nonprescription drugs for weight loss that have not been approved for that purpose should be informed that efficacy is unproved and warned that, in some cases, adverse effects could be serious.

Using role delineation data to design dietetics education curriculums

This discussion indicated the basis for the knowledge and performance requirements in the Standards of Education and related several requirements to selected activities in ADAs role delineation study. The examples showed how role delineation data can be used for curriculum development. Continued study of the role delineation data will provide additional and multiple uses for this important database.

Nonpharmacologic treatment of obesity.

Experts agree that overweight and obesity pose a significant public health problem in the United States. Obesity is considered to be a complex, multifactorial disease involving genetics, physiology, psychology, and environment, and is influenced by cultural messages. Comorbidities linked to obesity include coronary heart disease, stroke, hypertension, diabetes mellitus, gout, dyslipidemias, cholecystitis, and gallstones. Pharmacists can help patients with dietary goals by understanding sound principles of weight management.

Dietetic Interns Using Computer Simulations Model Care Planning Strategies of Registered Dietitians

Abstract Fifty-five dietetic interns from eight different programs used three computer-based simulations of patients with cardiovascular disease during the orientation phase of the internship. Users were asked to assess each patient and develop a nutrition care plan. The simulations included a medical record and other information typically available for a newly hospitalized patient. A main menu of eight choices was available at the start of the simulation, and could be accessed from any point in the program. These choices were: A. Visit patient, B. Visit at mealtime, C. Review chart, D. Calculate kcal/protein needs, E. See patients menu, F. Review nutrition screening, G. Prepare care plan, and H. Finished with assessment. Users could move freely through the simulation, viewing data in each section as desired. Upon completion of the nutrition care plan to the users satisfaction, a series of feedback screens was shown. These screens showed the nutrition-related problems identified by the user, and the pathway (sequence of choices) used to complete the care plan. In addition, feedback informed the user of how a panel of experienced dietitians had approached care planning with this patient. At the end of the feedback section, users continued with the next simulation. Menu choices of dietetic interns were rank-ordered and compared across simulations using Friedmans chi-square test. The choice of F (Review Screening) was progressively earlier (2.8 for simulation 1, 1.6 for simulation 2, and 1.4 for simulation 3, p

Computer-Based Clinical Simulations Enhance Care Planning Skills of Dietetic Interns

Abstract A computer-based simulation system (CPSS) was developed to include three realistic scenarios of patients with cardiovascular disease. Beginning dietetic interns used either these simulations or an alternative computer tutorial (NCPT) during their internship orientation. During the subsequent eight weeks of clinical rotations, interns were evaluated weekly by their clinical preceptors. Performance ratings were collected using a 31-item rating form and a five-point Likert scale (1=Unacceptable performance, 5=Outstanding performance). Four categories of behaviors represented the nutrition care planning process: A=Obtaining Data; B=Interviewing Client; C=Analyzing Data; D=Developing Plan. Over the eight weeks of evaluation, linear regression analysis revealed a faster rate of improvement (p

Antioxidant Education; Influence on Knowledge and Behavior

Abstract LEARNING OUTCOME: To examine the effects of an anti-oxidant educational program on knowledge and food behavior in female consumers. An antioxidant educational program was developed and validated with eighty-seven female consumers. Nine test sessions were divided equally into a control group, and two experimental treatments. All participants completed a pre- and one-month follow-up knowledge test about antioxidants and a nutrient specific food frequency questionnaire (FFQ) on foods rich in antioxidants. No other data was collected on the control group. All six experimental treatment sessions participated in an audio visual educational program, developed for this study,on antioxidants and completed a knowledge assessment immediately after the program. Additionally, three of the experimental sessions participated in a food tasting activity of foods rich in antioxidants during the educational program. One-month follow-up knowledge and FFQ assessments were distributed by mail to all participants with a 85% return. Pre- versus one-month follow-up knowledge test scores increased significantly (p≤0.05) for both the control and experimental groups. Dietary intake of foods rich in antioxidants increased significantly (p≤0.05) for both experimental groups, while the control group had a significant decrease(p≤0.05)in the dietary intake of these foods. There were no significant differences between the two experimental groups on dietary intake of foods rich in antioxidants. This study indicates an educational program on antioxidants was effective in positively changing consumers knowledge about antioxidants and their food behavior on consumption of foods rich in antioxidants.