Simone Gibson

Programmatic Assessment of Competence in Dietetics: A New Frontier

Palermo, MNutDiet, MPH, Grad Cert Health Prof Ed, PhD, a senior lecturer, Simone Jane Gibson, Grad Dip Diet, Grad Cert Health Prof Ed, PhD, a lecturer, and Janeane Dart, Grad Dip Diet, Grad Cert Acad Pract, a senior lecturer, Monash University, Department of Nutrition and Dietetics, Notting Hill, Australia; Kevin Whelan, MSc, MA, PhD, RD*, a professor, King’s College London, Division of Nutrition Sciences, United Kingdom, and Faculty of Life Sciences & Medicine, London, UK; and Margaret Hay, MAPS, Grad Dip Epi, Grad Cert Health Prof Ed, PhD, an associate professor, Monash University, Faculty of Medicine, Nursing and Health Sciences, Victoria, Australia.

Effects and associations of nutrition in patients with venous leg ulcers: A systematic review

AIMS To identify the associations and effects of nutritional characteristics and interventions on ulcer outcomes in adult patients with venous leg ulcers. BACKGROUND Venous leg ulcers are the most prevalent type of lower limb ulcer; however, little evidence exists regarding the relationship between nutritional status and ulcer healing. DESIGN A systematic search of English language articles was conducted using the Cochrane Collaboration Handbook for Systematic Reviews of Interventions. DATA SOURCES A search of databases Ovid MEDLINE, EMBASE, Cochrane, CINAHL and Scopus was performed for studies published between January 2004 - May 2017. REVIEW METHODS Quality of the included studies was assessed using the Cochrane Collaborations Risk of Bias Assessment tool and the relevant Joanna Briggs Institute quality appraisal checklists. RESULTS Twenty studies met the inclusion criteria. All participants had Clinical Aetiology Anatomy Pathophysiology classification C5 (healed) or C6 (active) ulcers. Studies were conducted in a range of clinical settings with relatively small sample sizes. The majority of patients were overweight or obese. Increased body mass index was associated with delayed wound healing. Vitamin D, folic acid and flavonoids were associated with some beneficial effects on ulcer healing. Dietary intakes of omega-3 fatty acids, vitamin C and zinc were low for some patients. CONCLUSION Current evidence suggests that venous leg ulcer patients are more likely to be overweight or obese. However, evidence for weight management improving wound healing is lacking. Micronutrients, including vitamin D and folic acid, may improve wound healing in at-risk patients.

An observational study investigating the impact of simulated patients in teaching communication skills in preclinical dietetic students

BACKGROUND Simulated patients (SPs) are often used in dietetics for the teaching and assessment of communication skills. The present study aimed to determine the impact of a SP encounter on communication skills in undergraduate preclinical dietetic students in the context of the resources required for delivering this educational strategy. METHODS This observational study collected assessment data from four cohorts of third-year dietetic students to examine the effect of participation in SP-embedded Objective Structured Clinical Exams. Students completed two SP interviews, 2 weeks apart, and communication skills were measured on both occasions. A subgroup of students received a video of their SP encounter. Differences between the two SP interview scores were compared to assess the impact of the SP encounter on communication skills. The required staff and resources were described. RESULTS Data were collected involving 215 students. Out of 30 marks, there was a modest mean (SD) improvement in communication skills from the first to the second SP interview of 2.5 (4.2) (P < 0.01). There was an association between student ability and improvement in communication skills, with failing students demonstrating the greatest improvement between SP encounters. There were no observed benefits for the subset of students who received videos. CONCLUSIONS Providing repeat SP interview opportunities results in only modest improvement in communication skills for most students. The use of SPs needs to be considered in context of the substantial costs and resources involved and tailored to student ability.