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The Role of Nutrition in Maintaining Health in the Nation's Elderly: Evaluating Coverage of Nutrition Services for the Medicare Population (2000)

Chapter: Appendix E: The American Dietetic Association Foundation Knowledge and Skills and Competency Requirements for Entry-Level Dietitans

« Previous: Appendix D: State Licensure Laws for the Practice of Dietetics (as of June 1999)
Suggested Citation:"Appendix E: The American Dietetic Association Foundation Knowledge and Skills and Competency Requirements for Entry-Level Dietitans." Institute of Medicine. 2000. The Role of Nutrition in Maintaining Health in the Nation's Elderly: Evaluating Coverage of Nutrition Services for the Medicare Population. Washington, DC: The National Academies Press. doi: 10.17226/9741.
×

Appendix E
The American Dietetic Association Foundation Knowledge and Skills and Competency Requirements for Entry-Level Dietitians

Individuals interested in becoming Registered Dietitians should expect to study a wide variety of topics focusing on food, nutrition, and management. These areas are supported by the sciences: physical and biological, behavioral and social, and communication. Becoming a dietitian involves a combination of academic preparation, including a minimum of a baccalaureate degree, and a supervised practice component.

The following foundation knowledge and skill requirements are listed in the eight areas that students will focus on in the academic component of a dietetics program. Foundation learning is divided as follows: basic knowledge of a topic, working or in-depth knowledge of a topic as it applies to the profession of dietetics, and ability to demonstrate the skill at a level that can be developed further. To successfully achieve the foundation knowledge and skills, graduates must demonstrate the ability to communicate and collaborate, solve problems, and apply critical thinking skills.

These requirements may be met through separate courses, combined into one course, or as part of several courses as determined by the college or university sponsoring a program accredited or approved by the Commission on Accreditation/Approval for Dietetics Education (CAADE) of The American Dietetic Association.

Suggested Citation:"Appendix E: The American Dietetic Association Foundation Knowledge and Skills and Competency Requirements for Entry-Level Dietitans." Institute of Medicine. 2000. The Role of Nutrition in Maintaining Health in the Nation's Elderly: Evaluating Coverage of Nutrition Services for the Medicare Population. Washington, DC: The National Academies Press. doi: 10.17226/9741.
×

FOUNDATION KNOWLEDGE AND SKILLS

Content Area

Basic Knowledge about

Working Knowledge of

Demonstrated Ability to

COMMUNICATIONS

negotiation techniques, lay and technical writing, media presentations

interpersonal communication skills, counseling theory and methods, interviewing techniques, educational theory and techniques, concepts of human and group dynamics, public speaking, educational materials development

present an educational session for a group, counsel individuals on nutrition, demonstrate a variety of documentation methods, explain a public policy position regarding dietetics, use current information technologies, work effectively as a team member

PHYSICAL AND BIOLOGICAL SCIENCES

exercise physiology

organic chemistry, biochemistry, physiology, microbiology, nutrient metabolism, patho-physiology related to nutrition care, fluid and electrolyte requirements, pharmacology: nutrient-nutrient and drug-nutrient interaction

interpret medical terminology, interpret laboratory parameters relating to nutrition, apply microbiological and chemical considerations to process controls

SOCIAL SCIENCES

public policy development

psychology, health behaviors and educational needs, economics and nutrition

 

RESEARCH

research methodologies, needs assessments, outcomes based research

scientific method, quality improvement methods

interpret current research, interpret basic statistics

Suggested Citation:"Appendix E: The American Dietetic Association Foundation Knowledge and Skills and Competency Requirements for Entry-Level Dietitans." Institute of Medicine. 2000. The Role of Nutrition in Maintaining Health in the Nation's Elderly: Evaluating Coverage of Nutrition Services for the Medicare Population. Washington, DC: The National Academies Press. doi: 10.17226/9741.
×

FOUNDATION KNOWLEDGE AND SKILLS

Content Area

Basic Knowledge about

Working Knowledge of

Demonstrated Ability to

FOOD

food technology, biotechnology, culinary techniques

socio-cultural and ethnic food consumption issues and trends for various consumers, food safety and sanitation, food delivery systems, food and non-food procurement, availability of nutrition programs in the community, formulation of local, state, and national food security policy, food production systems, environmental issues related to food, role of food in promotion of a healthy lifestyle, promotion of pleasurable eating, food and nutrition laws/regulations/ policies, food availability and access for the individual, family, and community, applied sensory evaluation of food

calculate and interpret nutrient composition of foods, translate nutrition needs into menus for individuals and groups, determine recipe/formula proportions and modifications for volume food production, write specifications for food and foodservice equipment, apply food science knowledge to functions of ingredients in food, demonstrate basic food preparation and presentation skills, modify recipe/ formula for individual or group dietary needs

Suggested Citation:"Appendix E: The American Dietetic Association Foundation Knowledge and Skills and Competency Requirements for Entry-Level Dietitans." Institute of Medicine. 2000. The Role of Nutrition in Maintaining Health in the Nation's Elderly: Evaluating Coverage of Nutrition Services for the Medicare Population. Washington, DC: The National Academies Press. doi: 10.17226/9741.
×

FOUNDATION KNOWLEDGE AND SKILLS

Content Area

Basic Knowledge about

Working Knowledge of

Demonstrated Ability to

NUTRITION

alternative nutrition and herbal therapies, evolving methods of assessing health status

the influence of age, growth, and normal development on nutritional requirements; nutrition and metabolism; assessment and treatment of nutritional health risks; medical nutrition therapy, including alternative feeding modalities, chronic diseases, dental health, mental health, and eating disorders; strategies to assess need for adaptive feeding techniques and equipment; health promotion and disease prevention theories and guidelines; influence of socioeconomic, cultural, and psychological factors on food and nutrition behavior

calculate and/or define diets for common conditions, i.e., health conditions addressed by health promotion/disease prevention activities or chronic diseases of the general population, e.g., hypertension, obesity, diabetes, diverticular disease; screen individuals for nutritional risk; collect pertinent information for comprehensive nutrition assessments; determine nutrient requirements across the life span, i.e., infants through geriatrics and a diversity of people, culture, and religions; measure, calculate, and interpret body composition data; calculate enteral and parenteral nutrition formulations

Suggested Citation:"Appendix E: The American Dietetic Association Foundation Knowledge and Skills and Competency Requirements for Entry-Level Dietitans." Institute of Medicine. 2000. The Role of Nutrition in Maintaining Health in the Nation's Elderly: Evaluating Coverage of Nutrition Services for the Medicare Population. Washington, DC: The National Academies Press. doi: 10.17226/9741.
×

FOUNDATION KNOWLEDGE AND SKILLS

Content Area

Basic Knowledge about

Working Knowledge of

Demonstrated Ability to

MANAGEMENT

program planning, monitoring, and evaluation, strategic management, facility management, organizational change theory, risk management

management theories; human resource management, including labor relations; materials management; financial management, including accounting principles; quality improvement; information management; systems theory; marketing theory and techniques; diversity issues

determine costs of services/operation, prepare a budget, interpret financial data, apply marketing principles

HEALTH CARE SYSTEMS

health care policy and administration, health care delivery systems

current reimbursement issues, ethics of care

 

Individuals are expected to develop competence to practice dietetics through a supervised practice component in programs accredited or approved by CAADE. Competency statements specify what every dietitian should be able to do at the beginning of his or her practice career. The core competency statements build on appropriate knowledge and skills necessary for the entry-level practitioner to perform reliably at the level indicated. One or more of the emphasis areas are added to the core competencies so that a supervised practice program can prepare graduates for identified market needs. Thus, all entry-level dietitians will have the core competencies and additional competencies according to the emphasis area(s) completed.

Suggested Citation:"Appendix E: The American Dietetic Association Foundation Knowledge and Skills and Competency Requirements for Entry-Level Dietitans." Institute of Medicine. 2000. The Role of Nutrition in Maintaining Health in the Nation's Elderly: Evaluating Coverage of Nutrition Services for the Medicare Population. Washington, DC: The National Academies Press. doi: 10.17226/9741.
×
Core Competencies for Entry-Level Dietitians
  1. Perform ethically in accordance with the values of The American Dietetic Association

  2. Refer clients/patients to other dietetics professionals or disciplines when a situation is beyond one’s level or area of competence

  3. Participate in professional activities

  4. Perform self assessment and participate in professional development

  5. Participate in legislative and public policy processes as they affect food, food security, and nutrition

  6. Use current technologies for information and communication activities

  7. Supervise documentation of nutrition assessment and interventions

  8. Provide dietetics education in supervised practice settings

  9. Supervise counseling, education, and/or other interventions in health promotion/disease prevention for patients/clients needing medical nutrition therapy for common conditions, e.g., hypertension, obesity, diabetes, and diverticular disease

  10. Supervise education and training for target groups

  11. Develop and review educational materials for target populations

  12. Participate in the use of mass media for community-based food and nutrition programs

  13. Interpret and incorporate new scientific knowledge into practice

  14. Supervise quality improvement, including systems and customer satisfaction, for dietetics service and/or practice

  15. Develop and measure outcomes for food and nutrition services and practice

  16. Participate in organizational change and planning and goal-setting processes

  17. Participate in business or operating plan development

  18. Supervise the collection and processing of financial data

  19. Perform marketing functions

  20. Participate in human resources functions

  21. Participate in facility management, including equipment selection and design/redesign of work units

  22. Supervise the integration of financial, human, physical, and material resources and services

  23. Supervise production of food that meets nutrition guidelines, cost parameters, and consumer acceptance

  24. Supervise development and/or modification of recipes/formulas

Suggested Citation:"Appendix E: The American Dietetic Association Foundation Knowledge and Skills and Competency Requirements for Entry-Level Dietitans." Institute of Medicine. 2000. The Role of Nutrition in Maintaining Health in the Nation's Elderly: Evaluating Coverage of Nutrition Services for the Medicare Population. Washington, DC: The National Academies Press. doi: 10.17226/9741.
×
  1. Supervise translation of nutrition into foods/menus for target populations

  2. Supervise design of menus as indicated by the patient’s/client’s health status

  3. Participate in applied sensory evaluation of food and nutrition products

  4. Supervise procurement, distribution, and service within delivery systems

  5. Manage safety and sanitation issues related to food and nutrition

  6. Supervise nutrition screening of individual patients/clients

  7. Supervise nutrition assessment of individual patients/clients with common medical conditions, e.g., hypertension, obesity, diabetes, diverticular disease

  8. Assess nutritional status of individual patients/clients with complex medical conditions, i.e., more complicated health conditions in select populations, e.g., renal disease, multi-system organ failure, trauma

  9. Manage the normal nutrition needs of individuals across the life span, i.e., infants through geriatrics and a diversity of people, cultures, and religions

  10. Design and implement nutrition care plans as indicated by the patient’s/client’s health status

  11. Manage monitoring of patients’/clients’ food and/or nutrient intake

  12. Select, implement, and evaluate standard enteral and parenteral nutrition regimens, i.e., in a medically stable patient to meet nutritional requirements where recommendations/adjustments involve primarily macronutrients

  13. Develop and implement transitional feeding plans, i.e., conversion from one form of nutrition support to another, e.g., total parenteral nutrition to tube feeding to oral diet

  14. Coordinate and modify nutrition care activities among caregivers

  15. Conduct nutrition care component of interdisciplinary team conferences to discuss patient/client treatment and discharge planning

  16. Refer patients/clients to appropriate community services for general health and nutrition needs and to other primary care providers as appropriate

  17. Conduct general health assessment, e.g., blood pressure, vital signs

  18. Supervise screening of the nutritional status of the population and/or community groups

  19. Conduct assessment of the nutritional status of the population and/or community groups

Suggested Citation:"Appendix E: The American Dietetic Association Foundation Knowledge and Skills and Competency Requirements for Entry-Level Dietitans." Institute of Medicine. 2000. The Role of Nutrition in Maintaining Health in the Nation's Elderly: Evaluating Coverage of Nutrition Services for the Medicare Population. Washington, DC: The National Academies Press. doi: 10.17226/9741.
×
  1. Provide nutrition care for population groups across the lifespan, i.e., infants through geriatrics, and a diversity of people, cultures, and religions

  2. Conduct community-based health promotion/disease prevention programs

  3. Participate in community-based food and nutrition program development and evaluation

  4. Supervise community-based food and nutrition programs

COMPETENCY STATEMENTS FOR EMPHASIS AREAS

All dietitian education supervised practice programs must offer at least one emphasis area. The emphasis areas are not intended to prepare specialists or advanced level practitioners as defined for credentialing purposes. Competencies for each emphasis area build on the core competencies and are designed to begin to develop the depth necessary for future proficiency in that area of dietetics practice. More experience in at least one area provides a model for learning throughout one’s professional life.

For establishing an emphasis area, the program has the following options:

  • Use one or more of the four defined emphasis areas; or,

  • Develop a general emphasis by selecting a minimum of seven competency statements, relevant to program mission and goals, with at least one from each of the four defined emphasis areas. The selected competencies should build on the core competencies. General emphasis does not mean achievement of all competencies from all emphasis areas; or,

  • Create a unique emphasis area with a minimum of seven competency statements, based on environmental resources and identified needs.

Nutrition Therapy Emphasis Competencies
  1. Supervise nutrition assessment of individual patients/clients with complex medical conditions, i.e., more complicated health conditions in select populations, e.g., renal disease, multi-system organ failure, trauma

  2. Integrate pathophysiology into medical nutrition therapy recommendations

  3. Supervise design through evaluation of nutrition care plan for patients/clients with complex medical conditions, i.e., more com-

Suggested Citation:"Appendix E: The American Dietetic Association Foundation Knowledge and Skills and Competency Requirements for Entry-Level Dietitans." Institute of Medicine. 2000. The Role of Nutrition in Maintaining Health in the Nation's Elderly: Evaluating Coverage of Nutrition Services for the Medicare Population. Washington, DC: The National Academies Press. doi: 10.17226/9741.
×

plicated health conditions in select populations, e.g., renal disease, multi-system organ failure, trauma

  1. Select, monitor, and evaluate complex enteral and parenteral nutrition regimens, i.e., more complicated health conditions in select populations, e.g., renal disease, multi-system organ failure, trauma

  2. Supervise development and implementation of transition feeding plans from the inpatient to home setting

  3. Conduct counseling and education for patients/clients with complex needs, i.e., more complicated health conditions in select populations, e.g., renal disease, multi-system organ failure, trauma

  4. Perform basic physical assessment

  5. Participate in nasoenteric feeding tube placement and care

  6. Participate in waivered point-of-care testing, such as blood glucose monitoring

  7. Participate in the care of patients/clients requiring adaptive feeding devices

  8. Manage clinical nutrition services

Community Emphasis Competencies
  1. Manage nutrition care for population groups across the lifespan

  2. Conduct community-based food and nutrition program outcome assessment/evaluation

  3. Develop community-based food and nutrition programs

  4. Participate in nutrition surveillance and monitoring of communities

  5. Participate in community-based research

  6. Participate in food and nutrition policy development and evaluation based on community needs and resources

  7. Consult with organizations regarding food access for target populations

  8. Develop a health promotion/disease prevention intervention project

  9. Participate in waivered point-of-care testing, such as hematocrit and cholesterol levels

Foodservice Systems Management Emphasis Competencies
  1. Manage development and/or modification of recipes/formulas

  2. Manage menu development for target populations

  3. Manage applied sensory evaluation of food and nutrition products

  4. Manage production of food that meets nutrition guidelines, cost parameters, and consumer acceptance

  5. Manage procurement, distribution, and service within delivery systems

Suggested Citation:"Appendix E: The American Dietetic Association Foundation Knowledge and Skills and Competency Requirements for Entry-Level Dietitans." Institute of Medicine. 2000. The Role of Nutrition in Maintaining Health in the Nation's Elderly: Evaluating Coverage of Nutrition Services for the Medicare Population. Washington, DC: The National Academies Press. doi: 10.17226/9741.
×
  1. Manage the integration of financial, human, physical, and material resources

  2. Manage safety and sanitation issues related to food and nutrition

  3. Supervise customer satisfaction systems for dietetics services and/ or practice

  4. Supervise marketing functions

  5. Supervise human resource functions

  6. Perform operations analysis

Business/Entrepreneur Emphasis Competencies
  1. Perform organizational and strategic planning

  2. Develop business or operating plan

  3. Supervise procurement of resources

  4. Manage the integration of financial, human, physical, and material resources

  5. Supervise organizational change process

  6. Supervise coordination of services

  7. Supervise marketing functions

RESOURCES

Directory of Dietetics Programs: The Directory of Dietetics Programs is the complete listing of CAADE-accredited Coordinated and Internship Programs, CAADE-approved and accredited Dietetic Technician Programs, and CAADE-approved Preprofessional Practice and Didactic Programs in Dietetics. Advanced degree and specialty practice education programs also are listed. Copies of the Directory may be ordered from ADA Customer Service. Call 1-800-877-1600 ext. 5000 for price and ordering information.

Web Site: The ADA Web site includes a listing with selected information on CAADE-accredited/approved programs. The URL is http://www.eatright.org/caade.html.

For More Information Contact:

ADA Education and Accreditation Team

312/899-0040, ext. 5400

Fax: 312/899-4817

E-mail: education@eatright.org

SOURCE: Reproduced with permission from The American Dietetic Association, Commission on Accreditation for Dietetics Education.

Suggested Citation:"Appendix E: The American Dietetic Association Foundation Knowledge and Skills and Competency Requirements for Entry-Level Dietitans." Institute of Medicine. 2000. The Role of Nutrition in Maintaining Health in the Nation's Elderly: Evaluating Coverage of Nutrition Services for the Medicare Population. Washington, DC: The National Academies Press. doi: 10.17226/9741.
×
Page 342
Suggested Citation:"Appendix E: The American Dietetic Association Foundation Knowledge and Skills and Competency Requirements for Entry-Level Dietitans." Institute of Medicine. 2000. The Role of Nutrition in Maintaining Health in the Nation's Elderly: Evaluating Coverage of Nutrition Services for the Medicare Population. Washington, DC: The National Academies Press. doi: 10.17226/9741.
×
Page 343
Suggested Citation:"Appendix E: The American Dietetic Association Foundation Knowledge and Skills and Competency Requirements for Entry-Level Dietitans." Institute of Medicine. 2000. The Role of Nutrition in Maintaining Health in the Nation's Elderly: Evaluating Coverage of Nutrition Services for the Medicare Population. Washington, DC: The National Academies Press. doi: 10.17226/9741.
×
Page 344
Suggested Citation:"Appendix E: The American Dietetic Association Foundation Knowledge and Skills and Competency Requirements for Entry-Level Dietitans." Institute of Medicine. 2000. The Role of Nutrition in Maintaining Health in the Nation's Elderly: Evaluating Coverage of Nutrition Services for the Medicare Population. Washington, DC: The National Academies Press. doi: 10.17226/9741.
×
Page 345
Suggested Citation:"Appendix E: The American Dietetic Association Foundation Knowledge and Skills and Competency Requirements for Entry-Level Dietitans." Institute of Medicine. 2000. The Role of Nutrition in Maintaining Health in the Nation's Elderly: Evaluating Coverage of Nutrition Services for the Medicare Population. Washington, DC: The National Academies Press. doi: 10.17226/9741.
×
Page 346
Suggested Citation:"Appendix E: The American Dietetic Association Foundation Knowledge and Skills and Competency Requirements for Entry-Level Dietitans." Institute of Medicine. 2000. The Role of Nutrition in Maintaining Health in the Nation's Elderly: Evaluating Coverage of Nutrition Services for the Medicare Population. Washington, DC: The National Academies Press. doi: 10.17226/9741.
×
Page 347
Suggested Citation:"Appendix E: The American Dietetic Association Foundation Knowledge and Skills and Competency Requirements for Entry-Level Dietitans." Institute of Medicine. 2000. The Role of Nutrition in Maintaining Health in the Nation's Elderly: Evaluating Coverage of Nutrition Services for the Medicare Population. Washington, DC: The National Academies Press. doi: 10.17226/9741.
×
Page 348
Suggested Citation:"Appendix E: The American Dietetic Association Foundation Knowledge and Skills and Competency Requirements for Entry-Level Dietitans." Institute of Medicine. 2000. The Role of Nutrition in Maintaining Health in the Nation's Elderly: Evaluating Coverage of Nutrition Services for the Medicare Population. Washington, DC: The National Academies Press. doi: 10.17226/9741.
×
Page 349
Suggested Citation:"Appendix E: The American Dietetic Association Foundation Knowledge and Skills and Competency Requirements for Entry-Level Dietitans." Institute of Medicine. 2000. The Role of Nutrition in Maintaining Health in the Nation's Elderly: Evaluating Coverage of Nutrition Services for the Medicare Population. Washington, DC: The National Academies Press. doi: 10.17226/9741.
×
Page 350
Suggested Citation:"Appendix E: The American Dietetic Association Foundation Knowledge and Skills and Competency Requirements for Entry-Level Dietitans." Institute of Medicine. 2000. The Role of Nutrition in Maintaining Health in the Nation's Elderly: Evaluating Coverage of Nutrition Services for the Medicare Population. Washington, DC: The National Academies Press. doi: 10.17226/9741.
×
Page 351
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Malnutrition and obesity are both common among Americans over age 65. There are also a host of other medical conditions from which older people and other Medicare beneficiaries suffer that could be improved with appropriate nutritional intervention. Despite that, access to a nutrition professional is very limited.

  • Do nutrition services benefit older people in terms of morbidity, mortality, or quality of life?
  • Which health professionals are best qualified to provide such services?
  • What would be the cost to Medicare of such services? Would the cost be offset by reduced illness in this population?

This book addresses these questions, provides recommendations for nutrition services for the elderly, and considers how the coverage policy should be approached and practiced. The book discusses the role of nutrition therapy in the management of a number of diseases. It also examines what the elderly receive in the way of nutrition services along the continuum of care settings and addresses the areas of expertise needed by health professionals to provide appropriate nutrition services and therapy.

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