September 4, 2012

Will New Tool Really Help Dietitians?

When I read this, I could not believe that this was being said by a registered dietitian. I mean that she is right in what she says, but to say it publicly has to be daring. It is so important that I am going to quote it, "Only 80 percent of the dietitians we surveyed did any pre-assessment of the client's nutrition literacy, which makes it difficult for educators to target their counseling so clients can understand and act on the information they are given." Karen Chapman-Novakofski is a registered dietitian (RD) and University of Illinois professor of nutrition extension.
From a profession that lives by its mandates, mantras, and dogma, this RD speaks very plainly about why dietitians and some nutritionists are often ignored by their clients. The attitude of RDs is so ingrained in their mantras that they do not pre-assess what their patient (client) has knowledge of and what they need to be taught to make the information useful.

I know that I am not surprised at her findings in the survey. Here we get into using terms that are not explained as well as they should be. Before today, I would have thought a nutrition educator was a teaching position at a college or university. On doing my research, this is true, but also encompasses nutrition educators in hospitals and medical centers as well. Some are also involved in business nutrition education, like agriculture businesses Archer Daniel Midlands, Monsanto, and the food industry.

If the 80 percent is from academia, and the medical arena, then this is why we get the mandates, mantras, and dogma. However, I do think that the term nutrition educators is just the latest phase we are going to have to get used to coming out of the Academy of Nutrition and Dietetics. A doctoral student, Heather Gibbs, has developed an algorithm that dietitians can use to determine precisely what knowledge and skills are required for a particular client.

I know algorithms can be very powerful tools, but I wonder how this will help a profession that works with mandates, mantras, and dogma. They seldom change and will avoid the algorithm as they are not as interested in education as they would lead you to believe. It could be that this may be about to change, but I would not get too enthused yet.

Some patients or clients as they are termed in this article need to know how to manage their consumption of carbohydrates, protein, and fat. Many more need to learn how to manage portion sizes and others need to learn how to read labels. Then many clients need to be able to categorize foods into nutrition groups properly. So with this algorithm dietitians will have the questions to assist them in assessing what the knowledge is that the client possesses and then teach the client what they need to know be become more nutritionally knowledgeable and manage their nutritional needs plus work to balance their daily nutrition.

Karen Chapman-Novakofski stresses that until health professional start asking questions to see what knowledge the patient has about nutrition, it will be impossible to effectively teach nutrition and create a behavior change. She also stated that until dietitians narrow their focus and understand what skills and literacy the client patient possesses, they cannot deliver information in a way that will be meaningful or usable by the client.

Dietitians must get away from the education level of the patient to understand that the patient and the level of nutrition they possess. Then the dietitians can adapt the education to fill in the gaps and make the information usable for the client. Chapman-Novakofski also said if you're the one being counseled, don't be afraid to ask “how” questions to force the dietitian to keep the discussion on your level.

The area Chapman-Novakofski did not cover was how to get the dietitian away from mandates, mantras, and dogma. Until these three areas are made useless to the dietitians, little nutritional education will be passed in a usable form for the clients.

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