by David Holben, PhD, RD, LD
Background Information (includes major/program information from departmental website)
Dietetics is a career for the Twenty-First Century, as we all become more aware of the impact of nutrition and fitness on feeling and looking good — of living longer and healthier lives. Dietetics applies the sciences of nutrition and food to maintaining or improving human health.
At Ohio University, a student can major in either of two tracks: Dietetics or Nutrition with Science. Students electing Dietetics usually plan to practice their profession as:
clinical dietitians who work as part of a medical team in all types of health care facilities;
community dietitians who help promote the nutritional health of pregnant women, babies, the elderly and other individuals and groups as part of government-funded programs; they often present nutrition education to interested groups via written, oral and electronic media;
dietitians in business who develop, advertise and market food and nutrition products; alternatively they may work in corporate wellness programs or food-related community businesses;
management dietitians who plan and provide nutritional, as well as profitable meals for groups of people in health care institutions, schools, corporations, hotels and restaurants; they are responsible for personnel management, budgeting, and equipment purchase, in addition to meal preparation and service;
educator and research dietitians who teach nutrition and food science in universities and community colleges as well as investigate new areas of research in foods and nutrition (graduate study required); and/or
consultant dietitians who often work in their own private practice, offering advice on diet-related concerns to individuals and groups who seek their help.
Students electing Nutrition with Science, which includes additional and alternative science and mathematics courses, generally plan to pursue graduate study in human nutrition or enter a professional program in medicine.
Both tracks culminate in a bachelor of science degree and both are approved by the American Dietetic Association, the national organization of more than 65,000 dietetic professionals in the United States. To obtain the Registered Dietitian (R.D.) credential, students must obtain supervised practical experience by applying for and completing a dietetic internship following completion of the undergraduate program at Ohio University. Usually undertaken at a large healthcare facility, each internship program must be accredited by The American Dietetic Association and usually requires a grade-point average of 3.0 or higher for acceptance of student applications. Most internships require a year to complete, however part-time programs spread over two years are available at selected facilities. Upon completion of the internship, the student is eligible to take the national Registration Exam for dietitians, which must be completed with a minimum score for each of the five domains.
The Commission on Accreditation for Dietetics Education (CADE) is The American Dietetic Association’s accrediting agency for education programs preparing students for careers as registered dietitians. CADE requires that didactic program graduates have knowledge about “ethics of care.” In addition, students are required to have varying degrees of knowledge and skills related to research, nutrition/medical nutrition therapy, food systems (including procurement of food, equipment, and materials), and communication, among others, all which require the future practitioner to uphold ethical professional practice and conduct (www.eatright.org). Finally, The American Dietetic Association and its Commission on Dietetic Registration have adopted a voluntary, enforceable code of ethics. “This code, entitled the Code of Ethics for the Profession of Dietetics, challenges all members, registered dietitians, and dietetic technicians, registered, to uphold ethical principles.” (Code of Ethics, www.eatright.org)
Therefore, this module was designed to introduce aspects of ethics into courses taught by the writer. It is not exhaustive of what the graduate will have learned while at Ohio University or meant to be the sole means of the graduate to acquire the skills outlined by CADE.
Information outlined in this module will be incorporated into two courses taught by the writer: 1) HCFN 400A, Senior Seminar; and 2) HCFN 430, Therapeutic Nutrition. HCFN 400A provides an opportunity for majors in dietetics and nutrition with science to demonstrate personal and professional growth by investigating a topic and presenting it in class. Students lead discussions on topics that affect the profession, including ethics, and share experiences gained during field experience (1 lecture hour). HCFN 430 includes objectives related to use of dietary modification in prevention and treatment of disease, nutritional assessment, and problems in nutritional care (4 lecture hours).
HCFN 400A objectives will be accomplished using resources available from The American Dietetic Association, including The Code of Ethics for the Profession of Dietetics-A Trainer’s Guide (Appendix A).
The senior seminar student will be able to access The American Dietetic Association/Commission on Dietetic Registration Code of Ethics using technology (via the internet using a personal computer).
The senior seminar student will be able to state the function and purpose of The American Dietetic Association/Commission on Dietetic Registration Code of Ethics.
The senior seminar student will learn the principles of The American Dietetic Association/Commission on Dietetic Registration Code of Ethics and participate in a self-evaluation exercise that allows the learner to evaluate eight ethics scenarios and determine what principle(s) applies to the situation. Students will work individually and in groups to discuss the scenarios. Scenarios will include conflict of interest, confidentiality, and use of credentials, among others.
HCFN 430 objectives will be accomplished using the class session developed by the writer of this module, including resources available from the Human Genome Education Module II Project (Appendix B), and via a discussion of a manuscript entitled, Legal and ethical issues in feeding permanently unconscious patients-Position of ADA (Appendix C).
The senior therapeutic nutrition student will explore the social, legal, and ethical considerations of genetics in dietetics practice during a class session entitled, Genes: How do they fit? Specifically, the student will examine the Case History of Mrs. F, a woman diagnosed with colon cancer in young adulthood.
In groups, students will discuss special issues in genetic testing of children, privacy and confidentiality of genetic information, and communicating genetic information after viewing a video testimony by Mrs. F and review of her dialogue in writing.
After learning about use of alternative feeding modalities and completing a tube feeding exercise, the senior therapeutic nutrition student will review the aforementioned position paper and discuss it in groups. During the discussion, groups will be asked to formulate a set of guidelines or principles for feeding permanently unconscious clients.