N_D 498 02

My name is Danielle Villano and I will be your instructor this semester for Medical Nutrition Therapy II. I have worked in the clinical setting for 7 years. I am Board Certified in Pediatric Nutrition and have advanced training in NICU (neonatal) nutrition. In addition to teaching at UND, I also work for Altru as a Flex-time dietitian when I am available. I am a United States Navy Veteran who served for 8 years, thus leading to research interests in nutrition interventions in veterans. I also have a strong interest in feeding practices of neonates. I live in Grand Forks with my husband, three-year-old twin daughters and two dogs. I am looking forward to sharing my knowledge and experiences with you as we review the course materials.  

N&D 498 will address the following ACEND-required Knowledge (KRD’s) and competencies (CRD’s) for registered dietitians: After successfully completing this course, you should be able to:

• CRDN 1.2 Apply evidence-based guidelines, systematic reviews and scientific literature
  • Examples of learning activity: Major case study presentation
• CRDN 1.4 Evaluate emerging research for application in nutrition and dietetics practice
  • Examples of learning activity: Major case study presentation
• CRDN 1.6 Incorporate critical-thinking skills in overall practice
  • Examples of learning activity: Case studies
• CRDN 2.1 Practice in compliance with current federal regulations and state statutes and rules, as applicable and in accordance with accreditation standards and Scope of Nutrition and Dietetics Practice and the Code of Ethics for the Profession of Dietetics
  • Examples of learning activity: Applicable to all supervised rotations; reported by exception
• CRDN 2.2 Demonstrates professional writing skills in preparing professional communications
  • Examples of learning activity: Chart notes, Written case studies
• CRDN 2.4 Function as a member of inter-professional teams
  • Examples of learning activity: Medical rounds, Patient care conferences
• CRDN 2.5 Assign patient care activities to NDTRs and/or support personnel as appropriate
• CRDN 2.6 Refer clients and patients to other professionals and services when needs are beyond individual scope of practice
  • Examples of learning activity: Coordination of care reported in the major case study
• CRDN 2.7 Apply leadership skills to achieve desired outcomes
  • Examples of learning activity: Recommend diet prescription based on assessment process
• CRDN 2.8 Demonstrate negotiation skills
  • Examples of learning activity: Showing assertiveness when needed
• CRDN 2.10 Demonstrate professional attributes in all areas of practice
  • Examples of learning activity: Practice professional conduct (including active listening, constructive self-evaluation, professional dress and communication, attitude of learning and willingness to work; appropriate interaction with others; punctual and full attendance at assigned activities, acts within level of competence; sets priorities, handles increasing workload; accepts consequences of actions; follows through with responsibilities; maintains confidentiality and collegiality; accepts suggestions for improvement

• CRDN 2.11 Show cultural competence/sensitivity in interactions with clients, colleagues and staff

  • Examples of learning activity: Cultural Competency Assignment

• CRDN 2.12 Perform self-assessment and develop goals for self-improvement throughout the program

  • Examples of learning activity: Self-assessment/goals assignment; Midterm and final competency evaluation

• CRDN 3.1 Perform the Nutrition Care Process and use standardized nutrition language for individuals, groups and populations of differing ages and health status, in a variety of settings

  • Examples of learning activity: Conditions and Populations Activity Log

• CRDN 3.2 Conduct nutrition focused physical exams

  • Examples of learning activity: Simulation labs and onsite at facilities as permitted; Nutrition Focused Physical Exam assignment

• CRDN 3.4 Design, implement and evaluate presentations to a target audience

  • Examples of learning activity: Lunch ‘n Learn (Jamestown); Major case study presentation

• CRDN 3.6 Uses effective education and counseling skills to facilitate behavior change

  • Examples of learning activity: Diet education – inpatient and/or outpatient

• CRDN 4.3 Conduct clinical and customer service quality management activities

  • Examples of learning activity: Meal rounds; Clinical Quality Service activity

• CRDN 4.4 Apply current nutrition informatics to develop, store, retrieve and disseminate information and data

  • Examples of learning activity: EPIC training; Informatics review and summary assignment (alternative assignment)

• DPRC 1 Perform complex responsibilities of a dietitian working in a rural setting, demonstrating an understanding of federal, state, and non-governmental regulatory agency regulations and rules

  • Examples of learning activity: Discharge planning on major case study

Required Text:

Nelms MN & Sucher K. Nutrition therapy and pathophysiology (4th ed.). Boston, MA: Cengage Learning, Inc; 2020. ISBN: 978-0-357-04171-0

Required Online Case Studies:

The Nutrition and Dietetics Program has purchased you access to MNT case studies through an online case-study program EHR-GO. Directions for getting started with this program, including the access code can be found in Blackboard in the Lesson 1.  The program can be accessed at: https://ehrgo.com/dietetics/

Recommended Supplementary Resources:

Pronsky, Z. M., Elbe, D., & Ayoob, K. (2018). Food medication interactions. Birchrunville (Penn.): Food-Medication Interactions. 19^th edition. ISBN: 978-0-971-08967-9

Charney, P., & Malone, A. (2016). Academy of Nutrition and Dietetics pocket guide to nutrition assessment. Chicago, IL: Academy of Nutrition and Dietetics.

Access and Log in Information

This course was developed and will be facilitated utilizing Blackboard. To get started with the course, please go to: http://blackboard.UND.edu and log in with your NDUS.Identifier, Username and Password. If you do not know your NDUS Identifier or have forgotten your password, please visit Your NDUS Account page on the UIT website.

Course Overview

The course content is organized by activities and assignments. Each assignment activity contains a variety of links to articles, video/audio files, and other instructional resources selected to enhance the learning experience to support the topic. The student will need to familiarize themselves with the content within each folder. While the majority of course competencies are designed to be met during the student’s rotation at their Supervised Practice, supporting assignments and alternative assignments will also met the expectations of the course competencies should the student be unable to participate in activities at their Supervised Practice site.

What Should Students Do First?

Prior to the start of the first week you should have reviewed the syllabus and completed the “Online Learning Readiness Qualtrics Survey”.

How Students Should Proceed

On the left-hand side of Blackboard you will find the course menu which contains tabs organized by assignment and activity. 

The student should review the “Assignments” tab. Inside this tab you will find all essential information regarding activities and competency assignments including information regarding the Final Major case study, Counseling and Observation forms, an Electronic Portfolio and an Alternative Online Supervised Practice Assignments folder. Assignments will be turned in at this location.

The student should review the “Schedule” tab and “Rotation Site Info” tab to learn about the expectations of their assigned Supervised Practice facility.  In the “Resources” tab the student will find essential tools and resources necessary to be successful in to participate in Supervised Practice.

The student should review the “Debrief” tab contains information regarding Friday class time meetings. Each student will present a MNT topic to the class. The student will need to sign up for a topic and date on the sign up sheet located in the WIKI tab.  There will be a final Comprehensive exam that is due the final week of this course to assess your comprehension and application of those materials. 

The student should review the “Content hub” tab contains Evaluation Forms, Logs, Facility Case study information

Resources

Many services are available to UND students such as writing assistance from the UND Writing Center, free online tutoring from Smarthinking, and more. Visit the Student Resources page for more information. Students also have access to the UND Student Resource Site via Blackboard. It is recommended that you become familiar with the tools and tutorials within the site to better equip you in navigating the course.

Course Requirements/Expectations

Insert the course requirements/expectations. An example is posted below.

1. The student will review the syllabus and course schedule posted in Blackboard.
2. The student will access and follow all course instructions found in the weekly area of the Blackboard course.
3. The student will complete and submit assignments, exams, quizzes, etc. by the dated noted in Blackboard and on the course schedule. We will use Central Standard Time for due dates and times.
4. Attend Altru orientation
5. Schedule and prepare for midpoint and final conference with onsite instructor
6. Maintain a portfolio of work completed on rotations
7. Submit evaluation of preceptors and facilities
8. Abide by the professional dress code, work hours, conduct and other expectations provided
9. The student will participate fully and in a timely manner to get the benefit of learning from instructor and/or peers.

Insert information on how you will be communicating with students and how you would like them to communicate with you. Be sure to set expectations regarding response times. Some examples are provided below, please include all categories relevant to your instruction of this course:

Announcements

Announcements will be posted in Blackboard on a regular basis. Be sure to check the class announcements regularly as they will contain important information about class assignments and other class matters.

Email

You are encouraged to post your questions about the course in the FAQs discussion board forum in the Blackboard site. This is an open forum in which you and your classmates are encouraged to answer each other’s questions. But, if you need to contact me directly, check the Faculty tab in Blackboard or the syllabus for my contact information. I will respond back to you within 24 hours during the week or 48 hours on the weekend.

Discussion Forums, Blogs, & Wikis

These tools are an excellent way for you to engage with the course material and with your peers. Each week we will have at least one of these tools for you to participate in. You are expected to read all assigned discussion boards, blog posts, and/or wiki pages and provide thoughtful contributions.

Course Etiquette

When participating in class (online or in person) it is important to interact with your peers in an appropriate manner. Always use professional language (no netspeak) in your postings and emails. Please be respectful of your classmates at all times even if you disagree with their ideas.

A total of at least 270 hours of simulation, case studies and facility supervised practice experiences have been scheduled. It is mandated by accreditation standards that any time missed must be made up.

All required immunizations and verification must be approved through Verified Credentials by the due date indicated by the department, and any other paperwork as required by individual facilities must be completed prior to starting supervised practice.

Supervised Practice Rotation Site Policy

Once the schedule is completed and confirmed with facilities and preceptors, you must adhere to that established schedule. Exceptions are only acceptable in an emergency, and you must communicate any deviations to the schedule with your preceptor in a timely manner. Arrangements to make up missed time is up to the discretion of the preceptor and reported to the onsite instructor. A referral to the program director will occur to determine consequences of excessive absenteeism, including potential for delayed graduation.

DRESS CODE, WORK HOURS, CONDUCT AND OTHER STUDENT EXPECTATIONS:

• In all facilities, you – the student dietitian, are expected to abide by the same policies and procedures that are established for the staff of the facility.  This includes the dress code, hours, breaks, and professional responsibilities.  Wear your UND name tag at all times, unless the facility has other requirements.  You are required to attend any orientation or training sessions required by your facility.  If asked for, you supply the facility with immunization records, insurance and background check information from your Verified Credentials file online.  Neither faculty or staff has authorization to share this information for you. (FERPA regulation).
  • In general, appropriate dress for MNT rotations includes:
    • Aim for a professional (conservative) appearance.
    • Soft-soled (quiet) shoes.  No flip-flops, heels or open toes
    • Hosiery must be worn with all shoes
    • Clean, neat lab coat with UND name tag (unless the facility policy requires you to wear a name badge issued by them)
    • No capris or shorts
    • Skirts must be at a conservative length
    • No excessive skin exposure (i.e. no exposed midriff, plunging necklines, etc.)
    • No piercings other than one set of earrings.  Facial and tongue piercings must be removed.
    • Do not wear perfume/fragrance

** Note: Altru Health Services outlines a very detailed dress code. The full document is posted in your Blackboard course site.

• It is important to take advantage of every opportunity to learn at your facilities, to initiate work, and to ask for additional work and special projects.  It is imperative that you do not give the impression that you are trying to get out of work or wanting to leave early.  Personal commitments should not interfere with rotation experience and expectations.  If you get your own work completed early, ask your preceptor what else needs to be done.  Use extra time to review complex medical cases admitted to the facility.  Be constructive with your time; avoid “looking busy” to escape work.  Your work ethic is noticed.
• Do NOT use supervised practice time to work on other school assignments.  It is your responsibility to finish work for other classes at a time outside of the facility.  There may be instances where you have free time; use it to work on case studies only when no one else needs your assistance.
• Discuss the use of smart phones, computer use and other technology with your preceptor.  Unless you have extenuating circumstances, personal phone calls and other personal electronic communication should only occur during breaks
• Meal and shift breaks should be discussed with your preceptor.  A good clinical dietitian knows how well their patients and residents are eating.  Plan to conduct routine meal rounds.  That means that sometimes your lunch break does not follow typical lunch time.  Your meal break does not count for hours toward the hour requirement for your supervised practice experience.
• Be on time every day.  If you are not certain where your facility is located, do a test-run the day before.  Note that work hours vary from site to site and position to position.  All students must have reliable transportation to and from clinical sites.
• Follow charting protocol of each facility.  When paper records are used, never chart in pencil.  Use only a black pen or facility-approved computer/electronic procedures.
• Inquisitive minds are encouraged.  However, you are expected to remember what is told to you and be able to use that information without excessive repeated reminders. Know when to ask for help and when to use your own critical thinking skills to discover solutions.
• Review applicable didactic material before arriving at your rotation.  For example, if you are scheduled to work with renal patients, review your course materials on renal disease before your rotation.  Familiarize yourself with bariatric nutrition before arriving at Park Rapids, etc.  Your preceptors need you to arrive with good baseline knowledge to enable them to effectively work with you.
• Confidentiality.  As a member of the health care team, you will have access to confidential information about residents, employees, and facilities.  It is a breach of professional ethics to reveal any such information, except in the performance of professional duties.  Infringement of confidentiality may result in immediate suspension from the coordinated program in dietetics, pending resolution of the issue following appropriate University procedures.  Refer to your student handbook for further information on expected professional and ethical behavior.
• In the event of injury or illness, you will be seen in the emergency department and will be responsible for the expenses involved.  If you are in Grand Forks or the immediate area, you may utilize University Student Health Services.
• Absences are only excused in the case of extenuating circumstances.  If you are unable to be present at a facility at your anticipated time you are expected to contact your preceptor.  Missed supervised practice time must be re-scheduled at the convenience and discretion of the facility and your preceptor.  Rescheduling may require you to make up time on weekends and or during student breaks or holidays. 
• Maintain a positive attitude.  We are so fortunate to have as many preceptors as we do, who give freely of their time and expertise to enable you to fulfill your practice requirements.  You are expected to always show respect and gratitude.  The bottom line is you are the on-site representative of the Department of Nutrition and Dietetics program at UND, and you are expected to conduct yourself in a manner which will reflect positively not only on yourself, but the department and the university as well.
• Remember, you are in the important process of building your professional network.  Build your bridges; do not burn them.

Assignment Policy

Due dates for each assignment or activity will be posted in Blackboard.

Late Work

All assignments must be submitted by the due dates posted in the course. The acceptance of late assignments is at the discretion of the instructor, provided that you contact the instructor before the due date and ask for an extension. All requirements for this course must be completed during the course dates.

Instructor Responsibilities and Feedback

Insert responsibilities students can expect the instructor to meet. Example provided below.

• The instructor will provide feedback on all assignments and group activities by Wednesday of the following week.
• The instructor will be available during appointed Office Hours to answer questions, provide feedback, and offer advice.Class Participation

Class Participation

It is essential for the success of this course that the student attend supervised practice at the assigned facility from Monday through Thursday, for 32 hours per/week. The student will be required to attend a weekly debrief on Fridays of each week.

Students are required to login regularly to the online class site. Students are also required to participate in all class activities such as discussion board, blogs, and wikis.

Incompletes

It is expected that students will complete all requirements for a course during the time frame of the course. For reasons beyond a student’s control, and upon request by the student or on behalf of the student, an incomplete grade may be assigned by the instructor when there is reasonable certainty the student will successfully complete the course without retaking it. The mark “I,” Incomplete, will be assigned only to the student who has been in attendance and has done satisfactory work up to a time within four weeks of the close of the semester, including the examination period, and whose work is incomplete for reasons satisfactory to his or her instructor. More information regarding UND’s Incomplete policy can be found on The Grading System webpage.

University of North Dakota Policies & Resources

Academic Integrity

Academic integrity is a serious matter, and any deviations from appropriate behavior will be dealt with strongly. At the discretion of the professor, situations of concern may be dealt with as a scholastic matter or a disciplinary matter.

As a scholastic matter, the professor has the discretion to determine appropriate penalties to the student’s workload or grade, but the situation may be resolved without involving many individuals. An alternative is to treat the situation as a disciplinary matter, which can result in suspension from the University, or have lesser penalties. Be aware that I view this as a very serious matter, and will have little tolerance of or sympathy for questionable practices. A student who attempts to obtain credit for work that is not their own (whether that be on a paper, quiz, homework assignment, exam, etc.) will likely receive a failing grade for that item of work, and at the professor’s discretion, may also receive a failing grade in the course. For more information read the Code of Student Life.

Access & Opportunity, Disability Support and Medical Services

If you have emergency medical information to share with me, or if you need accommodations in this course because of a disability, please visit with me as soon as possible. My office hours are at the top of this syllabus. If you plan to request disability accommodations, you are expected to register with the Disability Support Services (DSS) office online, (180 McCannel Hall, 701.777.3425).

If you have a temporary medical condition such as a broken arm or recovering after surgery, you may be able to arrange for courtesy services. In most cases, it is expected that you will make your own arrangements for these services. Examples of courtesy services include access to a test scribe if the student has a broken hand; lift equipped van transportation when the student has a broken leg or temporary accessible parking for a student using crutches for a short period. If you are unable to make your own arrangements, please contact DSS (777-3425). Unlike services and/or accommodations provided to eligible students with disabilities, the University is NOT obligated to provide courtesy services.

Resolution of Problems

Should a problem occur, you should speak to your instructor first. If the problem is not resolved, meet with insert name of conflict mediator or ombudsperson if available in your department, otherwise delete this sentence. If the problem continues to be unresolved, go to the department chair, and next to the college Dean. Should the problem persist, you have the right to go to the Provost next, and then to the President.

Notice of Nondiscrimination

It is the policy of the University of North Dakota that no person shall be discriminated against because of race, religion, age, color, gender, disability, national origin, creed, sexual orientation, gender identity, genetic information, marital status, veteran’s status, or political belief or affiliation and the equal opportunity and access to facilities shall be available to all. Concerns regarding Title IX, Title VI, Title VII, ADA, and Section 504 may be addressed to: Donna Smith, Director of Equal Employment Opportunity/Affirmative Action and Title IX Coordinator, 401 Twamley Hall, 701.777.4171, UND.affirmativeactionoffice@UND.edu or the Office for Civil Rights, U.S. Dept. of Education, 500 West Madison, Suite 1475, Chicago, IL 60611 or any other federal agency.

Reporting of Sexual Violence

If you or a friend has experienced sexual violence, such as sexual assault, domestic violence, dating violence or stalking, or sex-based harassment, please contact UND’s Title IX Coordinator, Donna Smith, for assistance: 701.777.4171; donna.smith@UND.edu; or visit the Title IX webpage.

Faculty Reporting Obligations Regarding Sexual Violence

It is important for students to understand that faculty are required to share with UND’s Title IX Coordinator any incidents of sexual violence they become aware of, even if those incidents occurred in the past or are disclosed as part of a class assignment. This does not mean an investigation will occur if the student does not want that, but it does allow UND to provide resources to help the student continue to be successful at UND. If you have been the victim of sexual violence, you can find information about confidential support services on the Title IX webpage.

UND Cares Program

The UND Cares program seeks to educate faculty, staff and students on how to recognize warning signs that indicate a student is in distress.

How to Seek Help When in Distress

We know that while college is a wonderful time for most students, some students may struggle. You may experience students in distress on campus, in your classroom, in your home, and within residence halls. Distressed students may initially seek assistance from faculty, staff members, their parents, and other students. In addition to the support we can provide to each other, there are also professional support services available to students through the Dean of Students and University Counseling Center. Both staffs are available to consult with you about getting help or providing a friend with the help that he or she may need. For more additional information, please visit the UND Cares program Webpage.

How to Recognize When a Student is in Distress

The term “distressed” can mean any of the following:

• Student has significant changes in eating, sleeping, grooming, spending, or other daily activities.
• Student has cut off or minimized contact with family or friends.
• Student has significant changes in performance or involvement in academics, sports, extracurricular, or social activities.
• Student describes problems (missing class, not remembering, destructive behavior) that result from experiences with drinking or drugs.
• Student is acting withdrawn, volatile, tearful, etc.
• Student is acting out of character or differently than usual.
• Student is talking explicitly about hopelessness or suicide.
• Student has difficulty concentrating or difficulty carrying on normal conversation.
• Student has excessive dependence on others for company or support.
• Student reports feeling out of control of one’s emotions, thoughts, or behaviors.

UND Cares about Your Success

Important information is available to you through Starfish, which is an online system used to help students be successful. When an instructor observes student behaviors or concerns that may impede academic success, the instructor may raise a flag that notifies the student of the concern and/or refer the student to their academic advisor or UND resource. Please pay attention to these emails and take the recommended actions. They are sent to help you be successful!

Starfish also allows you to (1) schedule appointments with various offices and individuals across campus, (2) request help on a variety of topics, and (3) search and locate information on offices and services at UND.

You can log into Starfish by clicking on Logins on the UND homepage and then selecting Starfish. A link to Starfish is also available in Blackboard once you have signed in.

Ensure Accessibility

To comply with the latest accessibility guidelines, documents posted online, including, but not limited to, Adobe PDF files, Microsoft Word documents, Microsoft PowerPoint presentations, and online flipbooks, must be screen-reader friendly. For directions on how to make your syllabus and other course materials accessible, visit the Creating Accessible Content webpage on the TTaDA site.