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J Educ Eval Health Prof > Epub ahead of print
J Educ Eval Health Prof. 2020; 17: 40.
Published online December 14, 2020.
[Epub ahead of print]
Increased competency of registered dietitian nutritionists in physical examination skills after simulation-based education in the United States
Elizabeth L. MacQuillan  , Jennifer Ford  , Kristin Baird 
Department of Allied Health Sciences, College of Health Professions, Grand Valley State University, Allendale, MI, USA
Correspondence  Elizabeth L. MacQuillan ,Email:
Editor:  Sun Huh, Hallym University, Korea
Submitted: November 5, 2020  Accepted after revision: December 12, 2020
This study aimed to translate simulation-based dietitian nutritionist education to clinical competency attainment in a group of practicing registered dietitian nutritionists (RDNs). Using a standardized instrument to measure performance on a newly-required clinical skill, the nutrition-focused physical exam (NFPE), competence was measured both before and after a simulation-based education (SBE) session.
Eighteen practicing RDNs were recruited by their employer, Spectrum Health. Following a pre-briefing session, participants completed an initial 10-minute encounter, performing NFPE on a standardized patient (SP). Next, participants completed a 90-minute SBE training session on skills within the NFPE, including hands-on practice and role play, followed by a post-training SP encounter. Video recordings of the SP encounters were scored to assess competence in 7 skill areas within the NFPE. Scores were analyzed for participants’ initial competence and change in competence.
The proportions of participants with initial competence ranged from 0% to 44% across the 7 skill areas assessed. The only competency where participants initially scored in the “meets expectations” range was “approach to the patient.” When raw competence scores were assessed for changes from pre- to post-SBE training, the paired t-test indicated significant increases in all 7 competency areas following the simulation-based training (P<0.001).
This study showed the effectiveness of a SBE training program for increasing competence scores of practicing RDNs on a defined clinical skill.
Keywords: Clinical competence; Motivation; Nutritionists; Physical examination; United States
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