Abstract:

Background:
The National Health Service is committed to improve patients care and clinical outcomes [1]. Evaluation of dietetic practice with a focus on clinical, credible and evidence based patients outcome measure is now crucial [2,3]. The master module in Nutrition Support (NS) aims to equip dietitians with: knowledge and skills in clinical nutrition and the ability to measure their clinical effectiveness, focusing on quality and patient centred outcomes. The assessment enables dietitians to practice critical appraisal skills related to their work environment using evidence based dietetic practice.

Aim:
The aim of this project was to evaluate the impact of the master module in NS on: participants’ knowledge, changes occurred in practice and measurements of patients’ outcomes.
Methods: 30 delegates from the past 3 years were invited by means of an electronic questionnaire to evaluate the course and the effect on their clinical practice. All responses were anonymised.

Results:
16 subjects completed the questionnaire. 14 out of 16 reported that doing a master module in NS was worthwhile because it gave them the ability to increase their level of knowledge and confidence and consolidate their critical appraisal skills. Participants reported that their ability to reflect on current practice and implement changes have significantly increased following the completion of the work placed audit. This was exceptionally highly evaluated: 15 delegates replied they are more confident in identifying shortcomings in clinical practice and all delegates either undertook or are planning to do another audit as a result of attending the module. Although equipped with the skills of how to measure dietetic outcomes, lack of time was perceived as the main barrier.

Discussion:
Our evaluation mirrors works published by other health care professions [4,] and confirms that providing a master module in NS to qualified dietitians enhanced their knowledge and openness to change. Our evaluation highlights the importance of combining assignments with clinical practice (such as work placed audit) and that this is an effective education strategy [5]. Finally, measuring dietetic outcomes are still seen as additional work rather than being embedded in every day practice.

Conclusion:
The master module in NS equips dietitians with advanced competencies in NS and ability to evaluate their practice. However, this evaluation showed shortfalls in relation to capturing dietetics outcomes in clinical practice, which will shape future modules.

References:
[1] Department of health (2011) Equity and excellence: Liberating the NHS. Accessed on the 7th March 2016: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/213823/dh_117794.pdf
[2] British Dietetic Association (2011) Model for Dietetic outcomes. Accessed 28th February 2016: https://www.bda.uk.com/publications/archive/bda_outcome_model__2011_archived
[3] Weekes CE, Spiro A, Baldwin K et al.( 2009) A review of the evidence for the impact of improving nutritional care on nutritional and clinical outcomes and cost. J Human Nutr. & Diet. 22(4): 324-35
[4] Stathopoulos I, Harrison K. (2003) Study at Master's Level by Practising Physiotherapists Physiotherapy. 89: 158–169
[5] Coomarasamy A, Khan K.(2004) What is the evidence that postgraduate teaching in evidence based medicine changes anything? A systematic review. BMJ. 30; 329: 1017.

Keywords:

Continuing professional development, impact on quality.