Clinical Nutrition Department, The University of Kansas Health System, Kansas City, KS.
Department of Dietetics and Nutrition, University of Kansas Medical Center, Kansas City, KS; College of Applied Medical Sciences, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.
J Nutr Educ Behav. 2020 Sep;52(9):882-889. doi: 10.1016/j.jneb.2020.03.011. Epub 2020 May 21.
To develop, implement, and evaluate a patient simulation to assess Nutrition-Focused Physical Exam (NFPE) skills among dietetics students.
Three student cohorts (n = 47) in a combined internship and master's program participated. Curricula included: (1) formal instruction with practice resources, (2) baseline NFPE evaluation performed on a classmate, and (3) final NFPE evaluation performed on a standardized patient. Trained observers evaluated students using the NFPE Skills Assessment tool. Self-rated performance was assessed by the 8-item survey completed at baseline and after the final evaluation. Paired t tests analyzed differences in observed NFPE skill, and 1-tailed Wilcoxon signed-rank test analyzed differences in survey responses.
Nutrition-Focused Physical Exam skill improvements were observed for each cohort (P < .05). Surveys demonstrated increased comfort touching patients (P < .001), and improved self-rated abilities to assess subcutaneous fat, muscle stores, fluid accumulation, and micronutrient deficiency (P < .001).
Simulations were an effective method for increasing observed and perceived NFPE skills among dietetics students. These findings justify the investigation of these methods within a larger sample of students from multiple programs with rigorous study design.
开发、实施和评估一项患者模拟评估，以评估营养学学生的营养为重点的体格检查（NFPE）技能。
参与的是一个联合实习和硕士课程的三个学生队列（n=47）。课程包括：（1）正式的指导和实践资源，（2）对同学进行 NFPE 基线评估，（3）对标准化患者进行最终 NFPE 评估。经过培训的观察员使用 NFPE 技能评估工具评估学生。自我评估表现通过基线和最终评估后完成的 8 项调查进行评估。配对 t 检验分析了观察到的 NFPE 技能差异，1 尾 Wilcoxon 符号秩检验分析了调查响应的差异。
每个队列的 NFPE 技能都有所提高（P<0.05）。调查显示，触摸患者的舒适度有所提高（P<0.001），自我评估评估皮下脂肪、肌肉储存、液体积累和微量营养素缺乏的能力也有所提高（P<0.001）。
模拟是提高营养学学生观察和感知 NFPE 技能的有效方法。这些发现证明了在更大的来自多个课程的学生样本中，通过严格的研究设计，对这些方法进行调查是合理的。
