Davis Amanda, Meloncelli Nina, Hannigan Amy, Ward Warren
Queensland Eating Disorders Service, Metro North Hospital and Health Service, Brisbane, Australia.
Royal Brisbane and Women's Hospital, Allied Health, Metro North Hospital and Health Service, Brisbane, Australia.
J Eat Disord. 2022 Jul 4;10(1):93. doi: 10.1186/s40337-022-00617-7.
The recently published Australia and New Zealand Academy of Eating Disorders (ANZAED) practice and training standards for dietitians providing eating disorder treatment recommended dietitians working in eating disorders (EDs) seek further clinical experience, training, and supervision to provide effective evidence-informed treatment. Access to dietetic clinical supervision is problematic, secondary to limited trained supervisors, location, cost, and lack of organizational support. Demand for clinical supervision increased with the 2022 introduction of ANZAED credentialing for eating disorder (ED) clinicians in Australia and addition of the Eating Disorder Management Plan to the Medicare Benefits Scheme. In 2018, QuEDS piloted a model of online peer group supervision with the goal of increasing service capacity to provide ED-specific clinical supervision to dietitians. Positive evaluation of the pilot led to the rollout of QuEDS Facilitated Peer Supervision (QuEDS FPS) program which was evaluated for utility and acceptability.
By August 2021 five QuEDS FPS groups were established each with a maximum of 10 Queensland-based dietitians from public hospital, community, or private practice plus an additional Facilitator and Co-facilitator. A total of 76 participants enrolled in the program over the study period in addition to the 10 participants from the pilot program. Participant experience was evaluated with anonymous, voluntary surveys at baseline (59 responses), 6 months follow-up (37 responses), plus a one-off survey in August 2021 (50 responses). Pilot participant's Baseline and Follow-up surveys were not included in this evaluation.
Survey responses were positive across the four Kirkpatrick training evaluation domains of reaction, learning, behavior, and results. Respondents reported positive change to clinical practice (98%), including increased confidence to implement evidence-informed guidelines, and improved engagement with, and advocacy for, ED clients. Service capacity to provide supervision was increased by high participant to Facilitator ratios (10 participants to one Facilitator and one Co-facilitator) and recruitment of external Facilitators. Respondents indicated they would recommend QuEDS FPS to other dietitians and 96% planned to continue with the program.
QuEDS FPS program increases capacity to provide supervision with demonstrated positive impacts on dietitians' confidence and ability to deliver dietetic interventions in the ED arena and, by inference, the dietetic care of people with an ED.
最近发布的澳大利亚和新西兰饮食失调学会（ANZAED）为提供饮食失调治疗的营养师制定的实践和培训标准建议，从事饮食失调（ED）工作的营养师寻求更多临床经验、培训和监督，以提供有效的循证治疗。由于受过培训的监督员数量有限、地点限制、成本问题以及缺乏组织支持，获得饮食临床监督存在问题。随着2022年澳大利亚对饮食失调（ED）临床医生引入ANZAED认证以及医疗保险福利计划中增加饮食失调管理计划，对临床监督的需求增加。2018年，昆士兰饮食失调服务（QuEDS）试点了一种在线同行小组监督模式，目标是提高为营养师提供特定于ED的临床监督的服务能力。对该试点的积极评估导致了QuEDS促进同行监督（QuEDS FPS）计划的推出，并对其效用和可接受性进行了评估。
到2021年8月，共设立了五个QuEDS FPS小组，每个小组最多有10名来自公立医院、社区或私人诊所的昆士兰营养师，外加一名协调员和一名联合协调员。在研究期间，除了试点项目的10名参与者外，共有76名参与者报名参加了该计划。通过在基线（59份回复）、6个月随访（37份回复）以及2021年8月的一次性调查（50份回复）中进行匿名自愿调查来评估参与者的体验。本次评估未包括试点参与者的基线和随访调查。
在柯克帕特里克培训评估的反应、学习、行为和结果这四个领域，调查回复均为积极。受访者报告临床实践有积极变化（98%），包括实施循证指南的信心增强，以及与ED患者的互动和对他们的支持有所改善。高参与者与协调员比例（10名参与者对应一名协调员和一名联合协调员）以及外部协调员的招募提高了提供监督的服务能力。受访者表示他们会向其他营养师推荐QuEDS FPS，96%的人计划继续参加该计划。
QuEDS FPS计划提高了提供监督的能力，对营养师在ED领域提供饮食干预的信心和能力产生了积极影响，并由此推断，对ED患者的饮食护理也有积极影响。
