Master of Science in Nutrition and Integrative Health Tai Sophia Institute NUTR 652: Practitioner Skills 2 Spring 2013;

2.0 credits Sections 1 & 2 Faculty: Lead Faculty: Rebecca Snow Email: Rsnow@tai.edu Phone: 410.888.9048 x6653 Purpose: The purpose of Practitioner Skills 2 is to provide effective and holistic clinical strategies and assessment tools to prepare students for clinical practice in a variety of outpatient settings. Students will learn to assess nutrition status by conducting dietary and health histories, observing the patient and using anthropometrics. Students will hone their healing presence work (COA601A) as they are introduced to practice motivational interviewing and health behavior change techniques. Practitioner Skills 2 provides the intermediary-level clinical skills and strategies necessary to begin clinic-level coursework, students will continue to build on the concepts and techniques of this course in Practitioner Skills 3. Objectives: To successfully pass this course, the student shall:
Begin to demonstrate case history taking skills (i.e. client rapport, effective listening, agenda setting) in practice sessions Demonstrate ability to observe patient and utilize various clinical assessment tools Articulate and synthesize subjective and objective data gathered from an intake form and client interview to form an assessment Begin to develop critical thinking skills, identifying nutritional imbalances and articulating strategies for nutrition intervention. IDEA Center Objectives Developing specific skills, competencies, and points of view needed by professionals in the field most closely related to this course

Learning to apply course material (to improve thinking, problem solving, and decisions)

Outcomes: At the end of this course the student will: Have foundational skills for clinical and community practice, including case history taking and reading and evaluating health and diet history questionnaires, anthropometrics and physical, energetic assessment.

Demonstrate a growing confidence in assessing, interviewing and counseling clients Demonstrate an emerging confidence in assessing a clients well-being in relationship

to nutritional imbalances, energetic patterns and physiology. Be able to articulate clinical strategies, prioritize and integrate dietary/behavior recommendations in a cohesive fashion

Schedule: CLASS SCHEDULE SECTION 1

Date 1/13/13 1/13/13 Time 8:30-9:45 am 9:5512:35 pm Lecture Course introduction and overview, What does a Nutritionist do anyways? Taking a Case History: reviewing the intake form, health history, diet history: FFQ, diet records, 24-hour recall, typical day, SOAP notes, introduction to assessment and planning Taking a Case History continued, in-class practice Introduction to Motivational Interviewing: Stages of Change model, Agenda setting Corresponding Reading & Assignments Nelms, Chapter 2 Nelms, pp 34-45, Conway, Chapter 5; Faculty Snow, R Snow, R

1/13/13 1/13/13

1:25-2:40 pm 2:50- 5:30 pm

1/27/13

9:5512:35

Nutrition assessment: Introduction to anthropometrics Bring calculator

Intake Form Assignment Distributed Mason and Butler, Chapters 1-3 Practice Interview Assignment Distributed Nelms pp 45-52, 58-62 Intake Form Assignment DUE

Snow, R Snow, R

Snow, R

1/27/13 1/27/13 2/18/12

1:25 2:40 pm 2:505:30 pm 1:255:30 pm 1:25 5:30 pm

Nutrition assessment: Introduction to physical exam Client interview in front of the class Energetic assessment; Providing a framework for energetic assessment; Tongue diagnosis, other signs and symptoms, dietary strategies Physical assessment: Tying it all together with in-class practice All you need for class: Calculator, blank paper and pen and anthropometric handouts. Please put other items in car to make space in the classroom for the activities of the day

Lee & Nieman, Chapter 10

Snow, R Guest Faculty Snow, R

Pool article; Trickey book section

2/20/13

Snow, R & guest faculty

3/1/13 4/1/13 8:3011:10 am 11:20 am

NO CLASS NO CLASS

Practice Interview Assignment DUE Observational Assessment Assignment DUE Snow, R Snow, R

4/14/13 4/14/13

Creating a plan of action: Dietary interventions and strategies Open for review topics; Getting ready for clinic-

-12:35 pm

level

SECTION 2
Date 1/12/13 1/12/13 Time 9:55 11:10 am 11:1012:35 pm Lecture Course introduction and overview, What does a Nutritionist do anyways? Taking a Case History: reviewing the intake form, health history, diet history: FFQ, diet records, 24-hour recall, typical day, SOAP notes, introduction to assessment and planning Taking a Case History continued, in-class practice Nutrition assessment: Introduction to physical exam Introduction to Motivational Interviewing: Stages of Change model, Agenda setting Corresponding Reading & Assignments Nelms, Chapter 2 Nelms, pp 34-45, Conway, Chapter 5; Faculty Snow, R Snow, R

1/12/13 1/12/13 1/26/13

1:25-4:05 pm 4:15- 5:30 pm 8:3011:10 am

1/26/13

11:20 am -12:35 pm

Nutrition assessment: Introduction to anthropometrics Bring calculator

Intake Form Assignment Distributed Lee & Nieman, Chapter 10 Mason and Butler, Chapters 1-3 Practice Interview Assignment Distributed & Intake Form Assignment DUE Nelms pp 45-52, 58-62

Snow, R Snow, R Snow, R

Snow, R

1/26/13

1:25 2:40 pm

Nutrition assessment: Introduction to anthropometrics continued Bring calculator

Nelms pp 45-52, 58-62

Snow, R

1/26/13 2/19/12

2:505:30 pm 1:255:30 pm 1:25 5:30 pm

Client interview in front of the class Energetic assessment; Providing a framework for energetic assessment; Tongue diagnosis, other signs and symptoms, dietary strategies Physical assessment: Tying it all together with in-class practice. All you need for class: Calculator, blank paper and pen and anthropometric handouts. Please put other items in car to make space in the classroom for the activities of the day Pool article; Trickey book section

Guest Faculty Snow, R

2/22/13

Snow, R & guest faculty

3/1/13 4/1/13 8:3011:10 am 11:20 am -12:35 pm

NO CLASS NO CLASS

Practice Interview Assignment DUE Observational Assessment Assignment DUE Snow, R Snow, R

4/13/13 4/13/13

Creating a plan of action: Dietary interventions and strategies Open for review topics; Getting ready for cliniclevel

Prerequisites: COA601A Becoming a Healing Presence (Practitioner Skills 1) Reading list: Required Reading: BOOKS 1. Conway, P. (2011). The Consultation in Phytotherapy (pp 205-321). Edinburgh: Churchill Livingstone, Elsevier. 2. Mason, P., C. Butler, et al. (2010). Health Behavior Change: A Guide for Practitioners. Edinburgh: Churchill Livingstone/Elsevier. Select readings READER from meeting point 1. Lee, R. D. and D. C. Nieman (2007). Chapter 10: Clinical assessment of nutritional status. Nutritional Assessment. New York: McGraw Hill. READER posted online 1. Nelms, M., K. Sucher, et al. (2007). Nutrition Therapy and Pathophysiology. Belmont: Wadsworth, Cengage Learning. Select readings 2. Pool, R. (1987). "Hot and Cold as an Explanatory Model: The Example of Bharuch District in Gujarat, India." Social Science and Medicine 25(4): 389-99. 3. Trickey, R. (1998). Appendix: Patterns of Disharmony. Women, Hormones, and The Menstrual Cycle. St. Leonards, Allen & Unwin: 3-9; 409-424.

Other Helpful Resources 1. Bickley, L. S. (1999). Bates' Guide to Physical Examination and History Taking. Philadelphia: Lippincott Williams & Wilkins. 2. Conway, P. (2011). The Consultation in Phytotherapy. Edinburgh: Churchill Livingstone, Elsevier. 3. Gagne, S. (2006). Energetics of Food : Encounters with Your Most Intimate Relationship. Santa Fe, Spiral Sciences. 1. Richman, J. and A. Sheth (2007). What's Your Poo Telling You? San Francisco: Chronicle Books. 2. Richman, J. and A. Sheth (2009). What's My Pee Telling Me? San Francisco: Chronicle Books. 3. Rollnick, S., W. R. Miller, et al. (2008). Motivational Interviewing in Health Care: Helping Patients with Change Behavior. New York: The Guilford Press. 4. Seller, R. (2000). Differential Diagnosis of Common Complaints. Philadelphia, W.B. Saunders Company. 5. Svoboda, R. E. (1998). Chapter 1: Dosha and Taste. Prakruti: Your Ayurvedic Constitution (pp 11-29). Bellingham: Sadhana Publications.

Materials:

Bring calculator to anthropometrics class and in-class assessment practice. Assignments All assignments for this class are practical in nature and are preparatory for clinic-level tracks, to build confidence and competence in reviewing intake forms, assessing diet and health, and interviewing skills. Engage with a spirit of inquiry and curiosity. Remember you are a beginner. When submitting work electronically, please make sure your name is in the title of the document. Quizzes You will sporadically be given short quizzes at the start of class on the assigned reading for that day. Intake Form Assignment 2 Part Assignment You will be given two client intake forms w/ abbreviated case history on the first day of class. For each client 1. Review the intake form first before reading the notes from the case history/interview. Act as if the client is coming to see you in clinic. Please demonstrate that you have considered all of the following questions after reviewing the intake form. What are some key areas of concern/interest regarding this persons nutritional status? Health status? What is important to note about supplements/prescriptions? Any red flags? What can you glean from their dietary history and other data? What questions do you have for this client? What additional research do you need to do regarding this client? No more than one pages per client handwritten. 2. Now read the fully case history and fill out the Journal Form (front and back). Through filling out this form please demonstrate that you understand the difference between nutrition assessment, and nutrition plan (goals, strategy and recommendations). This assignment is due to Rebecca in class on 1/27/13 (section 1) OR 1/26/13 (section 2). To recap, you need a handwritten page and journal form for each client. Please photocopy your work for class discussion or bring additional thoughts and questions on another sheet of paper for class discussion. Observational Assessment Practice Observe 8 individuals, not other Jan12 nutrition students. Take photos of their tongues. Include a concise evaluation of what you observe in each individual (tongue, face, nails, demeanor, voice, and any other observable and notable signs). Make sure to assess energetics and signs of nutritional imbalance as discussed in class. Include a very concise assessment(s) providing meaning to the phenomenon you observed. This does not need to be written in a paper format, rather you can write notes as you would in a patients chart. No more than a page per individual (no more than 4 pages total). This assignment is due to Rebecca on 4/01/13, either electronically rsnow@tai.edu or via mailbox. Make sure the photos are embedded in the document for easy review.

Practice Interview Assignment You will be required to conduct 3 practice interviews with write-up; details will be discussed in class. This assignment is due to Rebecca on 3/01/13, either electronically rsnow@tai.edu or via mailbox. Please note: 10% reduction of grade for late assignments, regardless of reason. There is a 20% reduction in grade if more than a 1 week late. For late assignments, additional coursework may need to be completed to pass the class. I will only send an email if I do not receive your assignment by the due date, otherwise you can assume I received your assignment. Evaluation 80% grade is required to pass the course. Quizzes 20% Intake Form Assignment 25% Practice in Observational Assessment 25% Practice Interviews 30%

Attendance & Tardiness Policy: Attendance and participation in class are essential for meeting the outcomes and objectives of this course and the program as a whole. Arriving late to class is a disturbance to your classmates and your instructor. It is the students responsibility to stay up-to-date on any missed coursework, regularly checking the course website for updates. If you miss a class, you are encouraged to contact a classmate so they can collect handouts for you. Absences may require that students do extra work to make up for missed material. This course is very experiential, 80% attendance is required. Plagiarism, Information Literacy & Appropriate Referencing of Sources: Plagiarism: Plagiarism, defined as using the published or unpublished works or ideas of another without properly citing the material used and its source, or presenting another persons work as your own, is an infraction of Tai Sophia Institutes academic honesty policy. Please carefully note all reference sources on your assignments. Information Literacy: Students who are unable to complete homework because of challenges with information literacy skills are asked to seek assistance in the library. The library offers training sessions and support for development of these skills. In some cases, students may be required to complete training sessions in order to pass a course if they demonstrate an inability to meet the demands of the assigned coursework.