Practice Competencies for Nutrition Practitioners to Maintain Credentials

Staying up-to-date with national standards and criteria for knowledge and practice is crucial for health care practitioners. Beginning June 1, 2016, for recertifying credentialed nutrition and dietetics practitioners completing the 2016-2021 recertification cycle, the Commission on Dietetic Registration (CDR) transitioned into an updated credentialing system based on practice competencies. All other practitioners will be transitioned into the new system over the next five years.Our online courses all adhere to these new standards.What are practice competencies?CDR developed practice competencies to provide overarching, validated standards for both the registered dietitian/nutritionist (RDN) and nutrition and dietetics technician registered (NDTR). According to CDR,

“Practice competencies define the knowledge, skill, judgment and attitude requirements throughout a practitioner’s career, across practice, and within focus areas. Competencies provide a structured guide to help identify, evaluate, and develop the behaviors required for continuing competence.”

The competencies are divided into 14 broad spheres that encompass the range of professional activities within the nutrition profession, including:9 core essential practice competencies that describe the knowledge, skills, judgment and attitudes that apply to all credentialed nutrition practitioners regardless of role, area of practice, or setting:

1. Ethics and Professionalism
2. Communications
3. Leadership and Advocacy
4. Critical Thinking and Decision Making
5. Informatics
6. Research, Evidence-Informed Practice and Quality Improvement
7. Safety and Risk Management
8. Food, Nutrition, Dietetics and Physical Activity
9. Education and Counseling

5 functional essential practice competencies that describe the role-specific knowledge, skills, judgment and attitudes needed for a particular practice focus.

1. Clinical Care
2. Business, Industry and Product Development and Marketing
3. Community and Population Health
4. Foodservice Management
5. Organization Management

The 14 spheres are further divided into 55 practice competencies for RDNs and 50 practice competencies for NDTRs. Finally, there are 352 performance indicators for RDNs and 271 performance indicators for NDTRs.CDR used a 7-step process to develop the competencies, beginning with a literature review and global environmental scan of nutrition and dietetics competencies, and included a national validation study of the essential practice competencies by credentialed nutrition and dietetics practitioners to validate the relevance of the competencies and performance indicators.How do the new competencies work in practice?CDR developed a new, 3-step process to develop a professional development plan for continuing education:

1. Create a learning plan
2. Use an activity log to track learning
3. Evaluate the learning activities

A primary feature of this process is the online, interactive Goal Wizard. The Goal Wizard is the cornerstone for creating a learning plan, asking a series of questions based on practice status, daily professional activities, and current and future learning needs to develop an Individual Practice Competency Profile.Once the Profile is developed, the practitioner chooses performance indicators that relate to each competency to create a learning plan that reflects current practice needs and goals. Steps 2 and 3 are carried out during the 5-year certification period.Simulation Tool: The Dream WizardThe Dream Wizard is a demo version of the Goal Wizard, which gives practitioners an opportunity to try out the new process without committing to a learning plan. I spent 15 minutes using the Dream Wizard, identifying 35 different competencies that I currently need in my practice.The next step is to select competencies that reflect current or future learning needs for the next 5 years, selecting at least one competency to add to the learning plan as a goal. In addition, every practitioner is required to select at least one competency from the Ethics and Professionalism sphere. There is no upper limit on the number of competencies a practitioner may select.After choosing competencies for the learning plan, the next step is to identify specific performance indicators for each competency. In this new system, performance indicators replace the learning need codes used previously. After a total of 30 minutes, I completed a demo learning plan with 11 competencies.Reflections on using the new competency systemAmy McAllister, MA, RDN, LDN, CDOE, Director, Product Management & Clinical Development, Prevention at Optum recently started the new PDP recertification process, which she found somewhat confusing. After using the Goal Wizard and refining her practice goals, she still is not confident that the learning plan reflects her continuing education needs. While her primary role revolves around leadership and includes competencies such as “collaborates with others to achieve common goals and to optimize delivery of services,” “applies principles of project management to achieve goals and objectives”, and “demonstrates sound professional judgement and strategic thinking in practice”, McAllister is concerned that her PDP does not include competencies for clinical expertise that are crucial to her role at Optum. McAllister understands that CDR intends the PDP process to be fluid so that each practitioner has the ability to refine and change the PDP as needed to reflect career changes or changes in education needs and will update and refine her plan as she puts it into use.Lacie Peterson, MS, RD, CDE, Clinical Assistant Professor, Dietetic Internship Program at Utah State University also started the new PDP process. One of the major changes is some of the new terminology that is used, and she recommends reviewing the resources at https://www.cdrnet.org/competencies-for-practitioners before beginning the process. Peterson felt that originally she had too many performance indicators and revised her plan to end up with about 10 main competencies and 1-2 performance indicators for each section. She teaches a short lecture to her students on using the PDP, suggesting they focus competencies and performance indicators on the upcoming 2-3 years and also be ready to revise the objectives when career directions or opportunities change.The new competency-based recertification is designed to meet the needs of two different groups: credentialed nutrition professionals and stakeholders including employers, accreditation bodies, and the public. The competencies are expected to guide professional development and assist practitioners in career progression as well as communicate the numerous roles of nutrition practitioners and their professional competence. Just as nutrition guidelines and recommendations are regularly updated based on the most current scientific research, nutrition professionals must also be prepared to revise and update professional development standards and procedures.If you want to update your credentials, consider one of our online classes!References

1. Commission on Dietetic Registration. Essential Practice Competencies for the Commission on Dietetic Registration’s Credentialed Nutrition and Dietetics Practitioners. https://admin.cdrnet.org/vault/2459/web/files/final-cdr_competency.pdf Accessed 3-6-17
2. Commission on Dietetic Registration. CDR’s 2013 FNCE presentation: Introducing Practice Competencies. https://www.cdrnet.org/cdr-competencies-presentation Accessed 3-6-17
3. Commission on Dietetic Registration. PDP Featuring Essential Practice Competencies Tutorial Presentation. https://www.cdrnet.org/competencies-tutorial-presentation Accessed 3-6-17
4. Commission on Dietetic Registration. Professional Development Portfolio Guide with Essential Practice Competencies. https://www.cdrnet.org/pdp-guide-featuring-essential-practice-competencies Accessed 3-6-17
5. Commission on Dietetic Registration. The Dream Wizard: A Demo Version of the Goal Wizard Tool. https://secure.eatright.org/CGI-BIN/lansaweb?wam=DW3000&webrtn=entrywr&ml=LANSA:XHTML&part=PRD&lang=ENG Accessed 3-8-17
6. Commission on Dietetic Registration. Frequently Asked Questions (FAQ) about the Professional Development Portfolio (PDP) https://admin.cdrnet.org/vault/2459/web/files/Competencies%20FAQ.pdf accessed 3-6-17

 Article written by Lynn Grieger, RDN, CDE, CPT, CHWC