Systems Thinking and Sustainable Food Systems in Dietetics Education: A Survey of Directors.

BACKGROUND: Systems thinking is recommended, but not required, for teaching food and water system sustainability in nutrition and dietetics education. OBJECTIVE: This study investigated systems thinking and sustainable, resilient, and healthy food and water systems (SRHFWS) in nutrition and dietetics programs. It examined program directors' practices, values, attitudes, confidence levels, and the relationships between systems thinking, teaching SRHFWS topics, confidence levels, and years of experience as a dietitian and program director. DESIGN: Conducted in September 2022, the study used a descriptive design with a validated 20-item Systems Thinking Scale (STS) and a researcher-designed survey with 1-5 Likert-type scales. PARTICIPANTS/SETTING: The online survey was distributed to 611 Accreditation Council for Education in Nutrition and Dietetics (ACEND) program directors, with a 27% (n=163) response. STATISTICAL ANALYSIS: Descriptive statistics (frequency, mean, standard deviation) were calculated using Excel. Inferential statistics were examined using R. ANOVA was used to compare experience as RDN and experience as a program director to confidence levels in teaching each SRHFWS topic. Linear regression was used determine the relationship between total STS score and demographic and programmatic variables. RESULTS: Seventy-seven percent of program directors scored high on the STS (mean score 65.2, on a 0-80 scale, SD 8.4), and more than 85% of directors agreed including systems thinking in dietetics was important. However, only 32.1% reported teaching systems thinking. Less than half of program directors agreed systems thinking was adequately addressed in ACEND standards, and nearly 80% of program directors agreed there was room to strengthen systems thinking content. Directors neither agreed nor disagreed there are adequate ACEND standards addressing SRHFWS and reported SRHFWS topics were inconsistently taught. Confidence levels were lowest for teaching economic and environmental topics. Awareness and use of resources developed by the Academy of Nutrition and Dietetics Foundation was low. CONCLUSIONS: Integration of systems thinking in nutrition and dietetics education presents promising opportunities to address complexity in the field. Applying systems thinking to teach SRHFWS may narrow the disparity between educators' perceived importance and program coverage. Enhancing program directors' awareness and utilization of Foundation resources and improved alignment between practice standards and accreditation standards may empower program directors to use systems thinking to teach sustainability-related challenges in nutrition and dietetics.

South Africa celebrates 15 years of clinical associates.

ABSTRACT: Clinical associates (ClinAs) in South Africa are modeled after physician associates in the United States and the Netherlands and clinical officers elsewhere in Africa. The first ClinAs began their education in 2008 and started working in 2011. Three universities offer a 3-year bachelor of clinical medical practice degree. This article documents the nascent healthcare profession's origins, development, current status, and future. In the next decade, South Africa needs to address the challenges of ClinA supervision with tiered practice regulations, combat unemployment, and increase graduate retention by developing career paths.

Curricula Mapping of Physician Associate/Physician Assistant-Comparable Professions Worldwide Using the Learning Opportunities, Objectives, and Outcomes Platform.

ABSTRACT: Given the international growth of physician associate/physician assistant (PA) and PA-comparable professions, it is crucial to understand the educational curricula of PA/PA-comparable professions worldwide. This article provides an overview of the process and development of the PA/PA-comparable curricula mapping design applying an international framework. It uses an innovative web-based tool, the Learning Opportunities, Objectives, and Outcomes Platform (LOOOP), to map and evaluate course content, teaching strategies, assessment formats, and learning outcomes. It highlights the project's rationale, challenges, and future implications.

Assessing Youth Safety Knowledge through the Agriculture Experience Tracker (AET).

The purpose of this study was to assess high school agricultural education youth safety knowledge. The target population consisted of high school agricultural education youth, ages 14-19 years, who were enrolled in School Based Agricultural Education programs that utilized the AET agricultural safety exam feature between the dates of May 2019 and June 2020 (N=1478). The safety knowledge questions were randomly generated from the National Safe Tractor and Machinery Operation Program instructor curriculum resources. The exam consisted of 50 multiple-choice and true/false questions with one point being awarded for each correct answer and covered topics such as safety basics, agricultural hazards, tractors, connecting and using implements with tractors and materials handling. The majority of respondents were male (n = 865, 58.5%); and in eleventh grade, twelve grade, or beyond high school (33.8%, 34.3%, and 22.9% respectively). Most respondents indicated they were from a rural area (52.5%), and most had not received formal safety training (74.4%). Test scores for the 1478 respondents ranged from a minimum of 4 to a maximum of 98. Within each independent variable, test scores averaged in the low 60's with the exception of test scores from students in 8th, 9th, and 10th grade which averaged 78, 46, and 56 respectively. Research and continuous education are needed to influence the behaviors of young workers in agricultural settings.

Opinions of supervisors of clinical associates in South African district hospitals.

OBJECTIVE: To determine the opinions of supervising physicians about the introduction of clinical associates at South African district hospitals in 2012. METHODS: Twenty-four healthcare professionals in Gauteng and North West provinces were selected to participate in cross-sectional qualitative interviews exploring their opinions on the clinical practice of clinical associates, the effect of the new cadre, their achievements, and the concerns of the supervisors. The inductive content analysis process generated several themes. RESULTS: Three positive themes related to clinical associate practice were identified: professionalism, skill level, and efficiencies in patient management. Themes of concern included overtime and calls, writing prescriptions, and supervision. CONCLUSIONS: Interview results highlighted acceptance and appreciation for the introduction of clinical associates. Baseline opinions enhanced curriculum development and will inform further research on the effect of clinical associates on healthcare delivery in South Africa.

Effectiveness of Utilizing an Evidence Based Safety Curriculum to Increase Student Knowledge.

The purpose of this study was to determine the effectiveness of utilizing an evidence based, "Train the Trainer" approach to increase the safety knowledge and awareness of secondary students. Participating teachers attended a 10-hour, inquiry-based summer training workshop utilizing National Safe Tractor and Machinery Operations Program (NSTMOP) materials focusing on roll-over protection structures, mini-tilt table construction, and on-farm tractor risk assessments. Teachers incorporated workshop lessons into existing curricula. Students completed pretests prior to instruction and posttests after instructional units were delivered. A total of 118 students provided completed pre- and posttests, with most students identifying as male and more than half enrolled in ninth grade. Wilcoxon Sign-Rank test showed students' posttests were statistically significantly (Z =-5.22, p < .001) higher than pre-tests. Student performance in this study suggests the Fair Labor Standards Act exemption provided for youth between the ages of 14 and 15 years old who have completed specific safety training needs to be revisited. Additionally, increasing the age restriction for hazardous occupations in agriculture would be consistent with other industries. In order for students to learn agricultural safety in the classroom setting, teachers participating in this study may consider preparation and continuing education programs that incorporate more production-based experiences focused on safety.

Clinical Associate students' perception of the educational environment at the University of the Witwatersrand, Johannesburg.

BACKGROUND: An important determinant of a student's behaviour and performance is the school's teaching and learning environment. Evaluation of such an environment can explore methods to improve educational curricula and academic atmosphere. AIM: To evaluate the educational environment of the Bachelor of Clinical Medicine Practice programme as perceived by students at the University of the Witwatersrand, South Africa. SETTING: This cross-sectional study was conducted with all final-year students (n = 25) enrolled in 2011, with a response rate of 88% (n = 22). Students were in two groups based in the Gauteng and North-West provinces. METHODS: Data were collected using the Dundee Ready Educational Environmental Measure questionnaire, which was administered to all students. Total and mean scores for all questions were calculated for both groups. RESULTS: The learning environment was given an average score of 130/196 by the students. Individual subscales show that 'Academic self-perception' was rated the highest (25/32), whilst 'Social self-perception' had the lowest score (13/24). Positive aspects of the academic climate included: student competence and confidence development; student participation in class; constructive criticism provided; empathy in medical profession; and friendships created. Areas for improvement included: feedback provision to students; course time-tables; ensure non-stressful course; provision of good support systems for students; and social life improvement. CONCLUSION: Students' perceptions of their learning environment were 'more positive' than negative. Results from this study will be used to draw lessons for improving the curriculum and learning environment, improve administrative processes and develop student support mechanisms in order to improve their academic experience.