Important Information For All Students Taking Online Courses

Syllabus

Course Description:

Both the general public and health care practitioners alike are beset with a flood of nutrition information claiming the benefits of foods, supplements, products and services that promote better overall health and address disease. The challenge for the nutritionist is to critically appraise the nutrition literature and make patient decisions based on the most valid evidence available. Using sample clinical scenarios, this course will introduce the concepts and skills employed in Evidence-Based Nutrition practice. Students with be provided the critical skills to locate online scientific/medical information, as well as evaluate the quality of the research methodologies and statistical analyses reported out in the literature. This course is aimed at the practitioner, not researcher.

Students will be required to master the University of Bridgeport ExLibris search engine and peer reviewed licensed databases. Websites alone, and personal journal subscriptions, cannot be substituted for database assignments.

Students are encouraged to use the Discussion Board to share their thoughts and observations with colleagues. While some assignments are submitted to the Discussion board, the Instructors will not routinely monitor the dialog between classmates. Students are encouraged to contact either of the instructors Diane Mirvis or Andrea Sicari via email to ask specific questions or schedule telephone office hours.

Required Readings:

All Required readings are available either in Blackboard, either as excerpts from books, article reprints, PowerPoint presentations, or via links to electronic books in the Ebrary database accessible via the University of Bridgeport Wahlstrom Library website. All materials are free. Students must use their UBnet Id to access the Library databases from the first week of class.

Note that there are several digital books in Ebrary both on the topics of epidemiology and nutrition that may be useful for the student as a general reference source.

Learning Objectives:

· Acquire general knowledge of historical and current issues in nutritional epidemiology.

· Understand the Evidence – based Nutrition (EBN) approach to reading reports on nutritional studies.

· Exercise critical thinking skills to apply 5 step process of Evidence Based Nutrition.

· Be able to frame background and foreground clinical queries using the PICO form.

· Demonstrate skills in selecting and searching the appropriate online resources to perform effective searches.

· Utilize the EBN Critical Appraisal checklists to evaluate relevance and validity of articles and other resource materials.

· Gain a basic understanding of selected statistical functions required to critically appraise the literature using established checklists.

· Develop a framework of ethical and legal application of nutritional research in daily practice.

· Initiate a life long commitment to inquiry and searching out the best possible evidence for patient decisions.

Assessment:

Each student will explore a research topic that has been selected for its current importance in the nutritional literature. The Final Project will be to produce an answer to a hypothetical patient issue through evaluation of the existing research based on critical evaluation using Evidence Based Nutrition (EBN) techniques. He/she will be required to submit exercises during the semester to demonstrate competencies in each of the above areas. Assignments will reflect critical thinking and problem solving, not memorization or multiple test questions.

Exercises must be submitted on date required or the instructor will deduct points. Students with a valid reason may contact the instructor to request an extension. When uploading to the Digital DropBox in BlackBoard students will see a message with a date and time stamp if their submission is successful. Further instructions on how to upload a file can be found in the Course Documents. It is the student’s responsibility to contact the instructor immediately if they do not receive notification of successful submission.

File Naming Conventions:

When sending emails include the following information in the subject line: Nutr 560M (section A or B)

All written assignments must be submitted using MS word v. 2003-2007 and will contain a header with the student’s name, assignment number, component part

E.g. Sicari, Andrea, Assignment 4, Checklist 1 of 2

Drop Box File Naming Conventions:

Because the Digital DropBox does not allow you to place characters such as _-+%# etc. in your filename, there will be the following naming convention:

Last name, First name, Assignment Number, and Part

E.g. Sicari, Andrea, Assignment 4, Checklist 1 of 2

The Final Grade will consist of:

Assignments

1. Essay: Reflection on historical role versus current value of nutritional epidemiology, addressing specific points made in each of selected readings. 4%

2. Introduction in Discussion Board. 2%

3. Formulation of 1 Background Question and 1 Foreground Question using PICO form. 20%

4. Search of all relevant research sources. 30%

5. Comment in Discussion Board on Searching. 2%

6. Critical appraisal of key articles using EBN checklists 30%

7. Comment in Discussion Board on experience in using Critical Appraisal Checklists. 2%

8. Summarization of selected “gold standard” article into Critically Appraised Topic format (CAT) that answers patient question.

· Evaluating the applicability of the EBN standards to your patient final project topic (answering questions involving the CAT Bank Process and Steps 4&5 of the EBN) Post to Discussion Board 10%

Course Schedule:

1. 3.17.08

Introduction to Nutritional Epidemiology

Readings:

· “Nutritional Epidemiology: past, present, future”

· “Nutritional Epidemiology Issues in Chronic Disease at the Turn of the Century”

· “Good Calories, Bad Calories” from a scientific journalist

· “Food For Thought IV: A report from the Nation’s Media

The above readings all address the scientific strength of research into the impact of nutrition on general health and disease. Each article is written from a different point of view.

Submit to Digital Dropbox:

· Identify 3 important themes/points to compare and contrast, and discuss and summarize the views on these topics from all 4 authors. Make sure you cite from all 4 articles for each of the themes. 1 of the 3 themes must be on the future of nutritional epidemiology.

· How do you think knowledge of nutritional epidemiology will impact your professional practice?

Submit using MS Word, single spaced, Verdana 10 pt. font, 2 pages.

2. Submit to Discussion Board:

Sign on to discussion Board and introduce yourself. Please mention your profession, and whether you have had any previous course work in evidence based practice.

DUE: 3.24.08

3. 3.24.08 & 3.31.08

Knowing when and how to ask questions for best patient care

Readings:

· “Evidence – Based Nutrition, an Overview” slides 1-13. Mirvis

· www.iebn.org/aboutus.htm

· “How to Read a Paper” pp. 1-11 in Ebrary

· PICO Form

· “Evidence Based Medicine Toolkit” pp. 1-4 in Ebrary

Assignment:

Select a Patient Scenario from the Final Project Topic List. This will serve as a hypothetical patient encounter, and will serve as the basis for all the problem based activities you must master for this course.

Submit to Digital Dropbox:

· 1 background question using the PICO Form

· 1 foreground question using the PICO Form. Remember to include all variant terms needed to closely reflect your patient characteristics, outcome results that will help in supplying terms needed to search the online resources.

DUE: 4.7.08

4. 4.7.08, 4.14.08, 4.21.08, 4.28.08, & 5.5.08

Selecting and Searching the Appropriate Resources

Readings:

· “Evidence – Based Nutrition, an Overview” slides 14-29. Mirvis

· “How to Read a Paper” pp. 15-24 in Ebrary

· “Conducting Effective Searches” PowerPoint

Assignment:

Sign on to the UB Library website (make sure to sign in a second time on the UB Eureka homepage –the system will greet you by name if this is accessed correctly!). Using the terms suggested by your completed PICO Form, search all relevant databases on your research topic. Make sure you explore all databases the UB Library has available, including news artless found in Lexis/Nexis. Remember to search PubMed via the Library sign on – there will be more full text available. DO NOT USE WWW.PUBMED.ORG FOR THIS COURSE OR YOU WIL MISS FULL TEXT ARTICLES.

Once you have searched the licensed online databases of articles and e-books, search the catalog tab to explore the Library’s print book holdings. How valuable are they to you as Online learners? Then search other websites using Google, or reference print resources that you are familiar with, that you think may be useful.

If you get stuck on a how to use a particular search feature – contact either of the instructors, or one of the UB Librarians via phone 203.576.4747 or email!

Submit to Digital Dropbox Using Sample Search Form:

· List EACH database or site you explore – you must access a minimum of 6 databases. Include all UB database sources first, although you may add full text journals found on the Library website as well as other web based material in addition. For each, write down exactly the search terms you used, including any syntax (AND, OR, NOT, wild cards, parens, quotes, etc.)

· For each, write down the total of citations retrieved. This is known as “recall”. Count those that you think were relevant to your exact patient need. This is known as “precision”. Divide the Precision by total recall and calculate the percentage for each search. The Higher the percentage, the more effective the search OR the most indicative of the amount of published research relevant to your topic. Make sure to indicate if a source had no citations retrieved, and/or had no relevant citations.

· List the databases/sources that were most useful, the ones that were least.

· Make sure to use PubMed “Clinical Queries” feature in the blue column at left of website..

· Retrieve full text of no more than 6 most relevant citations for your exact patient PICO. Supply full, complete citations of the full text articles for the instructor to read.

5. Submit to Discussion Board:

Share your experience in searching the databases by supplying 3 tips you can share with your classmates that will help them search more successfully.

DUE: 5.12.08

6. 5.12.08, 5.19.08, 5.26.08, 6.2.08 & 6.9.08

Evaluating the information:

· Overview of Study Designs, with particular emphasis on problems of causality and other limitations for nutritional research

· Levels of Evidence

· Evidence Based Guidelines

· Using EBN Critical Appraisal Checklists

· Basic statistics used for Evaluation Checklists

Readings:

· “Evidence – Based Nutrition, an Overview” slides 30 -40. Mirvis

· “Risks and Benefits: Harvard’s Walter C. Willett on Epidemiology”

· “Nutritional Epidemiology: What is Important? How is it Important?”

· “Nutritional Epidemiology” Possibilities and Limitations”

· “Causal criteria in nutritional epidemiology”

· “Evidence-based Nutrition Practice Guidelines

· Basic Epidemiology Chapters 3,4, & 5

o Background on types of studies, basic statistics, and causality

· www.cebm.net (Good , general resource)

· Checklists For Assignment:

www.gla.ac.uk/departments/generalpractice/ca_check.htm

Assignment:

Read all the above reference materials to help you master the evaluation step of EBN. The readings on nutritional epidemiology specifically highlight the challenges this field represents for scientific research and reporting. Then select 4 of the articles/books/other information that you retrieved from your search and critically appraise the validity of the information contained. Use the correct type of the Critical Appraisal Checklists from the University of Glasgow, and fill in the form to the best of your ability. You must limit yourself to only 1 Manufacturer’s insert if you are basing your clinical advice on this format. Use the guideline found in T. Greenlaugh’s book for this particular Checklist.

Submit to Digital Dropbox:

· 2 completed Checklists for the most important articles found in your research. This exercise is designed to test your ability to use the Checklist process.

· How would you Grade the research recommendation found in each article using the Oxford Guidelines Grading of A – D found in the EBN PowerPoint presentation on slide 37? Grade each of the 4 Checklist articles/other information.

7. Submit to Discussion Board:

What was your experience using the Critical Appraisal Checklists?

DUE: 6.16.08

8. 6.16.08 & 6.23.08

Applying the results to your patient.

Summarizing the results of the “gold standard” article in a Critically Appraised Topic Format (CAT)

Readings:

· “Evidence – Based Nutrition, an Overview” slides 41-46. Mirvis

· http://ebm.bmj.com/cgi/reprint/6/3/70.pdf

Assignment:

· Following directions on “Evidence – Based Nutrition, an Overview” slide 44, select 1 of the most relevant article that best answers research topic for your Project. Try to limit yourself to no ore than 3 if you feel more than 1 is a “gold standard”.

Submit to Discussion Board:

· Answer questions raised on slide 44. Do you think, based on the research evaluation for this topic, that you can ethically/legally advise your patient in agreement with this recommendation

Submit:

· 1 – 2 page CAT.

· Brief answers to questions on slide 44.

· Evaluating your own grasp of the EBN process: Reflect back on which steps provided you with challenges, which issues you find difficult to perform. This section is not graded.

DUE: 6.30.08