Web - Based System for Training of Medical Doctors and Students in Nutrition

EDU NUTRI MED

GUIDE BOOK

for users

WEB - BASED SYSTEM FOR TRAINING OF MEDICAL DOCTORS AND STUDENTS IN NUTRITION

LEONARDO DA VINCI

ESPEN

C O T E N T S

I. “Edu Nutri Med “ system

1. Aims2

2. Objectives2

3. Training approaches2

4. Advantages of Web - based education2

5. Advantages of “Edu Nutri Med “ system3

6. Entries of the system3

II. Training content

1. Introductory Nutrition 3

2. Clinical Aspects of Nutrition 4

III. Learning steps:

1. Rules for applying and admission4

2. How to start5

3. Study approach5

- Traditional approach5

- Problem basedapproach5

4. Description of Module menu6

5. How to use a Module6

6. How to prepare portfolio7

7. Description of Clinical case Menu7

8. General information about Complementary Practical Courses

- List of the courses8

- Benefits of Practical courses8

9. Rules for Credit accumulation and procedure

10. Rules for Certification9

IV. Training Programme “ЕDU NUTRI MED”9

V. General Module content

- Basic Concepts in Nutrition13

- Diet and health19

VI. Clinical case content23

VII. Example of Clinical case: Stenosis pylori Gastrectomia25

VIII. Example of Portfolio27

IX. Subscription Form for admission and certification28

WEB - BASED SYSTEM FOR TRAINING OF MEDICAL DOCTORS AND STUDENTS IN NUTRITION

“ЕDU NUTRI MED”

Web - based training in Nutrition “Edu Nutri Med“ is a semi-virtual system using both on-line and real time courses

Web - based training is non-formal, flexible form of education important for life - long learning and Continuing Medical Education (CME)

The system aims at improving competence and skills of health related professionals in clinical nutrition

It is developed by the European university network and ESPEN with support of the EU Leonardo da Vinci program

The system provides creditsand certificates for Continuous Medical Education,European Diploma in nutrition and im future Masters program

Internet address:

Partners “ЕDU NUTRI MED”:

MEDICAL UNIVERSITY, PLEVEN, BULGARIA

Prof. R. Komsa-Penkova

NUTRISUB ASBL, ULB, BRUSSELS, BELGIUM

Prof. Y. A. Carpentier

CHARLES UNIVERSITY, PRAGUE, CZECH REPUBLIC

Prof. L. Sobotka

RF-WUNIVERSITÄT, BONN, GERMANY

Prof. W. Breipohl

EUROPEAN SOCIETY FOR CLINICAL NUTRITION AND METABOLISM

Prof. C. Pichard

ALLIANCE ‘ HEALTH IN OURHANDS, BULGARIA

As. Prof. K. Kovacheva

MEDICALUNIVERSITY, SOFIA, BULGARIA

Prof. N. Trifonova

I.“Edu Nutri Med“ system

1. Aims:

Providing an opportunity to physicians, specialists and students to acquire new competences and skills in general and clinical nutrition.
Encouraging the application of effective nutrition to promote the treatment of disease and better health.
Facilitating life-long learning.

2. Objectives:

Improve skills for practical management of nutritional support.
Ameliorate knowledge of nutrition as a preventive and curative measure.
Give tools to interpret new scientific information on disease mechanism and link with nutrition.
Provide new knowledge of a link between genetic predisposition and nutrition.

3. Training approaches:

Individual planning and Portfolio development: Individual list of modules, practical courses, lectures, consultations and tests
Individual tutoring
Case study approach and Problem-Based Learning
Access to new educational technologies: computer based learning, Web tutorial; on-line curricula, interactive learning
Self-training under individual plan: preparing reports, cases etc.

4. Advantages of Web - based education:

Web - based training is a transnational form of education in accordance with a policy of globalization in Europe
Web - based training is non-formal, flexible form of education important for life - long learning and Continuing Medical Education (CME)
Web - based system provides world wide access for training

5. Advantages of “Edu Nutri Med“ system:

European educational curriculum on nutrition developed by European university network
Innovative training methods
Individualized portfolio - based program and approach
Modules assigned with credits organized in specific curricula
Case study based approach with elements of problem-based learning
Complementary courses at partners’ universities and under ESPEN initiative
Forum for open discussion on hot topics and special cases in nutrition

6. Entries of the system:

The WEB system is organized with several entries: Study Navigator, Learning steps, Modules and Clinical cases.

Study Navigator guides through the system and explains the application and training procedure, module layout and description of its components, the rules for registration, application and certification.

Learning steps proposes in detail the methodology and content of the system. This entry allows starting a programme, explains system strategy, rules for preparation of individual portfolio and study program. It also provides links to modules and clinical cases as well as possibilities for communication with tutors and administrators.

Study Navigator: Study guide and Learning steps

Subscription: Rules and procedure for registration

Modules and Clinical cases: Educational content

Communication: Forum, access to tutors, experts and other users

Certification: Rules and procedures explaining evaluation, credit assigning, accumulation and certification

II.Training content

1. Introductory Nutrition

Basic Concepts in Nutrition

Nutritional Physiology and Biochemistry

Metabolism of Macronutrients

Metabolism of Vitamins and Micronutrients

Nutritional Requirements, Assessment and Support

Nutrition throughout Life Span

Nutrition and Public Health

Nutrigenomics

Economics of Nutrition

Analytical Methods

2. Clinical Aspects of Nutrition

Prevention of Chronic diseases- Diet and Health

Nutritional Disbalance

Substrates Used in Parenteral and Enteral Nutrition

Techniques of Nutritional Support. Enteral Nutrition

Techniques of Nutritional Support. Parenteral Nutrition

Nutritional Support in Critically Ill Patients

Nutritional Support in Patientswith Chronic Diseases

Nutrition and Cancer

Exposure to Toxic Environment

Nutrition, Alcohol and Drug Abuse

The Eating Disorder Continuum

Endocrine Diseases

Nutrition in Disorders of Metabolism

III. Learning steps:

1. Rules for applying and admission:

Eligibility:Medical Doctor and students; Health Related Professionals

No age or geographic limitation

Working language:English

Two application levels are available:

To Register for Free Access Complete the Registration Form
To Subscribe for Full Access and certification complete the Subscription Form and Gain: “Module Certificate” for Continuous Medical Education and/or “Diploma in Clinical Nutrition“

After submitting of the Subscription Form you will receive the complete study guide and personalized contact to your tutor.

2. How to start:

Register or subscribe
Go to the Module Menu
Go to the Clinical Cases Menu
Communicate with a tutor (after subscription only)
Chose your way of study: traditional or problem - basedapproach
Prepare your portfolio

Discuss with a tutor your selected modules, clinical cases and develop portfolio: schedule, individual training program and tasks, make a schedule for certification and credit accumulation

3. Study approach

Traditional approach:

Application
Tutor assignment
Going through Module menu and module selection
Going through Module general rules to get acquainted with content, credits, training approaches and requirements for assessment.
Portfolio development – individual programme and individual approach
Training guided by tutor, expert and supervisor
To get the certificate you have to cover pass standards and to accumulate the credits needed for certification or diploma

Problem basedapproach

Application
Tutor assignment
Going through Clinical case menu and selection of cases that you have in your practice
Making a strategy to solve your problem
Portfolio development – individual programme (module selection) and individual approach
Training guided by tutor, expert and supervisor
To get the certificate you have to cover pass standards and to accumulate the credits needed for certification or diploma

4. Description of Module menu

Module menu contains selected modules on nutrition: introduction into nutritional science and clinical aspects of nutrition and health related problem. Modules contain presentation of theory, lectures, references to scientific sources, book chapters, reviews, reports and web links. To gain practical skills in nutritional assessment and management the modules are linked to proper clinical cases.

To assess the competence and skills of the students every module contains requirements for evaluation and assessment, which are proposed by the expert.

The main information on each module is available on – line and the students are expected to learn it by themselves. The questions/problems of student on theory and clinical cases could be discussed on line with a tutor (expert if there is a need), discussed on forum session, announced for specific problems, or at the real courses, which is organized by partners’ universities and under ESPEN initiatives.

Modules have several levels of competence and they are provided with tests for self-assessment.

The module are developed by experts and enriched by different training approaches: Problem solving, Case study, Trainers’ and learners’ presentations, Collaborative training, and Practical training, Consultation self-training.

Module selection depends on individual needs of an applicant/student. The general approach for selection is presented in “General approach for learning” and it is made on the basis of the clinical cases which applicant/student used to have in his everyday practice. In this selection he is guided by an individual tutor.

After the module selection is made, the student guided by tutor described his portfolio from the modules, clinical cases and individual tasks, materials, links, schedule and venues.

5. How to use a Module

To start a module you have to open a mod.htm file, containing a Front-page of the module. Front page is divided into 3 parts,

Very left column is used for the content and links within the system.

The central part of the page contains the general information on the module.

On the right side there is the detail information on the modulepresented in the linked files.

The information in the module is presented on 3 different levels:

General information - first level is placed in the central part of the Front Page, it allows you to get acquainted with the module.

Second level – background reading is hyperlinked in the right column of the front-page. It is also obligatory reading if you want to certify your knowledge. We used Power point presentations and texts from European guidelines, book chapters, etc to prepare it.

There are also tests for each module.

Third level it is an advanced reading, it is hyperlinked in the same way as background reading, but it contains more detail information on each topic of the module. It provides the opportunity to go more in depth in the topic.

There is also an optional reading, where you can find information linked to the topic.

All that information is prepared in a way to produce easily a printable version.

6. How to prepare portfolio:

For traditional approach you go to ‘Modules’, select the modules according to topics of interest, contact your tutor, develop individual program of study, guided by tutor and start your training.

In case you prefer Problem Based Learning, you start with a problem of your patient.. From clinical case menu find similar clinical cases solved by experts in nutrition and benefit from the system, applying the same strategy in your practice.

Contact your tutor, develop individual program of study, guided by tutor and start your training.

7.Description of Clinical case Menu:

Clinical case menu:

The entry into a clinical case menu allows the applicant/student to have the immediate benefits from the system. The comparison of his personal clinical case with a corresponding clinical case solved by a specialist provides him the “know how” for his practice. In this way the applicant/student improves his skills for better management of nutritional problems of his patients. This methodology is very beneficial for physicians as they can apply the adequate strategy in specific clinical situations.

Once the student starts from a clinical case and solves it, he goes through similar cases to gain more information on the problem. Evidently, he still will not have proper skills to manage more complicated situation. He iscome convinced that he needs some theoretical knowledge that could be gained from modules’ information. The student could have much more benefits from the system if he completes the study by means of total Problem based approach:

After he enters the system he is assigned by and individual tutor who helps him to develop the strategy how to ameliorate his knowledge and skills, what information should be learned and which problems have to be solved.

Communication with a tutor allows the student to study at his own rhythm and interests under supervision of tutor and highly qualified experts. As the system is provided on the web, there are no communication barriers and problems. The applicant learns how the problem is solved by a specialist that allows him to solve a similar case from his clinical practice.

8. General information about Complementary Practical Courses

There are annual thematic satellite-conferences of ESPEN and courses organized at partners’ universities, covering main topics of WEB based system.

List of the courses

How to attend Complementary Practical Courses (go to Subscription and then registration for the course)

The entire curriculum is divided into several general topics, which is mainly covered at these courses in 4-5 years.

The program of the courses is announced in advance so that students will have the opportunity to choose the courses, to prepare themselves from on-line materials and then to participate actively in intensive training and certification at the courses.

Benefits of Practical courses: All the modules are divided into several general topics which are delivered at annual satellite-conference courses organized by ESPEN and at partners universities. All curriculum - main topics is covered at this courses in 4-5 years. The programme of the courses is announced one year in advance so that student will have the opportunity to prepare themselves on-line and the at the courses to participate in intensive training and certification.

9. Rules for Credit accumulation and procedure

The modules are assigned by credits that system provides you in case you cover module requirements.. Credit accumulation from different modules brings you the opportunity not only to collect the for CME in your country, but also to get European Diploma in Nutrition.

10. Rules for Certification:

Certification levels

Certificate for nutritional module with credits in national CME system

ESPEN diploma “Specialist in Clinical Nutrition”

Master degree in nutrition

Certification Methodology

Accumulative certification: collection of marks from tests, exams, student developed materials and others

Tests for continuous assessment of theory and clinical cases

Student prepared materials according to individual program: reports, research and clinical cases.

Attending Complementary Practical Courses

Final test

IV. Training Programme “ЕDU NUTRI MED”

Topics and Modules / ALL / Practical Courses / Оn-linelearning / Student developed materials / Final test
h / h / h / h
c / c / c / c

Basic Concepts in Nutrition

1800 / 120
I. Basic Concepts of Nutritional Science / 540 / 36
- Module 1 Principles of Nutritional Science / 90 / 6
- Module 2 Nutritional Physiology and Biochemistry / 180 / 12
- Module 3. Metabolism of Macronutrients / 90 / 6
- Module 4. Metabolism of Vitamins and Micronutrients
-Vitamin metabolism.
-Trace element metabolism.
-Water and electrolytes / 90 / 6
- Module 5. Nutritional Requirements, Assessmentand Support / 90 / 6
II. Nutrition throughout life span / 270 / 18
- Module 6.
Pregnancy, Infants and Nutrition / 90 / 6
- Module 7. Children and nutrition / 90 / 6
- Module 8
Nutritional support in the elderly / 90 / 6
III- Nutrition and Public Health / 270 / 18
- Module 9.
Nutrition and health / 90 / 6
- Module 10. Nutrition in different countries / 90 / 6
- Module 11. EU developing / 90 / 6
IV. Nutrigenomics / 270 / 18
- Module 12. Evolution of genomic versus food patterns / 90 / 6
- Module 13. Gene expression – nutrients / 90 / 6
- Module 14. Response to nutrients – gene polymorphism / 90 / 6
V. Economics of Nutrition / 90 / 6
- Module 15 Economics of Nutrition / 90 / 6
VI. Analytical Methods
Assessment of nutrients / 360 / 24
- Module 16. Assessment of nutrients / 90 / 6
- Module 17. Analytical Methods
Protein analysis / 90 / 6
- Module 18. Analytical Methods
Lipid analysis / 90 / 6
- Module 19. Analytical Methods
DNA analysis / 90 / 6
Diet and health
- / 1800 / 120
I. Prevention of chronic diseases- Diet and health / 300 / 20 / 3-ти
**
- Module 20. Obesity and Nutrition / 60 / 4
- Module 21. Nutritional support of diabetic patient / 60 / 4
- Module 22.
Cardiovascular problems and Nutrition / 60 / 4
- Module 23. Allergy and Nutrition / 60 / 4
- Module 24. Prevention of cancer diseases / 60 / 4
II. Techniques of Nutritional support / 360 / 24
-Module25Nutritional imbalance / 60 / 4
- Module26Substrates used in parenteral and enteral nutrition / 60 / 4
- Module 27.Parenteral nutrition / 60 / 4
- Module 28. . Enteral nutrition / 60 / 4
- Module 29. Nutritional support in critically ill patients
а) Trauma;b) Postoperative nutrition;c) Sepsis / 120 / 8
III. Nutritional support in patients with chronic diseases / 750 / 50
- Module 31. Renal diseases / 60 / 4
- Module 32. Cardiac and pulmonary diseases / 120 / 8
-Module 33.Endocrinedisorders
а) Obesity
b) Diabetes
c) Lipidemia / 120 / 8
- Module 34. Inflammatory bowel diseases / 60 / 4
- Module 35. Liver and pancreas disease / 120 / 8
- Module 36. Neurological diseases / 90 / 6
- Module 37. Nutritional support in AIDS / 60 / 4
- Module 38. Nutritional support in cancer / 120 / 8
IV. Exposure to Food contaminationtoxic environment / 300 / 20
- Module 39. Exposure to toxic environment
Technologies / 60 / 4
- Module 40. Production, quality control, storage / 60 / 4
- Module 41.
Modified food and genes / 30 / 2
- Module 42.
Nutrition and drug abuse
Metabolic disturbance in drug addiction / 90 / 6
- Module 43. Nutrition and alcohol / 60 / 4
V. The Eating Disorder Continuum / 90 / 6
- Module 44.Behavioral deviations and Nutrition. / 30 / 2
- Module 45. Bulimia / 30 / 2
- Module 46. Anorexia / 30 / 2

V. General Module content

Basic Concepts in Nutrition

Module I: Principles of Nutritional Science

Credit: 6

Module Dates and Venues:

Aim of the unit To give students an overview of nutrition as a science, the main principles of nutrition, the biological value of nutrients and food

Prior Knowledge: chemistry, biology

Methods of Training: Lectures 2 x 2hr; Practicals 2 x 3hr, self-training 6 hr, tutoring 2hr

Coordinator: Partner, Department, Prof

Lecturers:

Content: Historical review of nutrition. Fundamental concept of nutrition: trends in food consumption. Nutritional requirements. Major food sources. Biological value of nutrients. Diet and food, and nutrients. Interaction of nutrition with physical activity. Nutrition and its function in health and disorders of health.