CDBC January 2019 Quality Assurance Newsletter

CDBC Quality Assurance Update – January 2019

This update includes information on the following items:

Quality Assurance Program Framework

Nutrigenomics

Quality Assurance

Program Framework

The CDBC is introducing an updated Quality Assurance Program Framework to further define its quality assurance strategy as part of the duty to “ establish and maintain a continuing competency program to promote high practice standards amongst registrants ” under the Health Professions Act (section 16(2)(e)).

The framework outlines the authority, mandate and objective of the quality assurance program and explains program elements and processes for the Continuing Competence Program, randomized audit of Professional Development Plans and new assessment processes permitted in the CDBC bylaws (sections 56(3)(c) and 58). The framework aims to provide a fair and standardized process for registrants struggling with their submissions while ensuring the CBDC can provide support and proactive measures to correct identified issues.

New components of the

framework include:

Review of CCP submissions by the Quality Assurance Committee after two failed attempts* at meeting the assessment criteria

Review by the Quality Assurance Committee of evidence of continuing education completion (e.g., portfolio, conference attendance certificate) and a third CCP submission to meet the assessment criteria

In the event of a third failed CCP submission and/or failure to provide evidence of continuing education completion, referral to a competence assessment process (includes a scored assessment and a competence-based panel interview) and,

Remediation work** (e.g., readings, course work and mentorship) in collaboration with the QA Committee and College staff if competency gaps are identified in the competence assessment process.

* Missing entries or other technical errors will not be accounted as failed attempts

**Remediation as part of this framework is distinct from remediation required by the Inquiry Committee.

The framework has been approved by the CDBC Board and will take effect in 2019-2020. The 2020 CCP group will be the first cohort to be reviewed under the new framework. If you’d like to know if this new framework will apply to your next CCP submission, you may find your CCP group by signing into your CDBC account and accessing the Continuing Competence Program from Online Services. Select Self-Assessment or Professional Development Plan to view your CCP information at the top of the page.

Nutrigenomics

Nutrigenomics (also referred to as nutrigenetics or nutritional genetics) may be defined as a subspecialty of nutrition science, studying how genome-diet interactions influence individuals’ and populations’ response to food, disease susceptibility, and population health.

Although the term technically refers to the influence nutrients have on genome expression, it may also refer to how a person’s genome affects the way their body reacts to certain foods when consumed (*see references below).

A nutrigenomic test typically requires a sample of saliva from which the genome is analyzed for specific genetic markers. These markers may indicate how a person responds to certain nutrients and their risk of nutrition-related chronic disease through identifying what variant of a gene they have. An example of this would be identifying which gene variant the client may have for responding to caffeine they ingest through diet (*references 3 and 4).

Nutrigenomics falls within the scope of practice of a Dietitian as it involves the collection of information on how individual genetic variations may affect a person’s response to food and examining how the interaction between genes and food can positively influence health outcomes. Generally, a Nutrigenomics lab will send genetic testing results to the Dietitian who can then discuss the results and appropriate dietary modifications with their client.

Nutrigenomics may be part of the assessment of the Dietitian and impact the design of the individual care plan. As for any new or emerging practice, Dietitians should refer to the Decision Tool for New Aspects of Dietetic Practice and decide if nutritional genetic testing is relevant in their practice and clinically useful for their client.

For example, the Decision Tool may be used to determine if nutrigenomic testing is an appropriate resource to inform a client’s dietary needs and if the administration of the test by a Dietitian is consistent with their responsibilities under the CDBC Bylaws, Code of Ethics and Standards of Practice. The CDBC also prepared a Q&A and helpful resources to support Dietitians with evidence-based information on nutrigenomics.

The College encourages Dietitians to consider emerging nutrition care approaches and trends with an evidence-informed lens and in consideration of the legislated dietetic scope of practice, bylaws, code of ethics and standards of practice.

*References

1. Camp, KM and Trujillo, E. Position of the Academy of Nutrition and Dietetics: Nutritional Genomics. Journal of the Academy of Nutrition and Dietetics. 2014; 114(2): 299-312.

2. College of Dietitians of Alberta. Nutrigenomics in Dietetic Practice: College of Dietitians of Alberta Position Statement . 2015.

3. College of Dietitians of Ontario. Keeping Pace with Innovations in Care . Résumé. 2014; accessed September 24, 2018

4. Dietitians of Canada. Learning on Demand. Nutrigenomics: Genetic Testing for Personalized Nutrition ; accessed July 30, 2018.

5. Ordre Professionnel des Diététistes du Québec. L’utilisation de la nutrigénomique et de ses tests par les professionnels de la santé [French]. 2016.

Please contact Mélanie Journoud, Deputy Registrar - Quality Assurance,

if you have any questions about items in this Update.

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