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Nutritional Care for the High-Risk Infant APR

The Medical University of South Carolina's Advanced Practice Residency

The Department of Pediatrics and Division of Neonatology at the Medical University of South Carolina Children's Hospital are excited to introduce our new Advanced Practice Residency training program, "Nutritional Care for the High-Risk Infant" for Registered Dietitians (RDs) with at least 5 years of experience who are interested in high-risk infant nutrition.  It is a year-long, primarily distance-learning program that, at completion, will fulfill the 75 CPEUs required for a RD's 5-year recertification.


Introduced by the Academy of Nutrition and Dietetics (A.N.D.) Council on Future Practice in late 2013, an APR is a fairly new training pathway for RDs consisting of specific accreditation standards “to foster advance practice and to provide a career ladder for Registered Dietitians” as well as to “provide growth for the competent dietitian to achieve expert level status in the specific field of specialty”.  Our APR has been approved  by AND's Accreditation Council for Education in Nutrition and Dietetics (A.C.E.N.D.) as the first pediatric nutrition residency program in the country.
This program is NOT a dietetic internship designed to train for entry-level practice.  Rather, it is tailored to train practicing dietitians with multiple years of experience to achieve an "expert" level of knowledge and expertise in high-risk infant nutrition through the convenience of a primarily e-learning format.  



To provide an interprofessional, evidence-based, advanced practice training program that will teach residents to consistently provide expert nutritional care for high-risk infants through systematic clinical teaching, critical evaluation of research and application of potentially better practices to improve nutritional outcomes.

Program Goals:

Goal 1: To train proficient registered dietitians to become expert clinicians in the nutritional   management of the high-risk infant through the application of evidence-based practice

Goal 2:   To build advanced-practice leadership and interprofessional skills in the AP resident


Our APR is an interprofessional, evidence-based training program that will teach RD residents to consistently provide expert nutritional care for sick infants, with a concentration in neonatology, cardiology, and surgery.  RD residents will be taught by combining core clinical teaching with principles of research, critical analysis of research evidence, and quality improvement processes.  Using this approach, residents will learn to evaluate, develop, and improve clinical practices that will ultimately impact nutritional outcomes for high-risk infants.  The APR will include a comprehensive evidence-based curriculum, mentoring, and teaching from a select group of advanced practice and expert professionals at MUSC who will work closely with AP residents to support successful completion of all program curricular activities: didactic, supervised practice, and capstone work.  Additionally, each AP resident will have an identified mentor from his/her home facility who is also committed to providing guidance and oversight for their resident during the capstone portion of the APR.


All RD residents can continue to work in their home facility while enrolled in the APR as a distance, e-learning format is predominantly used for the didactic component of this program.  During the first six months, weekly didactic and program-focused sessions will be scheduled with the residents using Skype and Moodle (an e-classroom program).  The second six months will focus on capstone project completion which will be a research or quality improvement project completed at the resident's home facility.  All residents will be required to come to Charleston, SC for a 1-week, hands-on, supervised practicum during the first six months of the APR at MUSC.  The AP resident will also be required to present their capstone presentation via phone conference using WebCT or Skype. 

The APR will be offered twice a year, accepting up to 4 residents for each program session.


  • This APR program is one of the first "true" advanced practice pediatric training programs (as reviewed by ACEND).  Other similar pediatric traineeships focus on “building a foundation” in pediatric/neonatal nutrition versus “advancing the foundation” of a proficient dietitian.
  • As an innovative and comprehensive training program, not only will AP residents receive a "Certificate of Completion", their 5-year recertification requirement of 75 CPEUs will also be fulfilled at program completion, and contact hours may be also applied towards the 2,000 hour requirement for taking the CSP exam.
  • As a novel program, this APR plans to offer evidence-based training in specific areas not emphasized by other pediatric nutrition traineeships:  interprofessionalism, application of evidence-based medicine, and research.  In fact, MUSC’s growth and dedication to interprofessional education and collaborative care have opened doors for learning opportunities in clinical and research environments.  As such, this APR was able to easily integrate didactic and supervised training opportunities from many pediatric disciplines (medicine, pharmacy, nursing/lactation, occupational/speech therapies, and research) into its curriculum, making this APR uniquely different from other available programs.  
  • As a state-of-the-art program, this APR will offer multidimensional didactic training offerings through a mix of “tele-education” venues, such as live lecture and discussion activities, conferences, and journal clubs using Skype; and self-paced e-learning modules using Moodle.  
  • As a “true” APR program, this program requires a capstone project in the form of an IRB-approved research study and/or quality improvement project resulting in a submitted manuscript and professional presentation.
  • As an invested group of faculty, mentors, and teachers dedicated to creating a successful APR program, we plan to maintain contact with resident graduates up to two years post-program completion to assess the attainment of “advanced practice” expertise (i.e., contributions to leadership, interprofessionalism, and research).
  • Supporting MUSC’s commitment to interprofessionalism, our goal for the future is to provide a unique program that does not only consist of registered dietitians, but of other professions such as physicians, nurse practitioner students, and PharmD residents, who desire advanced-level training in the area of nutritional care for the high-risk infant.  Providing interprofessional training opportunities will enable residents to better learn from, with, and about each other.  The intent is to ensure that residents of this program develop a requisite set of interprofessional competencies that will enable them to function more effectively in health care delivery and biomedical research environments.

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