By : Kerri Schumacher

Love it or hate it, you have to admit social media is a widely used tool for marketing, influencing, branding, and grabbing attention. While much in social media goes unchecked, my internship experiences have taught me that dietitians have a responsibility to uphold. Some individuals and companies share an overwhelming amount of misinformation related to diet and health via social media every day. Open any social media platform and you will find erroneous information on diets, false interpretations of nutrition guidelines, and supplementation schemes. There are even some people who call themselves “nutritionists” who have no credible training and put out misinformation to the public. Unfortunately, many of these posts are not tagged “unreliable,” or “not true.” It is not always easy for those using these social media platforms to know what is credible. 

An emphasis on informatics at the UMD’s dietetic internship has allowed me the opportunity to complete various projects using technology, internet, and social media platforms. As I researched for credible information during these projects, I became aware of the issue of misinformation presented in social media. Many of my internship projects, such as constructing a website, compiling nutritional infographics with researched information, creating a professional LinkedIn account and posting for the internship’s social media accounts, are helping me hone my professional communication skills.  I am grateful that I will be a voice the public can turn to. I also appreciate the technology day lectures, which are given by dietitians who are skilled communicators. They are teaching me so many useful and interesting ways to connect with a variety of audiences. Perhaps the one that surprised me the most was a talk about connecting to certain audiences about nutrition via TikTok..

I have come to the conclusion that social media platforms can be more than what some call a “waste of time,” or a “mental break;” they can be “marketing tools on the go.” Some key tips and tools I have learned so far help me correctly use social media to foster my brand. I have mentioned some below because they are way too valuable not to share with you. Many dietitians share recipes, nutrition education and memes on social media. They even use social media to promote their private practices. If you are new to using social media professionally, or if you want to take your posts to the next level, here are a few tips that I learned. 

First, you must consider your audience and  gear your post to target them specifically. Answering, “Who is my audience?” will help you tailor your message to your desired audience. For example, if my post is about spin classes and the benefits of doing vigorous cardio/weight lifting, an older adult might not be as engaged considering they may or may not be able to perform that type of intense exercise anymore. Next, you will want to identify what you want your posts to accomplish– Are you trying to …inform, entertain, solve a problem, empower or relate to your audience? Each one of these sets a direct intention on your purpose of sharing, which you can then use to create what your post will look like and how the content is made. This encourages the thought process of keeping their engagement along with promoting your account.

Creating an engaging social media post is a good first step, but I have learned there is more to consider before posting. Each social media platform has ways to increase engagement. Knowing about a platform’s algorithm can help you boost your messages. Algorithms tend to look at views, comments, likes, and re-shares when internally ranking posts. There are so many strategic things you can do to influence if a platform promotes your posts that I can’t cover them all here. I will mention a couple important ones. Timing is definitely something to consider. If you post at a time when your followers are online and most active, you give yourself a better chance of getting more likes. Another common way to increase engagement is by using hashtags. For some platforms, you can add relevant hashtags to your post to reach people who are interested in your topic; how many hashtags you might use varies with each platform.

To get the most out of my social media accounts, I learned to gather analytic information. I use that analytical data to assess how well my targeting worked and make adjustments for future posts. Below is a picture to show what this looks like. This example shows the age range and gender that this specific account has reached. I can use this, and other analytical data, to see if I am reaching my target audience.

 Last but not least, you must consider research. Dietitians have a strong science background and are trained to discern between credible and questionable nutrition information. We must make our voices heard by providing quality nutrition information that counters false nutrition claims. The easiest way to make sure you are using credible recommendations is to go back to the source. Is the website a .gov, .org., or .edu? Does it correlate with the US. Dietary Guidelines for Americans or the Academy of Nutrition and Dietetics? Paying attention to where the information is coming from should be the top priority.

Each month, I have put these keys to social media success into practice by posting through the UMD Dietetic Intern Instagram and Twitter. I have included one of my previous posts along with the captions so you can see these tools in direct use. The first one refers to an infographic I made during my bariatric surgery rotation at INOVA. I was explaining “Tips for Healthy Grocery Shopping,” so that bariatric surgery patients could incorporate healthy eating habits at home. I was hearing how the changes they had to make to their diet in order to prep for surgery and become ready for post-op was becoming stressful for them. I thought grocery shopping tips would be a great starting point to gear their focus for preparing meals at home. My goal was to provide tips to keep them from becoming overwhelmed at the store. You can notice the use of the hashtags along the bottom as well. 

Right now, my content definitely varies on topics depending on my rotation or what I learn during a specific experience,  but it has come a long way since I started. In my opinion, it is important to mention and spike conversations on topics like these in order to make improvements for the future. It is crucial to not assume everything on the internet is true. I will now leave you with this:  I challenge you to find one post on Instagram and see if you can determine where the information came from. Ask yourself the right questions, dig deeper into the details, and keep your eyes open for next time.

How to Confidently Create Your Personal Brand in the Dietetics Field

By: Skylar Sites

Being halfway through my internship, I am understanding the importance of personal branding for my dietetics career. Personal branding is creating the perception of yourself, based on your abilities, experiences and achievements. It is a buzz phrase I heard often during college, but until the training I received in my internship, I didn’t fully grasp its value. We often get shy and feel uncomfortable when talking about building our personal brand because it seems like we are going to have to brag or sound self-centered. To some extent, this is true but building your personal brand is so much more than that, and it is imperative in the field of dietetics. Personal branding is useful in marketing yourself to potential employers.

During my undergraduate career, I created a LinkedIn profile as well as a personal website to apply to dietetic internship programs. I struggled with designing the website in a way that looked visually appealing while also displaying all the projects and work experiences that I believed to be relevant. Thankfully, from the beginning of the University of Maryland’s dietetic internship we had lectures and workdays to develop and enhance our personal branding. I decided to create a completely new personal website that used colors and designs that showed my personality in a more accurate manner, while still displaying all the work and knowledge I am gaining in my rotations. I also acquired the comfort to interact with others and post regularly on my Linkedin profile. I feel confident and have great pride in the personal brand that I am creating for myself, but it definitely was not always this way. Check out my tips below to see how I transformed myself from someone who avoided talking about my accomplishments to someone who now shows off my personal brand with pride. 

  1. Create your personal website on a platform/site that feels comfortable to you. There are many site options out there such as Wix or Weebly. I chose one that I was comfortable using and that helped me be confident as I easily navigated the tool and designed my website without unneeded frustration. Personally, I switched over from Wix in college to Weebly for my current site because we learned that it is generally more user-friendly and allows you to alter the style more. 
  2. Think about your target audience when creating your personal brand. One thing my writing and personal brand instructors have hammered home is the importance of identifying my goals and my target audience. For example, they indicated that if you hope to gain a position working in pediatrics, you will want your personal brand to be colorful, fun, and engaging with lots of graphics. On the other hand, this style would likely not work well marketing to a job working with an older population. Understanding your goals and potential audience will help create an authentic and effective personal brand. 
  3. Always be true to yourself and be confident in who you are. Whether it is posting on professional platforms like Linkedin, sharing your work samples on a website, or creating content on social media; it is important to feel confident in yourself and stay true to your beliefs. This is the best way to create a personal brand that will help you obtain jobs and opportunities where you fit in best. When I first began creating my new personal website, I looked at so many examples that our tech team sent us. I got lost in all of these examples by others and almost created a site that reflected the style and goals of our tech team based on their sites. Thankfully, I realized this in time to change the color schemes, tab names, and overall layout of my site to better reflect the work I have done in college and thus far in my internship. 
  4. One of the biggest tips that I learned throughout our branding training in the internship is that consistency is key. This means that if you have multiple sites (LinkedIn, personal website, Instagram, Twitter, etc.) that you use for professional functions, the design, style and tone should be similar. For example, I use the same cover photo on my LinkedIn account and the main page of my personal website. Furthermore, I use my profile picture (seen below) as my professional headshot on multiple platforms. I also have created a food and nutrition Instagram account where I chose to also use neutral colors because I want my brand to be seen as calm and inviting.

This shows the start of my LinkedIn profile. It is very similar to the main page of my personal website. Both utilize neutral background colors and food, which portray my calm personality and love for nutrition and cooking.

As a current dietetic intern and a future dietitian, I have learned that successful personal branding is essential not only for future employment opportunities but also to share helpful content with the public. Personally, I hope to use my nutrition education and social media presence to spread sound nutrition information backed by science to the general public. I found personal branding intimidating at first and I am so thankful that I have had many opportunities so far in my internship to break down the mental barriers I had created when it comes to marketing myself and my abilities. I hope that by sharing my experiences and my tips I can help motivate you to begin working on your personal brand as well!

Learning Experiences Throughout a Clinical Rotation

By: Hannah Etman

In the days leading up to my clinical rotation, I wondered if I had done enough preparation. I had been told countless times that in my clinical rotation I would finally learn to apply the knowledge gained through past coursework and assignments, but I couldn’t help but feel uncertain of what the next 10 weeks at Meritus Medical Center would bring. Entering a 257-bed hospital with little hospital-based dietetics experience was a nerve-wracking experience, but a welcomed one. The excitement and anticipation that I felt upon beginning my clinical rotation were enough to push away the doubt that sometimes crept up—and this ultimately led to an incredible learning experience and a stronger leaning towards clinical dietetics as a career path. 

Seeing patients on general medical-surgical floors contributed greatly to my growth as a clinical intern. I spent the bulk of my rotation on these floors, seeing varying degrees of mostly medically-stable patients and helping to determine their best course of nutrition-related care. Because most of the units at Meritus include a wide variety of patients and disease states, I was constantly shifting gears—seeing patients with renal issues, tube feeding requirements, and heart failure, to name a few. For the first six weeks of my rotation, I spent one to two weeks at a time with a different dietitian, learning the ins and outs of their assigned floors and patients. One of the most significant takeaways from these six weeks was the importance of viewing the patient’s clinical picture as a whole. Patients often had multiple comorbidities and therefore I had multiple things to consider when determining their specific nutrition therapies. It was crucial for me to critically evaluate all aspects of their chart before interviewing them so that I could ask them thoughtful, detailed questions. On some medical-surgical units, I attended multidisciplinary rounds, but on others it worked best for me to evaluate the patients’ charts and then speak to them directly. Ultimately, determining nutrition therapy for these patients came down to their whole clinical picture, other providers’ recommendations, and my discussions with patients.

The overall process I used to evaluate Medical-Surgical patients.

After spending the first six weeks of my clinical rotation on medical-surgical units, I had the privilege of rotating in the Intensive Care Unit (ICU) for two weeks. This was the most highly anticipated experience of my clinical rotation and one that I had unknown expectations for. I quickly learned that the fast-paced nature of an ICU forces you to be ready to change gears at nearly any time. Patients are constantly being transferred in and out and diets may need to be upgraded or downgraded which requires a level of precision and attention that is often more intense than on a medical-surgical floor. This is not to say, however, that any type of unit is easier or more difficult than another. Each unit and patient is different and requires varying levels of care, some requiring little attention and some requiring many follow-ups and changes in care. In the ICU, I spent much of my time practicing tube feeding calculations. Many patients that I saw were either on ventilators or unable to eat food orally and usually required enteral feeding. This meant I spent many of my hours calculating a patient’s estimated nutrient needs, calculating a tube feeding regimen that met those needs and confirming my work with the ICU dietitian so that she could fill in the order on her computer. While in rounds in the ICU, I noticed myself listening intently to what each of the nurses, doctors, and other providers had to say in case anything affected the patient’s nutrition therapy. When there were terms or references that I did not understand, I made sure to write them down and either look them up later or ask the dietitian to explain them to me. Throughout my two weeks in the ICU, I learned to be okay with switching tasks quickly and prioritization. Many different problems or situations arise and it is necessary to evaluate the urgency of each and plan your schedule around that. The changing, highly acute ICU environment helped me further develop my critical thinking skills, manage time wisely, and refine my tube feeding knowledge. 

The Meritus formulary detailing the types of supplements and formulas available.

A handout created by one of my preceptors to help choose the right tube feeding formula for a patient.

Another aspect of my clinical rotation that contributed to my learning was completing a minor and major case study. I chose two patients to study, write about, and then present my findings to the Meritus dietitians. For my mini case study, I chose an adult patient with a suspected fatty acid oxidation defect which interested me due to the infrequence of this condition, especially among adults. I completed a nutritional assessment on the patient, collected information from their chart, and spoke with the patient directly. Afterward, I completed a write-up in which I highlighted my findings from their chart and delved into a further discussion of the condition. I presented this to the dietitians at Meritus towards the middle of my rotation and received great feedback, which I attribute largely to many of the skills I honed during my rotation and while drafting my case study. Patient communication, time management, and my efficiency in assessing patients were reinforced when gathering information for each case study. For my major case study, I chose a patient during staff relief who came into the hospital with persistent nausea and vomiting and was later found with an intestinal obstruction. Similar to the mini case study, I collected pertinent information and completed an assessment on the patient, but I had to collect much more data due to the more detailed nature of the major case study. I went through all of the notes from providers, lab values, medications given, and their medical history. Right now I am in the write-up phase of this case study and will soon present it to the Meritus dietitians, along with other guests. By doing these two case studies, I have learned the importance of thoroughness. There were many times where I realized I was missing a small piece of information, only to have to go back into a patient’s chart to retrieve it. Because of this, I have become more meticulous when gathering the necessary information. I have also learned better methods of taking information and turning it into a presentable format. 

Throughout my clinical rotation, I kept an open mind with a positive outlook in order to gain as much knowledge and experience as possible. It was especially helpful being able to experience the difference between nutrition therapy on medical-surgical units and the ICU. I left Meritus feeling extremely confident in my clinical abilities compared to how I felt when I was just beginning. I attribute much of this to smaller learning opportunities I had throughout my rotation and I am excited to apply what I have learned in future situations.

Prepping for a Clinical Rotation

By: Frances Miller

The clinical rotation in the dietetic internship is a great foundation for all dietitians no matter what path they take after the internship. Prior to my clinical rotation, I did not necessarily see myself as a clinical dietitian. By keeping an open mind, I was able to build a good foundation of clinical knowledge that I can use in a variety of positions. By the end of this rotation I found that I enjoyed clinical more than I was expecting, particularly my time in the intensive care unit (ICU). 

During my first few weeks I felt I was overloaded with information. During this time I was learning the electronic health record system, brushing up on medical terminology and medications I had not previously seen, and, of course, reviewing clinical information I had learned in undergrad. Overall I found that by taking time at the end of the day to review new or complex information, I successfully absorbed the information that was thrown at me throughout the day. I also spent time reviewing prior to rotations in units with a specific focus such as the ICU, renal, pediatrics, etc. This allowed me to feel prepared and confident in my ability to perform calculations and take on more difficult patients on my own. 

Being prepared also meant having the right tools for the job. One of my sites required me to bring my personal computer. It was not required at every site, but I found it helpful to have on hand. This also allowed me to work on projects and homework in the mornings before my official workday started. Since traffic can be unpredictable, I found myself arriving early to my rotation on a daily basis. I used this time preparing my brain. By this I mean I checked my email and worked on clinical homework or projects. This warmup time made it easier for me to feel ready to tackle more difficult information early in the workday. Additionally, I always had buffer time to ensure I was never late to my rotation.

From my personal experience the majority of my preceptors used their phone’s calculator rather than carrying a separate one; however, I still think it is a good idea to bring a calculator. If my phone dies or I have a preceptor who prefers calculators, I will already be prepared. I mainly used this calculator in my two weeks in the ICU. On my first day during rounds, I calculated around seven tube feeding calculations, all of which were calculated correctly. This is something that I did not feel comfortable doing prior to the start of my rotation. I gained confidence by asking questions throughout, spending time reviewing, and being able to complete these calculations on my own!

The thing I struggled most with before starting was determining how I could best organize my papers. I was given several helpful handouts and readings that I wanted to keep on hand. I also had an additional notebook that I used to take notes of things I wanted to refer back to when the day was over. I ended up choosing to bring both a notebook and a binder. I used a few page protectors for handouts that I referred to daily; for others, I used a hole punch and filed them in my binder. I used my notebook to take notes of things I wanted to ask my preceptor or research at home. I learned to make a copy of important documents that I wanted to refer back to after my rotation; this way if they got damaged or worn down I would still have a copy to refer back to.

An additional item that is by no means a necessity, but I used frequently, is my blue light glasses. Clinical dietitians spend a good chunk of the day looking at computer screens. My glasses kept my eyes from tiring out, and also helped me get good sleep even if I was working on clinical homework. 

The internship is for learning; the expectation is not that interns will be perfectly clinically competent right away. Preceptors expect interns to make mistakes and learn from them during their rotations. I came to this rotation prepared to ask questions and research what I didn’t know. I learned that being open minded and asking questions even if I felt as though I should have known the answer, showed my preceptors that I was engaged and wanted to improve.


The Importance of Early Intervention in Weight Management in a Pediatric Setting

By: Skylar Sites

Last month, I had the honor of interning with the IDEAL Weight Management Clinic through Children’s National Medical Center. IDEAL stands for “Improving Diet, Energy and Activity for Life.” This is an outpatient program providing early intervention in children who, based on their BMI-for-age, require either lifestyle interventions, medication or bariatric surgery for weight management. However, surgery is only used as a last resort if lifestyle interventions and medication do not result in weight maintenance or, hopefully, weight loss. Additionally, the clinic sees a select few patients who have a normal BMI for their age but have other complications such as dyslipidemia or prediabetes. In this rotation, I was exposed to a wide range of reasons why a child may struggle with weight management. I believe that weight bias and stigma is such a problem in our healthcare system and country as a whole. I appreciated this experience where the providers emphasized that weight management is more complex than a child’s appetite and physical activity level. There are many physiological reasons that a child may struggle with weight management. Examples include hormonal imbalances involved in PCOS (polycystic ovarian syndrome) or hypothyroidism where an individual’s metabolism is slower than expected.

This was my first rotation after my main clinical rotation, where I saw all adult patients. Transitioning to pediatrics was an adjustment, but one that I really enjoyed. I originally fell in love with nutrition due to the role that it plays in preventative medicine. The nutrition choices we make everyday can impact such a wide range of outcomes whether it is our energy level or lab values and related health outcomes. With the IDEAL Clinic, I connected to that initial allure of nutrition while I got practical experience. I counseled children, along with their families, on how to make small, attainable changes in their daily lives. These small changes will help ensure they can be healthier now and into adulthood. In each appointment, the dietitian and I would discuss how the previous goals that the family set for themselves were going. We would then assess if they were ready for new goals to be set or if we should just “stay the course.” Commonly we set goals for drinking more water daily, eliminating sugar-sweetened beverages, increasing physical activity or including more fruits and vegetables daily.

I assisted the registered dietitian in all visits by filling out the sheet we used to help guide children and families in setting goals.

This rotation also helped to enhance my cultural competency. I talked to several families who did not speak English and required a call-in interpreter. At first, I was concerned that this would make education more difficult for these families. However, the clinic had all the patient handouts written in other languages and the interpreter was able to call in through a video so the translation process went very smoothly.

One of my projects during this rotation was to make a handout that would be beneficial for the clinic to provide to children and their families. Given the time of year, I decided that a predominant issue would be providing ideas on how children can remain active with the earlier sunset as well as cold weather approaching. Most families shared that it has been extremely difficult even in nice weather to encourage their children to remain active during quarantine. Many children are experiencing decreased physical activity due to lack of group sports or in-person gym classes. This combined with a normally decreased level of physical activity in the winter makes this a big concern. Exercise is important for all, but is especially crucial for children who are trying to manage their weight. In this handout, I provided suggestions on how kids can stay active and enjoy it in many different ways, such as trying a dancing video on YouTube or going outside and sledding with their siblings.

Overall, this rotation provided great exposure to working in a pediatric setting, practicing cultural competence and understanding the complexities behind weight management. This was a part of nutrition that I had not previously been exposed to, but I can see myself working in pediatric nutrition in the future.