The Syllabus: The Program Building Block

2014 Headshot_Short HairAs undergraduate and graduate healthcare management education programs move to a competency based framework for curricula, one of a program’s hurdles is assessment of student achievement of those competencies. The basis for this assessment begins in the very building block of our curricula, the syllabus, which many faculty (and some lawyers) call “our contract with the student.” To that end our syllabi should be specific to the course topic, but also address the rest of the program and how this particular course fits into the bigger picture of the competency framework.

While many readers may feel this is a fundamental area of academic freedom where the instructor is free to include or omit whatever he or she desires,  the fact of the matter is to be learner centered and equitable to all students, certain elements must be included. Many of these are considered boilerplate elements:

• The instructor’s name, contact information, and office hours;
• Meeting times and place;
• Course catalog description;
• Academic integrity policies and other academic policies (lateness, use of technology, class deportment, etc.);
• Evaluation methods and grading scales;
• Assignment details;
• Required and recommended textbooks or readings;
• A weekly calendar with topics covered;
• Assignments and due dates; and,
• Rubrics for evaluation of the assignments (or links to an online repository of rubrics).

In addition to these above noted elements, I suggest syllabi should include:
• Course objectives using Bloom’s taxonomy;
• Competency framework for the program (can be an appendix, or a link to an external source); and,
• Crosswalk (aka a matrix or grid) connecting the course objectives, competencies for the course, and assessments (assignments) of the competencies.

Course objectives are not tasks or activities, or even course competencies. Course objectives are the guideposts to the students and the instructor for course expectations. The educationally accepted approach for articulating these objectives utilizes Bloom’s taxonomy. The action verb at the start of each course objective enables the instructor to distinguish between Lower Order Thinking Skills (LOTS) and Higher Order Thinking Skills (HOTS). In a graduate program, with rare exception, the majority of the course objectives should be HOTS. In an undergraduate program, the upper level courses should, likewise, utilize HOTS. It is helpful to have colleagues and university curriculum committees review your course objectives to ensure they are consistent with the level of coursework. Here’s an example from our graduate course, HCM 669, Patient Advocacy for Healthcare Quality.

Course Objectives
1. Critique concepts and theories about patient advocacy in health care, utilizing case studies and real world applications;
2. Analyze qualitative and quantitative data to assist in formulating effective patient advocacy initiatives;
3. Design a process to evaluate the effectiveness of patient advocacy efforts in a healthcare organization;
4. Create an action plan to improve patient advocacy in a healthcare organization;
5. Construct an interdisciplinary, organization-wide strategy for evaluating the patient advocacy action plan;
6. Advocate for patient-centered care, patient safety systems, and patient involvement in healthcare organizations; and,
7. Demonstrate effective written, verbal, and interpersonal proficiencies in application of course materials.

Once you have you have decided on your competency framework, you can then crosswalk the course outcomes to the competencies and to the assessments/assignments. This table should be front and center in the syllabus, right after course objectives. By doing this, the instructor and the program remind the students of the high priority placed on the competencies and clearly links the course outcomes to the competencies and the assessments/assignments. If a student complains they don’t understand why they have to do a particular assignment, the instructor can remind him of this crosswalk and the explicit link. I like to tell students there are no assignments in this course, “Just because.” The rationale for each assignment is there from the first day of the class.  The following is how I applied this to our Patient Advocacy course. For the purpose of brevity, I have only provided one example of this alignment.

The Stevenson University Healthcare and Management Program has adopted a Health Leadership Competency Model to guide the design of all courses in the curriculum. The following table delineates the relationship between Program Objectives, Course Objectives, Health Leadership Competencies, and Assessments/Evaluations of Competency Attainment.

Course Outcome #3

Design a process to evaluate the effectiveness of patient advocacy efforts in a healthcare organization.

Health Leadership Competencies

• Interpersonal Communication
• Writing Skills
• Personal and Professional Ethics
• Cultural Competency
• Health care Issues and Trends
• Standards & Regulations
• Health care Personnel
• Health Economics
• Organizational Dynamics and Governance
• Problem-solving and Decision-making
• Time Management
• Quantitative Skills
• Legal principles development, application and assessment
• Quality Improvement/Performance Improvement

Human Resources Patient Advocate Interview Questions and Big Case Study 2 & Reflective Assignment
Discussion Forum: Letter to a CEO

While the competencies we have assigned to this course may seem overwhelming, remember when a program is new, it is important to see what works and what doesn’t work in a course. We will be revisiting this matrix in the future, and based on student, faculty, and stakeholder feedback, we will make adjustments accordingly and document those revisions to the curriculum. After reading the above, if you feel you might want to make revisions to your syllabi, this might be a good time to review course sequencing and the levels of the competencies expected from the course and the program, overall. So how do we assess the students’ competencies? That complex and complicated subject will be the topic for my blog for next month.

Sharon Buchbinder is Professor and Program Coordinator for the MS in Healthcare Management at Stevenson University in the Graduate and Professional School and former chair of the Association of University Programs in Health Administration (AUPHA). She is also the author of three books from Jones & Bartlett: Introduction to Health Care Management, Cases in Health Care Management, and Career Opportunities in Health Care Management.

Here are some references if you are interested in this topic:
Armstrong, P. (2015). Bloom’s taxonomy. Retrieved from

Broom, K., Wood, S., & Sampson, C. (2013, Summer). Current trends in graduate-level healthcare management education: An examination of accreditation outcomes. The Journal of Health Administration Education, 30(3)159-179.

Buchbinder, S. (2015, June 12). MS in Healthcare Management Program Healthcare Leadership and Management Competencies. Owings Mills, MD: Stevenson University, Graduate and Professional Studies. Retrieved from

Buchbinder, S. (2015). HCM 669 Patient advocacy for healthcare quality [Syllabus]. Owings Mills, MD: Stevenson University, Graduate and Professional Studies.

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The Health Benefits of Regular Physical Activity

Lilah Al-Masri, MS, RD, CSSD, LD

Lilah Al-Masri, MS, RD, CSSD, LD

Simon Bartlett, PhD, CSCS, ATC

This week, our special guest bloggers, Lilah Al-Masri, MS, RD, CSSD, LD, and Simon Bartlett, PhD, CSCS, ATC, authors of 100 Questions and Answers about Sports Nutrition & Exercise, provide expert insights on the health benefits of regular physical activity.

People exercise for numerous reasons including weight loss, weight gain, to improve performance or to improve overall health and well- being. Regular physical activity is one of the most important things a person can do to improving health. The following are some of the more significant benefits associated with consistent exercise:

  • Weight control
  • Reduce the risk of cardiovascular disease
  • Reduce the risk for type II diabetes and metabolic syndrome
  • Reduce the risk of some cancers
  • Strengthen bones and muscles
  • Improve mental health and mood
  • Improve the capacity to do daily activities and prevent falls (older adults)
  • Increase longevity

Weight Control

Both diet and exercise play a critical role in controlling weight. Weight gain is the result of consuming more calories that you expend; conversely, weight loss is the result of burning more calories that you consume. Regular physical activity not only helps one burn more calories, but provides additional health benefits as well. When it comes to weight management, a person’s physical activity needs will vary greatly; not all individuals lose and maintain weight the same way. It is recommended to work your way up to 150 minutes of moderate-intensity aerobic activity each week (approximately 30 minutes per day 5 times per week). If you are in need of professional help to get started, it is advisable to seek the help of an exercise physiologist and/or registered dietitian.

Reduce the Risk of Cardiovascular Disease

Heart disease and stroke are two of the leading causes of death in the United States. By following the guidelines of completing at least 150 minutes of moderate-intensity aerobic exercise, you can put yourself at a lower risk for these diseases. It is known that regular aerobic exercise lowers blood pressure and improves cholesterol levels.

Reduce the Risk for Type II Diabetes and Metabolic Syndrome

Diabetes is the inability to control glucose levels in the bloodstream.   Metabolic Syndrome consists of high blood pressure, excess weight (fat) around the waist, low HDL cholesterol, and high triglycerides. Research shows much lower rates for these conditions when moderate-intense aerobic activity is conducted between 120 and 150 minutes per week.

Reduce the Risk of Some Cancers

Research shows that physically active people have a lower risk for colon and breast cancer than non-physically active people. If you are a cancer survivor, exercise has been shown to offer a better quality of life and improve physical fitness.

Strengthen Bones and Muscles

Research shows that doing regular aerobic exercise at a moderately intense level can slow the loss of bone density, reduce hip fractures from falls, improve balance and coordination, and provide a higher level of functional capacity for everyday living. Strength training exercises can also help maintain muscle mass and strength, improve joint and tendon integrity, and decrease susceptibility to injury. The recommendation for strength training is 2 to 3 times per week.

Improve Mental Health and Mood

Regular physical activity can help keep your thinking, learning, and judgment skills sharp as you age. Exercise has been shown to reduce depression and may improve sleep. Research has shown that doing aerobic activity or a mix of aerobic and strength training 3 to 5 times per week for 30 to 60 minutes can provide these mental health benefits.

Improve the Capacity to do Daily Activities and Prevent Falls

Research has shown that physically active middle-aged or older adults have a lower risk of functional limitations (such as climbing stairs, lifting heavy objects, or doing work around the home) than inactive people. Independence can be maintained with regular aerobic and strength training activities.

Increase longevity

Science shows that physical activity can reduce the risk of dying early from the leading causes of death, like heart disease and some cancers. People who are physically active for approximately 7 hours per week have a 40% lower risk of dying prematurely than those who are active for less than 30 minutes a week. You don’t have to do high amounts of activity or vigorous-intensity activity to reduce your risk of premature death. Doing at least 150 minutes a week of moderate-intensity activity can provide substantial benefits and is a good first goal.

There are some individuals who are hesitant about becoming active due to the fear of being injured or concerns that exercise has to be hard in order to gain a benefit. The good news is that moderate-   intensity aerobic activity, like brisk walking, is both beneficial and safe for most people.

It is important to understand that all physical activity should initially be done slowly. Additional intensity and frequency can built up over time. Cardiac events, such as a heart attack are rare during physical activity. However, the risk can increase when one becomes much more active than usual, especially after long periods of inactivity. An example of risk could be shoveling snow when not aerobically conditioned to meet the demands of such an intense activity. That is why it is important to start slow and gradually increase the level of activity. If there is any doubt as to how to go about developing a safe and effective program, you should consider consulting with an exercise physiologist or a trainer that has certifications in strength and conditioning from the ACSM or NSCA.

If someone has a chronic health condition such as arthritis, diabetes, or heart disease, talk with your physician to determine if your condition limits, in any way, your ability to be active. It is important to remember, that any amount of physical activity is better than none. Working with a professional will help you find a program that fits your needs and provide an essential health benefit. information can be found in 100 Questions and Answers About Sports Nutrition and Exercise by Lilah Al-Masri, MS, RD, CSSD, LD and Simon Bartlett, PhD, CSCS, ATC. Until 11/30/2015, save 25% plus free shipping when you order online. Use coupon code SportsNut at checkout to apply the discount. U.S. orders only.

Do you have a nutrition or exercise question? If so, submit them to . Questions will be answered on a monthly basis.

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October 25th-31st is Respiratory Care Week

Celebrate Respiratory Care Week October 25th-31st by recognizing respiratory care professionals and raise awareness for improving lung health around the world.

Download American Association for Respiratory Care’s Respiratory Care Week Planning Guide to help organize events for your universities and communities.

Visit us at booth # 814 November 7th-10th in Tampa, Florida for AARC’s Congress 2015.

Check out a few of our Respiratory Care titles that will be featured at out booth at AARC Congress 2015. Use coupon code RCWEEK to receive 25% off and free ground shipping through 11/10/15.







For more Respiratory Care titles visit our website at

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Celebrate National Pharmacy Technician Day

October 20th is National Pharmacy Technician Day. This day recognizes technicians for their support and contributions throughout the year.  This annual event is endorsed by the American Association of Pharmacy Technicians (AAPT) and the Pharmacy Technician Educators Council (PTEC).

Learn more about Pharmacy Technicians by checking out our Pharmacy texts!

Professional Skills for the Pharmacy Technician aids technicians in viewing themselves as professionals within the health system. This easy-to-read text addresses some of the skills that could facilitate getting along in the workplace, and increasing safety  and communication. This resource discusses topics dealing with interpersonal relationships, conflicts, training of new employees, management and supervision within the technician ranks, and the importance of the technician role within the healthcare system.

Use coupon code PHARMTEC25 for 25% off and free ground shipping through the end of the month. Learn more about our pharmacy technician texts by visiting our website.

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October is Physical Therapy Month

National Physical Therapy Month is hosted by APTA to recognize how physical therapists and physical therapists assistant help transform individual’s lives by improving motion.

APTA’s campaign this year is the #AgeWell Campaign. This campaign focuses on healthy aging and how physical therapists can help individuals overcome pain, and gain and maintain movement.

National Physical Therapy Month also celebrates Global PT Day of Service on October 17th. Join PTs, PTAs, students, and physical therapy staff to participate in a day of service. APTA is hosting a series of events at its headquarters for local members, staff, and their families.

To learn how you can make a difference, visit,

Want to learn more about Physical Therapy? Check out our new Physical Therapy Texts!

Manual Therapy of the Extremities presents manual therapy techniques for the upper and lower extremities from a variety of perspectives. The presentation multiple techniques for each joint restriction is a unique feature of this book that provides students with a comprehensive and well-rounded approach to mobilization. Available January 2016

Dreeben-Irimia’s Introduction to Physical Therapist Practice, Third Edition is written specifically for  PTA’s and will help instructors introduce students to information regarding professionalism, professional roles, interpersonal communication, physical therapist’s behavior and conduct, teaching and learning, and evidence-based practice. Available January 2016

Guide to Evidence-Based Physical Therapist Practice, Third Edition’s  reader-friendly style facilitates learning and presents the knowledge and skills essential for physical therapist students to develop a foundation in research methods and methodologies related to evidence-based medicine. Special Value Pricing Available

Visit our website to view all of our Physical Therapist and Physical Therapist Assitant titles.

Take 25% off with free ground shipping with coupon code PTMONTH to celebrate National Physical Therapy Month.






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October is American Pharmacists Month!

The goal of American Pharmacists Month (APhM) is to promote the pharmacy profession as medication experts. This event aims to educate the public and policy makers about the role pharmacists play in the reduction of overall health care costs and the safe and effective management of medications.

To Learn more about APhM visit,

New Pharmacy Texts:

Pharmacy Practice and the Law, Eighth Edition by Richard R. Abood:

Reviews federal law and policy as it applies to and affects the pharmacist’s practice. This comprehensive, accessible text provides background, history, and discussion of the law to enable students to learn the facts, and apply and critically evaluate the information.

Patient Communication for Pharmacy: A Case-Study Approach on Theory and Practice by Min Liu:

Uses the case studies approach to develop readers’ understanding of the unique communication dynamics between pharmacists and patients. This text offers a unique focus on skills acquisition and the practicality of real-life case studies on pharmacist-patient communication. Incorporate current theory on patient=provider communication by including behavioral change theories, focusing on skills acquisition, utilizing case studies developed from interview data with practicing pharmacists.

Use Coupon Code APHM25 for 25% off and free ground shipping through the end of the month.

To learn more visit our website,

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October is Health Literacy Month!

Organizations and individuals promote Health Literacy month to raise awareness about the need for understandable health information. This annual event was founded by Jones & Bartlett Learning’s author, Helen Osborne.

“Be a Health Literacy Hero” is the theme for Health Literacy Month. This month is about finding ways to improve and solve health communication problems.

To learn more about Health Literacy Heroes and Health Literacy Month visit,

Learn more about Health Literacy by checking out Health Literacy From A to Z: Practical Ways to Communicate Your Health Message, Second Edition by Helen Osborne.

Health Literacy From A to Z  is an easy to use handbook designed for healthcare students and health professionals. This first-of-its-kind resource  provides strategies that can be used in everyday practice. The Second Edition is updated and revised to reflect current health literacy research and practice with new information about timely health literacy topics. This edition has 145 new sections including 4 sections about Technology.

For more information on Health Literacy visit,


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What Is the Role of a Health Navigator on the Health Care Team?


In 2015, Kay Perrin, PhD, MPH, joined us as a guest blogger for a series of five blog posts on the topic of the exciting new career field of the Health Navigator. This is the third of five.

The purpose of this blog series is to describe the concept of health navigators. In the first blog, I defined the basic role of health navigator. After having a few conversations with colleagues, I decided that it is time to write a blog about what role the health navigator does not play in the health care system. Some nurses have commented that health navigators should not work in hospitals because they will not have clinical training. Other colleagues have mentioned that health navigators may never find jobs, because no one knows how their role fits into the health care team. Now, you see the reason for writing this blog about the role of health navigators on the health care team.

My colleagues are correct. Health navigators lack the clinical background to be licensed to treat patients and health navigators are not employed as home health aides or certified nursing assistants. So the question remains: What is the role of health navigators on the health care team?

Before answering this question, let’s take a step back and review the impact of the Patient Protection and Affordable Care Act (PPACA) issues related to decreasing the 30-day hospital readmission rate among Medicare patients. Since its effective date in 2012, Section 3025 of the PPACA has targeted the high readmission rates by reducing payments to hospitals for Medicare beneficiaries readmitted within 30 days of a previous discharge from the same hospital including the applicable conditions of acute myocardial infarction (AMI), heart failure (HF), and pneumonia (PN). In 2015, the list is extended to include acute exacerbation of chronic obstructive pulmonary disease (COPD), elective total hip arthroplasty (THA), and total knee arthroplasty (TKA) in 2015. Unlike other new programs created by the federal health law, the readmissions program offers hospitals no rewards for improvement or the opportunity to opt out. Effective October 2015, Medicare is increasing the final maximum penalty to a 3 percent reduction for all readmitted patient stays. The national average of readmission rates is 19% and in 2013, 53% of U.S. hospitals sustained penalties. As PPACA penalties increase, hospital administrators give greater scrutiny to all readmission costs. It is therefore critical to reduce Medicare patient hospital readmissions.

With this PPACA information in mind, the discussion starts with a focus on the role of health navigators in hospitals. Frequently, hospitals declare a chronic shortage of licensed physicians and nurses to adequately staff the insufficient number of hospital beds. This equation results in a vicious cycle: a) Low staffing of licensed health care personnel leads to high patient acuity to health care staff ratios; b) high patient acuity ratios leads to longer work hours, greater medical errors, reduction of quality patient care, increase in PPACA penalties linked to high patient readmission rates; c) overworked clinical staff leads to resignations and chronic shortage of licensed nurses and physicians – thus the cycle continues. When health navigators are inserted into the hospital care team, the problems associated with a shortage of licensed clinical staff is not solved; however, a few of the other problems might be reduced. Let’s propose the following case study.

Mary Smith, 76 years old, was admitted via ambulance with a fractured femur and moderate COPD. She lives with her husband, Charles (age 82). They have been married for 52 years and have lived in their one-story house for the last 40 years. They have no intention of moving at this time. Mary had surgery to repair her femur followed by four days of physical therapy. She is walking well with a walker and still needs pain medication at night. The hospital social worker stopped by yesterday for a brief assessment. Mary stated that she wanted a home health aide daily for the first few days after discharge. The social worker entered this request in the EMR for Mary’s physician. Mary’s physician stopped by around 6:00 a.m. and told her that she would be discharged later that morning. Mary was not completely awake during his visit. He wrote a few prescriptions and told Mary that the nurse would go over everything after Mary ate breakfast. He also mentioned that he would see her in his office in about seven days to remove the incision staples. Mary called Charles. He arrived in time to hear the nurse review the discharge orders and the two prescriptions of antibiotics and pain pills. The physical therapy assistant delivered the rented walker and the transporter was called after Charles helped Mary get dressed. On the way home, they dropped off the prescriptions at the local pharmacy for a pick-up later in a few hours. Once at home, Charles pulled into the garage and helped Mary out of the car. Using her walker, they both realized that there are three steps without a handrail from the garage into the house. With only one step into the front door, Mary was forced to walk much further to enter her home. She rested while Charles returned to the pharmacy. While he was gone, the home health agency called and told Mary that her Medicare supplement did not approve the request for home health. Mary was disappointed but her leg was hurting too much to continue the conversation. Charles returned and Mary took a pain pill. Later in the afternoon, she needed use the bathroom. Charles helped her, but they realized that the walker did not fit through the bathroom doorway. They decided that she could walk into the bathroom, lean on the vanity and inch herself a few feet to the toilet with Charles behind her for balance. However, due to the pain medication, being sleepy and only leaning on the vanity, she missed a step. When she began to fall, Charles was unable to maintain his balance. Mary fell. Charles called 911 and she was readmitted to the hospital.

Now let’s review the same scenario with the pre-discharge services of a health navigator employed by the hospital. The health navigator would: a) meet with Mary and Charles in the hospital two days prior to discharge; b) meet Charles at their home to determine steps, lighting, scatter rugs, access through bathroom doorway using a walker, height of bed and toilet, etc.; c) request that physical therapy teach Mary how to negotiate a few stairs with her walker; d) order a bedside commode since the bathroom door was too narrow for her walker; e) give Charles the prescriptions to fill prior to discharge; e) call several home health agencies to negotiate health insurance coverage for a few days of service; and f) move the physician’s follow-up appointment within three days after discharge rather than seven days. These non-clinical actions would have likely kept Mary from a readmission thus saving her additional pain, suffering and financial burden. In addition, the hospital would not have been accessed a PPACA penalty for Mary’s readmission with 30 days.

Although health navigators are not intended to solve the numerous problems facing hospitals, employing health navigators improve the chances of reducing Medicare hospital readmission rates. The health navigators will have time to sit and carefully listen and access the challenges of patients and caregivers. They will make home visits prior to discharge, arrange transportation for follow-up appointments, verify that prescriptions are understood and filled, and note simple suggestions that might be missed among other over-burdened health care team members. It should also be noted that reducing the rate of Medicare readmission by one or two patients annually would pay the salary of a health navigator working in a clinical setting.

 —Kay Perrin

KayPerrinKay Perrin, PhD, MPH, is an Associate Professor and Assistant Dean for the Office of Undergraduate Studies at the University of South Florida, College of Public Health. Dr. Perrin’s research focuses on adolescent health with a special interest in teen pregnancy. Dr. Perrin also serves on several community boards in the Tampa Bay Area. Dr. Perrin is the author of four titles from Jones & Bartlett Learning: Principles of Evaluation and Research for Health Care Programs, Essentials of Planning and Evaluation for Public Health (both published in 2014), and the upcoming Principles of Health Navigation, available in early 2017. Follow Kay Perrin on Twitter @KayPerrinPhD or watch a webcast of Dr. Perrin’s October 2014 Webinar on Teaching Health Research, Program Planning, and Evaluation.

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Healthy Snacking 101

Lilah Al-Masri, MS, RD, CSSD, LD

Lilah Al-Masri, MS, RD, CSSD, LD

Simon Bartlett, PhD, CSCS, ATC

This week, our special guest bloggers, Lilah Al-Masri, MS, RD, CSSD, LD, and Simon Bartlett, PhD, CSCS, ATC, authors of 100 Questions and Answers about Sports Nutrition & Exercise, lend their expert perspectives on healthy snacking.

Healthy snacking is an important part of the diet whether you consider yourself an athlete or not. Many people considering snacking to be an unhealthy habit when in actuality snacking helps manage weight, ensures adequate fuel for the muscles and brain, and it improves muscle recovery. Most people should consume 3 meals and 2-4 snacks/day. The number and type of snack is dictated by hunger, work schedule, athletic involvement, weight goals, and sleep.

To become a good snacker one must implement three strategies 1) recognize your hunger cues, 2) distinguish a snack from a treat, and 3) select nutrient rich-snacks.

It seems obvious; when you are hungry you should eat, but this isn’t always the case. Some people eat when they are not hungry and some people are poor at identifying their hunger. Most people only identify hunger as stomach pangs, but after stomach pangs have been sensed, too many hours have passed without feeding the body. Hunger cues can include fatigue, poor concentration, headaches, lightheadedness, irritability, shakiness, and sleep disturbances. These symptoms are usually felt before the stomach pangs and should be acted upon immediately to prevent more intense hunger and additional energy loss. Being able to detect your body’s hunger cues is important, as this will stabilize energy and metabolism throughout the day leading to better physical and mental performance. What are your hunger cues?

The ability to distinguish a healthy snack from a treat will allow for proper fueling of the body. Healthy snacks are nutrient-rich and provide whole grains, fiber, lean proteins and/or healthy fats. On the other hand, treats such as candy, chips, and fried foods, are “empty” calories. Snacks provide fuel and satisfy hunger while treats usually only satisfy a craving.

Selecting a snack is not always easy, but once you identify your level of hunger you will be able to choose more wisely. When you begin to feel hungry, rate it on a scale of 1-5 (1 = satisfied and 5 = starving). Your hunger level will help guide you in choosing a light, moderate or heavy snack. A light snack would include fresh fruit, raisins, dry cereal, low-fat Greek yogurt, low-fat pudding. A moderate snack would include fruit with peanut butter, oatmeal, cereal and milk, yogurt parfait. A heavy snack would include a peanut butter or lean protein sandwich, cheese and crackers, omelet.

Smart Snacking Tips:

  • Plan ahead: Spend a few minutes in the evening planning/packing snacks for the next day.
  • Establish a routine: Consuming regular meals and snacks helps prevent feeling overhungry, achieve weight goals, and allow proper energy for exercise.
  • Identify snacks versus treats: Healthy snacks are nutrient dense and satisfy hunger.
  • Keep snacks readily available: Place snacks in your gym bag, purse, or desk drawer at work for quick fuel when you need it.

Sample day:

Breakfast: English muffin with PB & J, fruit, yogurt and/or low-fat milk

Snack: Fresh fruit and/or low-fat string cheese

Lunch: Turkey sandwich on wheat, vegetables and hummus, pretzels, low-fat milk

Snack: Greek yogurt with fruit

Dinner: Grilled chicken, rice, vegetable, low-fat milk

* Note – If you exercise prior to breakfast, you should have a snack before the workout such as fruit and/or granola bar. If you exercise twice or more per day, including a snack after dinner, such as PB & banana on wheat bread with low-fat chocolate milk, is beneficial.

Healthy snacking is an important part of a fueling plan. Listen to your body and keep nutrient-rich foods readily available. When you are eating well, your body will react positively and you will be able to achieve your physical, mental and weight goals. information can be found in 100 Questions and Answers About Sports Nutrition and Exercise by Lilah Al-Masri, MS, RD, CSSD, LD and Simon Bartlett, PhD, CSCS, ATC.

Do you have a nutrition or exercise question? If so, submit them to . Questions will be answered on a monthly basis.

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What is This Thing Called Competency Based Education?

2014 Headshot_Short HairThe buzz in health care management education is all competencies, all the time. Your program, whether at the undergraduate or graduate level, must be anchored in a competency based framework. The framework selected must be based on your program’s mission, vision, and values, your target students and the outcomes, i.e., where do you expect these students to go. Every meeting you attend will touch upon competencies and the dreaded assessments. Some may ask, “Why the big push?” Others may say, “What was wrong with the old fashioned way?”

Despite the fact that many of our current CEOs, COOs, and CFOs, came from the lecture, test, and pass the courses until you graduate model, these same employers grew to question the ability of graduates to take on the brave new world of health care. No longer was it appropriate to give good content and launch students across the graduation stage into the real world. The employers were not pleased with the quality and skills of the students coming to them, no matter how high the student’s GPA. Higher education, in general, and health care management education, in specific, continues to be called on the deficiencies in skills of their graduates.

The fact that graduates struggle to find jobs combined with hard data on the declining traditional undergraduate student population (the baby bust, if you will), means higher education is fighting to maintain relevancy to employers and adult learners, alike. Enter competency based education (CBE), a notion that is based not on time to graduation, but on demonstration of the required knowledge skills and abilities. This means in some experimental sites the Department of Education (DOE) is watching to see how this new concept works out. The sticking point, as you can well imagine, is the definition of direct assessment required to demonstrate competencies.

One federal definition says:

“`direct assessment program”, an instructional program that uses or recognizes direct assessment of a student’s learning in lieu of credit or clock hours.”

The experiment sites guide states:

“A direct assessment program is an instructional program that, in lieu of credit hours or clock hours as a measure of student learning, utilizes direct assessment of student learning, or recognizes the direct assessment of student learning by others. The assessment must be consistent with the accreditation of the institution or program utilizing the results of the assessment.”

So what does this mean to healthcare management programs? I anticipate a growing number of potential students who are already working in the field, but who do not have degrees (a rather large number, by the way) will be searching for programs that offer opportunities for portfolio review (direct assessment of learning by others) and direct assessment of their competencies by experts at the institution or partner institutions. I also suspect this will take longer to come to fruition in healthcare management, given some of issues surrounding those universities that thought they’d be approved by the DOE, then weren’t. As of July, 2014, only two universities have had success in negotiating the complicated federal application and approval process.

In the meantime, I recommend taking a good hard look at our own programs and asking some tough questions, some of which should include:

• Do we have a mission, vision and value statement that drives a competency based curriculum?
• Do we obtain input into the curriculum from all stakeholders, including employers, community partners, students, alumni, and advisory board members?
• Do we use this input to adjust our competencies and curriculum?
• Do we directly measure, i.e., assess, these competencies and address shortcomings in our program when students don’t perform well?
• Do we have a strategic plan that incorporates environmental factors, such as CBE?
• Are we relevant to the populations and communities we serve?
• Do employers tell us they want more of our graduates?

We cannot sit on the sidelines and wait for the brave new world of competency based education to go away quietly. It’s time to take a critical look at who we are and what we contribute to our students’ education and the field of health care management. If we don’t, we will be the architects of our own demise.

Sharon B. Buchbinder, RN, PhD

Sharon Buchbinder is Professor and Program Coordinator for the MS in Healthcare Management at Stevenson University in the Graduate and Professional School and former chair of the Association of University Programs in Health Administration (AUPHA). She is also the author of three books from Jones & Bartlett: Introduction to Health Care Management, Cases in Health Care Management, and Career Opportunities in Health Care Management.

Here are some references if you are interested in this topic:
Everhart, D., Sandeen, C., Seymour, D. & Yoshino, K. (n.d.) Clarifying competency based education terms. American Council on Education and Blackboard. Retrieved from

Fain, P. (2014, July 23). Experimenting with aid. Retrieved from

Fain, P. (2014, February 21). Taking the direct path. Retrieved from

Federal Register. (2009, October 217). 34 CFR Parts 600 and 602: Institutional Eligibility Under the Higher Education Act of 1965, as Amended, and the Secretary’s Recognition of Accrediting Agencies; Final Rule. Retrieved from

Kamenetz, A. (2014, October 7). Competency-based education: No more semesters? Retrieved from

U.S. Department of Education (2015, September). Introduction to competency based education. CBE experiment guide. Retrieved from

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