SPE for Candidates

What you need to know: Supervised Practice Experience

A minimum of 1,000 hours of supervised practice in the personalized nutrition care model which addresses the CNS SPE competencies is an essential component of the CNS credential.

Indirect Experience (optional and maximum of 250 hours)

Candidates may opt to start with observational hours as they are learning the PN care model and just beginning to apply foundational coursework to clinical situations. During observational SPE, candidates will earn hours across Categories A, B and C in the following ways:

  • Listening to videos of client and practitioner interactions and discussing findings with the supervisor;
  • Shadowing an experienced clinician in active clinical care, and discussing cases with the supervisor;
  • Participating in supervised simulation exercises and/or role playing;
  • Utilizing case studies to analyze clinical cases and prepare treatment plans or handouts that are reviewed by the supervisor.  
  • NOTE: Observational hours are not required, and candidates may earn the complete 1,000 hours in Direct experience. 

Direct Experience (minimum of 750 hours)

While earning direct experience, candidates and supervisors work together to ensure they are each meeting their responsibilities. During direct SPE, candidates will earn hours across the Categories A, B and C in the following ways:

  • Counseling individuals and groups
  • Activities directly related to the counseling of active individual clients and groups of clients such as completing chart notes and/or treatment plans, evidence-based research activities directly related to developing treatment plans, and communicating with clients or other members of a client’s healthcare team between live sessions;  
  • Participating in community education including the development and delivery of education to a specific population; 
  • Supervisor-led grand rounds and one-on-one meetings covering active client cases. 

The following activities do not qualify for SPE hours:

  • Research that is not related to a current client
  • Writing books, articles, blogs, etc.
  • Teaching classes in academic programs
  • Developing condition-based training programs and treatment protocols not related to a current client
  • Presenting educational lectures, videos, webinars, etc. academics for mass audience
  • Watching educational lectures, videos, webinars, etc.

Category A: Personalized Nutrition (PN) Assessment & Interpretation​

Nutrition assessment is an ongoing, dynamic process that incorporates a systematic approach to collect, record, and interpret quantitative and qualitative inputs including diet, lifestyle, behavior, symptoms, nutritional genomics, biochemical laboratory markers, and personal and family health history. ​

The nutrition assessment is used to identify existing manifestations of dysfunction as well as the underlying root causes of imbalance which contribute to risk factors and current nutritional health issues to enable effective treatment and prevention strategies and monitor improvements​.

Category B: PN Intervention, Education, Counseling & Ongoing Care​

A nutrition intervention consists of planned actions designed to change nutrition related or lifestyle-related behaviors for the purpose of resolving health issues or optimizing health. It may involve any of the following activities: research related to treatment plan, development of medical nutrition therapy interventions, client education, counseling and management of individuals or groups, food preparation instruction, shopping, sustainability practices, and behavioral/motivational counseling. ​

Interventions may include changes to diet; use of targeted nutraceuticals; addressing issues related to lifestyle factors such as movement, sleep, stress management; addressing food related behaviors such as timing of eating, eating environment, fasting, food selection, food storage, and food preparation.

Category C: Nutrition Monitoring & Evaluation​

Regular re-evaluation of medical nutrition therapy treatment and prevention plan and goals in accordance with evaluation of improvements made based on symptoms, overall health status, and quantitative and qualitative data. Includes review of clinical research, standards of care, and other indirect contact. Ongoing monitoring and evaluation are crucial to a robust client care, as they enhance personalization of interventions throughout the duration of the care process. ​

Regular assessment of subjective input and collection of objective data enables honing and refinement of therapeutic intervention strategies to build self-efficacy and behavior change in the individual, thereby optimizing quantitative and qualitative measures of an individual's health.

Candidates are responsible to:

  • Secure setting(s) and qualified, approved supervisor(s) for the tailored practice experience
  • Review the current licensing statutes and regulations in their state before beginning the SPE
  • Keep timely and detailed records throughout the SPE to ensure records are complete for BCNS and state licensing board review
  • Document and submit application materials upon completion of 1,000 hours
  • Use the PN Case Data Collection for each client and review with the supervisors
  • Submit one PN Case Data Collection and one PN Case Report to supervisor for approval at the end of the SPE
  • Meet regularly with supervisors
  • Disclose to their clients that they are under supervision required to earn the CNS credential
  • Hold student or professional commercial liability insurance while under supervision