Supervised Practice Experience Overview
Satisfactory completion of the CNS Supervised Practice Experience is essential to being awarded the CNS credential. The program is structured to ensure each candidate obtains the in-depth knowledge and skills expected of an advanced-level nutrition professional while maintaining the flexibility required to achieve individual career goals. As such, candidates are responsible for tailoring their own supervised experience based on all program requirements outlined herein as well as locating supervisors that meet the qualifications outlined below.
Although the Supervised Experience Program may be completed before or after passing the BCNS Certifying Examination, it is important to note that historically those who have completed the practice experience perform better on the examination than those who have not. The CNS credential will not be awarded until the completed experience has been approved by the BCNS credentials council
- The CNS Supervised Practice Experience consists of 1,000 hours of supervised practice in clinical nutrition care in the following nutrition categories in accordance with CNS Supervised Practice Experience Competencies. Work done in each of the categories must address the competencies outlined in Appendix A.
- Domain A: Fundamental Principles of Nutrition (minimum 250 hours)
- Domain B: Nutrients and Human Health (minimum 140 hours)
- Domain C: Nutrition Assessment (minimum 140 hours)
- Domain D: Clinical Intervention and Monitoring (minimum 350 hours)
- Domain E: Public Health (minimum 60 hours)
- Domain F: Practice Management (minimum 60 hours)
- The supervised experience may be obtained entirely or partly from:
- Internship, residency or clinical rotation
- Clinical practice setting
- Community setting
- Institutional setting
- Home health care setting
- Practicum as part of a master's or doctoral degree program (up to 250 hours)
- In order to address the required competencies, the 1,000 hours may come from multiple venues and supervisors. Supervisors may supervise a candidate in multiple settings, and candidates may work with multiple supervisors. Each supervisor must meet the eligibility requirements and be approved by the BCNS prior to supervising candidates for eligible practice hours.
To be eligible, all supervised experience must be gained after the candidate matriculates into the qualifying degree program. The purpose of the supervised experience is to demonstrate the application of the didactic coursework. The practice experience is more meaningful and beneficial if begun after the majority of the didactic coursework requirements have been met. Therefore, it is expected that most candidates will have completed most, if not all, of the relevant didactic coursework prior to beginning the SPE.
- For candidates who have had significant clinical nutrition practice experience prior to applying for the CNS credential, this guideline will be evaluated on a case by case basis.
- BCNS allows supervision to be done in person, remotely, or a combination of the two.
- Candidates can earn both Observational Experience and Independent/Direct Experience.
Types of Experience CNS Candidates Can Earn
Observational Experience (max 250 hours). Examples include:*Listening to videos or client/practitioner interactions
*Sitting in on a consultation conducted by another practitioner
*Participating in a virtual clinic or group mentorship program
*Role playing with colleagues
*Conducting research on behalf of another professional
Independent/Direct Experience (min 750 hours). Examples include:*Spending time directly with the client
*Researching and developing client treatment plans
*Researching and preparing client handouts or other educational materials or client educational workshops
*Reviewing above work with a supervisor
Types of Supervision CNS Supervisors can Offer
The Candidate and Supervisor are in the same physical location.
The candidate is supervised by someone who is NOT in the same physical location. Supervision may be done by phone, online conference platforms or group webinars
Each candidate is responsible for locating the setting(s) for the experience and qualified supervisor(s), and for working with the supervisor(s) to tailor the experience in accordance with CNS Supervised Practice Experience Requirements and CNS Supervised Practice Experience Competencies. Note: to meet all of the competencies, candidates may need to work with multiple supervisors in multiple settings (such as a practicum or internship, clinical practice, community, institutional or home health care setting.)
To ensure that candidates are working with a BCNS qualified supervisor, each candidate is responsible for ensuring the completion and submission of the CNS Supervisor Approval Application for each supervisor they will work with. Note: the approval of the candidate’s supervisor does not mean the candidate’s experience is approved. Candidates are required to submit a Candidate’s Report upon the completion of the SPE, which will be reviewed for approval.
- Candidates are encouraged to review the CNS SPE competencies to develop a comprehensive program that meet the CNS requirements.
- Each CNS candidate must document and attest to the completion of 1,000 hours, by completing on an ongoing basis and submitting the following documentation:
- CNS Candidate's Report
- CNS SPE Tracking Tool
- Candidates are required to complete 5 BCNS Personalized Nutrition Case Study Reports that must:
- have occurred within the past 5 years of the time they submit their SPE hours to the BCNS
- be discussed with and approved by their Supervisor(s) – these forms are NOT to be submitted to the BCNS
- Although the BCNS SPE requirements have been developed to dovetail with those of many state licensing boards, requirements vary from state to state. Thus, BCNS approval of SPE does not guarantee approval in all states. Most states separately evaluate the education, examination, and SPE of each candidate individually. The CNS SPE requirements are flexible to allow each candidate to design an SPE that meets both individual career goals and objectives and state licensing statutes and regulations in the state in which they intend to practice. For best outcomes, BCNS strongly recommends that each candidate review the current licensing statute and regulations in their state before beginning the SPE so that it may be designed to meet the state’s requirements for record-keeping, supervisor qualifications, competencies and skills, practice facilities, etc. This should not be difficult, but planning and record-keeping is essential. It can also be helpful to obtain a copy of the licensure application ahead of time so that candidates understand the documentation that will be required for licensure. Applications are generally available online, but in some states it will be necessary to call the department handling the process to obtain a copy. (To learn more about each state’s licensing statute and regulations, visit our Advocate page).
- Candidates are responsible for making any financial arrangements with supervisors which may range from a paid internship to a mentorship program for which there may be a fee to candidates; BCNS requirements do not address financial arrangements.
About the Supervisors
Supervisors must meet both of the following criteria:
- Must have a minimum of 3 years full time clinical experience in nutrition care or the equivalent; and
- Must hold at least one of the following:
- CNS credential in good standing; or
- Master’s of science or doctoral degree in a field of nutrition/dietetics; or
- Licensed MD/DO with didactic training or education and experience in clinical nutrition as documented by 75 CE credits or the equivalent over the past 5 years (without exception); or
- Doctoral-level health professional (e.g. DC, ND, PharmD) who meets curriculum eligibility requirements for CNS and who can legally provide nutrition services in the state of practice. Doctors of Chiropractic (DCs) must also be a CNS or MS, Nutrition.
For those health professionals who are not CNSs, licensed nutritionists or do not hold an MS or graduate degree in nutrition, the BCNS evaluates both didactic training and experience in clinical nutrition for each potential supervisor to determine their ability to provide a robust SPE for CNS candidates. Supervisors must demonstrate training and experience in nutrition assessment, nutrition intervention including medical nutrition therapy and evaluation.
Additional Requirements for Supervisors
- The above eligibility requirements apply to all supervisors, including faculty of a degree program offering practicum or internship.
- The supervisor’s qualifying degree must be from a regionally accredited institution.
- The supervisor must have the equivalent of three years of full-time clinical experience in nutrition care completed after obtaining the required credential or degree. Licensed or certified nutritionists or dietitians are only eligible as supervisors if they also hold a master’s or doctoral degree in the field of nutrition from a regionally accredited institution.
- Approved supervisors may supervise multiple candidates on an ongoing basis.
- Supervisors may not be married to, related to or domestic partners with the supervisee(s)
- Supervisors are responsible for completing the BCNS Supervisor Approval Application and submitting it to the BCNS along with their current CV. If the supervisor is pre-approved, the one-page Supervisor Application Addendum is required for each new candidate being supervised.
- Supervisors are responsible for assisting each candidate in tailoring an experience that meets the CNS supervised practice experience requirements, CNS supervised practice experience competencies and the candidate’s career goals.
- Each supervisor is responsible for holding regularly scheduled sessions with the candidate. Meetings may be held in-person or remotely. BCNS requires that for every 40 hours the candidate works toward meeting the competencies, a minimum of 1 hour must be spent with the supervisor reviewing cases, competencies covered, etc.
- Each supervisor is responsible for verifying the completion of the hours reported on the CNS Supervised Practice Experience Candidate’s Report, rating the candidate’s performance in each of the designated competency categories, and submitting the CNS Supervised Practice Experience Supervisor’s Report for approval by the BCNS Credentials Council.
- Each supervisor is responsible to review and approve each of the 5 Personalized Nutrition Case Study Report competed by the candidate.
- It is expected that holding regularly scheduled sessions with the candidate will allow supervisors to identify on an ongoing basis, competency areas that require improvement so that any deficiencies may be adequately addressed during the supervised practice experience.