practices even with the servIng of an adequate diet ..

ACKNOWLEDGEMENT The authors thank the directors and staff of Camp Sweeney, Gainesville, Tex., for permission to carry out the study and their assistance in it.

REFERENCES 1. Dietary Levels of Households in the

United States, Spring 1965, Agricultural Research Service, USDA, Washington, D.C., Jan. 1968.

2. Breakenridge, M. E., "Food attitude of 5-12 year old children," J. Amer. Diet. Assn., 35:704-709, 1959.

3. Pilgrim, F. J., "What foods do people ac­cept or reject?," J. Amer. Diet. Assn., 38:439-443,1961.

4. Hunt, F. E., Patton, M. B. and Carver, A. F., "Plate waste in a school lunch," J. Amer. Diet. Assn., 34:810-813, 1958.

5. Pattison, M., Barbour, H., and Eppright, E. S., Teaching Nutrition, 2nd Ed., Iowa State College Press, Ames, Iowa. 1963, p. 89.

6. Jackson, R. L., "Nutrition management of children with diabetes mellitus," J. Amer. Med. Assn., 168:42-46, Sept. 6, 1958.

7. Beaty, L., "Use of communication media to influence change," Nutrition Educa­tion Conference Proceedings, USDA, Washington, D.C., 1967, pp. 25-26.

FOOD AND NUTRITION EDUCATION FOR MENTALLY DISTURBED WOMEN

Margaret Wilkinson, Elinor Kerrey, Ruth Ganshorn and Constance Kies

An evaluation of teaching nutrition/meal management classes for emotionally disturbed women in a day care center is presented. Such classes, may be of therapeutic as well as practical value.

Classes in nutrition and meal manage­ment perhaps can be an important part of a rehabilitation program for mentally disturbed women. The Food and Nutri­tion Department, College of Home Eco­nomics, University of Nebraska, spon­sored a series of such classes for women who were patients in a day care program at the Lincoln Regional Center at the re­quest of this agency. The classes were suggested by staff psychiatrists as possi­bly offering opportunities for social in­teraction and for strengthening of self­esteem, two important factors in the treatment of mental illness (1, 2). In ad­dition, it was thought the classes might offer opportunities for the women to be­come more effective homemakers by increasing their knowledge and under­standing of nutrition and meal manage­ment.

Most of the classes were held in a foods laboratory at the university be­cause experiences and trips ·away from the hospital environment. were of thera­peutic value to the women. Also, it was thought that the women would gain some personal prestige and self-esteem by be­ing able to say that they were attending classes at the university.

Twenty-four classes were held (3) with attendance per class ranging from 4 to II patients. Close supervision of the patients was possible at. all times because they were accompanied to the classes by a nurse, an aide, and a recreational ther­apist. Although instructors of the class

THE A UTHORS are, respectively, Instruc­tor, Instructor, Associate Professor, and Professor, Dept. of Food and Nutrition, University of Nebraska, Lincoln, Neb. 68503.

had no formal training in working with mentally disturbed individuals, all had had some formal classes in psychology. Hence, communicat,ion between the hos­pital and university staff members was greatly eased and much informal train­ing occurred during the course of the project. Professionally trained individ­uals must complement and supplement their respective competencies.

Most of the patients suffered from chronic mental illness and were in vary­ing stages of the illness. The degree of illness was likely to change from week to week. Sometimes t.he woman exhibited symptoms of their illness or of the effects of medication at the time classes were held. However, the classes proceeded with few unusual incidents.

Ages of the women varied from 27 to 62 years. Nearly all were married with families. Enrollment in the program was encouraged by the rehabilitation staff of the institution. Educational achievement and intelligence levels varied consider­ably. Of the 14 women who attended classes at least five times, four were col­lege graduates, two had attended college, six were high school graduates, two had attended high school for only two years, and one had an eighth grade education. All of the women belonged to the low or low-middle economic class.

Each lesson began with a short discus­sion of the particular food group being studied that day (3). This was followed or accompanied by a food preparation demonstration. Then the women, in small groups, prepared foods using reci­pes which pertained tp the day's lesson. As part of each lesson, a complete meal containing food from each of the four

14 I JOURNAL OF NUTRITIONEDl,ICATION '.

food groups was planned, prepared, and served. While the meal was teacher pre-planned, processes involved in plan­ning were presented. When the foods prepared by each group were added to the buffet table, a complete luncheon resulted. In this manner, the women ex­perienced preparation of food and saw how these foods could be incorporated into meals acceptable to the cultural val­ues of this society.

No pressure was placed upon the patients to learn facts. The primary ob­jectives of the classes were to foster self­confidence and encourage social interac­tion. However, since it would be difficult to measure the effectiveness of the classes in regard to the latter factors, short tests over the subject matter were adminis­tered. After determining that short tests did not seem to cause anxiety in the pa­tients, pre-tests and post-tests were ad­ministered over some of the lessons in order to obtain information for evalua­tive purposes. Test scores indicated that the women had gained some understand­ing of the principles of nutrition and meal management (3).

To provide additional opportunities for actual experience and application of knowledge, groups of four women were asked to plan, prepare, and serve a meal to the entire group. Accordingly, on two occasions meals were prepared and served in the day care area at the hospi­tal. On one occasion the meal was pre­pared and served by the patients in the home of an instructor to provide a more realistic experience.

Since food is a topic of universal in­terest and in itself encourages conversa­tion, the lessons contributed to social

SUMMER, 1971

interaction. The meals appeared to be relaxing experiences which seemed to be anticipated with pleasure and enjoyed by the patients. Occasionally, a patient would report that she had prepared a meal a~ home using information she had received in class. Her pride in the praises from her family made it evident that her self-esteem had been strengthened.

The food and nutrition classes for mentally disturbed women provided op­portunities for social interaction, for en­hancemen~ of self-esteem, and for learn­ing the principles of nutrition and meal management. They also provided an ad-

ditional opportunity for the University of Nebraska to extend its services to members of the community. University staff participants in the project devel­oped increased awareness of the special problems facing women who are suffer­ing from mental illness.

Published with the approval of the Direc­tor as paper No. 3048, Journal Series, Ne­braska Agricultural Experiment Station. Information presented in this paper was taken from a report "Food and Nutrition Education in a Day Care Program for Men­tally Disturbed Women" (Dept. of Food and Nutrition Report No. 3, University of

Nebraska). Single copies of this report are available free from the Department of Food and Nutrition, University of Nebraska, Lin­coln, Nebraska, 68503.

REFERENCES

1. Felix, R. H., Mental Illness, Columbia University Press, New York, 1969.

2. McDonald, L., "Psychiatric rehabilitation -resources in a revolution," J. R ehab., 35 :31, 1969.

3. Wilkinson, M. R., Kerrey, E., Ganshorn, R. and Kies, C., Food and Nutrition Ed­ucation in a Day Care Program for Men­tally Disturbed Women, Dept. of Food and Nutrition Report No. 3, University of Nebraska, 1970.

EDUCATION FOR DIETETICS: THE IN-BASKET TECHNIQUE

The "In-Basket Problem," a management training technique, can be adapted for education of dietitians. Evolution from educational objectives and development and use of the technique are described here.

The recent evolution in the role and lifetime goals of the therapeutic dieti­tian has called for equally marked changes in methods of instruction. Text­book lectures or question and answer sessions cannot adequat.ely prepare the student dietitian to be a member of the medical team where decision making is a vital function . Manpower shortages require that the dietitian be prepared to perform t.hose professional duties and responsibilities which are unique to her role; dietary technicians and aides can easily perform many of the routine tasks formerly cherished by the dietitian. The entire educational process is under at­tack from students who demand "rele­vance" and application of learning to the real needs of the profession in which they are eager to practice (1).

Relevance can best be determined by structuring teaching content and learn­ing situations to prepare the student for levels of skill delineated in specific com­petencies which are basic to minimum academic requirements for membership in the American Dietetic Association (2). The competencies, proposed by the Committee on Academic Requirements and accepted on a trial basis for pilot programs, provide a concrete basis for determining course objectives and stu-

THE AUTHOR is Assistant Professor of Home Economics, Mercy College, Detroit, Mich ., on leave for graduate study. Present address is School of Home Economics, 1787 Neil Ave., Columbus, Ohio, 43210.

SUMMER, 1971

dent activities which are selected to de­velop these basic skills and attitudes.

Mager (3) emphasizes that teaching objectives should be prepared in such a way that they form the basis for student evaluation. The objectives are to be spe­cific in terms of student activi,ty and level of performance that will be considered as "acceptable." Bloom (4) further spe­cifies that these objectives be aimed toward not only knowledge of facts but also understanding, application, analysis, synthesis, and evaluation of mater~als

and data.

In-Basket Technique The "In-Basket Technique" may be

used as a teaching and evaluation device which can fulfill each of the above spe­cifications. This technique has been used primarily in management situat.ions and has not been extended into the behavior­al or professional sciences. Hubbard (5) has successfully used the "In-Basket Technique" in teaching Food Service Management; we propose that this meth­od can also be effectively used in training for therapeutic dietetics.

Briefly, the in-basket is a tool which may be adapted for day-to-day class­room sessions or used as an evaluation technique. The "In-Basket Problem" presents a series of situations, letters, memos, phone calls, notes, etc., that might logically be contents of one's in­coming letter-box on a certain day.

The participant becomes "Miss Jones,

Sister Mary Rosita Schiller

the therapeutic dietitian, at Moonville Hospital." The cont,ents of her in-basket are waiting upon her arrival at the office. Each item in the basket is to be consid­ered, a decision made concerning its dis­position, and the appropriate action is taken. If a letter is to be written, she writes it; if a conference is to be held she makes arrangements for the meeting, indicates who the other participants will be, and writes the agenda. If a patient is to be seen, she notes what approach she will take and what background informa­tion she has which is needed in this situ­ation. The value of the in-basket is that the participant commits herself in writ­ing to the decisions which she makes. She is also required to justify all actions which she exercises.

The in-basket as an evaluation tool can be used as an examination ,to be ana­lyzed at the next class session, or as a "take home" examination to be discussed at a later time. It is essential that the in­basket decisions be discussed so that the participant. receives feed-back on the ap­propriateness of her decisions, is made aware of alternate avenues of action, and receives support from her colleagues for insights and appropriate decisions. The in-basket is a learning device and all of its potential for instruction should be employed.

Use of the Technique "In-Basket. Technique," management

games to be played by individuals, were

JOURNAL OF NUTRITION EDUCATION I 15