What is Nutrition Diagnostics?

Nutritional diagnosing (Kight) is evidence-based ruling out and ruling in of nutritional health related problems that RDs are uniquely qualified to identify and process.

Nutritional diagnosing:

  • allows the study of nutritional problems and their causes
  • allows us to diagnose nutritional health problems, utilizing nutrition/dietetic-specific human condition codes (a scientifically standardized language and classification system) that give direction for classifying treatments provided – i.e. describe nutritional diagnosis(es) and etiology(ies)
  • provides a framework for use of a Nutrition Focused Physical Exam to identify physical signs and symptoms of nutrient deficiencies (or excesses)

How does Kight’s NCP differ from AND’s process?

    • Kight’s Nine-Step Nutritional Care Process
      • Unfolding and/or re-situating of knowledge selectively and sequentially as related to the patient’s condition, the scientific method process, and nutritional injury reference person.
      • Can uncover new information and knowledge, extend clinical understanding and theorize on mechanisms of action/effect/intervention.
        • The process is ‘human condition’ based and identifies clinical outcomes related to and caused by nutrition issues.  This requires a broad and deep understanding of medicine, physiology, pathophysiology, pharmacology, biochemistry and nutrition.
        • The Nutritional Injury-Specific Nutritional diagnostic codes and related categories (NI-S NDCs) are nutrition/dietetic-specific human condition codes that give direction for classifying treatments provided by describing nutritional diagnosis(es) and etiology(ies)

      Nine Steps

      1. Evidence – gathering information in the 5 axis of evidence (includes a history & NPE)
      2. Diagnosis(es) – evaluating the evidence to determine a diagnosis (using the NI-S NDCs) and staging of Nutritional Injury
      3. Etiology(ies) – evaluating the evidence to identify NI-S NDC etiologies
      4. Goals – identifying goals/expected outcomes that will guide interventions and resolve the problem/diagnosis
      5. Interventions – evidence based interventions that address the etiologies and moves patient toward desired/expected outcome(s)
      6. Black Box A – evaluation/critical thinking/theorizing on mechanism of action/effect/intervention that gets to proximal outcomes.  What happened as a result of the intervention?
      7. Proximal Outcomes – evaluation of indicators influenced by the interventions and of changes in nutritional health/status of patient
      8. Black Box B – evaluation/critical thinking/theorizing on mechanism of action/effect/intervention that gets to distal outcomes.  What happened as a result of the intervention?
      9. Distal Outcomes – evaluation of indicators influenced by interventions and of changes in nutritional health/status of patient

      AND’s Nutrition Care Process (NCP)

      • Systematic problem-solving method that dietetics professionals use to critically think and make decisions to address nutrition related problems and provide safe and effective quality nutrition care.

      Four steps

      1. Nutrition Assessment – at the end of the assessment step, data are clustered, analyzed, and synthesized.
      2. Nutrition Diagnosis – a nutrition diagnostic category is identified and a diagnostic statement is formulated – a PES statement.
      3. Nutrition Intervention – realistic and measurable outcomes are set
      4. Nutrition Monitoring and Evaluation – progress in attaining the expected outcomes is tracked.

      Nutrition Diagnosis Components:

      • Problem (Diagnostic Label)
      • Etiology (Cause/Contributing Risk factors)
      • Signs/Symptoms (Defining Characteristics)

      Nutrition Diagnostic Statement: PES

      Diagnostic Codes include three domains;

      1. Clinical – nutritional findings/problems identified that relate to medical or physical conditions
      2. Behavioral – Environmental- nutritional findings/problems identified that relate to knowledge, attitudes/beliefs, physical environment, or access to food and food safety
      3. Intake – actual problems related to intake of energy, nutrients, fluids, bioactive substances through oral diet or nutrition support (enteral or parenteral support

What are the rotation experiences?

Cox College students receive a wide range of supervised practice experiences.  We believe in fostering relationships with our preceptors and personnel at supervised practice facilities that promote open feedback as a way to continuously improve the rotation experiences. Many of our preceptors are former Cox College students giving them a unique understanding of our program.  Examples of rotation experiences are described below.

Cox South, Springfield MO

Cox Branson, Branson MO













Clinical Experiences

Cox College’s relationship with CoxHealth Systems creates a unique opportunity for collaboration with clinical preceptors, which is foundational in our program.  The inpatient clinical experiences are divided between Cox South Hospital and Meyer Orthopedic and Rehabilitation Hospital in Springfield, MO and Cox Branson in Branson, MO.  The outpatient clinical rotations include CoxHealth’s Center for Health Improvement in Springfield, MO and the Veteran’s Affair clinics in Mount Vernon and Branson, MO.


Community Experiences

Community supervised practice rotations include a wide variety of facilities throughout the Springfield area.  Rotations include experiences with retail dietitians at Hy-vee and Price Cutter grocery stores, WIC nutrition, local community health center nutrition, CoxHealth Wellness counseling, private practice outpatient nutrition counseling, and long-term care/rehabilitation nutrition consulting.

Additional community experiences will be provided outside of those rotations required for a course and include Hy-vee’s Fast, Fresh, and Delicious cooking school food demos; Bright Sky private practice experience; KGBX Women’s Show food demo; National Nutrition Month recipe preparation and booth collaboration.


Foodservice and Clinical Management Experiences

CoxHealth systems and Mercy Hospital in Springfield, MO provide the foodservice and clinical management supervised practice experiences.

What does the schedule look like?

The MND/DI is a 22 month program which has an August start.  Fall, spring, and summer semesters of the first year include seated or online courses as well as the majority of the supervised practice experiences.  The second year includes fall and spring semesters with seated or online courses as well as advanced supervised practice.  Graduation occurs in May of the second year.  The program follows Cox College’s academic calendar [link to academic calendar]for breaks and holidays.

Click for detailed program information

How much does the program cost?

The total cost is estimated at $36,750. See program Cost breakdown here

What is the difference between the total estimated cost and tuition and fees?

The total estimated cost includes estimated cost of housing, transportation, textbooks, and program supplies plus the cost of tuition and fees.  Expenses listed are not an official quote and are provided as a guide only.

What is a cohort model?

As opposed to a traditional graduate program, a cohort engages a tight knit learning community of students who progress through the academic program together. The cohort model benefits students by providing academic and logistical support as well as allowing courses to successively build upon each other creating a richer learning experience. as a guide only.

Do I have to be a registered dietitian to enter the Master of Science program?

No. The Master’s in Nutrition Diagnostics/Dietetic Internship is a combined program for individuals who have completed at least a bachelor’s degree, as well as accredited Didactic Program in Dietetics (DPD) coursework requirements. The MND/DI provides the supervised practice experience that is required to be eligible to take the registration examination for dietitians. The combined program offers students the opportunity to complete a Master’s in Nutrition diagnostics as a component of the required supervised practice component. Please see the Program Information section for more information.

Is financial aid available?

Yes. Application for financial aid is made by completing the Free Application for Federal Student Aid (FAFSA).  Priority is given to applications processed by April 1.  The application is available online January 1 for the upcoming academic year. Please see the links below for more information.

Cox College Financial Aid and Bursar


Are there scholarships available?

Yes. Cox College awards over $243,000 in scholarships from the CoxHealth Foundation and the CoxHealth Auxiliary. This is made possible by our loyal supporters. See the Cox College Financial Aid and Bursar Information [hyperlink] page for more information.

The Academy of Nutrition and Dietetics, through its many association groups, offers a variety of scholarships to individuals pursuing degrees in food and nutrition related areas. General scholarship and educational stipend information from the Academy of Nutrition and Dietetics Foundation, the dietetic practice groups and affiliate (state) and district dietetic associations can be accessed from the respective group’s website:





Is housing available on campus for students?

No, there are no university-sponsored dormitories at Cox College. Students are responsible for living and transportation expenses.  Springfield is home to many privately owned student housing options. Many students choose to live near the Cox College Campus (1423 N Jefferson Ave, Springfield, MO 65802) or near the CoxHealth South campus (3801 S National Ave, Springfield, MO 65807) as this is where many supervised practice rotations occur.  There are also many apartment options located near Missouri State University Campus which is centrally located in Springfield.


When does the program start and end? What does a typical week look like?

The MND/DI program is a 22-month program that starts in August and ends 22 months later in May.  All students in their cohort start together and finish together. The first year involves taking classes on Monday and attending supervised practice rotations Tuesday through Friday.  Supervised practice hours are also done during the first summer and some evenings and weekends during the first year.  The second year of the program involves more advanced supervised practice on Mondays and attending classes on Tuesdays and Thursdays.  Additional supervised practice is done on a few weekends and evenings in the second year as well.

Tell me more about the demographic of students in the program.

The college as a whole is representative of the Springfield, MO population, however the MND-DI program takes students from all over the country and tends to be a more diverse group.  Visit census.gov for more information on the demographics of Springfield, MO.

What type of student would make a good MND/DI candidate?

The rigorous, fast-paced environment of the MND/DI program requires students to be able to adapt to a wide ranging set of ever changing and challenging experiences.  Ideal candidates possess traits such as dedication, determination, and motivation.  Strong analytical and critical thinking skills along with emotional intelligence are highly regarded.  As with any graduate program, the ability to provide, receive, and grow from feedback with self-control and professionalism is desired.