Dietetics students placement 1,2 & 3 transition

WHAT DO YOU KNOW ALREADY?

New Curriculum update

New Curriculum update

Drivers for change . . . BDA (2008) Curriculum Framework for the Pre-Registration

Education and Training of Dietitians 2013 update in press

New curriculum developments Development of academic curriculum to ensure that all aspects

of the curriculum framework are covered Incorporation of the Nutrition & Dietetic Care Process (BDA,

2009) to placement education. 2012 updated as Model and Process for Dietetic Practice (BDA 2012).

Review of placement structure Placement 1 – 2 weeks Placement 2 – 12 weeks Placement 3 – 14 weeks

Placement ‘language’

Placement A Placement 1

Placement B Placement 2

Placement C Placement 3

New Curriculum update

Placement 1 (2 weeks) To observe and understand the required knowledge, skills and professional attributes to

implement nutrition & dietetic care with individuals in a variety of settings To practice skills at an appropriate level in the application of the nutrition & dietetic care

process Placement 2 (12 weeks)

To observe and practise the knowledge, skills and professional attributes required to implement the dietetic care process with individuals and groups in a variety of settings

Placement 3 (14 weeks) To continue to develop dietetic practice and apply the knowledge, skills and professional

attributes required to implement the nutrition & dietetic care process with individuals and groups and organisations/communities in a variety of settings

To develop and apply the knowledge, skills and professional attributes required to implement the nutrition and dietetic care process in the context of public health nutrition

Progression from Placement 1 to 3

Progression from Placement 1 to 3

Placement Timings

Placement 1 January Summer (June – September)

Placement 2 February and May / June

Placement 3 September

Implementation of New Programme

Implemented in academic year 2011-12 in PG at both universities

Implemented in academic year 2011-12 in UG at both universities (now in year 3 of programme and due to take all new placements after January 2014 C’s)

Gradual switch from ABCs to 123s

‘Hybrid’ placements e.g. 2B’s

References

The British Dietetic Association Curriculum Framework for the Pre-Registration Education and Training of Dietitians available at www.bda.uk.com

Course documents on the London Dietetic Website (www.londondietetics.co.uk)

Nutrition & Dietetic Care Process

Nutrition and Dietetic Care Process

What is your understanding of the process?

Nutrition and Dietetic Care Process

Nutrition and Dietetic Care Process - BDA (October 2009)Based on American Dietetic Association (ADA) model,

published in JADA in 2003 Lacey K & Pritchett E. 2003. Nutrition Care Process and Model: ADA adopts road map to

quality care and outcomes management. JADA 103 (8): 1061 -1072

A step wise approach to dietetic careDefines the actions, critical thinking and specialist skills that

are components of the dietetic interventionCan apply to an intervention with:

An individual An education or therapeutic group A defined population or public health campaigns with a community

Nutrition and Dietetic Care Process

Diagnosis• Identify and label problem• Determine contributing risk factors• Cluster signs and symptoms

Monitoring and Evaluation• Monitor progress• Measure outcome indicators• Evaluate outcomes

Assessment• Collect timely & appropriate data• Interpret with evidence-based standards

Intervention•Plan nutrition intervention•Implement nutrition intervention

Screening and Referral

Nutrition and Dietetic Care Process

Process can be applied to all stages of a dietitian’s career

May be applied with differing levels of skill and understanding

A structured framework used to support provision of care. It is not designed to standardise care but to aid individualised care

New Curriculum update

Placement learning outcomesBased on the Nutrition and Dietetic Care Process

In relation to patient/client assessment phase, students will be able to . . . .

In relation to the nutrition & dietetic diagnosis, students will be able to . . . .

In relation to patient/client intervention, planning and implementation, students will be able to. . . .

In relation to monitoring and evaluation, students will be able to . . . In relation to professional attributes, students will . . . .

Nutrition and Dietetic Care Process: Placement Programme Planning

Programme planning that follows structure of DCP (e.g. placement 2)

Week 2 – Assessment Week 5 – Diagnosis Week 7 – Formulating and implementing interventions Week 9 – Monitoring and evaluation

Widening departmental participation Learning can take place for some elements of DCP across all

clinical specialities

Structure learning activities around the DCP Clinical observation forms, self-review forms, care plan templates Makes observation more active for deeper learning Focuses learning on key areas of process

Reflective feedback Use Clinical observation forms as basis for discussion

Preparing for a new clinical specialty Assessment – Relevant anthropometric variables, biochemistry Intervention – Relevant resources, treatments, AHPs Monitoring & Evaluation – Relevant clinical guidelines, follow up, handover

Nutrition and Dietetic Care Process: Placement Learning

Placement 1,2, 3

Focus of PlacementsFocus of Placements

Placement 1: The assessment phase with individuals only.

Placement 2: The whole dietetic care process with individuals and groups.

Placement 3: The whole dietetic care process with individuals, groups and communities/ organisations.

Placement 1

Placement 1 Learning Outcomes

Show awareness of the sources of information available to be used by dietitians.

Identify how a dietitian selects and utilises appropriate information from a range of sources necessary.

Demonstrate appropriate skills in gathering information from a range of appropriate sources.

Show awareness of how the dietitian uses the information gathered and critical thinking to formulate and justify a nutrition & dietetic diagnosis.

Placement 1 Learning Outcomes

Explain how the dietitian uses information gathered and critical thinking to formulate and justify dietetic management goals.

Explain how the dietitian uses information gathered and critical thinking to develop and implement a dietetic action plan to achieve the management goals.

Explain how the dietitian reviews, monitor and evaluates dietetic interventions.

Demonstrate consistent professional behavior in accordance with the legal and ethical boundaries of the dietetic profession and the requirements of the Health Professions Council.

Assessment of Placement 1

In order to pass students must have successfully met all learning outcomes through: Attendance

Completion of a portfolio

Portfolio should contain: Evidence of observed professional practice (checklist)

Documentation from a Facilitated Case Discussion (including Dietetic Care Plan and supervisor evaluation)

Evidence of completion of activities related to information gathering for use in the assessment phase of the NCP

Reflective piece regarding learning on placement 1

Placement 1 Workbook Activities

Focused around each component of assessment:

Nutrition ScreeningAnthropometryBiochemistryClinical assessmentDietary assessmentEnvironment/ Economic/ EducationalCan be completed independently or in pairs/ small groupsPlacement 1 workbook

End of Placement Processes

Students should not fail placement 1 as long as they have attended and have completed the workbooks to an acceptable standard.

They need to have completed all of the activities, which means you have a responsibility to make them available and if one is cancelled, to find an alternative.

Complete the “End of Placement 1 Review form” with the student and both sign. Nominated Student Lead countersigns the form then 1 copy to student, keep one for file and return 1 to the relevant university.

Placement 1 regulations

Students should normally attend 100% of the placement. If sickness results in absence from placement, students will be expected to make up the agreed number of hours or repeat the placement, subject to discussion between the HEI and the lead practice educator. This will take into account current performance and the potential effects on future progression. Any occupational health requirements related to prolonged sickness absence will be managed through the HEI provision.

Placements 2 & 3

Placement 2 and 3

• Duration - 12 week block placement 2

- 14 week block placement 3 (3 week public health component)

Learning OutcomesLearning Outcomes

Focus 1 2 3

In relation to patient/client assessment phase

1. Show awareness of the sources of information available to be used by dietitians 2. Identify how a dietitian selects and utilises appropriate information from a range of sources necessary 3. Demonstrate appropriate skills in gathering information from a range of appropriate sources.

1. With decreasing direction, demonstrate the ability to identify, collect and interpret relevant information and evidence from the range of sources available

1. With minimal guidance, demonstrate the ability to identify, collect and interpret relevant information and evidence from the range of sources available

Focus 1 2 3

In relation to the nutrition & dietetic diagnosis

4. Show awareness of how the dietitian uses the information gathered and critical thinking to formulate and justify a nutrition & dietetic diagnosis

2. With minimum guidance formulate and justify appropriate nutrition and dietetic diagnoses

2. Independently formulate and justify appropriate nutrition and dietetic diagnoses

In relation to patient/client intervention, planning and implementation

5. Explain how the dietitian uses information gathered and critical thinking to formulate and justify dietetic management goals

3. With decreasing direction, develop suitable dietetic management goals4. With decreasing direction, design and implement an action plan for achieving dietetic goals

3. Develop suitable dietetic management goals.

4. Design and implement an action plan for achieving dietetic goals

Focus 1 2 3

In relation to patient/client intervention, planning and implementationCont’d

6. Explain how the dietitian uses information gathered and critical thinking to develop and implement a dietetic action plan to achieve the management goals

In relation to monitoring and evaluation

7. Explain how the dietitian reviews, monitor and evaluates dietetic interventions

5. With decreasing direction, review, monitor and evaluate dietetic interventions

5. Review, monitor and evaluate dietetic interventions

Focus 1 2 3

In relation to Professional attributes

8. Demonstrate consistent professional behaviour in accordance with the legal and ethical boundaries of the dietetic profession and the requirements of the Health Professions Council.

6. Understand and demonstrate reflective practice and consistent professional behaviour in accordance with the legal and ethical boundaries of the dietetic profession and the requirements of the Health Professions Council7. Communicate effectively in all areas of dietetic practice covered in placement 2

6. Understand and demonstrate reflective practice and consistent professional behaviour in accordance with the legal and ethical boundaries of the dietetic profession and the requirements of the Health Professions Council.

7. Communicate effectively in all areas of dietetic practice

Placement assessments

Placement 2 & 3In order to pass Placement 2 or 3 the student must have satisfied

the dietitian in charge of training that they have demonstrated competence in all 7 placement learning outcomes

The student must demonstrate competent practice as assessed through practice supervision and evidenced by a portfolio

Supporting material Benchmark statements Portfolio contents grid and supporting documentation

Week of placement  1 2 3 4 5 6 7 8 9 10 11 12

Individual patient/clientconsultations self review

1 1 1 1 1

ClinicalObservation form

2 2 2 2 2 2 2 1 1 1

Working with groups self review

1 1 1

Group Work Observation Form

1 1 1

Evidence of health promotion project

1

Professionalism /Clinical governance grid

1 1 1

Patient feedback form

1 1

Audit project sign off sheet

1

Care plans 1 1 1 1

Weekly review forms

1 1 1 1 1 1 1 1 1 1 1 1

End of placement summary

1

Student reflection on placement overall

1

Shaded = for completion by DietitianClear = for completion by Student. Bold = joint completion

Placement 2 and 3

•Hours – as a full time member of staff– flexibility may be required to allow for late running clinics and out of

hours work– study time – 3 hours per week

Assessment of Placements 2 & 3

Procedures in the event of failure Students who fail to meet 4 or more LOs will have failed and will be

entitled to apply for full repeat placement. Students who fail to meet up to 3 LOs will normally be allowed to extend

by up to 4 weeks. Decision to extend taken in consultation with student, placement educator

and tutor. Students failing to meet learning outcomes after an extension are entitled

to apply for a repeat placement.

Repeat Placement Panel

Repeat Placement Panel Decision to allocate repeat placements is made by Repeat Placement

Panel consisting of external examiner, dietetic practice educator who is a member of the London Dietetic Education Stakeholder Group, dietetics placement tutor and dietetics course leader.

Decision to allocate a repeat placement will be based on: total hours allowed Reasons for initial failure Action taken to address issues for failure Student engagement with remedial programme

HandbooksHandbooks

Sample portfolio in handbookPlacement 2 Handbook

Placement 3 Handbook

Additional Guidelines in handbookAdditional Guidelines in handbook

Placement RegulationsGuidelines for placement Health Promotion

ProjectsGuidelines for Placement Public Health Projectshttps://metranet.londonmet.ac.uk/fms/MRSite/

acad/fls/LD/Public%20Health%20Component%20of%20Placement%203%20Guidance%20for%20Practice%20September%202012.pdf

Placements Approval

Approval process

All new placement sites will require a placement agreement

Paperwork  Placement approval form including action plans and the

additional documents requested (practice placement profile, placement programme, organisational structure showing where the dietetics department sits and dietetic department structure to show skill mix)

emailed to dietetics@londonmet.ac.uk

HEI quality lead will review the paperwork

Approval process

VisitCarried out by an HEI representative an experienced practice educator opportunity to meet the named trainer and student training lead to discuss the programme, documentation and any further support required and key dietitians involved in training.time at the end of the visit for the visitors, named trainer and student training lead to discuss any outstanding action points.

Post visitshort summary of the visit will be provided by the HEI representative who led the approval visit.copy of the completed paperwork will be sent to the named student trainer and the HEI quality lead

References

BDA (2008) ‘Curriculum Framework for the Pre-Registration Training of Dietitians’ http://members.bda.uk.com/education/CurriculumDocument080826.pdf

BDA (2009) ‘Nutrition and Dietetic Care Process’ http://members.bda.uk.com/Downloads/NutritionDieteticCareProcessOctober2009.pdf

BDA (2012) ‘Model and Process for Nutrition and Dietetic Practice http://members.bda.uk.com/profdev/profpractice/modeldieteticpractice/index.html