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UBC Dietetics Program. Forum for Enhanced Education & Discussion (FEED):. NUTRITION CARE SESSION. December 6 th 2018. To join the teleconference:

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  1. UBC Dietetics Program Forum for Enhanced Education & Discussion (FEED): NUTRITION CARE SESSION December 6th 2018 To join the teleconference: From the Vancouver area, call 604-899-2339From outside Vancouver, call toll-free 1-877-385-4099After calling the number, enter the password: 6836560#

  2. Nutrition Care I, II & III Modules Teaching & Learning Resources Mini-workshop Wrap-up TODAY’S PLAN

  3. PRACTICE EDUCATION: BRIEF OVERVIEW

  4. Nutrition care (nc) Modules 2013 Integrated Competencies for Dietetic Education and Practice (ICDEP) led to program changes: Terminology (i.e., “clinical” to “nutrition care”) New competency and performance indicator language Decreased focus on exposure to all areas of practice; emphasis on broad skill development Nutrition Care Competencies: Assess nutrition-related risks and needs (14 indicators) Develop nutrition care plans (10 indicators) Manage implementation of nutrition care plans (4 indicators) Evaluate and modify nutrition care plans (4 indicators)

  5. Nutrition care (NC) Modules Additional Competencies Progress towards managing a small patient caseload Design enteral feeding (8 indicators) Design parenteral feeding (5 indicators) Deliver group education sessions (comm. & collaboration) Develop learning resources (comm. & collaboration) Develop effective patient/client counseling approaches (comm. & collaboration)

  6. NC MODULES: COMPETENCIES All 3 components together ensure students are ready for entry level dietetic practice.

  7. Module forms & expectations Expectations/Roles: Students manage the module forms Module requirements section (pg 2) – a student responsibility Student identifies learning goals and draws preceptor attention to module activities and timelines Preceptors provide support and guidance Teach student practical skills & applications of knowledge Provide ongoing feedback to support development Verify competence through evaluation

  8. NC I: MODULE requirements • See: Summary of Changes to Modules and Forms

  9. NC ii: Module requirements

  10. What Year 5 students should know on day 1 of practice education ICDEP knowledge areas related to NC: Anatomy & Physiology Biochemistry Food Health System in Canada Human Nutrition Across the Lifespan Microbiology Nutrition Assessment Nutrition Care Process & Medical Nutrition Therapy Pharmacology Population Food Systems and Food Security Communication Teaching & Learning

  11. Nutrition Care Process & Medical Nutrition Therapy Etiology and pathophysiology of nutrition-related diseases Nutrition-related disease management strategies Use of assessment, diagnosis, intervention, monitoring, evaluation (ADIME) in medical nutrition therapy    Calculation of energy and nutrient requirements for conditions/diseases Goal setting and outcome measurement in nutrition therapy Oral, enteral, and parenteral nutrition support Feeding assessment, including identification of chewing, swallowing and feeding problems Complementary and alternative nutrition therapies What Year 5 students should know on day 1 of practice education

  12. Human Nutrition Across the Lifespan Ingestion, digestion, absorption, metabolism and excretion of nutrients Biochemical utilization of nutrients and energy Nutrient and energy requirements Physical activity and energy balance Nutrition recommendations and guidelines Effect of deficiencies and toxicities of nutrients Food sources of nutrients and dietary supplements Role of nutrients and other food components in health Dietary practices What Year 5 students should know on day 1 of practice education

  13. Food Physical properties and chemical composition of food Food preservation, storage and packaging Role of ingredients and their interaction in food preparation Household food preparation Application of dietary requirements, guidelines, guidance tools to food planning Food modification to address therapeutic, textural or other needs Sensory evaluation of food Religious and cultural food practices Food labeling Food-borne illness What Year 5 students should know on day 1 of practice education

  14. Population Food Systems and Food Security Food production, preparation, processing, distribution and waste management Global and local food systems and factors affecting the supply of food Sustainable food practices Food markets and marketing of food Factors affecting access to food Disaster planning Food consumption patterns and trends What Year 5 students should know on day 1 of practice education

  15. Teaching & Learning Resources NC I, II, and III Module Forms Each form has a checklist section to assist preceptor and Year 5 students to plan activities to meet competencies Nutrition Tracking Form Tube Feeding Modules & Simulations (NC II only) Available at: UBC Dietetics Practice Education Website

  16. Teaching & Learning Resources Setting the Stage for Success (handout, video) What Makes a Successful Preceptor (videos) Using Questions as a Teaching Strategy (video) Promoting Critical Thinking (handout) Providing Effective Feedback (handout) Student Performance Issues Flowchart (handout) Annual Preceptor Education Events (videos) Available at: UBC Dietetics Website (Preceptor tab)

  17. Mini workshop: PROVIDING EFFECTIVE FEEDBACK

  18. Mini workshop: PROVIDING EFFECTIVE FEEDBACK 1 minute activity With a partner, or on your own: Reflect back to a time when you received some constructive feedback. What factors do you think influenced how well the feedback was received?

  19. Mini workshop: PROVIDING EFFECTIVE FEEDBACK • Environmental factors • How often? • Where? • Consider timing. Quality of Feedback • Interpersonal factors • Confidence • Personality • Learning style • Communication style • Culture • Generational • Situational factors • Content (positive vs negative) • Specificity

  20. Mini workshop: PROVIDING EFFECTIVE FEEDBACK 1 minute activity With a partner, or on your own: What challenges have you encountered when providing students with feedback?

  21. TIPS FOR providing EFFECTIVE feedback Set the stage. Discuss ahead of time how often and how feedback will be provided (immediately after activity, on the fly, end of the day). Consider including how the feedback will be use in the evaluation process. Establish a safe learning environment. Choose a private space, one on one, and allow adequate time to complete the discussion. Prompt student to self-assess first. How do you feel it went? If you were to do it again, what would you do the same/different? What did you learn from the session? Ask permission before providing feedback. Would you be open to receiving some feedback right now? Be clear and specific. Convey key messages only. Avoid generalizing language (i.e., always, never). Focus on the action, and not the person. Be aware of your tone and body language. Encourage student to develop a plan.Ask them come up with strategies for improving performance. If the student is unsure, provide guidance. Close the feedback discussion. Confirm understanding (What do you think” or “how do you feel about...”), and next steps. Keep feedback separate from evaluation.

  22. RESOURCES ON providing effective feedback Video available at: http://dietetics.landfood.ubc.ca/preceptors/preceptor-events/ Handout available at: http://dietetics-landfood.sites.olt.ubc.ca/files/2016/07/Providing-Effective-Feedback-May-13-16.pdf

  23. REFERENCES Dietitians of Canada. Preceptor Education eLearning Course for Dietitians. 2018. https://courses.dietitians.ca/course/view.php?id=74 Hardavella G, Aamli-GaagnatA, Saad N, RousalovaI, Sreter KB. How to give and receive feedback effectively. 2017; 13(4): 327-333. Wilkinson ST, Couldry R, Phillips HP, Buck B. Preceptor development: providing effective feedback. Hosp Pharm. 2013; 48(1): 26-32.

  24. Reference slides: FEEDBACK from students/preceptors Feedback collected regularly: Modules and forms: annually (preceptors, students, coordinators) Year 5 student satisfaction survey: annually Preceptor satisfaction survey: every 2 years Student and preceptor surveys: Satisfaction measured with 5-point Likert scales Open-ended questions - things that work well, opportunities for improvement

  25. Year 5 Student Survey 2018 All Year 5 students respond to survey (n=33), requirement of practice education Generally high satisfaction with NC Satisfaction with various aspects ranges from 3.7 to 4.58 Previous low satisfaction with academic preparedness has improved from 2.79 (2017) to 3.7 (2018) Likely due to revised nutrition care courses, FNH 470 & FNH 475 Reference slides: FEEDBACK from students/preceptors

  26. Year 5 Student Survey 2018 Things that worked well: Ongoing constructive feedback with opportunities to apply learning and demonstrate growth Progressive NC module structure (NC I, II, III) Supportive preceptors who were keen to teach, allowed students to learn by doing Exposure to a good variety of clinical areas, mix of inpatient and outpatient experiences Reference slides: FEEDBACK from students/preceptors

  27. Year 5 Student Survey 2018 Improvement Opportunities: Module forms are too long Some students felt it wasn’t feasible to complete all readings Level of independence expected in each module varied by preceptor Home enteral teaching and parental experiences were difficult to obtain for some students Placements should be at least 3-weeks long Decrease or reallocate NCII expectations (education resource, oral presentation, group education) Like the idea of having the same preceptor for a module Reference slides: FEEDBACK from students/preceptors

  28. Preceptor Survey 2017 Respondents (n=100): NC I - 22, NC II - 56, NC III - 22 Respondents mostly satisfied with NC modules • Mean scores of 3.79 to 4.36 out of 5 • Majority of means over 4 Lowest scores related to: student academic preparedness (mostly in NC I & II) • Anticipate low scores to improve next year with implementation of revised nutrition care courses - FNH 470 & FNH 475 Reference slides: FEEDBACK from students/preceptors

  29. Preceptor Survey 2017 Things that worked well: Module forms are an improvement from past years – e.g. placement planning checklist, performance guide; less time consuming to complete Having a plan for readings, questions etc. for intern to complete before/during placement 3-week placement length is an improvement Interns who are well-prepared, motivated and self-directed with their learning do well Active participation in NC I sets them up well for NC II (rather than primarily observing) Reference slides: FEEDBACK from students/preceptors

  30. Preceptor Survey 2017 Improvement Opportunities: Clearly communicate expectations that interns need to do self-directed work on their own time to support learning Difficult to manage time and workload while supporting an intern Clarify expectations re caseload (particularly for NC III) More independence earlier in NC modules to better prepare interns for NC II & III, particularly ensuring hands-on practice in NC I Reference slides: FEEDBACK from students/preceptors

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