Dietetics students placement 1,2 & 3 transition

1. Dietetics students placement 1,2 & 3 transition

2. New Curriculum update What do you know already?

3. 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

4. Placement ‘language’ • Placement A Placement 1 • Placement B Placement 2 • Placement C Placement 3

5. 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

6. Progression from Placement 1 to 3

7. Progression from Placement 1 to 3

8. Placement Timings • Placement 1 • January • Summer (June – September) • Placement 2 • February and May / June • Placement 3 • September

9. 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

10. 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)

11. Nutrition & Dietetic Care Process

12. Nutrition and Dietetic Care Process • What is your understanding of the process?

13. 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 care • Defines the actions, critical thinking and specialist skills that are components of the dietetic intervention • Can apply to an intervention with: • An individual • An education or therapeutic group • A defined population or public health campaigns with a community

14. Diagnosis • Identify and label problem • Determine contributing risk factors • Cluster signs and symptoms • Assessment • Collect timely & appropriate data • Interpret with evidence-based standards • Intervention • Plan nutrition intervention • Implement nutrition intervention • Monitoring and Evaluation • Monitor progress • Measure outcome indicators • Evaluate outcomes Nutrition and Dietetic Care Process Screening and Referral

15. 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

16. New Curriculum update Placement learning outcomes • Based 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 . . . .

17. 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

18. Nutrition and Dietetic Care Process: Placement Learning • 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

19. Placement 1,2, 3

20. Focus 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.

21. Placement 1

22. 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.

23. 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.

24. 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

25. Placement 1 Workbook Activities • Focused around each component of assessment: • Nutrition Screening • Anthropometry • Biochemistry • Clinical assessment • Dietary assessment • Environment/ Economic/ Educational • Can be completed independently or in pairs/ small groups • Placement 1 workbook

26. 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.

27. 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.

28. Placements 2 & 3

29. Placement 2 and 3 • Duration - 12 week block placement 2 - 14 week block placement 3 (3 week public health component)

30. Learning Outcomes

34. Placement assessments Placement 2 & 3 • In 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

35. Shaded = for completion by Dietitian Clear = for completion by Student. Bold = joint completion

36. 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

37. 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.

38. 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

39. Handbooks • Sample portfolio in handbook Placement 2 Handbook • Placement 3 Handbook

40. Additional Guidelines in handbook • Placement Regulations • Guidelines for placement Health Promotion Projects • Guidelines for Placement Public Health Projects https://metranet.londonmet.ac.uk/fms/MRSite/acad/fls/LD/Public%20Health%20Component%20of%20Placement%203%20Guidance%20for%20Practice%20September%202012.pdf

41. Placements Approval

42. 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

43. Approval process Visit • Carried 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 visit • short 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

44. 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