Clinical ("Real World") Mentoring – Training a Dietetic Intern While at Work

1. Clinical ("Real World") Mentoring – Training a Dietetic Intern While at Work Alana D. Cline, PhD, RD Program Director, UNC Dietetic Internship

2. So, Do You Really Want to Do This Precepting? • “There is no more noble occupation in the world than to assist another human being –– to help someone succeed.” Alan Loy McGinnis • “If you don’t invest very much, then defeat doesn’t hurt very much and winning is not very exciting.” Dick Vermeil

3. Some Tools for Preceptors Teaching “Clinically” • Know what a “good” preceptor really is. • Know the limitations and strengths of interns. • Use a model for the teaching of knowledge application and use. • Additional thoughts and strategies.

4. 1) A “Good” Preceptor: • Demonstrates enthusiasm and patience; shows respect for people of all backgrounds. • Remembers interns are preparing for entry-level work; participates in own professional enhancement regularly. • Is honest, self-confident & willing to demonstrate skills for the intern.

5. A Good Preceptor (cont.): • Challenges intern performance by giving them responsibility. • Is specific with praise and appropriate feedback. • Honors the interns’ efforts.

6. 2) Limitations and Strengths of Interns: • They are intelligent with LOTS of book knowledge; they have different modes of learning – visual, auditory, practical. • They have an untested work ethic; they may not know how to prioritize work or manage time; they may be unsure of their abilities. • They may not understand the limitations imposed by reality; they are idealistic.

7. Limitations and Strengths of interns (Cont.): • They may have limited client/patient contact; limited management and foodservice experience; limited team experiences, therefore limited skills; limited communication skills. • Don’t assume a MS or PhD intern has more advanced clinical or administrative skills. It is often not the case.

8. A Model for Teaching the Application and Use of Knowledge: • DR. FIRM (PICHERT, P. 465-479) • D: demonstration, presentation, problem solving. • R: rehearsal of content. • F: feedback and correction. • I: independent practice. • R: review. • M: motivate to persevere.

9. A Model for Teaching (cont.) • Demonstration: Allow intern to observe the professional at work. Discuss problem-solving techniques. • Rehearsal: Practice with the intern the skills they need to have ready. • Feedback: Be open, corrective and specific. Give hints for efficiency, thoroughness. Quiz the intern, emphasize thoroughness.

10. A Model for Teaching (cont.) • Independent Practice: Assign deadlines for specific tasks, shorten deadlines as intern progresses. On smaller tasks, allow intern to “sink or swim”. • Review: Have intern demonstrate tasks. Identify strengths and weaknesses. Don’t assume anything, request rehearsal again if needed.

11. A Model for Teaching (cont.) • Motivate: • Explain why good and conscientious work makes a difference; and to whom it matters. • Help intern to learn: • How to collect data. • How to interpret and synthesize findings. • How to formulate alternative management plans. • How to evaluate the effect of action taken.

12. Additional Thoughts and Strategies • Create a learning environment: • Where Interns can make a mistake without fear of reprisal. • Where Interns are expected to solve problems and receive feedback for their efforts. • Where you as the Preceptor know the difference between “need to know” vs. “nice to know” in order for the intern to truly be at entry-level.

13. Additional Thoughts and Strategies (cont.) • Evaluation: • Should be ongoing during the process of rotation experience and frequent to help modify skills and behaviors. • Should be at the end of the rotation experience to determine what expectations have been met and what skills and behaviors need to be strengthened in future activities.

14. Additional Thoughts and Strategies (cont.) • Handling difficult situations; CAUSES: • Inadequate knowledge prior to the rotation. • Skill deficiencies (unable to translate theories to treatment). • Personality difficulties (poor communication and interpersonal relationships). • Situational difficulties (ex: intern’s parent died of cancer, intern avoids working w/cancer patients).

15. Additional Thoughts and Strategies (cont.) • Handling difficult situations; STRATEGIES: • First, remember that rotations can be adapted as long as the intern learns the desired competency. • Be realistic about expectations of intern. • I.D. problems early; deal with them early. • Interns need to know consequences of their actions for clinical outcomes (patient, staff, department) and for their place as an intern.

16. Additional Thoughts and Strategies (cont.) • Handling difficult situations; STRATEGIES: • Frequent, ongoing evaluation provides the forum for discussion of problems as well as positive feedback. • In discussion, be specific and to the point. • Clearly spell out rules and expectations. • Try to I.D. positive in intern to provide a foundation on which to build improvement. • Talk with the intern about situations that make them apprehensive.

17. Additional Thoughts and Strategies (cont.) • Handling difficult situations; STRATEGIES: • Provide sources of additional information outside of the rotation. • Remember also: Without you as a preceptor there could not be dietetic practice programs. You have an enormous impact on the education of aspiring practitioners. Your efforts ARE APPRECIATED!!!

18. Last But Not Least • Use the Program Director as a resource for yourself. • I will do my best to clarify the internship process. • I am here to support your efforts and advocate for both you and the intern. • My goal is success for everyone involved in the program. Your efforts should pay off for you too. • “Success comes from knowing that you did your best to become the best that you are capable of becoming.” --- John Wooden. Back to Preceptors’ Page