Preceptor Training & Luncheon March 10, 2016 Respect, Reward, Recognize Respect, Reward, Recognize You, the preceptor, are my partner in the education of dietetic interns. My goal is to have you actively participate in the continuous quality improvement process surrounding the UCA Dietetic Internship (DI).Your input regarding the interns, scheduling, rotations, assignments, etc. is essential to the success of this internship. I RESPECT your expertise and welcome your feedback on a continuous basis, both through informal and formal means. The UCA Dietetic Interns must demonstrate professional attributes including timeliness, organization, RESPECT, a positive attitude, motivation, open-mindedness, flexibility, and patience. Interns must always be RESPECTFUL of your willingness to precept and understand that your full-time commitment and priority to providing patient/client care and/or high-quality food and nutrition services is in addition to precepting. In an effort to REWARD you for your time and to make the precepting of UCA dietetic interns as efficient and seamless as possible, we host a preceptor training and luncheon each spring. Additionally, we strongly recommend that all preceptors complete the on-line CDR Dietetic Preceptor Training Course. Each August at the Dietetic Intern Graduation Reception, preceptors will be RECOGNIZED for their contribution to the UCA DI program. Interns will nominate preceptors in each of three areas: Community, Clinical, and Foodservice. These preceptors will also be nominated for the AND Outstanding Preceptor Award. History of the UCA DI Housed in Department of Family & Consumer Sciences, College of Health & Behavioral Sciences 1991: Established as an AP4 program 1998: Awarded DI status 2011: Awarded continued accreditation for 10 years 2015: Approved for pre-select option and PhD RD ISPP Mission The mission of the UCA Dietetic Internship is to provide a high quality program in dietetics, dedicated to assisting interns with development of needed skills for the varied roles of the dietitian in today’s society by providing a supervised practice component which ultimately culminates in registration eligibility with the Accreditation Council for Education in Nutrition and Dietetics (ACEND). Interns will be provided opportunities to develop expertise in nutrition therapy, community nutrition, foodservice systems management, and business/entrepreneur competencies while developing professional attitudes and competent professional behavior. Goals The dietetic internship implements its mission through the establishment of the following program goals: 1. Prepare graduates to be competent, professional entry-level dietitians. 2. Provide graduates with a basic knowledge of a broad range of career opportunities in the field of dietetics. 3. Prepare graduates for employment in community health and/or community nutrition programs. ACEND Requirements • The Accreditation Council for Education in Nutrition and Dietetics defines 23 standards for Dietetic Internships. • Five of these 23 standards involve preceptors. Eligibility for ACEND Accreditation 1. Program Characteristics and Finances 2. Title IV Compliance for Free-Standing Programs 3. Consortia Program Planning and Outcomes Assessment 4. Program Mission 5. Program Goals 6. Program Objectives 7. Program Assessment 8. On-going Program Improvement Curriculum & Student Learning Objectives 9. Program Concentrations 10. Curricular Mapping 11. Learning Activities 12. Curriculum Length 13. Learning Assessment 14. On-going Curricular Improvement Program Staff and Resources 15. Responsibilities of the Program Director 16. Faculty and Preceptors 17. Continuing Professional Development 18 Program Resources 19. Supervised-Practice Facilities Students 20. Student Progression and Professionalism 21. Student Complaints 22. Information to Prospective Students and the Public 23. Policies and Procedures Standard 10: Curricular Mapping The program must map its curriculum around ACEND’s Core Knowledge and Competencies using sound educational methodology to prepare graduates to enter dietetics practice in any setting and produce optimal client or patient outcomes. Guideline 10.1 a. The curriculum map must identify didactic and supervised practice course(s) that interns will complete to meet each of the Core Knowledge and Competencies, including the Support Knowledge and the Concentration Competencies defined in Standard 9, Program Concentrations. b. The curriculum map must include supervised practice experiences that occur in various settings or practice areas to achieve the competencies in a manner appropriate for implementing the curriculum. Programs should include such areas as acute care, extended care, public health/community, prevention and wellness, and food service, but may also include other areas such as education, research, informatics, genetics/genomics, management, consultation, and so on. c. The curriculum map must sequentially and logically organize the progression of didactic and supervised practice courses from introductory to more advanced learning activities and build on previous knowledge or experience to achieve the expected depth and breadth of knowledge and competency by completion of the program. d. The curriculum map must culminate in experiences (such as planned staff experience) to demonstrate entry-level competence. Evidence Guideline 10.1 Evidence a. Curriculum map shows all ACEND required competencies met (see below) b. Curriculum map shows all ACEND required settings and practice areas (see below) c. Foodservice management progression: general management functions school foodservice staff training. Clinical progression: general medicine, wellness, WIC, LTC, pediatrics diabetes, renal critical care, nutrition support staffing. d. Two week school foodservice staffing at the end of the first summer. Two week clinical staffing at the end of the second summer. Semester 1 (First Summer) FACS 5315 Nutrition Services Practicum I (3 hours) & Foodservice Rotations FACS 5316 Nutrition Services Practicum II (3 hours) & Foodservice Rotations FACS 5317 Community Nutrition Practicum (3 hours) & Community Rotations FACS 5321 Nutrition Services Administration (3 hours) & Management Rotations X X X X X X X X X X X X X X X X X X X CRD 2.13 CRD 2.12 CRD 2.11 CRD 2.10 CRD 2.9 CRD 2.8 CRD 2.7 CRD 2.6 CRD 2.5 CRD 2.4 CRD 2.3 CRD 2.2 CRD 2.1 CRD 1.5 CRD 1.4 CRD 1.3 CRD 1.2 Courses & Rotations CRD 1.1 Curricular Map X X X X X X X X X Semester 2 (Fall) X FACS 5324 Nutritional Assessment (3 hours) X Research Rotation X X Community / Public Health Rotations X X X Semester 3 (Spring) NUTR 6335 Nutrition Counseling (3 hours) & Wellness Rotations X X X X X X X X X X X X X X X X X X X LTC Rotation X Community Rotations X Public Policy Rotation Semester 4 (Second Summer) FACS 5318 Clinical Nutrition Practicum (3 hours) FACS 6313 Diet Therapy (3 hours) & Acute Care Rotations X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X CRD 4.11 X CRD 4.10 X CRD 4.9 X CRD 4.8 X CRD 4.7 X CRD 4.6 X CRD 4.5 X CRD 4.4 X CRD 4.3 X X X Semester 2 (Fall) FACS 5324 Nutritional Assessment (3 hours) X X X Research Rotation Community / Public Health Rotations X Semester 3 (Spring) NUTR 6335 Nutrition Counseling (3 hours) & Wellness Rotations X X X X X X X X X X LTC Rotation X Community Rotations X X X X Public Policy Rotation Semester 4 (Second Summer) FACS 5318 Clinical Nutrition Practicum (3 hours) FACS 6313 Diet Therapy (3 hours) & Acute Care Rotations CRD 4.2 CRD 4.1 CRD 3.6 CRD 3.4 CRD 3.3 CRD 3.5 Semester 1 (First Summer) FACS 5315 Nutrition Services Practicum I (3 hours) & Foodservice Rotations FACS 5316 Nutrition Services Practicum II (3 hours) & Foodservice Rotations FACS 5317 Community Nutrition Practicum (3 hours) & Community Rotations FACS 5321 Nutrition Services Administration (3 hours) & Management Rotations CRD 3.2 CRD 3.1.e CRD 3.1.d CRD 3.1.c CRD 3.1.b CRD 3.1.a Courses & Rotations CRD 3.1 Curricular Map X X X X X X X X X X X X X X X X X X X X X X X X X X X Standard 11: Learning Activities The program’s curriculum must provide learning activities to attain all the competencies defined to enter practice as a registered dietitian. Guideline 11.1 a. Learning activities must prepare interns for professional practice with patients/clients with various conditions, including, but not limited to overweight and obesity, diabetes, cancer; cardiovascular, gastrointestinal and renal diseases. b. Learning activities must prepare interns to implement the nutrition care process with various populations and diverse cultures, including infants, children, adolescents, adults, pregnant/lactating females and the elderly. c. Learning activities for interns must develop collaboration, teamwork, problem-solving, critical- thinking and self-assessment skills; and personal and professional attitudes and values, cultural competence, leadership and decision-making skills. AKA soft skills d. Learning activities must use a variety of educational approaches (such as field trips, role-playing, simulations, problem-based learning, classroom instruction, laboratory experiences) necessary for delivery of curriculum content, to meet learner needs and to facilitate learning objectives. e. Learning activities must include opportunities for interns to participate in interdisciplinary learning activities. f. Learning activities must be documented in course syllabi and supervised practice rotation descriptions with clearly defined objectives reflecting the breadth and depth of didactic and supervised practice course content and expected student performance. Evidence Guideline 11.1 Evidence a. Rotations include counseling, critical care, diabetes, general medicine, nutrition support, renal, weight management, and wellness. b. ADIME charting required in all courses and by most practice sites. Rotations include LTC, pediatrics, and WIC. c. Interns work with Chefs and foodservice staff, community nutrition professionals, and all members of the health care team (physicians, nurses, pharmacists, therapists); conduct grocery store tours, cooking classes, patient education / support groups; professional development portfolio including ethics and values; foodservice and clinical staffing. d. Approaches include classroom instruction, online modules (Molly Kellogg, CITI, WIC), and counseling role-playing. e. All rotations involve interdisciplinary learning activities including foodservice management, Cooperative Extension, Senior Citizen’s Centers, DHS, clinical rotations (e.g., patient rounds, discharge planning). f. Course syllabi and rotation evaluations document learning activities as defined by ACEND. Standard 16: Faculty and Preceptors The program must have a sufficient number of qualified faculty and preceptors to provide the depth and breadth of learning activities required in the curriculum and exposure to the diversity of practice. Guidelines Guideline 16.1 In addition to the program director, other full-time or adjunct faculty (such as practitioners) must teach profession-specific courses in the program Guideline 16.2 a. Program faculty, including the program director, must meet the college/university’s criteria for appointment, if the program is sponsored by a college/university. b. Preceptors must be credentialed or licensed as appropriate to meet state and federal regulations for the area in which they are supervising interns. c. The program must have a process for the periodic review of the effectiveness of faculty and preceptors. Guideline 16.3 a. New faculty members, instructors, and teaching assistants must be provided an orientation to the mission, goals, values, and educational philosophy of the dietetics program b. Preceptors must be provided orientation to the supervised practice objectives and professional competencies before assuming responsibilities Evidence Guideline 16 16.1 Evidence Program Director teaches: First Summer – Management Emphasis Summer I (6 hours): FACS 5315 Nutrition Services Practicum I FACS 5316 Nutrition Services Practicum II Summer II (6 hours): FACS 5317 Community Nutrition Practicum FACS 5321 Nutrition Services Administration Fall between Summers (3 hours): FACS 5324 Nutritional Assessment Spring between Summers (3 hours): NUTR 6335 Nutrition Counseling Second Summer - Clinical Emphasis May Intersession (3 hours): FACS 5318 Clinical Nutrition Practicum 10-Week (3 hours): FACS 6313 Diet Therapy Preceptors teach: Pediatric Orientation, WIC Orientation 16.2 16.3 PD meets UCA’s criteria for appointment (RDN credential, PhD, clinical experience). All preceptors are credentialed by CDR and have experience in their area of supervised practice. PD receives student evaluations at the end of each academic course as well as evaluation by interns at mid-point and end of the internship. Interns evaluation preceptors and rotation sites at the end of each rotation. New faculty orientation includes the mission, goals, values, and educational philosophy of the dietetics program. Preceptor orientation and handbook includes supervised practice objectives and professional competencies before assuming responsibilities. Standard 17: Continuing Professional Development Program faculty, including the program director and preceptors, must show evidence of continued competency appropriate to teaching responsibilities, through professional work experience, graduate education, continuing education, research or other activities leading to professional growth and the advancement of their profession. Guideline 17.1 a. All faculty members should receive on-going training to become proficient in the use of the program’s technology and educational methodologies. b. All faculty members, including preceptors, instructors, and teaching assistants should receive on-going training based on evaluation by the program director and feedback from interns. c. All faculty members, including preceptors, should be familiar with the purpose of ACEND’s accreditation process and intent of the standards. Evidence Guideline 17.1 Evidence a. UCA IDC provides on-going training regarding technology and educational methodologist. Faculty attend at least one training each academic year. b. On-going training for preceptors include Spring Preceptor Symposium, DI Handbook, and intern evaluations (provided in aggregate at the end of each academic term). c. ACEND Mission: ACEND ensures the quality of dietetics education to advance the practice of the profession. ACEND Vision: ACEND is valued for advancing excellence in dietetic education. ACEND Values: ACEND volunteers and staff exhibit the following values in their accreditation activities and interpersonal interaction: Objectivity—ACEND board members, program reviewers and staff evaluate all matters related to program evaluation in a fair and unbiased manner. Integrity—ACEND board members, program reviewers and staff demonstrate honest and ethical behavior in all interactions, actions and decisions. Accountability—ACEND board members, program reviewers and staff accept responsibility for assuring that ACENDaccredited programs provide education and experiences that meet all accreditation standards. Respect—ACEND board members, program reviewers and staff treat all people with consideration, courtesy, and dignity. Standard 19: Supervised-Practice Facilities The program must have policies and procedures to maintain written agreements with institutions, organizations and/or agencies providing supervised practice experiences to meet the competencies. The policies and procedures must address the selection and periodic evaluation of adequacy and appropriateness of facilities, to ensure that facilities are able to provide supervised practice learning experiences compatible with the competencies that interns are expected to achieve. Guideline 19.1 a. A program under the Didactic Nutrition and Dietetic Education Program standards is not required to demonstrate compliance with Standard 19 and its guidelines if it does not provide supervised practice to its students. b. Agreements must be signed by administrators with appropriate authority in advance of placing students/interns c. Agreements must delineate the rights and responsibilities of both the sponsoring organization and affiliating institutions, organizations and/or agencies Affiliate Agreements Policy The master Memorandum of Agreement approved by the UCA Legal Council will be used for all potential rotation sites. The potential site will review the agreement, discuss any potential areas of conflict, sign the agreement and return to the Internship Director. Original, signed Memorandum of Agreements will be kept in a filing cabinet in the director's office. Each site will be provided with a signed copy of the Agreement. The Memorandum of Agreement will be signed and filed with the Internship Director prior to any intern beginning their rotation at that facility. The agreement is open-ended pending a 30-day written notice from either party. Preceptor Roles Planner – Preceptors serve as planners in a number of capacities. On a day-to-day basis, they are responsible for planning the experiences and learning activities of the intern. In addition, they play an integral role in the planning and modification of the curriculum and supervised practice experience in conjunction with the DI team. Role model – By exemplifying professional behaviors and the principles outlined in the Code of Ethics, preceptors teach by example. Information provider – By sharing relevant information in their area of expertise and staying current with recent developments and research, preceptors serve as information providers and assist interns with gathering the necessary information for competency development. Facilitator of learning – Preceptors function as facilitators of learning by coupling experiences and tools with guided questioning and feedback. In this manner, interns are able to develop critical thinking and problem solving skills. Resource developer – By guiding interns to the appropriate materials (current research, protocols, practice guidelines, manuals, etc.) and other professionals that will assist interns in their practice and professional development, preceptors serve as resource developers. Assessors of learning – Preceptors serve as front-line evaluators of interns’ learning and competence as they progress through the supervised practice rotation. Preceptor Resources DI Director, Nina Roofe: nroofe@uca.edu Website: http://uca.edu/facs/programs/dietetic- internship/preceptors/ UCA DI Preceptor Handbook CDR: http://www.cdrnet.org/ Community of AR preceptors Why Be a Preceptor? Giving back to the profession—someone precepted for each of us Shape the future of the profession Networking and sharing of ideas Excitement and energy of interns CPEUs Spring Symposium (4 CPEUs) CDR Dietetics Preceptor Course (8 CPEUs): http://www.cdrnet.org/news/online-dietetics-preceptor-trainingcourse-free-of-charge Molly Kellogg Counseling Modules (4 CPEUs)—request access code from DI Director CHBS Webinars Torreyson Library on-site access How to Give Effective Feedback Clear expectations lead to improved outcomes and evaluations. Give Positive Feedback Confronting This is based on observable behaviors and facts: Criticizing This is based on feelings and perceptions: Problem--focuses on the problem, with concrete, objective facts. Specific--identifies specifically what should occur or change starting with the most recent event. Change--focuses on the future and what can be changed, not on making the intern feel guilty, weak, or pessimistic; encourages intern to want to change. Relationship--focuses on improving performance, increasing commitment, and building a positive work relationship. Person--focuses on the person and her attitude or traits. General--uses general statements that may magnify the problem by using words like never, always, continually and so on. Blame--establishes blame, making the intern feel guilty and focuses on the past. Self-centers on the needs of the preceptor and sometimes involves venting own anger or frustration. Examples DESCRIBE the intern’s behavior RATHER THAN JUDGE the intern. “I saw you using the elevator. Remember to take the stairs when possible to keep the elevators uncongested.” Not, “Don’t be so lazy by taking the elevator”. PROVIDE SPECIFIC FEEDBACK, NOT GENERAL. “You need to wear a hairnet when you are in the kitchen.” Not “You’re not prepared to work with your hair that way”. PROVIDE CONCERN FOR the NEEDS OF both YOURSELF AND the INTERN. “I need to take a break from this situation. Please meet me in 30 minutes in my office and we will discuss the language you used with the cook.” Not, “I don’t have time for this nonsense. Don’t be rude to the cook anymore!” DIRECT FEEDBACK TO SPECIFIC BEHAVIOR which the INTERN CAN actually CHANGE. “The last time we met to evaluate your progress, I felt uncomfortable when you interrupted me and stood up and leaned toward me. Today when I review your progress, I will appreciate your staying seated and not interrupting. You will be given time to tell me things you believe I do not know.” The INTERN SOLICITS FEEDBACK. This is evidenced by the intern asking YOU how a specific situation or event or behavior was accomplished. This is an ideal situation—but not usually what occurs. TIME your FEEDBACK APPROPRIATELY. It should be as immediate as possible so that clarity is not lost. CHECK YOUR UNDERSTANDING with the Intern TO ENSURE CLEAR OMMUNICATION. “I want to check that we have both arrived at the same conclusions about how you will fulfill this competency. Please reiterate for me the steps you will take to complete this objective.” Difficult Interns Although the UCA DI Director and Selection Committee screen and select interns carefully, match them cautiously with each other and with preceptors, and select only the very best, we do occasionally have a difficult intern. Please respond to the difficult intern much the same as you respond to a difficult employee. If there are specific behaviors you won’t tolerate from your employees and staff, you should not tolerate them from the interns. Include the UCA DI Director as necessary as you work with the difficult intern, we must have documentation at all levels if we are expected to take any action. Sometimes the action will include simply placing the intern in another location---perhaps there is a personality conflict. Other times the action will include terminating the intern’s participation in the program entirely. Thank-You! We would not have a program without YOU! Questions?