UNC DIETETIC INTERNSHIP
ROTATION EVALUATION
COMMUNITY ROTATIONS
Intern Name
Date(s) of Experience
Experience Site(s)
Preceptor / Evaluator
Performance Standards (as defined in Competency Evaluation Guidelines):
4 = Exceptional
3 = Proficient
2* = Needs improvement (Intern will need to repeat the experience)
1* = Deficient (Intern will need to repeat the experience)
PRECEPTOR INITIAL ON EACH BULLETED ITEM WHICH IS APPLICABLE TO INDIVIDUAL ROTATION
Individual activities are organized under appropriate Competencies as required by ACEND.
One rotation evaluation will be used for all required activities and evaluations. The intern will keep the evaluation form until
all competencies have been evaluated during rotations at multiple facilities, if necessary.
Competencies
(CRD 1.2) Apply evidence-based guidelines, systematic reviews and scientific literature
(such as the Academy Evidence Analysis Library, Cochrane Database of Systematic
Reviews and the U.S. Department of Health and Human Services, Agency for
Healthcare Research and Quality, National Guideline Clearinghouse Web sites) in the
nutrition care process and model and other areas of dietetics practice.
Has the intern…
 Developed and presented an education class for a community program
(wellness, WIC, long-term care, or public health).
COMMENTS:
(CRD 1.4) Evaluate emerging research for application in dietetics practice:
Has the intern…
 Completed a scientific research module on identifying quality research, and
submit to preceptor a written critique for a research article published in a
nutrition related publication.(Clin, FS, or Comm)
 Discussed with preceptor articles from professional literature regarding
new aspects of community nutrition intervention on topics of interest.
COMMENTS:
4
3
2*
1*
(CRD 1.5/DI 4.5) Conduct research projects using appropriate research methods,
ethical procedures and statistical analysis. / Conduct clinical and customer service
quality management activities.
Has the intern…
 Researched a community nutrition-related problem and written a proposal
for studying or solving the problem.
COMMENTS:
(CRD 2.2) Demonstrate professional writing skills in preparing professional
communications (e.g. research manuscripts, project proposals, education materials,
policies and procedures):
Has the intern…
 Demonstrated ability to use computer hardware, software technology, webbased resources and the Internet to complete assignments and
experiences and communicate effectively
 Followed facility format and guidelines when developing documents
COMMENTS:
(CRD 2.3/CRD 2.4) ) Design, implement and evaluate presentations to a target
audience. / Use effective education and counseling skills to facilitate behavior change.
(considering life experiences, cultural diversity and educational background of the target
audience):
Has the intern…
 Created appropriate education materials, conducted and evaluated an inservice training for employees. (Clin, FS, or Comm)

Used the Academy Evidence-Based Library and develop a written
patient/ client material in a clinical or community setting. (Clin or Comm)
COMMENTS:
(CRD 2.5/CRD 2.10) Demonstrate active participation, teamwork and contributions in
group settings / Establish collaborative relationships with other health
professionals(physicians, nurses, pharmacists, etc.), and support personnel to deliver
effective nutrition services:
Has the intern…
 Interacted with other healthcare professionals. (Clin or Comm)
 Participated in information sessions with care givers. (Clin or Comm)
COMMENTS:
(CRD 2.6/CRD 2.8) Assign patient care activities to DTRs and/or support personnel as
appropriate. (considering the needs of the patient/client or situation, the ability of support
personnel, jurisdictional law, practice guidelines and policies within the facility) / Apply
leadership skills to achieve desired outcomes:
Has the intern…
 Provided RD staff relief (Comm - optional).
COMMENTS:
(CRD 2.7) Refer clients and patients to other professionals and services when needs
are beyond individual scope of practice:
Has the intern…
 Used appropriate judgment and referred clients and patients to other
professionals and services when needs are beyond individual scope of
practice. (Can be done in Clin)
 Investigated and developed material detailing available resources in the
community. (Clin or Comm)
COMMENTS:
(CRD 2.9) Participate in professional and community organizations:
Has the intern…
 Attended meeting(s) of professional organizations as available. (Clin, FS,
or Comm)
 Participated in a community organization’s outreach activity (Food Bank,
Salvation Army, etc.)
COMMENTS:
(CRD 2.11) Demonstrate professional attributes within various organizational cultures
(showing initiative and proactively developing solutions, advocacy, customer focus, risk
taking, critical thinking, flexibility, time management, work prioritization and work ethic:
Has the intern…
 Used appropriate judgment when initiating change and improving quality in the
organization.
 Used critical thinking, flexibility, and time management skills when completing
projects within the organization.
 Participated in activities to promote the dietetic profession and advocate for
clients and/or consumers. (Clin, FS or Comm)
COMMENTS:
(CRD 2.12) Perform self-assessment, develop goals and objectives and prepare a draft
portfolio for professional development as defined by the Commission on Dietetics
Registration:
Has the intern…
 Begun work on the Commission on Dietetic Registration’s Professional
Development Portfolio Process.
COMMENTS:
(CRD 3.1.a.) Assess the nutritional status of individuals, groups and populations in a
variety of settings where nutrition care is or can be delivered:
Has the intern…
 Interviewed patients/clients and gathered information appropriately to
complete an assessment and subsequent direction of nutritional
needs(optional)
 Conducted general screening and assessment using lab values, other
measures, and facility check-sheets as needed. (optional)
COMMENTS:
(CRD 3.1.b.) Diagnose nutrition problems and create problem, etiology, signs and
symptoms (PES) statements:
Has the intern…
 Applied and interpreted lab values for appropriate patient / client evaluation
(optional).
COMMENTS:
(CRD 3.1.c.) Plan and implement nutrition interventions to include prioritizing the
nutrition diagnosis, formulating a nutrition prescription, establishing goals and selecting
and managing intervention:
Has the intern…
 Coordinated and modified nutrition care activities among caregivers (optional).
 Charted as is appropriate in the community setting (optional).
COMMENTS:
(CRD 3.2) Demonstrate effective communications skills for clinical and customer
services in a variety of formats (using oral, print, visual, electronic and mass media
methods for maximizing client education, employee training and marketing:
Has the intern…
 Used the SMOG or similar readability formula effectively for developing written
materials for patient, client and general populations.(can also be completed in
Clin or Nutrition Education concentration)
 Participated in a community awareness activity (i.e., health fair, published an
article) (Clin or Comm)
COMMENTS:
(CRD 3.3/CRD 4.9/ CRD 4.10) Develop and deliver products, programs or services that
promote consumer health, wellness and lifestyle management (consider health
messages and interventions that integrate consumer desire for taste, convenience and
economy with nutrition, food safety) / Analyze financial data to assess utilization of
resources / Develop a plan to provide or develop a product, program or service that
includes a budget, staffing needs, equipment and supplies:
Has the intern…
 Participated in a community based health promotion/ disease prevention
program. (Clin or Comm)
 Revised and distributed a modified recipe for consumers or clients. (Clin or
Comm)
 Reviewed budget for community agency services
COMMENTS:
(CRD 3.4) Deliver respectful, science-based answers to consumer questions
concerning emerging trends:
Has the intern…
 Identified an emerging trend of concern for consumers and developed a
client/patient fact sheet to answer commonly asked questions. (Clin or Comm)
. COMMENTS:
(CRD 3.5) Coordinate procurement, production, distribution and service of goods and
services:
Has the intern…
 Participated in as many of the following community programs as feasible,
identifying program mission and objectives:
o Supplemental Nutrition Assistance Program (SNAP)
o Summer Foodservice Program for Children
o Food Distribution Program (Food Bank)
o Commodity Supplemental Food Program
o Congregate and Home-Delivered Meal Programs
. COMMENTS:
(CRD 3.6) Develop and evaluate recipes, formulas and menus for acceptability and
affordability that accommodate the cultural diversity and health needs of various
populations, groups and individuals:
Has the intern…
 Written a cycle menu for a target population. (Clin, FS, or Comm)
. COMMENTS:
(CRD 4.1) Participate in management of human resources:
Has the intern…
 Participated in human resources activities, as the experience becomes
available.
. COMMENTS:
(CRD 4.3) Participate in public policy activities, including both legislative and regulatory
initiatives:
Has the intern…
 Completed a legislation project and identified regulatory agencies that would
oversee signed legislation.
 Identified grassroots efforts being made by a professional organization such
as the Academy or SNE.
. COMMENTS:
Major Strengths for the Intern:
Suggestions for Improvement for the Intern (Required for ratings of 1 or 2):
Intern comments:
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