Placement 1
Student Handbook
Modified November 2011
Placement 1 workbook
Contents
Section 1 - Placement 1 overview
................................................................................... 4
1.1
Introduction...................................................................................................................... 5
1.2
Aims of Placement 1 ...................................................................................................... 6
1.3
Learning outcomes for Placement 1 ....................................................................... 6
1.4
Teaching Strategy ........................................................................................................... 7
1.5
Syllabus .............................................................................................................................. 7
1.6
Teaching and Learning Resources ........................................................................... 7
1.5
Reading List ...................................................................................................................... 7
1.6
Assessment of Placement 1 ........................................................................................ 9
1.7
Feedback on placement ............................................................................................ 10
1.8
Policy for sickness/absence during placement ............................................... 10
Section 2 - Pre Placement processes
................................................................................ 12
2.1
Introduction................................................................................................................... 13
2.2
Pre Placement 1 Form ............................................................................................... 13
Section 3 - Initial placement processes ................................................................................ 20
3.1
Induction checklist ...................................................................................................... 21
3.2
Expectations Agreement........................................................................................... 24
Section 4 - Activities related to the Assessment phase of the Nutrition and
Dietetics Care Process
................................................................................ 26
4.1
Nutrition Screening .................................................................................................... 27
4.2
Anthropometry............................................................................................................. 30
4.3
Biochemistry ................................................................................................................. 33
4.4
Clinical assessment ..................................................................................................... 38
4.5
Dietary assessment ..................................................................................................... 44
4.6
Environment.................................................................................................................. 54
Section 5 - Facilitated case discussion ................................................................................ 58
5.1
Nutrition and Dietetic Care Plan............................................................................ 59
5.2
Facilitated Case Discussion...................................................................................... 61
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5.3
Facilitator feedback .................................................................................................... 63
Section 6 - Professionalism
6.1
Professionalism checklist ......................................................................................... 65
Section 7 - Reflection
7.1
................................................................................ 64
................................................................................ 68
Guided Reflection for the end of placement ...................................................... 69
Section 8 - Additional resources to support learning on placement ........................ 70
8.1
Observing hospital food service systems ........................................................... 71
8.2
Meeting members of the Multi Disciplinary Team ......................................... 72
8.3
Observation of group work activities ......................................................................... 73
8.4
An introduction to clinical audit ............................................................................ 77
Section 9 - End of Placement 1 processes ........................................................................... 80
9.1
End of Placement 1 review form ........................................................................... 81
9.2
Placement Evaluation ................................................................................................ 84
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Section 1 - Placement 1 overview
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1.1
Introduction
Placement 1 is a 2 week placement providing the opportunity for you to
observe and begin to develop core skills in implementing the dietetic care
process with individuals in a variety of settings.
All clinical placements are undertaken in an approved hospital and/or
community setting. The purpose of the practical placement component of your
course is to develop your dietetic judgment based on the clinical decision
making process, through a focus on the integration and practical application of
the knowledge and skills learnt in the university setting.
Placements are a compulsory component of your course. If you do not
successfully meet the learning outcomes for all three placements, you will not
meet the requirements for registration as a dietitian in the UK. They are also a
challenging but enjoyable part of your training, which allow you to develop
specific work skills and valuable professional relationships that prepare you
for your future career as a dietitian.
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1.2
Aims of Placement 1
1. To observe and understand the required knowledge, skills and
professional attributes to implement nutrition & dietetic care with
individuals in a variety of settings
2. To practice skills at an appropriate level in the application of the
nutrition & dietetic care process.
1.3
Learning outcomes for Placement 1
By the end of Placement 1, you should be able to:
1. Show awareness of the sources of information available to be used by
dietitians.
2. Identify how a dietitian selects and utilises appropriate information from
a range of sources necessary.
3. Demonstrate appropriate skills in gathering information from a range of
appropriate sources.
4. Show awareness of how the dietitian uses the information gathered
and critical thinking to formulate and justify a nutrition & dietetic
diagnosis.
5. Explain how the dietitian uses information gathered and critical thinking
to formulate and justify dietetic management goals.
6. Explain how the dietitian uses information gathered and critical thinking
to develop and implement a dietetic action plan to achieve the
management goals.
7. Explain how the dietitian reviews, monitor and evaluates dietetic
interventions.
8. Demonstrate consistent professional behavior in accordance with the
legal and ethical boundaries of the dietetic profession and the
requirements of the Health Professions Council.
Your placement provider will support you in meeting these learning outcomes
through a range of activities which have been designed to suit a variety of
learning styles and support you in your preparation for future academic study,
future placements and employment as a registered dietitian.
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1.4
Teaching Strategy
Students will be guided in their learning using a combination of observation,
guided tasks and activities, private study, discussion and feedback. Please
refer to Appendix 5 for a copy of a draft Placement 1 programme. They will
work the same hours as a full time member of staff. Some flexibility may be
required to allow for late running clinics etc.
1.5

Syllabus
Observation of the use of the Nutrition and Dietetic Care Process by
Dietitians, with individuals in a variety of settings

Observation of how Dietitians interpret current professional conduct
documents through their dietetic practice and opportunity to demonstrate
professional behaviour

Development of skills in gathering information for use in the assessment
stage of the Nutrition and Dietetic Care Process
1.6
Teaching and Learning Resources
Resources that are common to all placement sites, or that may be useful, are
available at www.londondietetics.co.uk
1.5
Reading List
Thomas B and Bishop J (eds). (2007). Manual of Dietetic Practice (4th
edition). Blackwell Science. Oxford1.
Thomas B and Bishop J (2007)
Manual of Dietetic Practice. 4th Edition. Blackwell Publishing
Food Standards Agency (2002) McCance and Widdowson's The Composition
of Foods. Sixth Summary Edition. The Royal Society of Chemistry,
Cambridge..
Parenteral and Enteral Nutrition Group of the British Dietetic Association
(2007-8) Pocket Guide to Clinical Nutrition 3rd Edition
http://www.peng.org.uk/pocket_guide.html
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Health Professions Council (2007) Standards of Proficiency - Dietitians.
Available from www.hpc-uk.org
Health Professions Council (2007) Standards of Conduct, Performance and
Ethics. Available from www.hpc-uk.org
Health Professions Council (2010) Guidance on conduct and ethics for
students. Available from www.hpc-uk.org
Health Professions Council (2008) Confidentiality - guidance for registrants.
Available from
www.hpc-uk.org
British Dietetic Association (2008) Code of Professional Conduct. Available
from www.bda.uk.com
British Dietetic Association (2009) 'Nutrition and Dietetic Care Process'
http://members.bda.uk.com/Downloads/NutritionDieteticCareProcessOctober2
009.pdf
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1.6
Assessment of Placement 1
In order to pass Placement 1 you must have successfully met the learning
outcomes through attendance and completion of a portfolio containing:

Evidence of observed professional practice
The student lead at your placement site will nominate an experienced
supervisor to complete a Professional Practice Checklist (see Section 6.1) at
the end of week 1and 2 of Placement 1. Your professional behavior will be
assessed against the Health Professions Council Guidance on Conduct and
Ethics for Students (HPC, 2010). This checklist, based on observed practice,
in addition to supporting verbal or written communications, will provide
evidence that you have met Placement 1 learning outcome 8.

Documentation from a facilitated case discussion including a
completed Nutrition and Dietetic Care plan and supervisor evaluation
Throughout Placement 1 you will be given the opportunity to observe
Dietitians complete a variety of patient consultations with a range of client
groups in a number of different settings. You will be required to complete a
Nutrition and Dietetic Care plan (see Section 5.1) for one new patient referral
that you have observed. This care plan will support you in meeting Placement
1 Learning Outcomes 1, 2, 4, 5, 6 & 7. You will then be required to present
this care plan to your supervising dietitians and peers in the form of a
facilitated case discussion. Your supervising dietitian will then complete a
profoma (see Section 5.2 & 5.3) commenting on your performance in relation
to each aspect of the Dietetic Care Process.

Evidence of completion of activities relating to gathering information
for use in the assessment stage of the Nutrition and Dietetic Care
Process
To support you in developing your information gathering skills, you will be
given the opportunity to work with dietitians to complete assessments for a
range of client groups in a variety of settings. You will also be required to
complete a number of predefined activities that will support you developing
you assessment skills. Completion of these activities may take place over
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more than one session and will involve both independent activities, activities
with a peer and feedback with your supervising Dietitian. Written
documentation of completed activities as set out in Section 4 of this workbook
will be used in conjunction with observed practice throughout this placement
as evidence that you have met Learning Outcome 3.

A reflective piece regarding learning from Placement 1
You will be required to complete a reflective piece at the end of Placement 1
to help you identify what you enjoyed most about Placement 1, areas of you
practice that you feel most confident about, aspects of Placement 1 that you
found challenging and areas of your practice that you would like to develop.
You will have an opportunity at the end of Placement 1 to discuss your
progress with your placement site and develop an action plan to support your
on-going professional development prior to implement prior to Placement 2.
You should keep this reflective piece in your portfolio and bring it to University
when asked. Following Placement 1, you will have an opportunity to discuss
this reflective piece with your Placement Tutor who will help you identify
learning opportunities to support you preparation for Placement 2. You will
also need to use this reflective piece to help you to complete your next preplacement form.
A template to help you to structure your reflective piece can be found in
Section 7 of this workbook.
1.7
Feedback on placement
You will receive on-going reflective formative feedback through assessment of
their performance throughout the placement.
1.8
Policy for sickness/absence during placement
You 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
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HEI and lead practice educator. This will take into account current
performance and potential effects on future progression. Any occupational
health requirements related to prolonged sickness absence will be managed
through the HEI provision.
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Section 2 - Pre Placement processes
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2.1
Introduction
In order to be eligible to undertake Placement 1 in a healthcare setting, you
must meet the following criteria:

You must normally possess Level 2 Award in Food Safety for Catering
from the Charted Institute of Environmental Health or an equivalent
qualification.

You must have enhanced CRB clearance and have been cleared for nonEPP activities by an approved Occupational Health Service.

You should also have normally have passed NFP039N, Nutrition, Food
Science and Catering. For the purposes of eligibility for Placement 1 a
provisional pass prior to Subject Standards Board approval will be
accepted.
2.2
Pre Placement 1 Form
Prior to Placement 1, you should also complete the Pre-Placement 1 Form
(see below for a template of this). The information provided on this form
allows your Placement 1 provider to make reasonable adjustments to meet
your individual learning needs and prior experience.
Process for completing Pre-Placement 1 form
1. Pre placement forms will be distributed and discussed during
Placement preparation session at University
2. Student to complete form and email back to
dietetics@londonmet.ac.uk copying in Heather Wanstall,
Placement Support Lecturer (h.wanstall@londonmet.ac.uk) by .
3. A pre-placement appointment is then routinely scheduled for
students prior to Placement 1 where the form will be reviewed
then returned to the Placement Tutor/ Lecturer when completed.
4. After completion, one copy of this form will be:

Retained by the university

One sent to the student training lead at the placement site

One held by the student in their portfolio
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Pre-placement 1 Form
Student Name and Contact details
Name:
Address:
Telephone:
Email:
University:
I am an Undergraduate/ Postgraduate (delete as applicable) in my __th year
of study.
Placement preparation
Academic performance (to be completed by the student - please tick the
box(es) that best describes your results so far. You are encouraged to provide
any additional information where relevant)
To date most of my grades have been:

70 and above

Ranging from 60-70

Between 50-60

Between 45-50
Comments:
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Date of CRB disclosure:
Any convictions or cautions? Yes/ No (Delete as applicable)
If more than one year has elapsed since the original disclosure, has a
Criminal Offence Screening Form (self declaration) been signed and
submitted to the University? Yes/ No (Delete as applicable)
Date of Non-EPP Occupational Health Clearance:
Sharing of pre-placement information:
I agree that the information included on this form can be shared with Dietetics
Manager only/ All staff involved in my training (delete as applicable)
Tutor/ Lecturer input (To be completed by university tutor)
Tutor/ Lecturer Name:
Signature:
Date:
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Personal statement
Please write a summary statement about yourself. You may wish to highlight
some of your strengths; personal attributes and any previous experiences you
feel may be relevant
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How would you describe yourself?
For each of the statements below, please mark the description you most
identify with. Please share some examples that would help illustrate each
statement in the box below.
I see myself as shy/outgoing OR not particularly shy/outgoing
I tend to be very organised and methodical in my approach to completing
work OR I prefer to work under pressure and to tight deadlines.
I tend to come up with new ideas and make suggestions OR I feel more
comfortable when I am asked to do something with clear guidelines.
Examples:
From your reflections on your previous learning, what have you
identified as your strengths?
From your reflections on your previous learning, what areas for
development prior to placement did you identify?
What steps have you taken to reduce these areas for development?
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Do you identify yourself as having a disability?
Yes/ No
If yes, what reasonable adaptations are you likely to need on placement
as a result?
Reflecting on your personal statement, your comments above and your
knowledge of yourself, please highlight any knowledge, skills or
experience you have that:
You feel will contribute to/benefit your placement experience:
You would like to develop/need to be taken into consideration by and
discussed with your practice educator:
Are there any other factors that might impact on your training that may need
to be considered by your practice trainer e.g. carer responsibilities, difficult
journey, religious requirements etc?
Name:
Signature:
Date:
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Section 3 - Initial placement processes
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3.1
Induction checklist
There are a number of key issues relating to your placement which you will be
introduced to during your first couple of days. This checklist should be
completed, in conjunction with your lead supervisor, as soon as possible after
your placement has started to ensure that all relevant areas have been
covered.
Induction item
Covered
Not
Additional notes
relevant
Introduction to dietetics
team
Lead supervisor
Layout of office (including
fire exits and other
facilities)
Telephone system and
bleeps
Site tour (including
catering facilities)
Hours of work
Procedures for
unexpected absence
(including sickness)
Uniform policy
Health and safety
information relevant to the
department & placement
Fire instruction and
procedures
Infection control policy
Arrangement of ID badges
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Security (personal;
personal effects and
building)
Access to IT systems
Written resources
available (e.g. diet sheets)
Introduction to catering
system and meal service
Placement program
Placement expectations
Peer learning
Feedback opportunities
- during activities,
following activities and
weekly/end of placement
feedback
Placement assessments
Professionalism (review of
professionalism checklist
to be completed at the
end of placement)
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Other relevant issues specific to the department/placement experience:
I confirm that I have been informed about and understand all of the above items
relevant to my placement:
Student ______________________________________________________
I confirm that the above induction programme has been completed for the above
student:
Lead Supervisor _______________________________________________
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3.2
Expectations Agreement
Your placement site has responsibility to provide you with a variety of learning
experiences to support you in meeting the Placement 1 learning outcomes,
while as adult learners, it is expected that you will also take responsibility for
your own learning.
With this in mind, you and your lead supervisor should review the following
expectations agreement at the start of your placement and sign it to ensure
that you and your placement site are clear about what is expected from both
parties during your placement.
What you can you expect from us as your placement supervisors:

To be treated with respect

To be clear about the aims and objectives of your overall training (and for
each activity)

To be treated fairly and non-judgmentally

That your training is well organised and you are given adequate notice of
tasks and tutorials

To be clear about what each dietitian expects of you during their time as
your placement supervisor

To be given adequate support

To have confidential matters kept confidential

To be given the opportunity to contribute to the day to day running of the
department

To receive honest and constructive feedback

To be given every opportunity to demonstrate your skills and abilities
What we expect of a student on Placement 1:

To work in line with the HPC Guidance for Conduct and Ethics for
Students (HPC, 2010)

To ensure that your supervisors are aware of your whereabouts at all
times (specifically in times of unexpected absence)

To treat all members of staff with respect
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
To accept feedback and work to address any areas highlighted

To be self-motivated

To inform your lead supervisor if tasks or tutorials have been cancelled
and need to be rearranged

To be prepared to evaluate yourself critically and to learn from your
mistakes

To prepare adequately for tutorials or other tasks, revising college notes or
reading around a subject if needed

To ask if you are unsure about something (although this doesn’t mean
asking a dietitian something that you could easily look up instead)

To use your initiative at every opportunity, for example answering the
phone if everyone else in the office is busy

To be punctual to meetings, tutorials etc

To meet deadlines without prompting and inform the supervising dietitian
in advance if you are having difficulty

To use any spare time in the office constructively

To check that you understand what is expected in terms of your evidence
portfolio

To accept that supervisors must make judgments about the adequacy of
the breadth and depth of your evidence
I agree to comply with the above expectations agreement:
Student ______________________________________________________
Lead Supervisor _______________________________________________
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Section 4 - Activities related to the Assessment phase of the
Nutrition and Dietetics Care Process
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4.1
Nutrition Screening
In this section you will be identifying the role that nutrition screening plays in
dietetic patient assessment. You will also collect patient information using a
nutrition screening tool.
1. What does the Trust Nutrition Policy say about Nutrition Screening? If this
information is not available, write what you would recommend.
2. What Nutrition Screening Tool does the Department use? List below what
information is gathered as part of the screening process?
Nutrition Screening Tool used
Information collected as part of screening process
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3. Discuss with the dietitian what staff can complete the Nutrition Screening
Tool and where the results of the screening are recorded.
4. Complete the Nutrition Screening Tool for two patients and record your
findings below.
Patient 1
Patient 2
5. What actions would you take based on the results of screening?
Patient 1
Patient 2
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6. What potential barriers to accurate and consistent completion of the
Nutrition Screening Tool can you identify? Discuss with the dietitian what
steps the Department have taken to address barriers to nutrition screening
and record your findings below.
7. From your work looking on Nutrition Screening, record below what you feel
are the differences between nutrition screening and nutrition assessment
by a dietitian.
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4.2
Anthropometry
In this section you will be identifying what anthropometrical variables are used
by the dietitian in the assessment and monitoring phases of the nutrition and
dietetic care process. You will also collect anthropometric information as part
of patient assessment.
1. Identify 4 anthropometric variables commonly measured in dietetic
assessment
1.
2.
3.
4.
2. Estimate the weight and height of 4 patients being seen by the dietitian
and compare your estimates with recorded weights and heights.
Estimated
height (m)
Actual height (m)
Estimated
Actual
weight (kg)
weight (kg)
1.
2.
3.
4.
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3. Calculate Body Mass Index (kg/m2) for the patients above and record
below whether the result in within, above or below the reference range.
1.
2.
3.
4.
4. What steps can be taken when weight and height are not available for a
patient?
5. Using two patients you have seen with the dietitian, identify what
anthropometric variables were used in the dietary assessment and how
these were interpreted and recorded.
Patient 1
Patient 2
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6. Identify all equipment available for the measurement of anthropometric
variables below.
7. With supervision, measure the height and weight for three patients of
different age groups in different settings where possible.
Height (or length) in m
Weight (kg)
1
2
3
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4.3
Biochemistry
In this section you will be identifying what biochemical parameters a dietitian
would use to help them complete a patient assessment. As you complete this
section you will be introduced to some complex terminology and principles
that you will learn more about at University prior to Placements 2 and 3.
1. In discussion with your supervising dietitian, complete the following
statement:
Assessing a patient’s biochemistry is important because . . .
2. Identify how a Dietitian collects biochemical parameters and how these are
recorded on dietetic records. Summarize your findings below:
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3. In conjunction with your supervising dietitian, identify 6 common
biochemical parameters that a dietitian might review when completing a
patient assessment. For each of the parameters, use the results recording
system to identify the standard unit of measurement and normal reference
ranges used.
Biochemical parameter
Standard units
Reference range
i.
ii.
iii.
iv.
v.
vi.
4. Use the table below to record the biochemical parameters available for two
patients who have recently been seen by a dietitian. For each result,
make sure that you have recorded the unit of measurement and identify
whether the result falls within, above of below the reference range
Patient 1
Result with unit
Interpretation
Patient 2
Result with unit
Interpretation
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5. Discuss the implications of Patient 1 and Patient 2’s biochemistry results
with your supervising dietitian and including how these results might
impact the dietetic intervention. Summarize your discussion in the boxes
below:
Patient 1
Patient 2
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6. In discussion with your supervising dietitian, identify one reason for a
patient having the following biochemical parameters above and/or below
the reference range:
Reason for value above
Reason for value below
reference range
reference range
Sodium
Potassium
Fasting
glucose
HbA1c
7. In discussion with your supervising dietitian, complete the following
sentences:
 In a patient with end stage renal failure, you would expect them to have
a raised U_____________ and C________________
 In a patient who is dehydrated, you would expect them to have a raised
S________________ and U____________________
 In a patient with newly diagnosed Type 2 Diabetes, you would expect to
see a raised F_________________ and H__________________
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 If a patient has an infection, they may have a raised
C________________________ and a lower A____________________
 A__________________ is not a good marker of nutritional status due to
it’s long half life
8. Use the table below to write down any new terminology that you have
come across while completing this workbook. Using an appropriate
source, summarize the terms definition for future reference
Word/term
Definition
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4.4
Clinical assessment
In this section you will be identifying the sources of information used to
undertake the clinical component of a dietetic patient assessment. You will
also become familiar with a number of common medical abbreviations and
medications that have the potential to impact a patient’s dietetic management.
As you complete this section you will be introduced to some complex
terminology and principles that you will learn more about at University prior to
Placements 2 and 3.
1. Based on your experience of observing a Dietitian complete a patient
assessment, identify 4 sources of information used to collect clinical data
about a patient. For each source, summarize the main sources of
information that can be obtained.
Information source
Information obtained
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2. Medical abbreviations and symbols are commonly used in clinical records.
Based on your experience so far, complete the table below – you might
find it helpful to look at some medical notes and a drug chart to help you
identify the meanings of some of these abbreviations. Discuss your
suggestions with your supervising dietitian.
Abbreviation
Meaning
PMH or PHx
D/H
FH or F/H
Dx
Sx
Ix
Rx
DNA
BP
Ca
GI or GIT
BNO
N&V
D&V
U&E’s
FBC
LFT’s
PO
od
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bd
tds
qds
PRN
Wt
HT
BMI
0 or ……0
Δ
1/7
2/52
3/12
3. Based on your experience so far, use the box below to summarize the
challenges of using medical abbreviations in practice.
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4. A patient’s prescribed medications are commonly noted in clinical records.
A number of medications may impact on your dietetic intervention. For the
medications listed below, use the British National Formulary (BNF) to
summarize the main reason for the medication and the impact the
medication or it’s side effects may have on a patients nutritional status:
Medication
Reason for medication
Impact on nutritional
status/dietetic intervention
Codeine
phosphate
Domperidone
Lactulose
Phenytoin
Amoxicillin
Propofol
5. Using the standard departmental format, gather the required clinical
information for at least 3 patients in at least 2 different settings (e.g.
inpatient/outpatient/care home/home visit) who has recently been referred
to the dietitian. Compare the information you have collected with the
information collected by a qualified dietitian and use this as an opportunity
to seek clarification on information that you did not understand.
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6. Identify 4 challenges of collecting clinical information about patients in
either an inpatient or outpatient setting. Following discussion with your
supervising dietitian, for each of the challenges, identify how they could be
overcome.
Challenge
How can it be overcome?
7. Based on your experience of paper and electronic clinical records, what
strategies can be employed to ensure patient confidentiality?
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8. Use the table below to write down any new terminology that you have
come across while completing this workbook. Using an appropriate
source, summarize the terms definition for future reference
Word/term
Definition
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4.5
Dietary assessment
In this section you will be identifying the sources of information used to
undertake the dietary component of a dietetic patient assessment. You will
also gain experience in assessing patient’s dietary intake. As you complete
this section you will be introduced to some complex terminology and
principles that you will learn more about at University prior to Placements 2
and 3.
1. Based on your experience of observing a Dietitian complete a patient
assessment, identify 3 sources of information used to collect dietary intake
data about a patient. For each source, consider the limitations of using
this method independently.
Information source
Limitations
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2. Summarize the following terminology, commonly used in relation to dietary
assessments. Discuss your definitions with your supervising Dietitian.
Term
Definition
Qualitative dietary
assessment
Quantitative dietary
assessment
24-hour recall
Food frequency
questionnaire
Typical days intake
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3. The focus of a dietary assessment can vary depending on the clinical
condition. For each of the scenarios below, consider the specific
information that you would want to ascertain as part of your dietary
assessment and the specific nutrients you would be interested in
assessing. Discuss your suggestions with your supervising Dietitian.
Scenario
Specific dietary information
Specific nutrients to
to collect
analyze
18 year old female
following a
vegetarian diet
referred for
assessment of
dietary adequacy
38 year old male
with newly
diagnosed Type 1
Diabetes
42 year old female
referred for dietary
advice following a
myocardial
infarction
78 year old male
referred for
nutritional support
having recently
started
chemotherapy for
throat cancer
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4. Using the standard departmental format, gather the appropriate dietary
information for at least 4 patients in at least 3 different settings (e.g.
inpatient/outpatient/care home/home visit) who has recently been referred
to the dietitian. Compare the information you have collected with the
information collected by a qualified dietitian, reflecting on the reason for
any discrepancies.
5. Using at least 1 of the dietary assessments that you have taken, complete
a qualitative assessment. Compare your assessment with that of a
qualified dietitian.
Diet History
Qualitative assessment
1.
2.
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6. With the help of your supervising Dietitian, calculate the nutritional
requirements for the relevant macro and micro-nutrients (including
calories, protein and fluid) for at least 1 of the patients who you have
collected dietary assessment data from.
7. Complete a quantitative dietary assessment for the patients whose
requirements you have calculated, firstly using your ready reckoner and
secondly using the dietary analysis software available at your placement
site. Compare the results you have obtained and consider the reason for
differences in outcomes with your supervising dietitian.
Diet
History
Quantitative assessment
Ready reckoner
Dietary analysis software
1.
2..
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8. Complete the following statement:
Food record charts can be used to collect dietary assessment data when
...
9. Using a food record chart/food diary you have seen during your
placement, complete a qualitative assessment of reported intake. Having
completed this activity, list the challenges of using this method as a tool for
assessing dietary intake and consider how these challenges could be
overcome.
Challenges of using food record
How these challenges could be
charts/food diaries
overcome
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10. To support your dietary assessments, it is important to have an awareness of the nutritional composition of supplements used at
your placement site. Use the table below to summarize the presentation and nutritional composition supplements you have
seen during placement 1. You may want to then continue to add to this list during future placements for your reference.
Supplement
name
Presentation
Common usage
Nutritional profile (per 100ml)
Energy
(kcal)
Protein (g)
Fat (g)
Sodium
(mg)
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11. Summarize the advantages and disadvantages of using nutritional
supplements to improve a patient’s nutritional status
Advantages of nutritional
Disadvantages of nutritional
supplements
supplements
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12. Working in ethnically diverse communities will mean that you regularly come across ingredients, recipes and dietary habits that are
unfamiliar to you. Use the table below to note down items that you have come across during this placement. You may want to
then continue to add to this list during future placements for your reference.
Ingredient/Recipe
Definition
Common usage
Nutritional profile
Other relevant information (e.g.
cooking methods/taste)
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Ingredient/Recipe
Definition
Common usage
Nutritional profile
Other relevant information (e.g.
cooking methods/taste)
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4.6
Environment
In this section you will be identifying how individual factors in a patient’s
environment are incorporated in dietetic patient assessment. The environment
part of dietetic patient assessment considers economic, social and
psychosocial issues including education, budget and access to foods as well
readiness to change and potential barriers to making dietary change.
1. For two patients you have seen with the dietitian, identify what sources
of information the dietitian used to collect information about the
patient’s environment.
Patient 1
Patient 2
2. For each patient list up to four factors from the patient’s environment
that the dietitian considered in their assessment.
Patient 1
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Patient 2
3. List below how these factors can potentially impact on dietary treatment
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4.Consider how factors in the local environment can impact on
dietetic treatment.
a. Choose a local area in discussion with the dietitian and use
sources such as www.healthprofiles.info to find about the
demographics of the area.
b. Find out about access to food in the area you have chosen. You
could use information available on the Internet to find out about
shops in the area or you may be able to walk around the area
and explore.
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c. Find out about access to leisure facilities in the local area
d. Record any barriers to the local population adopting healthy
lifestyles that you have identified.
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Section 5 - Facilitated case discussion
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5.1
Nutrition and Dietetic Care Plan
Assessment
Anthropometry
Biochemistry
Clinical
Dietary
Environmental
Nutrition and Dietetic Diagnosis
Problem
Aetiology
Signs and Symptoms
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Intervention, planning and implementation
Patient specific goals
Treatment plan
Intervention plan
Monitoring and evaluation
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5.2
Facilitated Case Discussion
Student Name
__________________________________________________________________
Peers present
__________________________________________________________________
Facilitators present
__________________________________________________________________
Facilitator evaluation
Please comment on the student’s performance in relation to each aspect of
the Dietetic Care Process. The learning outcomes under each section should
guide your comments. Please ensure at least 2 strengths and 2 areas for
development are provided for each section.
Assessment

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.
Nutrition and Dietetic Diagnosis
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
Show awareness of how the dietitian uses the information gathered and critical thinking
to formulate and justify a nutrition & dietetic diagnosis
Intervention, planning and implementation

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.
Monitoring and evaluation

Explain how the dietitian reviews, monitor and evaluates dietetic interventions
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5.3
Facilitator feedback
Overall strengths
Areas for development
Action points
Facilitator signature
_____________________________________________________________
Student signature
______________________________________________________________
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Section 6 - Professionalism
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6.1
Professionalism checklist
This checklist will be completed at the end of your placement by your lead
supervisor based on your conduct throughout this placement.
This checklist is based on the HPC Guidance on Conduct and Ethics for
Students (2010). This checklist, based on observed practice, in addition to
supporting verbal or written communications, will provide evidence that you
have met Placement 1 learning outcome 8: demonstrates consistent
professional behavior.
Professional attribute
Demonstrates this . . .
Consistently
Sometimes
Requires
further
evidence
Acts in the best interest of
service users
e.g. can reflect on care provided to patient or
groups to ensure equitable, nondiscriminatory care
Respects the confidentiality of
service users
e.g. adheres to data protection including
electronic records and observes appropriate
patient confidentiality
Keeps high standards of personal
conduct demonstrated through
appearance and behavior
e.g. reliable and punctual in attendance and
when completing tasks; demonstrates
appropriate telephone manner; adheres to
departmental dress code; demonstrates
respect for others; has appropriate
relationships and rapport with patients and
other health care professionals
Shows a commitment to keeping
professional knowledge and skills
up to date
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Placement 1 workbook
e.g. demonstrates an enquiring and proactive attitude; accepts constructive
feedback, recognizes individual learning
needs and implements learning agreements
Acts within the limits of current
knowledge and skills
Demonstrates effective
communication skills with service
users and placement provider
Seeks “informed consent” before
carrying out an intervention
Keeps accurate records
Deals fairly and safely with the
risks of infection
Behaves honestly, ensuring
behavior does not damage public
confidence in the profession
Acts in line with all other
professional and local
performance standards
In relation to overall professional practice, please comment below on:
Strengths
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Placement 1 workbook
Action points to be implemented prior to Placement 2
Areas for further development
Reasons for specific areas not being achieved
Signed:
Student ______________________________________________________
Lead Supervisor _______________________________________________
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Section 7 - Reflection
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7.1
Guided Reflection for the end of placement
Please complete this during your last week of placement and take it to your
final review. You should keep it in your portfolio and bring it to University
when asked. You will need to use it to complete your next pre-placement
form.
What did I enjoy most about Placement 1?
What areas of my practice during Placement 1 did I feel most confident
about?
What did I find most challenging about Placement 1?
What areas of my practice do I feel need to be developed prior to
Placement 2?
What actions do I need to put in place:
a) Before my next placement
b) During my next placement?
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Section 8 - Additional resources to support learning on
placement
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8.1
Observing hospital food service systems
When observing how a specific food system works (e.g. in a hospital/care
home setting) consider the following steps in the food chain:

How does the patient order food?
o Are menus available?
o Is there a fixed/ a la carte menu or a menu cycle?
o What provision is there for special dietary needs?

How are orders communicated to the catering department?

How are food provisions ordered, receipted and stored?

How is food produced?
o What food production system is used e.g. cook serve, cook chill
etc?

How is food distributed around the hospital?

How is food served?
o Is there a bulk or plated system?
o Is flexibility in portion size possible?
o Is flexibility of meal time possible?
o What happens if a meal is missed?
o What systems are in place to ensure that the patient gets the right
meal?

How is food intake monitored?
o Is there a system to identify those who need additional assistance
at meal times?
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8.2
Meeting members of the Multi Disciplinary Team
Dietitians work closely with a large number of other health care professionals
to support the delivery of patient care. During Placement 1 you will come into
contact with a number of these health care professionals. Use these
opportunities to consider how these healthcare professionals work with the
dietitian?
Consider at least 2 cases where the dietitian and healthcare professional have
worked together to deliver patient care:

What is the role of this healthcare professional and how does this impact
on the role of the dietitian in delivering patient care?

How does communication take place between the dietitian and this
healthcare professional?

What training (pre and post-registration) has the healthcare professional
undertaken in order to perform their role?

Are there any differences in the regulation of this profession and the
regulation of Dietetics?
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8.3
Observation of group work activities
You may have the opportunity to observe a dietitian completing a group
education session during Placement 1. Please use the form below to make
notes on the following aspects of the session noting specific examples where
applicable. Discuss your observations with the dietitian following the session.
Title of group session:
Type of audience:
Summary:
Planning for the session
Gathers appropriate information
to assess needs of group using
ABCDE as appropriate.
Identifies and prioritises dietetic
diagnoses of group with
justification
Develops clear dietetic
management goals
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Develops a plan with clear aims
and objectives/learning
outcomes.
Develops delivery plans based
on assessment of group,
location and time available
.
Bases content of the session on
evidence based practice/best
practice.
Delivery of the session
Introduces self and aim of
session
Clarifies groups’ expectations
Speaks clearly, using
appropriate language and
avoiding jargon.
Makes regular eye contact
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Placement 1 workbook
Encourages group participation
where appropriate
Listens attentively and
responds to verbal and nonverbal cues.
Uses notes/prompts
appropriately.
Invites and responds to
questions appropriately.
Maintains direction and
summarises.
Makes appropriate use of audio
visual equipment, other
resources and handouts
Demonstrates reflection ‘in
action’ and uses this to change
plan during session when
appropriate
Practices within the Standards
of Performance, Conduct and
Ethics:
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Placement 1 workbook
Implements different strategies
to influence nutritional intake
e.g. Behaviour modification,
negotiation
Keeps to time allocated
Evaluates session
appropriately
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8.4
An introduction to clinical audit
You might be given the opportunity to take part on a clinical audit while on
Placement 1. Ask your supervising dietitian to clarify what is meant by clinical
audit if you are not sure. Use the table below to summarise the details of the
audit you are taking part in.
Title of audit
Aim of audit
Background to
audit
What standards
are being used
to audit against
Data being
collected
Once you have collected the data, consider the following questions. Discuss
your responses with your supervising dietitian.
1. How easy was it to collect all of the required data?
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2. Was all of the required data available?
3. How long did it take to collect the data?
4. What would be your summary based on the data that you have collected?
5. What recommendations would you make based on the data you have
collected?
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Section 9 - End of Placement 1 processes
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9.1
End of Placement 1 review form
In order to demonstrate to your Placement provider that you have met all of
the learning outcomes for Placement 1, you will be required to submit your
portfolio either electronically or as a paper document at the end of your
placement to the nominated lead supervisor at your placement site. Having
reviewed your portfolio and considered your practice throughout the
placement, the lead supervisor will complete the end of Placement 1 form
(see________) to document your progress against the placement learning
outcomes. You and your lead supervisor should both sign this form to
indicate that you are in agreement about the assessment. Your lead
supervisor should then send this form to your Higher Education Institute. You
should also keep a copy of this form for your portfolio.
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Placement 1 workbook
End of Placement 1 review form
Name of student
Signature of student
Name of dietitian
Signature of dietitian
University student
attends
Location of Placement
Date
From
To
Number of weeks
completed
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Learning Outcome
Please
Enter  if
met
1. Show awareness of the sources of information available to be
used by dietitians
2. Identify how a dietitian selects and utilises appropriate
information from a range of sources necessary
3. Demonstrate appropriate skills in gathering information from a
range of appropriate sources.
4. Show awareness of how the dietitian uses the information
gathered and critical thinking to formulate and justify a nutrition &
dietetic diagnosis
5. Explain how the dietitian uses information gathered and critical
thinking to formulate and justify dietetic management goals
6. Explain how the dietitian uses information gathered and critical
thinking to develop and implement a dietetic action plan to
achieve the management goals
7. Explain how the dietitian reviews, monitor and evaluates dietetic
interventions.
8. Demonstrate consistent professional behaviour in accordance
with the legal and ethical boundaries of the dietetic profession
and the requirements of the Health Professions Council.
Is there evidence to demonstrate that all the learning outcomes have
been met? If not, please identify the specific learning outcomes not
met below:
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9.2
Placement Evaluation
You may be asked to give feedback to your placement provider about your
placement experience. You will also be required to complete an online survey
when you return to University to evaluate your placement experience. A link
to this survey will be sent to you when you complete your placement. You will
also have the opportunity to discuss your placement experience with your
peers and Placement Tutor. All sources of evaluation allow the Higher
Education Institutes and Placement Providers to develop the practice
education experience and will be used as evidence to identify the quality of
the placement experience. Please ensure that your feedback is constructive
and comprehensive. Please also bear in mind that references to individuals
should be avoided.
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