Training Future RDNs Strategies for Clinical Preceptors Babbi

Training Future RDNs: Strategies for Clinical Preceptors Babbi Hawkins, MS, RDN, LDN Director, UNCG Dietetic Internship Program Twin City Dietetic Association Meeting September 21, 2017

Outline • Overview of ACEND requirements for Programs & Preceptors • Preceptor roles • Strategies for Preceptors • Examples of Challenges for Preceptors • Resources for Preceptors • Intern Panel Behavioral Objectives • Describe 6 roles of the Preceptor • Recall 3 strategies for success that a Preceptor may employ when working with dietetic interns • Review resources for Preceptors

ACEND Accreditation Council for Education in Nutrition and Dietetics • Recognized by the US Department of Education as the specialized program accrediting agency for education programs in nutrition and dietetics; • Operates administratively autonomously from the Academy (& CDR); • Includes a governing unit (ACEND Board) that grants accreditation awards; • Oversees a voluntary system of evaluation which includes a self-study report and an on-site evaluation by peer reviewers that is used to verify the quality of service provided by academic programs and to protect the public interest.

DPD vs DI Didactic Program in Dietetics vs. Dietetic Internship • DPD: Focus on knowledge –lecture, memorization, testing, in the classroom KRDNs = knowledge requirements for RDNs • DI: Focus on core competencies – execution! in the field CRDNs = core competencies for the RDN (43 CRDNs/1200 hrs)

Definitions (published by ACEND) • Competency: Specific knowledge, skills, values and behaviors required for effective performance as a practitioner • Supervised Practice: Planned learning experiences in which interns perform tasks over defined periods of time to demonstrate mastery of ACEND competencies. (*Learning activities performed by interns that are not typically performed as part of the preceptor’s work responsibilities should not be counted towards fulfilling supervised practice hours in professional work settings. ) • Preceptor: A practitioner who serves as faculty for interns during supervised practice by overseeing practical experiences, providing one-onone training, and modeling professional behaviors and attitudes.

ACEND Accreditation Standards for DI Programs • Latest standards effective June 1, 2017 • 10 Standards, 2 of which apply to Preceptors: • Standard 7 - Faculty and Preceptors • Standard 8 - Supervised Practice Sites

Standard 7 - 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. 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, and research or other activities leading to professional growth in the advancement of their profession.

Review of Standard 7… • Sufficient number • Qualified • Provide the depth and breadth of learning activities • Exposure to the diversity of practice • Evidence of continued competency

Standard 8 – Supervised Practice Sites • 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 must address the selection and periodic evaluation of adequacy and appropriateness of facilities, to ensure that sites are able to provide supervised practice learning experiences compatible with the competencies that interns are expected to achieve.

Review of Standard 8… • Written agreements • Selection and periodic evaluation • Learning experiences compatible with the competencies

• • • Six (6) Roles of Preceptors Planner Role Model Information Provider Facilitator of Learning Resource Developer Assessor of Learning

Preceptor as Planner • Sets the intern’s work schedule • Selects patients, clients and employees with whom intern interacts • Determines the “sequence” of intern’s training ACEND says: “Supervised practice experiences must be sequentially and logically organized from introductory to more advanced learning activities, building on previous knowledge or experience to achieve competency by completion of the program. ”

Preceptor as Role Model • Model the professional behaviors the intern is expected to learn and perform • Be deliberate and intentional! • “Telling” the intern how to behave is not sufficient • Example: Demonstrate how to be empathetic vs tell the intern to be empathetic.

Preceptor as Information Provider • Share information • Assist interns with integrating knowledge and critical thinking skills • Keep abreast of current trends in your area of expertise

Preceptor as Facilitator of Learning • Use real-world cases as learning tools • Goes beyond the intern “shadowing” the preceptor • Includes questioning and feedback

Preceptor as Resource Developer • Help interns locate resources (reference materials, nutrition protocols, policies and procedures, best practices) • Introduce interns to other team members

Preceptor as Assessor of Learning • Determine whether the intern has met program requirements • Determine whether the intern has achieved entry-level competence • Complete documentation required by the program

Strategies for Successful Precepting Decide what qualities you’d like to be known for! Positive Characteristics to Consider • Accessible • Approachable • Enthusiastic • Patient • Encouraging • Supportive • Sense of humor! Negative Characteristics to Consider • Arrogant • Inaccessible • Insensitive • Authoritarian • Insecure • Demeaning

Strategies for Successful Precepting 1. Set the Expectation up front 2. Teach 3. Evaluate

Set the Expectation up front • Spend some time on orientation (organization, department, team, office, restrooms, where to store personal belongings) • Establish ground rules (dress code, work schedule, lunch break, any special requests, pet peeves, procedure in the event of illness/emergency, personal phone calls) • Define expectations (how would you like for the intern to communicate with you, how often can the intern expect to meet with you, to whom should the intern direct questions, what are the unspoken rules of the office)

Teach Example = DR. FIRM • Demonstrate (let the intern observe you in action) • Rehearse (trial-run, practice) • Feedback (open, corrective, specific) • Independent practice (“let go”) • Review (reflect, how did it go, questions) • Motivate to persevere (work w/ pt made a difference)

Evaluate • Tell the intern what she is doing well. (Example: Your technical skills are excellent; now, let’s work on speed. ) • Suggest ways to strengthen skills. (Here’s something that helped me get faster. ) • Be specific (interns are not mind-readers). • Is the intern achieving entry-level competence? • The results of the intern’s evaluation at the end of a rotation should NEVER come as a complete surprise.

Challenges for Preceptors v. Preceptor may feel tempted to vent and complain to the intern about work situations. v. Preceptor prefers that the intern’s documentation style/format matches her own style and focuses on this instead of quality/content of the intern’s documentation. v. Preceptor has difficulty “finding a balance”…providing enough challenge but not so much that the intern feels overwhelmed.

Reminders • The goal for interns is achievement of entry-level competence. • You have the authority to manage the intern’s rotation. • If you need support, please contact the DI Director (I am a phone call away!)

Intern panel • I asked the interns, • “What characteristics would you like for your preceptors to have? ” • And they said…

Thank you from the UNCG DI!!! The UNCG DI program wishes to thank our Preceptors for the mentoring you provide our interns! We couldn’t train future RDNs without you!!! *If you are not currently a preceptor for the UNCG DI and would like to serve as one, please contact Babbi at bshawkin@uncg. edu

Resources for Preceptors Cdrnet. org Free online training course for preceptors (8 CPEUs) Beginning June 1, 2017, preceptors of interns in an accredited program can earn up to 3 CPEUs per year (up to 15 for the 5 -year cycle) for Learning Activity Type 190: Leadership and Precepting. Complete and retain the Preceptor Verification and Self-Reflection form (signed & dated by the DI program director). Join NDEP (Nutrition and Dietetic Educators and Preceptors)

Resources for Preceptors nutrition. uncg. edu Info for Preceptors tab: Preceptors’ Guide for Teaching Dietetic Interns (handbook)

Review 1. Set the Expectation up front 2. Teach 3. Evaluate

References “Preceptors’ Guide for Teaching Dietetic Interns” prepared by Sylvia Escott-Stump via adaptation of materials and information presented at NDEP Area Meetings and Academy workshops. Available on the UNCG DI program website: nutrition. uncg. edu, info for preceptors tab. “Dietetics Preceptor Training Course” Available at cdrnet. org, accessed on 09/18/17