UBC Dietetics Major Preceptor Orientation Thursday Sept 8, 2:00-3:00pm AND Tuesday Oct 4 12:00-1:00pm (repeat session) Call into the UBC teleconference line: From the Vancouver area, call 604-899-2339 From outside Vancouver, call toll-free 1-877-385-4099 After calling the number, enter the password, 8774290#   Welcome, thank you for joining us!

Session Overview What is a preceptor? UBC Dietetics Program Website Internship documents Preceptor support resources Preparing for and facilitating a placement Q&A Will include an overview of the modules and forms, including revisions made this year

What is a Preceptor? Teacher? Mentor? Coach? We hear a variety of words used to describe a person who helps someone develop their skills. As a preceptor you might think of yourself as a teacher, a mentor or even a coach. Helpful to keep in mind that each of these words has their own meaning and definition as well. For example: Teacher – someone who shows or explains how to do something (in the practice setting) Mentor – experienced practitioner that advises or guides a new practitioner, often focused on career guidance and professional development Coach – focuses on performance, tasks that support skill develop In addition, a preceptor is also a role model, a facilitator and an evaluator. As a preceptor, you can and will be all of these things. Depending on where the intern is in their internship, their current knowledge and skills, the practice environment, and your personality, you might choose to approach the teaching-learning relationship in different ways.

A Preceptor: Plans placement-specific schedule and learning activities to support achievement of entry-to-practice competencies Supervises intern during a placement Facilitates intern learning in the practice setting Provides performance feedback throughout placement and formally evaluates intern performance at end of placement Informs core site internship coordinator of intern progress Looking a little bit more concretely at what a preceptor does as part of the UBC program, this slide lists key preceptor responsibilities

What makes a successful preceptor? http://dietetics.landfood.ubc.ca/preceptors/preceptor-resources/what-makes-a-good-preceptor/ A successful preceptor isn’t always easy to describe, but some preceptors have been kind enough to share their thoughts on this topic. You can click the link to watch the full video but a few points that were mentioned were things such as: -The creation of a safe learning environment an intern (where questions can be asked without fear and interns feel supported by their preceptors) -Work with interns as equals – recognizing that they are not quite a student, but they still need your help to gain skills and experience to enter practice -Acknowledge 2 way learning – interns are also helping you learn to be a better preceptor -Determine up front what an intern’s goals and expectations are, and make sure that you are able to share the same -Learning happens by watching, doing, debriefing – make sure there is time for that

The UBC Dietetics Major Website houses all of the resources you might need as a preceptor. The website can be found by Googling UBC Dietetics. Links to everything can be found under the preceptor tab. The table of contents bar on the left hand side can help you navigate the content and find what you are looking for. We’re going to walk through the various sections of the website during this orientation today

At the top of the sidebar on the left, is the “Internship documents At the top of the sidebar on the left, is the “Internship documents.” By clicking the link that comes up on that page, you will be redirected to the index of dietetics internship documents (filing cabinet) This part of the website houses all internship documents for preceptors, interns and site coordinators. The Internship Modules and Forms and Preceptor Specific Documents are likely to be the folders you frequent the most Tip: click the “parent directory” to navigate back out a sub-folder. Functions as the back button on your browser. If you only see the parent directory link in one of our folders, it means the folder is empty

Index of Dietetics Internship Documents If you are not already familiar with the structure of the UBC Dietetics Program, review the UBC Program/Internship Overview documents Find the UBC Dietetics Internship modules and forms for the module(s) applicable to your placement UBC Policies and Procedures – review as needed Other preceptor specific documents – education and resources In the Modules and Forms folder you will find all of the modules used throughout internship. Overview documents folder: -Internship structure -Role delineation document – articulates your role as a preceptor as well as the roles of everyone else involved in the internship (site coordinators, UBC program team, interns) -Integrated Competencies for Dietetic Education and Practice (ICDEP). The ICDEP competencies are the standard set for entry-to-practice now used for dietetic education across Canada. About ICDEP: -Released in 2013 -Competencies outline the minimum requirement to ensure safe, effective and ethical entry-level practice. -These competencies form basis for the “Performance Evaluation” section of each module document on the website Other things you will find on this part of the website, in addition to the overview documents and specific module forms, are listed on this slide

Modules and Forms What’s new? Minor changes made to modules and forms based on user feedback Restricted Activity B section removed from NC II form Proposal submitted to CDBC to allow all interns to apply for RA-B Education Module New approach: one professional education session (non-module activity) Since ICDEP was implemented in 2013, have made major changes to modules and forms each year. This year we only made minor changes. Minor changes include: -Clarified confusing wording -Fixed formatting errors -Added some N/A boxes to learning activities where interns and preceptors identified they were needed NC 2 form: -Removed preceptor verification section at the bottom of the form. This section did not seem to be functioning as intended, to support interns to obtain preceptor sign-off for RA B by the end of internship -Interns still need to provide care for a minimum number of TPN patients during internship as part of internship curriculum -Enhancements currently being made to provide practical knowledge and experience with TPN in clinical courses on campus -Proposal submitted to the CDBC to move towards all interns being eligible for RA B by the end of internship (same as A) Education module -Feedback from interns: lots of work, minimal unique contribution to competency attainment, redundant of activities done in campus part of program -Decision to remove from internship curriculum -Interns will plan and deliver one professional education session as a non-module activity during the internship year

Modules and forms – key features Six distinct sections: Intern Placement Planning and Learning Activities Checklist Preceptor Evaluation Checklist Performance Assessment Guide Performance Evaluation Intern Goal Setting Sheet Internship Coordinator Checklist The three sections in red are key preceptor responsibilities. Forms are still long, but efforts made to shorten and simplify preceptor section Not just an evaluation form, but a comprehensive guide for the placement – for preceptors and interns Sections: These items are not things that should be evaluated, but rather, things that interns should experience/do during their placements in order TO demonstrate the things that will ultimately be evaluated Preceptor will complete this once they have received the intern’s completed form towards the end of the placement – this checklist usually appears on page 4 or 5 of module document Section for interns and preceptors – goal is that same criteria is used for evaluation The performance evaluation section of the form look similar to the previous rendition of the forms, however, due to the creation of the learning activities checklist, the length of this section has been reduced Interns complete this at the end of each placement, and carry forward goals to the next placement For preceptors, it may be of interest to see what options are available should you think your intern may not complete their placement successfully. Otherwise, less relevant to preceptors.

Modules and forms – key features Performance Assessment Guide Consider performance “overall” but focus on where they are at by the end of the placement Choose rating that BEST represents performance 2 and 3 ratings in all competencies are required to pass placement Performance Assessment Guide provides detailed descriptions of how interns should be evaluated. Interns self-evaluate, and receive evaluation from each preceptor based on a 3 point competency scale. The performance assessment guide includes descriptions of what the 1, 2 and 3 ratings look like in practice Ratings: 1 – is used to indicate an intern has serious performance issues- repeated errors and inability to recognize situations beyond their capacity. Signifies that further action needs to be taken before an intern can move forward to next placement 2- intern is progressing and is aware of areas requiring further development or guidance. Still appropriate for entry-level practice 3- does not state that the intern knows/does everything independently, but they consistently demonstrate skills and attributes that would be used as an RD. They are able to recognize when they need help and reach out accordingly Many interns will achieve 3 ratings as they get more experience in internship, towards the middle and end of the year. However, some interns can achieve competency faster than others, so if it feels appropriate, you can certainly give a 3 rating early in the internship year. This slide includes a few overarching tips to consider when you are evaluating interns in a placement

Using Criteria for Evaluation Competency being assessed How well did the intern demonstrate these performance indicators? Visual representation of how to use the rating scale: In order to determine a rating for each competency (the numbered, bold, underlined statement at the top), preceptors should consider how well an intern demonstrated the listed performance indicators. While interns should be demonstrating ALL performance indicators listed (unless otherwise indicated), they needn’t be evaluated on each individual indicator. If there were significant strengths or weaknesses that led to give the intern a specific rating, that can be included in the comments. In the example shown on this slide, you might ask yourself: “how well did the intern assess nutrition-related risks and needs of patients/clients in this placement?” To answer the question, review each of the performance indicators listed below and determine how well they did with each of the indicators. -If intern performed most of the indicators well, consistently that would suggest a 3 rating -If intern performed some indicators well consistently, but showed room for improvement for some others, that might indicate a 2 rating -If several of the indicators were not demonstrated consistently, and you have concerns about the intern’s practice and suitability to move on to the next placement, that is when a 1 should be given

I’m still not very confident using the forms to evaluate interns… Watch this short video with key tips and example evaluation scenarios: http://dietetics.landfood.ubc.ca/preceptors/preceptor-orientation/

Preceptor Orientation  Preceptor Orientation Checklist - self-guided orientation Can help you to refresh when preparing for an intern's placement Orientation presentations posted here Back on the Dietetics Major website, we have a section called Preceptor Orientation. This is where you will find a link to a preceptor orientation checklist. Most of the topics outlined in this list are being covered here today, but feel free to use it as a refresher when preparing for your intern’s placement. Orientation sessions from the current year will also be posted here, evaluation video mentioned on previous slide is also posted here

Preceptor Resources Videos created by the UBC Dietetics Program Practice Perspectives: What makes a successful preceptor? Setting the Stage for Success Using Questions as a Teaching Strategy Additional Tips for Preceptors The next section on the website is really aimed at supporting preceptor development (beyond basic orientation) Several videos have been developed by the Program to help preceptors consider how they might be more effective educators. You might see some of your colleagues in these videos, as dietitians volunteered to act in the video clips (all links will work if you view these slides in presentation mode).

Preceptor Resources Practical handouts Current posted handouts: Setting the Stage for Success Promoting Critical Thinking Providing Effective Feedback Intern Performance Issues Flowchart Additional topics under development – check back from time to time! Have been building our handout library, for those of you that prefer reading written materials to watching a video. Handouts on key topics that preceptors ask for support on. Aimed to keep these handouts short and practical, with concrete examples and tips. Written specifically for the dietetics context, informed by teaching and learning scholarship Setting the Stage – accompanies the video, with the same name (addresses how to create a safe learning environment) Critical Thinking – includes helpful questions you can ask interns to support their CT Feedback – brand new, just posted Intern Performance Issues Flowchart – new, developed as a simple, visual tool to assist preceptors, interns and coordinators with what to do if a performance issue arises. Includes our contact info at UBC – encourage preceptors to reach out to us at any time if you suspect your intern may be struggling

Also on the website… Preceptor Education Events Information about upcoming events Video recordings of sessions from past events Join the preceptor interest group listserv Find out how to become a UBC Clinical Instructor Internship coordinators page – links to internship calendars The last few sections on the website provide information about: UBC Dietetics preceptor education events, annual live and videoconference education event, teleconference teaching sessions, building a library of recordings of past sessions A direct link to self-subscribe to our preceptor interest group listserv Information about applying to become a UBC Dietetics Clinical instructor. Being a clinical instructor is great perk for preceptors who contribute to dietetic education – for example, it gets you access to the UBC library database (journal articles etc.)

Preparing for a Placement Find the UBC Dietetics Internship modules and forms for the module(s) applicable to your placement – this is your (and your intern’s) guide to the placement Plan ahead in your schedule – try to minimize non-essential meetings and activities to allow time to discuss and debrief with intern Provide your intern with any resources or tools that would be helpful to review ahead of time Now that we have covered where most of the resources and information can be found, will briefly outline some of the activities that can be done ahead of time to help prepare for a smooth placement. Find the UBC Dietetics Internship modules and forms for the module(s) applicable to your placement -located in the filing cabinet Plan ahead in your schedule -Having chunks of time in the day (even if it is only 15 mins here and there) is very helpful to allow time for discussion/feedback/debriefing with intern. -Minimizing meetings if you can, or finding other ways to make a little time can help the placement go smoothly for everyone involved Provide resources for review ahead of time -Interns are prompted to contact you to ask for resources prior to start of placement (copy of your job description, role profile or link to clinic website can all be helpful to provide ahead)

Preparing for a Placement A few key tips: Designated weekly non-placement half-day (every Thursday) Protected time for research, professional presentation, education sessions, self-directed learning Discuss early in placement and arrange to work placement activities around this Supervision expectations If a preceptor is off-site during any part of a placement, a conversation about an alternate supervisor (if necessary) and appropriate activities to engage in should occur Be in the know Role Delineation document Internship and Coordinator calendars Designated weekly half-day -Has been part of internship curriculum, but not consistently implemented -In place to support interns with the many non-placement activities going on -Intention is to consistently protect this time, regardless of what is going on in the placement setting -Move towards 3 week minimum placements, to lessen the impact of weekly half day on achievement of placement competencies Supervision -Preceptor responsibility -If a preceptor will not be on site, that can work, as long as a conversation happens about what appropriate activities are to engage in and who to contact if needing help -If this becomes problematic, contact site coordinator

Once your intern arrives Review module form together Focus on “Intern Placement Planning and Learning Activities Checklist” Identify activities to be completed Within the first 3 days of placement Throughout placement 2-3 days prior to end of placement (and preceptor evaluation checklist) Form is designed to be a guide to planning the placement, the first few pages are a checklist for interns and preceptors

Establish a plan for a successful placement Discuss placement setting hours of work, routines, dress code, appropriateness of electronic device use, methods of communication, etc. Discuss schedule/plan to ensure required learning activities can be achieved including any deferred from past placement(s) Discuss and finalize intern goals for the placement Within the first 3 days – several of the checklist activities in the module forms are designed to set up the placement for success Some example learning activities are listed on this slide

Throughout placement Module-specific learning activities - provide opportunities to demonstrate performance indicators outlined in the Performance Evaluation section of the module form When designing the placement experience: Performance Indicators are the “what” Learning Activities are the “how” For example – seeing a patient independently to complete an initial nutrition assessment would support the ‘assess nutrition related-risks and needs’ competency, as well as several performance indicators related to that

Some other food for thought Be clear about expectations from the beginning – refer to the Module Expectations in the Introduction section of the module (page 1) Observation goes both ways – they can learn from observing you, and you can help guide them by providing feedback based on observation Provide regular feedback Interns are there to learn from you – your knowledge and experience can’t be learned from a textbook! We have tried to be clear about what is expected for different modules/placements – make sure you and your intern are too Observation – goes both ways Feedback isn’t always about evaluation, in fact research has discovered that regular feedback, given well before formal evaluation is done, is critical for student development You are providing the practical piece of the puzzle and that is something they haven’t yet been able to experience- includes not just knowledge application, but professional attitudes, behaviour, practical elements of practice (where to find a recorded patient weight, how to navigate a referral process to a practitioner in the community)

Who to contact? Can help you with: For FH, IH, PHC & non-health authority sites: UBC Dietetics Practice Educator Kara Vogt kara.vogt@ubc.ca 604-827-0762 For PHSA, Island Health, VCH & NH: UBC Dietetics Education Coordinator Heather Tufts heather.tufts@ubc.ca 604-827-5762 Questions about the internship Your ideas/suggestions for the program in general Your ideas/suggestions for preceptor or intern supports Consultation on teaching and learning: Strategies to support a struggling intern Advice on intern teaching strategies Resources for preceptors * Can also encourage your intern to contact us directly for learning support and/or resources Your core site internship coordinator (CSIC) Intern scheduling questions/issues Intern performance issues (e.g. concern intern will not pass) Local preceptor resources Also consider: networking with other preceptors (dietitians and interprofessional colleagues) -Role delineation doc (mentioned earlier) also includes this information about which person at UBC supports each specific health authority -Having Kara or Heather designated as a contact for specific HA is new strategy we’re trying this year. Our hope is that this will provide enhanced timely access and support to us at UBC for all HA -If you forget and contact the wrong person, or both of us, don’t worry. The main point is we would love to hear from you and help you whenever we can, so don’t hesitate to reach out

Want more preceptor development opportunities? Attend sessions offered by the UBC Dietetics Program: Annual preceptor education and networking event (Sept 29, 2016) FEED teleconferences (next session Feb 2017, for PPH preceptors) UBC Dietetics Program site visits in your area Identify preceptor workshops and resources in your organization Subscribe to Centre for Health Education Scholarship (CHES) newsletters – great resources and workshops Next Forum for Enhanced Education and Discussion (FEED) teleconference in spring 2017 – specifically for PPH preceptors, information and discussion that is unique to that module CHES events are often offered at VGH or UBC, with video conference around the province

Questions?