Consultation on Draft Accreditation Standards for Dietetic Internship/Practicum Programs Summary of Findings Presentation for PDEP Annual Meeting June 12, 2013

Overview of Presentation 1.Background 2.Purpose of consultation 3.Approach 4.On-line survey respondents 5.On-line survey overall findings 6.Integrated findings a.Overarching themes b.Key areas for consideration 7.Next Steps

1. Background: Development of Standards In April 2012, PDEP SC appointed an Accreditation Standards Development Working Group (ASDWG) to develop new standards for the accreditation of education programs ASDWG membership included Dietetic Education Programs (4), regulators (1) and Dietitians of Canada (1) The draft accreditation standards were reviewed by the PDEP SC in January 2013 and a revision was completed for use for the consultation phase of this project In March, 2013 The PDEP SC contracted Parker-Taillon Consulting Inc. to conduct the consultation process

1. Background: Overview of PDEP Accreditation Standards (1) Six Standards: Program Governance and Structure Program Administration: Students/Interns Program Administration: Curriculum Program Administration: Academic and Professional Staff Program Administration: Resources Program Evaluation

1. Background: Overview of PDEP Accreditation Standards (2) Elements: Standard Statement: Overall expectation of the educational program Criteria: Specified expectations forming the basis for testing or judging whether a standard has been met Elaboration: Expectations for meeting the criterion Documentation required: Documentation requirements and examples of how the criterion can be met

2. Purpose of Consultation To engage stakeholders in determining if the draft Standards: are applicable are achievable are understandable permit program autonomy have appropriate documentation requirements

3. Approach: Overview Consultation involved three major activities: Focus Group Consultation On-line Consultation Analysis/Report preparation

3. Approach: Focus Group Consultation Two focus groups were held by teleconference in April/May 2013 Participants involved: –members of the Alliance of Canadian Dietetic Regulatory Bodies (n=10) –representatives of Dietitians of Canada (n=10) Focus groups were 1.5 hours in length and questions were pre-circulated

3. Approach: On-line Survey Conducted over three weeks in May 2013 using on-line survey tool (SurveyMonkey) The survey was distributed to 59 stakeholders from three stakeholder groups –dietetic education programs –accreditation committee members –accreditation surveyors

3. Approach: Analysis and Report Preparation The Consultants reviewed the findings from the focus groups and on-line survey individually and identified key themes The key themes from the two activities were then analyzed and integrated The draft Preliminary Report was prepared and submitted to the AWG and PDEP Steering Committee for feedback. The document was revised based on the feedback received.

4. On-line Survey: Respondents (1) Received a total of 41 responses, resulting in an overall response rate of 69%. Responses by stakeholder group* –dietetic education programs (92.5%) –accreditation committee members (25%) –accreditation surveyors (12.5%) *Note: Total >100% as respondents were able to indicate more than one group.

4. On-line Survey: Respondents (2) Responses by type of education program: –integrated program (44.4%) –stand alone internship program (33.3%) –combined Master’s program (13.9%) –stand alone academic program (8.3%) Location of respondents: Nine of ten provinces were represented

5. On-line Survey: Overall findings (1) Overall a high level of agreement with the Standards document: There was >90% agreement that all of the draft Standards statements were clear and relevant For Standards 3 and 6 there was >90% agreement for all of the related criteria, elaboration, and documentation requested For the other Standards (1, 2, 4, and 5) there was > 80% agreement for all but three of the related criteria, elaboration, and document requested The documentation requested for 11 of the 24 criteria had <90% agreement

5. Online survey: Overall findings (2) Standard 1 Program Governance and Structure Over 90% agreement with all Elements except: Elaboration 1.4 Documentation 1.2, 1.4, 1.5 Standard 2 Program Administration: Students/Interns Over 90% agreement with all Elements except: Documentation 2.1, 2.2, and 2.3 Standard 3 Program Administration: Curriculum Over 90% agreement with all Elements Standard 4 Program Administration: Academic and Professional Staff Over 90% agreement with all Elements except: Elaboration and Documentation for 4.1, Standard 5 Program Administration: Resources Over 90% agreement with all Elements except: Criterion and Documentation for 5.3 and 5.4 Standard 6 Program EvaluationOver 90% agreement with all Elements

6. Integrated Findings Integrated focus groups and on-line survey findings are presented under three topics: a.Overarching themes b.Key areas for consideration

6 a. Overarching Themes in the Feedback (1) - General Diversity of Programs: Generally positive feedback about combining the standards. Need to recognize diversity – focus on outcomes Growth and future innovation: Differing views Transition period needed Resource implications: Need more discussion with university administration Documentation requested: Add more specific information about expectations

6 a. Overarching Themes in the Feedback (2) - Gaps Examples of gaps identified included: Add definition and guidelines for minimum number of internship/practicum hours (Criterion 3.2) Address development of quality improvement and professional leadership. Include research as a value of the standards. Add more detail about coordination between university, placement, professional systems Add more detail about accreditation decisions

6 b. Key Areas for Consideration Focus on the following four key areas: Three elements where there was <80% agreement: –Criteria 1.2 Documentation requested –Criteria 4.2 Elaboration –Criteria 4.3 Elaboration/Documentation requested Overarching issue: Criteria 3.2 Documentation Requested

6 b. Key Areas for Consideration Standard 1 - Program Governance and Structure –1.2 Criteria 1.2 The Program’s parent institution/organization supports the achievement of program objectives and student/intern centered, professional practice education Documentation requested Documentation that the parent organization/ institution recognizes that the status of the Program is equivalent to other professional practice education programs. Feedback: Unclear about documentation requested What is meant by "other" professional practice education programs? Wonder if documentation needs to frame the status of the program in comparison to other programs, or simply to recognize it as a professional practice education program (or perhaps could add that “program prepares graduates for entry into a regulated health profession”)

6 b. Key Areas for Consideration Standard 4 - Program Administration: Academic and Professional Staff Criteria 4.2 The individual responsible for directing the Program is a dietitian who has the appropriate credentials and is appointed by an administrative head within the institution/organization. Elaboration for Academic Programs 4.2.1: The designated dietetics program director (faculty member responsible for directing the Program) has a PhD, is appointed to a full-time tenure/ tenure-track position and is registered with the provincial dietetic regulatory body The dietetics program director receives a minimum of one-half unit of course relief per semester or equivalent. Feedback on The PhD requirement for the Program director may be limiting Rather than focusing on credentials, could the focus for the Program Director be on roles or functions, e.g., authority, responsibility and time to manage the program. Feedback on This may be restrictive and impact on a program’s flexibility to meet the criterion. Some university’s collective agreements do not offer course relief. Key issue should be that the director is given adequate time to carry out functions

6 b. Key Areas for Consideration Standard 4 - Program Administration: Academic and Professional Staff Criteria 4.2 The individual responsible for directing the Program is a dietitian who has the appropriate credentials and is appointed by an administrative head within the institution/organization. Elaboration for Internship/Practicum Programs: Practicum/internship program coordinator has a post-graduate degree; is registered with the provincial dietetic regulatory body; has a permanent, or renewable contract position (with term); and has a minimum of three years of work experience prior to appointment Practicum/internship program coordinator must have time (1 FTE per interns/practicum students) and support to managing all required aspects of the program. Feedback on Is it necessary for the coordinator to have a post-graduate degree, e.g., would it be more important to focus on the specific qualifications to support dietetic intern learning? Is a minimum of three years experience sufficient to have the necessary skills (e.g., program evaluation, curriculum development, conflict resolution)? Feedback on In some programs this ratio may be restrictive and prevent expansion of the program. Good to have this ratio; however, it is too high and doesn’t reflect current norms.

6 b. Key Areas for Consideration Standard 4 - Program Administration: Academic and Professional Staff Criteria 4.3. The number and type of academic appointments and professional positions to the Program are sufficient to achieve learning outcomes. Elaboration For Academic Programs: The program has no fewer than four full-time faculty members who hold a tenure-track/tenured appointment and who are registered with the provincial dietetic regulatory body. At least two of the appointments are with professorial rank, i.e. assistant, associate or full professor. Feedback on How was this number determined and what is the evidence to support this; could a ratio that is based on number of students and placements be more useful? This doesn’t support program diversity and the need to consider other faculty with different backgrounds who enhance programs, such as Agriculture, Food Science, Adult Education, or part-time faculty members, who are highly qualified and skilled senior expert dietitians. There are not many RDs who have the level of education required to have a tenure- track appointment

6 b. Key Areas for Consideration Standard 3 - Program Administration: Curriculum – 3.2 Criterion 3.2 The curriculum is logically constructed to achieve expected learning outcomes for students/interns. Elaboration The curriculum sequencing is appropriate for progressive student/intern learning. Flow of learning builds in complexity with reinforcement as required to achieve the ICDEP Documentation requested Evidence that internship/practicum meets guideline requirements including a minimum of 1250 hours of applied learning in a practice setting (definition and guidelines being developed). Feedback How was the 1250 hours or applied learning in a practice setting was determined? What is the definition of a practice setting? Please note that most programs use cases, simulation, applied workshops and educational sessions to fulfill the competencies and to support student/intern learning. If programs are competency based, then why is a specific number of hours given? Perhaps this could be more of a guideline.

7. Summary and Next Steps Overall the Standards were very well received Common themes in the feedback: –More clarification about basis of some requirements –More clarification about some documentation expectations –More flexibility (focus on outcomes) and perhaps use specifics as guidelines Next steps include: –Re-engage the Accreditation Standards Working Group to complete revisions to the Standards document –Implementation of the Standards Thank you! Questions?