1. 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

2. Behavioral Objectives
Outline
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
Overview of ACEND requirements for Programs & Preceptors
Preceptor roles
Strategies for Preceptors
Examples of Challenges for Preceptors
Resources for Preceptors
Intern Panel

3. 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.

4. DPD vs DI Didactic Program in Dietetics vs. Dietetic Internship
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)

5. 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-on- one training, and modeling professional behaviors and attitudes.

6. 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

7. 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.

8. 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

9. 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.

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

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

12. 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.”

13. 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.

14. 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

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

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

17. 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

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

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

20. 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)

21. 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)

22. 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.

23. Challenges for Preceptors
Preceptor may feel tempted to vent and complain to the intern about work situations.
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.
Preceptor has difficulty “finding a balance”…providing enough challenge but not so much that the intern feels overwhelmed.

24. 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!)

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

26. 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

27. 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)

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

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

30. 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