Consultation Document: Seeking Feedback on Performance Indicators for Inclusion in the Integrated Competencies for Dietetic Education and ...

Page created by Douglas French
 
CONTINUE READING
Consultation Document: Seeking Feedback on Performance Indicators for Inclusion in the Integrated Competencies for Dietetic Education and ...
Consultation Document:
 Seeking Feedback on Performance Indicators for Inclusion in the
Integrated Competencies for Dietetic Education and Practice, v3.0

    To access the online feedback survey click here:
              https://www.surveymonkey.com/r/WNL6HTB
     BUT BE SURE TO CAREFULLY STUDY THIS DOCUMENT FIRST!

                                                                    1
Preamble

The Partnership for Dietetic Education and Practice (PDEP) is nearing completion of the
final steps in developing the 2020 update to the Integrated Competencies for Dietetic
Education and Practice (ICDEP).

Purposes of ICDEP
ICDEP serves two purposes:

       1. It describes the minimum set of practice abilities that a dietitian is expected to
       possess at the point of entry-to-practice. These abilities are called Practice
       Competencies (PCs).

       2. It delineates the manner in which possession of the PCs is to be assessed
       pre-registration. Assessment is required in three distinct settings:
               i. Within the academic component of education programs
               ii. Within the practicum component of education programs
               iii. In the Canadian Dietetic Registration Examination (CDRE)
       While each assessment setting has inherent advantages and constraints, all
       assessment takes place pre-licensure; therefore no setting is able to directly
       measure candidate performance in practice (practice being the context of the
       PC). For this reason, explicit expectations for performance in each assessment
       setting are captured in behavioural descriptors called Performance Indicators
       (PIs).

Evolution of ICDEP since v2.0 (2013)
PDEP’s ICDEP v3.0 Working Group developed modified Domains of Competence
(formerly known as Areas of Practice), a revised Statement of Entry-Level Proficiency,
and updated PCs, with widespread stakeholder consultation, over the period January
2018 through June 2019.

The 7 inter-related Domains of Competence are illustrated in the chart on the cover
page. As the chart suggests, the Domains of Competence overlap and inform one
another. It also signifies that Food & Nutrition Expertise is central to all activities carried
out in the common practice domains of Nutrition Therapy, Health Promotion and Food
Provision. Professionalism & Ethics, Communication & Collaboration and Leadership
frame and inform the practice domains.

Within the Domains there are 54 PCs, from which a total of 227 PIs have now been
drafted.

For ICDEP v3.0, four significant modifications have been proposed in approach:
   1. The Foundational Knowledge (FK) specifications in v2.0 (which were content-
      based statements of the broad knowledge base necessary to perform the PCs)
      have been replaced by performance-based PIs. To accommodate this in part,
      the new Domain Food & Nutrition Expertise was developed.
                                                                                               2
2. The number of assessment statements has been reduced by almost 50% (from a
       total of 441 PI/FK statements in v2.0 to 227 PIs in v3.0), in an effort to streamline
       ICDEP and reduce redundancy.
    3. The former Area of Practice Management, which contained PCs involving food
       service operations as well as more generic management skills, has been
       separated into two Domains: Leadership and Food Provision.
    4. A modified version of Miller’s Pyramid of Clinical Competence (see below) has
       been developed and is now used to specify the nature of assessment required of
       PIs within the three assessment settings.

Statement of Entry-Level Proficiency
ICDEP is an entry-to-practice standard. Education and assessment should be
structured to reflect performance consistent with the following statement of entry-level
proficiency:
        Entry-level dietitians independently apply routine approaches consistent with
        standards and best practices in the profession. They recognize situations
        beyond their capacity and take appropriate steps to ensure that such situations
        are addressed safely and ethically.
        With experience and further education, knowledge, abilities, judgement and
        efficiency evolve consistent with practice.

The Nature of Assessment Required
The nature of assessment required in each assessment setting has been identified
using a PDEP-developed adaptation of Miller's Pyramid of Clinical Competence.1
Represented graphically as shown below, this hierarchy of assessment methodologies
consists of 4 behavioural levels labelled Knows (K) / Knows How (KH) / Shows How
(SH) / Does (D). The nature of the assessment required is provided in the PC/PI grid,
and is reflected in the verb used in wording the PI statement:

               Nature of Assessment             Verbs used in corresponding PI statement
           Knows (K)                         Demonstrate awareness; demonstrate knowledge
           Knows How (KH)                    Demonstrate understanding
           Shows How (SH)                    An action verb connoting: perform in simulation
           Does (D)                          An action verb connoting: perform in the workplace

1
 For origin see:
G. E. Miller. The assessment of clinical skills/competence/performance. Acad Med 1990;65:S63-67, and
A. Gwilliam. TrueAbility. 2018; retrieved from
https://i1.wp.com/www.trueability.com/wp-content/uploads/2018/08/Millers-Pyramid-.jpg?ssl=1

                                                                                                       3
Nature of PI Assessment
Development towards competence in practice

                                                                         DOES               Assessment based on observation* of performance in
                                                                                            the workplace

                                                                                               Assessment based on observation* of performance, in a
                                                                                               workplace simulation, typically taking place in an academic
                                                                    SHOWS HOW
                                                                                               education setting

                                                                                                    Assessment based on application of knowledge in the
                                                                     KNOWS HOW                      context of practice, demonstrated in multiple-choice testing,
                                                                                                    case study, written or oral assessment, taking place
                                                                                                     in an academic education setting or the CDRE

                                                                                                            Assessment based on possession of knowledge,
                                                                                                            demonstrated in multiple choice testing, written or oral
                                                                        KNOWS
                                                                                                            assessment, taking place in an academic education
                                                                                                            setting or the CDRE

                                                                 * Observation may be direct (undertaken by the assessor) or
                                                                 indirect (anecdotal, based on discussion with others)

                                             Here is an example of how the adaptation of Miller’s Pyramid should be applied to the
                                             PIs:
                                                    Consider PC 1.06: Ensure appropriate and secure documentation, and
                                                    specifically PI 1.06a: Document relevant information accurately and completely,
                                                    in a timely manner.
                                                   PI 1.06a describes the behaviour to be assessed. Aspects of this behaviour can
                                                   be assessed at any of the 4 Miller levels:
                                                   Knows assessment:
                                                          This would indicate that the student knows about the characteristics of
                                                           documentation normally required, devoid of any specific context or
                                                           application. This could be determined via a written test, an oral test, or a
                                                           multiple choice question.
                                                   Knows How assessment:
                                                          This would indicate that in addition to Knows, the student would be able to
                                                           identify the characteristics of documentation that would apply in a specific
                                                           context of practice or practice scenario. Similar to Knows, Knows How
                                                           performance could be determined via a written test, an oral test, or a
                                                           multiple choice question.

                                                                                                                                                          4
Shows How assessment:
             This would indicate that the student can actually perform the required task
              of documenting appropriately, based on observation of her/his
              performance in a simulation of practice such as a food/communication lab,
              a simulation with a standardized patient, a computer-based simulation,
              etc.
      Does assessment:
             This would indicate that the student can actually perform the required task
              of documenting appropriately in a practice setting, based on observation
              of her/his performance in the dietetic workplace. Such observation may,
              for example, involve a preceptor reviewing and assessing the student’s
              chart notes for accuracy, completeness and timeliness following a patient
              interaction.
             It is only at the Does level that the student performs in a setting that
              closely mirrors what real-life practice may be like; thus Does assessment
              is sometimes considered to be the ‘gold standard’ relative to clinical
              competence and it lies at the top of the pyramid. That said, dependent on
              the nature of the PI, Does assessment may be neither feasible nor
              sufficiently comprehensive in the practicum setting.
      Note that with reference to the PC/PI grid (see page 6 of this document) the
      required assessment for PI 1.06a is Knows How in academic and Does in
      practicum.

The PI Consultation Process and the Finalization of ICDEP v3.0
The period of final consultation on ICDEP v3.0 will take place over the period October –
November 2019, and will seek feedback from individuals involved in the provision and
assessment of entry-to-practice education. It will be survey-based.

If you wish to provide feedback it is essential that you spend some time examining the
PC/PI grid below. To view and respond to the feedback survey, go to:
https://www.surveymonkey.com/r/WNL6HTB In order to respond you will need to have
this Consultation Document available for reference. The survey will close at the end of
the day on November 24 2019, Pacific time.

Over the period December 2019 – February 2020 CDRE management personnel will be
asked to identify PIs that will incorporated into the CDRE blueprint.

In early 2020 an ICDEP Interpretation Guide will be prepared. This will include an
introduction to dietetic practice in Canada, information about the structure and purposes
of ICDEP, and a glossary of key terminology with definitions and references.

Final approval of ICDEP v3.0 by the PDEP Steering Committee is anticipated in April
2020. Within approximately two years of implementation, PDEP is expected to initiate a
user feedback process that may result in some minor operational refinements.

                                                                                          5
PC / PI GRID

        Practice Competencies
                                                                 Performance Indicators (PIs)
(abilities expected of the dietitian at                                                                                                               PI Assessment Required
                                                  (performance that will be assessed prior to registration)
           entry-to-practice)
                            Terms in red will be defined in the ICDEP Interpretation Guide                                                         Academic1   Practicum1   CDRE2
                                                                                                                                                                                    1
                                                                                                                                                                                     Academic / Practicum assessment coding is based
1. Professionalism and Ethics
                                                                                                                                                                                    on an adapted Miller's pyramid:
    1.01 Practice within the context of Canadian diversity                                                                                                                          K = Knows; KH = Knows How
                                               a    Demonstrate knowledge of Canadian food, health and social systems                                 K                             SH = Shows How; D = Does
                                                                                                                                                                                    2
                                               b    Demonstrate understanding of the impact of diverse attitudes and values on health                 KH                                CDRE assessments have not yet been determined

                                               c    Act in a manner that supports health equity and social justice                                    SH           D
    1.02 Practice according to legislative, regulatory and organizational requirements
                                               a    Demonstrate knowledge of federal requirements relevant to dietetic practice                       K

                                               b    Demonstrate knowledge of provincial / territorial requirements relevant to dietetic practice      K

                                                    Demonstrate knowledge of regulatory scope of practice, bylaws, standards of practice and
                                               c                                                                                                      K
                                                    codes of ethics
                                               d    Adhere to regulatory requirements                                                                              D
                                               e    Comply with organizational policies and directives                                                             D
    1.03 Act ethically and with integrity
                                               a    Treat others with respect                                                                         SH           D
                                               b    Act in a manner that engenders trust                                                              SH           D
                                               c    Act in accordance with ethical principles                                                         SH           D
                                               d    Accept accountability for decisions and actions                                                   SH           D
                                               e    Act in a manner that upholds the reputation of the profession                                     SH           D
                                               f    Maintain professional boundaries                                                                  KH           D
    1.04 Act in a manner that promotes cultural safety
                                                    Act with awareness of how a dietitian's biases, beliefs, behaviours, power and privilege
                                               a                                                                                                      KH           D
                                                    may affect others
                                               b    Demonstrate understanding of cultural sensitivity and humility                                    KH
                                                    Demonstrate awareness of Indigenous values and ways of knowing related to health and
                                               c                                                                                                      K
                                                    wellness
                                                    Demonstrate knowledge of the ongoing impact of colonization / residential schools /
                                               d                                                                                                      K
                                                    intergenerational trauma / systemic racism on Indigenous peoples in Canada
                                                    Demonstrate awareness of the role of self-determination in supporting capacity
                                               e                                                                                                      K
                                                    development
    1.05 Employ a client-centred approach
                                               a    Demonstrate knowledge of principles of a client-centred approach                                  K
                                               b    Ensure informed consent                                                                           KH           D
                                               c    Identify client perspectives, needs and assets                                                    KH           D
                                               d    Engage client in collaborative decision making                                                    KH           D
                                               e    Maintain client confidentiality and privacy                                                       KH           D
    1.06 Ensure appropriate and secure documentation
                                               a    Document relevant information accurately and completely, in a timely manner                       KH           D
                                               b    Maintain security and confidentiality of records                                                  KH           D
    1.07 Practice in a manner consistent with principles of safety
                                               a    Demonstrate knowledge of risks inherent in practice settings                                      K
                                               b    Identify risks and hazards in the practice setting                                                             D
                                               c    Contribute to an organizational culture of safety                                                 KH           D
    1.08 Manage time and workload
                                               a    Prioritize activities                                                                             KH           D
                                               b    Meet deadlines                                                                                    SH           D
    1.09 Employ an evidence-informed approach to practice
                                               a    Demonstrate knowledge of factors that contribute to decision making                               K
                                               b    Demonstrate knowledge of the process of evidence-informed decision making                         KH
                                               c    Make evidence-informed decisions                                                                  KH           D
    1.10 Engage in the process of reflective practice
                                               a    Demonstrate knowledge of principles of reflective practice                                        K
                                               b    Assess effectiveness of practice                                                                               D
                                               c    Seek resources to improve practice                                                                             D
    1.11 Practice within limits of current personal level of professional knowledge and skills
                                               a    Articulate individual level of professional knowledge and skills                                  KH           D
                                               b    Identify situations which are beyond personal capacity                                                         D
                                               c    Address situations beyond personal capacity                                                                    D
    1.12 Maintain comprehensive and current knowledge relevant to practice
                                               a    Use relevant terminology                                                                          SH           D
                                               b    Identify relevant sources of information                                                          KH           D
                                               c    Critically appraise information relevant to practice                                              KH           D
                                               d    Identify emerging information relevant to practice                                                K            D
    1.13 Use informatics to support practice
                                               a    Demonstrate knowledge of information technologies relevant to practice                            K
                                               b    Use information management software                                                               SH           D
    1.14 Maintain personal wellness consistent with the needs of practice
                                               a    Identify personal assets and barriers affecting practice                                          SH           D
                                               b    Address personal barriers affecting practice                                                      SH           D

       Consultation Version Oct-Nov 2019                                                                                                                                                                                     6
PC / PI GRID

        Practice Competencies
                                                                 Performance Indicators (PIs)
(abilities expected of the dietitian at                                                                                                           PI Assessment Required
                                                  (performance that will be assessed prior to registration)
           entry-to-practice)
                            Terms in red will be defined in the ICDEP Interpretation Guide                                                     Academic1   Practicum1   CDRE2
                                                                                                                                                                                1
                                                                                                                                                                                 Academic / Practicum assessment coding is based
2. Communication and Collaboration
                                                                                                                                                                                on an adapted Miller's pyramid:
   2.01 Use appropriate communication approaches                                                                                                                                K = Knows; KH = Knows How
                                                 a   Identify opportunities for and barriers to communication relevant to context                 KH           D                SH = Shows How; D = Does
                                                                                                                                                                                2
                                                 b   Use communication approaches appropriate to context                                          SH           D                    CDRE assessments have not yet been determined

                                                 c   Use language appropriate to context                                                          SH           D
   2.02 Use effective written communication skills
                                                 a   Write in a manner responsive to the needs of the audience                                    SH           D
                                                 b   Write clearly and in an organized fashion                                                    SH           D
                                                 c   Use correct grammar and spelling                                                             SH           D
   2.03 Use effective oral communication skills
                                                 a   Speak in a manner responsive to the needs of the audience                                    SH           D
                                                 b   Speak clearly and in an organized fashion                                                    SH           D
                                                 c   Use appropriate tone of voice                                                                SH           D
   2.04 Use appropriate digital platforms for communication
                                                 a   Demonstrate knowledge of digital communication platforms, and their appropriate uses         K
                                                 b   Use digital communication platforms relevant to context                                      SH           D
   2.05 Use effective interpersonal skills
                                                 a   Employ principles of active listening                                                        SH           D
                                                 b   Use and interpret non-verbal communication                                                   SH           D
                                                 c   Act with empathy                                                                             SH           D
                                                 d   Establish rapport                                                                            SH           D
                                                 e   Employ principles of negotiation and conflict management                                     SH           D
                                                 f   Seek and respond to feedback                                                                 SH           D
                                                 g   Provide constructive feedback to others                                                      SH           D
   2.06 Engage in teamwork
                                                 a   Demonstrate knowledge of principles of teamwork and collaboration                            K
                                                 b   Contribute effectively to teamwork                                                           SH           D
   2.07 Participate in collaborative practice
                                                 a   Identify scenarios where dietetics knowledge is a key element in collaborative practice      K
                                                 b   Identify scenarios where the expertise of others is a key element in dietetic practice       K
                                                 c   Facilitate interactions and discussions among team members                                   SH           D
                                                 d   Contribute dietetics knowledge in collaborative practice                                     KH           D
                                                 e   Draw upon the expertise of others                                                            KH           D
                                                 f   Contribute to effective decision making                                                      SH           D
3. Leadership
   3.01 Assess and enhance approaches to practice
                                                 a   Conduct a situational analysis                                                               SH           D
                                                 b   Analyze, interpret and consolidate evidence to establish a course of action                  SH           D
                                                 c   Plan the implementation of change                                                            SH           D
                                                 d   Plan the evaluation of change                                                                SH           D
   3.02 Participate in practice-based research
                                                 a   Frame research questions                                                                     SH           D
                                                 b   Critically appraise literature                                                               SH           D
                                                 c   Use relevant research methodology                                                            SH           D
                                                 d   Interpret research findings                                                                  SH           D
                                                 e   Communicate research findings                                                                SH           D
   3.03 Use management skills
                                                 a   Contribute to strategic and operational planning                                             KH           D
                                                 b   Contribute to human resource management                                                      KH           D
                                                 c   Contribute to financial management                                                           KH           D
                                                 d   Contribute to physical resource management                                                   KH           D
   3.04 Advocate for ongoing improvement of nutritional health and care
                                                 a   Identify opportunities for advocacy                                                          K            D
                                                 b   Identify strategies for effective advocacy                                                   KH           D
                                                 c   Engage in advocacy relevant to practice setting                                                           D
   3.05 Foster learning in others
                                                 a   Identify opportunities for learning                                                          K            D
                                                 b   Assess learning needs and assets                                                             SH           D
                                                 c   Develop appropriate learning outcomes                                                        SH           D
                                                 d   Implement appropriate educational strategies                                                 SH           D
                                                 e   Assess achievement of learning outcomes                                                      SH           D
   3.06 Undertake knowledge translation
                                                 a   Identify food- and nutrition-research knowledge relevant to others                           K            D
                                                 b   Reframe knowledge into a format appropriate for other users                                  SH           D
   3.07 Foster development of food literacy in others
                                                 a   Identify strategies to assist the development of food literacy                               KH           D
                                                 b   Engage in activities to build food literacy                                                  SH           D

      Consultation Version Oct-Nov 2019                                                                                                                                                                                  7
PC / PI GRID

        Practice Competencies
                                                                 Performance Indicators (PIs)
(abilities expected of the dietitian at                                                                                                          PI Assessment Required
                                                  (performance that will be assessed prior to registration)
           entry-to-practice)
                            Terms in red will be defined in the ICDEP Interpretation Guide                                                    Academic1   Practicum1   CDRE2
                                                                                                                                                                               1
4. Food and Nutrition Expertise                                                                                                                                                 Academic / Practicum assessment coding is based
                                                                                                                                                                               on an adapted Miller's pyramid:
   4.01 Apply understanding of food composition and food science                                                                                                               K = Knows; KH = Knows How
                                             a     Demonstrate understanding of physical and chemical properties of food                         KH                            SH = Shows How; D = Does
                                                                                                                                                                               2
                                             b     Demonstrate understanding of food processing and preservation                                 KH                                CDRE assessments have not yet been determined
                                                   Demonstrate understanding of the role of ingredients and their interaction in food
                                             c                                                                                                   KH
                                                   preparation
                                             d     Demonstrate understanding of the sensory evaluation of food                                   KH
                                             e     Demonstrate understanding of microbes in food                                                 KH
                                             f     Identify sources of micronutrients and macronutrients in foods                                K
                                             g     Identify sources of non-nutrient functional components in food                                K
   4.02 Apply understanding of food environments
                                             a     Demonstrate knowledge of government policy in regulating food products in Canada              K
                                             b     Demonstrate understanding of factors affecting food systems** in Canada                       KH
                                             c     Demonstrate awareness of Indigenous values and ways of knowing related to food                K
                                             d     Demonstrate understanding of factors affecting the food security*** of Canadians              KH
                                             e     Demonstrate understanding of factors affecting food safety                                    KH
                                             f     Demonstrate understanding of sustainable food systems and practices                           KH
   4.03 Use food skills
                                             a     Create food plan based on client situation                                                    KH
                                             b     Select food appropriate to client situation                                                   KH
                                             c     Interpret food label to assist in food selection                                              KH
                                             d     Critically appraise food messaging and marketing to assist in food selection                  KH
                                             e     Demonstrate food preparation techniques                                                       SH
                                                   Demonstrate awareness of the availability and preparation of Indigenous traditional /
                                             f                                                                                                   K
                                                   country foods
                                             g     Demonstrate understanding of food modifications to address client needs                       KH
   4.04 Apply understanding of human nutrition and metabolism
                                             a     Demonstrate understanding of the role of nutrients and other food components                  KH
                                                   Demonstrate understanding of the processes of ingestion, digestion, absorption and
                                             b                                                                                                   KH
                                                   excretion
                                             c     Demonstrate understanding of metabolism                                                       KH
   4.05 Apply understanding of dietary requirements and guidelines
                                                   Demonstrate understanding of dietary requirements across the lifespan, in health and
                                             a                                                                                                   KH
                                                   disease
                                                   Demonstrate understanding of the role of physical activity and energy balance in
                                             b                                                                                                   KH
                                                   determining dietary requirements

                                             c     Demonstrate understanding of how deficiencies and toxicities of nutrients affect health       KH

                                             d     Demonstrate understanding of current nutrition recommendations and dietary guidelines         KH

                                             e     Demonstrate understanding of the role of supplements in meeting dietary requirements          KH
   4.06 Apply understanding of dietary practices
                                             a     Demonstrate understanding of behavioural theories relevant to food choice and eating          KH

                                             b     Demonstrate understanding of psychological and social aspects food choice and eating          KH

                                             c     Demonstrate understanding of the impact of financial resources on food choice and eating      KH

                                                   Demonsrate understanding of the inter-relationship between the environment and dietary
                                             d                                                                                                   KH
                                                   practices
                                             e     Demonstrate knowledge of cultural and religious impacts on dietary practices                  K
                                                   Demonstrate awareness of the role of Indigenous traditional / country foods in dietary
                                             f                                                                                                   K
                                                   practices
                                             g     Demonstrate knowledge of trends in food consumption                                           K
   4.07 Integrate nutrition therapy fundamentals and practices
                                             a     Demonstrate knowledge of human physiological systems in health and disease                    K

                                             b     Demonstrate knowledge of the etiology and pathophysiology of nutrition-related diseases       K

                                             c     Demonstrate knowledge of nutrition-related disease management strategies                      K
                                             d     Demonstrate understanding of the nutrition care process                                       KH
                                             e     Demonstrate understanding of enteral nutrition practices                                      KH
                                             f     Demonstrate understanding of parenteral nutrition practices                                   KH
                                             g     Demonstrate understanding of swallowing assessment practices                                  KH
                                             h     Demonstrate swallowing assessment techniques                                                  SH
                                             i     Demonstrate understanding of counselling theories                                             KH
                                             j     Demonstrate counselling techniques                                                            SH
   4.08 Integrate population health promotion principles and approaches
                                             a     Demonstrate knowledge of determinants of health, health equity and social justice             K
                                             b     Demonstrate knowledge of frameworks for population and public health                          K
                                             c     Demonstrate understanding of health promotion                                                 KH
                                             d     Demonstrate understanding of strategies to promote the health of populations                  KH

                                             e     Demonstrate understanding of the values and philosophy of public and population health        KH

      Consultation Version Oct-Nov 2019                                                                                                                                                                                 8
PC / PI GRID

         Practice Competencies
                                                                  Performance Indicators (PIs)
 (abilities expected of the dietitian at                                                                                                                     PI Assessment Required
                                                   (performance that will be assessed prior to registration)
            entry-to-practice)
                             Terms in red will be defined in the ICDEP Interpretation Guide                                                               Academic1   Practicum1   CDRE2
                                                                                                                                                                                           1
                                                                                                                                                                                            Academic / Practicum assessment coding is based
     4.09 Integrate quantity food provision principles and practices
                                                                                                                                                                                           on an adapted Miller's pyramid:
                                                              Demonstrate knowledge of processes for purchasing, receiving, storage, inventory control
                                                       a                                                                                                     K                             K = Knows; KH = Knows How
                                                              and disposal of food
                                                       b      Demonstrate knowledge of facility layout and equipment for food production                     K                             SH = Shows How; D = Does
                                                                                                                                                                                           2
                                                       c      Demonstrate knowledge of food production and distribution procedures                           K                                 CDRE assessments have not yet been determined

                                                       d      Demonstrate understanding of recipe development and standardization                            KH
                                                       e      Demonstrate understanding of menu planning                                                     KH
                                                        f     Demonstrate knowledge of food provision in emergency planning                                  K
                                                       g      Demonstrate knowledge of approaches to food marketing                                          K
                                                              Demonstrate understanding of food provision strategies that foster healthy food
                                                       h                                                                                                     KH
                                                              environments
5. Nutrition Therapy
     5.01 Assess nutrition status of individuals
                                                       a      Use appropriate nutrition risk screening strategies                                            KH           D
                                                       b      Identify and obtain relevant information                                                       KH           D
                                                       c      Engage client, family and/or relevant others in assessment                                     KH           D
                                                       d      Engage other care providers in assessment                                                      KH           D
                                                       e      Interpret medical history                                                                      KH           D
                                                        f     Interpret medication data                                                                      KH           D
                                                       g      Interpret complementary and alternative medicine data                                          KH           D
                                                       h      Interpret demographic, psycho-social and health behaviour history                              KH           D
                                                        i     Interpret food and nutrient intake data                                                        SH           D
                                                        j     Interpret anthropometric data                                                                  SH           D
                                                       k      Interpret biochemical data                                                                     KH           D
                                                        l     Interpret results from medical tests and procedures                                            KH           D
                                                       m      Interpret information from mealtime / feeding observations                                     KH           D
                                                       n      Identify signs and symptoms of nutrient deficiencies or excesses                               KH           D
                                                       o      Interpret nutrition-focused physical findings                                                  SH           D
                                                       p      Identify chewing, swallowing and feeding problems                                              SH           D
                                                       q      Perform calculations to determine nutrition requirements                                       SH           D
                                                       r      Determine client nutrition requirements                                                        KH           D
     5.02 Determine nutrition diagnosis
                                                       a      Consolidate assessment findings to identify nutrition problem(s)                               KH           D
                                                       b      Prioritize nutrition problems based on importance and urgency                                  KH           D
     5.03 Develop nutrition care plan*
                                                       a      Identify nutrition care goals based on diagnosis                                               KH           D
                                                       b      Select appropriate nutrition interventions                                                     KH           D
                                                       c      Select therapeutic diet modifications                                                          SH           D
                                                       d      Select textural diet modifications                                                             SH           D
                                                       e      Develop or modify food plans                                                                   KH           D
                                                        f     Determine therapeutic supplementation needs                                                    KH           D
                                                       g      Design enteral nutrition regimens                                                              SH           D
                                                       h      Design parenteral nutrition regimens                                                           SH           D
                                                        i     Identify client learning needs and assets related to food and nutrition                        KH           D
                                                        j     Identify additional resources and support services required                                    KH           D
     5.04 Implement nutrition care plan*
                                                       a      Implement nutrition interventions                                                                           D
                                                              Coordinate implementation of nutrition care plan with client, care providers and relevant
                                                       b                                                                                                                  D
                                                              others
                                                       c      Facilitate nutrition education                                                                 SH           D
                                                       d      Provide nutrition counselling                                                                  SH           D
     5.05 Evaluate nutrition care plan*
                                                       a      Select strategies to monitor nutrition care plan                                               KH           D
                                                       b      Evaluate client progress in achieving nutrition care goals                                     KH           D
     5.06 Modify nutrition care plan* when appropriate
                                                       a      Identify factors influencing the effectiveness of nutrition care plan                          KH           D
                                                       b      Modify nutrition care plan                                                                     KH           D

* nutrition care plan includes any or all of the following:
food / nutrient delivery; nutrition education, nutrition
counselling, coordination of nutrition-related supports

6. Health Promotion
     6.01 Assess food- and nutrition-related situation of communities and populations
                                                              Recognize types and sources of information required to assess food and nutrition-related
                                                       a                                                                                                     K
                                                              situation of communities and populations
                                                       b      Participate in stakeholder engagement in assessment                                            KH           D
                                                       c      Access relevant assessment information                                                         KH           D
                                                       d      Interpret food and nutrition surveillance data                                                 KH           D
                                                       e      Interpret health status data                                                                   KH           D
                                                        f     Interpret information relating to the determinants of health and health equity                 KH           D
                                                       g      Interpret information related to food systems and food practices                               KH           D

         Consultation Version Oct-Nov 2019                                                                                                                                                                                          9
PC / PI GRID

         Practice Competencies
                                                                  Performance Indicators (PIs)
 (abilities expected of the dietitian at                                                                                                                   PI Assessment Required
                                                   (performance that will be assessed prior to registration)
            entry-to-practice)
                             Terms in red will be defined in the ICDEP Interpretation Guide                                                             Academic1   Practicum1   CDRE2
                                                                                                                                                                                         1
                                                                                                                                                                                          Academic / Practicum assessment coding is based
     6.02 Determine food- and nutrition-related issues of communities and populations
                                                                                                                                                                                         on an adapted Miller's pyramid:
                                                            Consolidate assessment findings to identify food- and nutrition-related assets, resources
                                                     a                                                                                                     KH           D                K = Knows; KH = Knows How
                                                            and needs
                                                     b      Prioritize issues requiring action                                                             KH           D                SH = Shows How; D = Does

     6.03 Develop food- and nutrition-related community / population health plan*                                                                                                        2
                                                                                                                                                                                             CDRE assessments have not yet been determined

                                                     a      Contribute to development of goals and objectives for plan                                     KH           D
                                                     b      Identify strategies to meet goals and objectives                                               KH           D
                                                     c      Identify required resources and supports                                                       KH           D
                                                     d      Contribute to development of action plan                                                       KH           D
                                                     e      Contribute to identification of evaluation strategies                                          KH           D
     6.04 Implement food- and nutrition-related community / population health plan*
                                                     a      Participate in plan implementation                                                             KH           D
                                                     b      Participate in stakeholder engagement in plan implementation                                   KH           D
     6.05 Evaluate food- and nutrition-related community / population health plan*
                                                     a      Participate in monitoring of implementation activities                                         KH           D
                                                     b      Contribute to plan evaluation                                                                  KH           D
     6.06 Modify food- and nutrition-related community / population health plan* when appropriate
                                                            Propose adjustments to plan to increase effectiveness or meet modified goals &
                                                     a                                                                                                     KH           D
                                                            objectives
* food- and nutrition-related community / population
health plan includes any or all of the following:
monitoring and evaluation of nutritional health and its
physical, political, economic and sociocultural
determinants; food systems and public policies
influencing diet; promotion of healthy eating, and
prevention of nutrition-related diseases
7. Food Provision*
     7.01 Determine food provision* requirements of a group / organization
                                                     a      Assess food provision requirements based on client context                                     KH           D
                                                     b      Identify environmental factors that may impact food provision                                  KH           D
                                                     c      Identify stakeholders to engage in assessment                                                  KH           D
                                                     d      Identify client needs, resources and assets                                                    KH           D
                                                     e      Consolidate assessment findings to determine food provision priorities                         KH           D
     7.02 Develop food provision* plan
                                                     a      Contribute to development of goals and objectives                                              KH           D
                                                     b      Identify approaches to meet goals and objectives                                               KH           D
                                                     c      Contribute to development of plan                                                              KH           D
                                                     d      Contribute to identification of evaluation strategies                                          KH           D
     7.03 Implement food provision*
                                                     a      Participate in food provision activities                                                       KH           D
     7.04 Evaluate food provision*
                                                     a      Participate in monitoring of food provision activities                                         KH           D
                                                     b      Contribute to evaluation of food provision                                                     KH           D
     7.05 Modify food provision* when appropriate
                                                            Propose adjustments to food provision, to increase effectiveness or meet modified goals
                                                     a                                                                                                     KH           D
                                                            & objectives
* food provision is the process of providing food to
individuals and groups in contexts such as: institutional
(healthcare, educational, carceral, daycare, long term
care); community-based (food distribution, gardens,
kitchens); recreational (sports activities, entertainment
sites, camps); business & commercial (hospitality,
restaurants, catering, food & beverage industry
including therapeutic products)

         Consultation Version Oct-Nov 2019                                                                                                                                                                                       10
You can also read