Placement B Student Portfolio 2020 - RGU

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Placement B Student Portfolio 2020 - RGU
Placement B

                        Student Portfolio

                             2020

Review: February 2021
Placement B Student Portfolio 2020 - RGU
Contents

Introductory Portfolio Information ................................................................ 3
Overview of Placement B ............................................................................ 4
Peer Assisted Learning (PAL): A Collaborative 2:1 Model for Placement B .......... 5
Expectations Agreement ............................................................................. 6
Confidentiality Agreement ........................................................................... 8
Guidance on attendance and absence during Dietetic Practice Placements ....... 10
Guidance on Extended Week Placements .................................................... 11
Good practice guide to appropriate dress .................................................... 12
Placement B - Summary of learning outcomes ............................................. 13
‘Know, Can, Do’ Model .............................................................................. 17
Induction Checklist ................................................................................... 18
Guide to compiling your portfolio ............................................................... 21
Placement B Induction Activity: Catering..................................................... 26
Placement B Activity: Individual Patient Consultations .................................. 29
Summary List of competent summative IPC tools ......................................... 34
Placement B Activity: Service User Involvement .......................................... 35
Placement B Activity: Asset Mapping .......................................................... 38
Placement B Activity: Quality Improvement Project ...................................... 42
Placement B Activity: Talk to service user group .......................................... 45
Talk to service user group assessment tool ................................................. 46
Placement B Activity: Case Presentation ..................................................... 48
Case Presentation Consent Form ................................................................ 50
Case Presentation Assessment Tool ............................................................ 51
Feed Forward Form .................................................................................. 52
Activities mapped to learning outcomes ...................................................... 54
Placement B: Professionalism checklist ....................................................... 55
Summary of Evidence Placement B ............................................................ 57
Observation of Practice Tool ...................................................................... 58
Reflective framework ................................................................................ 59
Review of Placement B ............................................................................. 60
APPENDICES ........................................................................................... 64
Understanding Duty of Care ...................................................................... 65
Guidance on use of the Gibbs Reflective Cycle (1988) ................................... 66
  Student Progression Algorithm ………………………………………………………………………. 77
  Fitness to Practice Algorithm ……………………………………………………………………………78
  Raising a Concern Algorithm ……………………………………………………………………………79

                                                    2
Introductory Portfolio Information

The following learning outcome framework, activities, tasks and associated
assessment tools have been developed in collaboration with all Health Boards in
Scotland, NHS Education Scotland and the three Universities in Scotland
(Glasgow Caledonian University, Queen Margaret University, and Robert Gordon
University) who offer pre-registration Dietetic training. Current students,
previous students and service users were also integral to the development
process. Furthermore, acknowledgement should be given to other Universities
in the UK and beyond who have been willing to share their resources, in
particular Kings College London and London Metropolitan University.

The framework is aligned to the British Dietetic Association (BDA) Curriculum
Framework for the Pre-Registration Education and training of Dietitians, the BDA
Model and Process for Nutrition and Dietetic Practice, the Health and Care
Professions Council (HCPC) Standards of Education and Training, and the HCPC
Standards of Proficiency for Dietitians. The portfolio has been approved by both
the HCPC and BDA and is therefore a compulsory requirement for dietetic
student training across Scotland.

The placement and portfolio has been developed in a manner that has been
cognisant of current drivers across Health and Social Care, the NHS Scotland
workforce vision and core values. Consideration has also been given to NHS
Education Scotland Post Registration Career Development Framework (for
Nurses, Midwives and Allied Health Professionals in Scotland), and the four
pillars of practice (Practitioner Level).    These pillars reflect the essential
requirements for the graduate workforce and therefore have been embedded in
the education and training activities in the three placement blocks to support
student progression and competence.

                           NES ‘Four Pillars of Practice’
Key documents
https://www.bda.uk.com/careers/education/preregcurriculum
https://www.bda.uk.com/professional/practice/process
http://www.hcpc-uk.org/aboutregistration/standards/sets/
http://www.careerframework.nes.scot.nhs.uk/using-the-framework/pillars-of-
practice.aspx

                                         3
Overview of Placement B

Placement B is 12 weeks long and the second of the 3 placements. This occurs
after the completion of placement A and must be successfully completed before
commencing placement C. This placement allows students to begin to apply the
theoretical knowledge they have learned at University and to develop the range
of skills needed to work as a dietitian.

This placement offers students the opportunity to gain experience in a range of
settings (health and social care) and with a range of patient/client groups.
Examples of appropriate settings are hospital wards, hospital outpatient clinics,
GP surgeries, health centres, patient’s homes and nursing/residential homes.
Some students may also visit schools and community groups as well as
undertaking health promotion work. Not all students will experience dietetic
practice in all settings but all students will be provided with appropriate
opportunities to meet the learning outcomes associated with Placement B.

The purpose of the Placement B is to allow students to begin to develop the
communication and practical skills required to work as a dietitian. To achieve
this they will have the opportunity to work with a number of different
patient/client groups and have the opportunity to develop dietetic interventions
for a range of clinical conditions. Throughout the placement, students will work
under supervision of a Practice Educator. The level of supervision will decrease
as the placement progresses, but students will not be autonomous in their
practice at the end of placement B.

Placement B has seven learning outcomes associated with it, most of which are
based on the various steps in the Nutrition and Dietetic Care Process (NDCP). It
is the responsibility of the student to gather evidence to demonstrate that they
have met the learning outcomes; this is collated in a portfolio of evidence. Work
undertaken throughout the placement will contribute to this ‘live’ portfolio so
students must consistently engage with all activities and collate their evidence
on an ongoing basis. All learning outcomes must be met by the end of the 12
weeks for students to progress onto placement C.

                                       4
Peer Assisted Learning (PAL): A Collaborative 2:1 Model for Placement B

Using PAL on Placement B
The term Peer Assisted Learning (PAL) essentially means that you will work in
collaboration with at least one other student in order to develop your knowledge
and skills. Peer assisted learning has been shown to be a more effective process
for learning than an individual based approach. It is seen as a natural
progression from problem based learning.

You may be working collaboratively on an ad-hoc basis throughout your 12-week
B placement with a peer. Some placement providers will use PAL more
extensively than others but all providers should include some PAL activities e.g.
Asset Mapping/Quality Improvement project for you to work with another
student on (should there be more than one student on placement at the time).
This method of working will not be new to you as you will have experienced
collaborative working either in pairs or teams throughout your time at university
and during your A placement. You and your peer may have different leaning
styles of learning. It is important to find this out early in your placement and
share this. You should respect your peers learning style and you may need to
adapt your way of working to accommodate this.

NB: You should note that your peer may be a student from a different University
to your own. You may also be at different stages in your training, for example
when a postgraduate and an undergraduate student are paired on placement.

Although you may work closely with a peer, you will also meet with a practice
educator during your B placement. This will allow you to discuss your learning
and seek advice and guidance in areas where peer working has left you unsure
about your knowledge or practice. You will be expected to feedback to the
facilitator on the PAL activities and also to feedback to your peer where
appropriate. Your facilitator should give you feedback individually and in your
peer group. You will be assessed against the learning outcomes on an individual
basis; your peer will not influence your ability to successfully meet the learning
outcomes.

PAL will work best when you are prepared to share your knowledge, skills and
experiences with your peer(s), and to begin to take responsibility for your own
learning.

                                        5
Expectations Agreement

University tutors and practice placement providers believe that students should
be treated as adult learners. This means you will be taking full responsibility for
your own learning and it is up to you to provide us with evidence of your
progress and your professional qualities at each stage. We will not chase you to
hand in work or undertake other tasks. However, please remember that if you
regularly fail to complete work within the allotted time, this does not
demonstrate commitment or a professional attitude.
In addition you must also remember and appreciate that a dietetic department is
a working department and the needs of the service must be the priority. In view
of this your programme could change at short notice and you should
demonstrate flexibility if this happens.

What you can expect from us:
   To be treated with respect
   To be clear about the aims and tasks of your placement
   To be treated fairly and non-judgmentally
   That your training is well organised and you are given adequate notice of
     tasks where possible
   To be clear about what each dietitian expects of you during their the time
     that they are facilitating your learning
   To be given adequate support
   To have confidential matters kept confidential
   To be given the opportunity to contribute to the day to day running of the
     dietetic department in the practice setting
   To receive honest and constructive feedback
   To be given every opportunity to demonstrate your skills and abilities
   You will have the opportunity to meet with a task facilitator after each
     task and receive feedback

What we expect from you:
   When working with your peers you should contribute equally to the task
     and work submitted
   When discussion of a topic is required with your peer around a task /
     topic, listen and acknowledge their views and opinions
   To treat all members of staff with respect
   To let us know if you have a problem with anything that affects your work
   To accept feedback and work to address any areas highlighted
   To be self-motivated
   To inform your supervisor / student training coordinator if tasks or
     tutorials have been cancelled and need to be rearranged
   To behave appropriately and professionally at all times
   To be prepared to reflect on your learning experiences and plan your
     future learning

                                        6
   To prepare adequately for tasks, revising notes or reading around a
       subject if needed
      To ask if you are unsure about something (although this doesn’t mean
       asking a dietitian something that you could easily look up instead!)
      To use your initiative at every opportunity, for example answering the
       phone if everyone else in the office is busy
      To be honest and say if you don’t know or understand something
      To be punctual to meetings, tutorials etc.
      To meet deadlines without prompting and inform the facilitating dietitian
       in advance if you are having difficulty
      To use any spare time within the placement constructively whether on
       campus or in the practice setting
      To ensure that you have completed all paperwork required before
       meetings and to ensure that all forms are filed in your portfolio
      Ensure supervisor / secretary knows where you are at all times
      To check that you understand what is expected in terms of your evidence
       portfolio
      Mobile phones should be switched off during the working hours of your
       placement
      Appropriate use of emails and internet in line with both the university and
       the NHS IT policies

I have read the above, which has been fully discussed with me. I am clear about
what is expected of me and I am happy to take full responsibility for my own
training.

Signed:

Name (PRINT):                                                    Date:

                                        7
Confidentiality Agreement

It is an important professional requirement that you maintain patient
confidentiality both when a student and when an HCPC registrant. In view of
this, you must agree to maintain confidentiality at all times. In addition to
patient confidentiality it is important that you consider the confidentiality of the
staff you work with whilst you are on placement, and the confidentiality of other
students who are in the placement setting with you.

Prior to proceeding to your practice placement you are required to sign a
confidentiality agreement to demonstrate that you understand and agree to
maintain confidential information regarding patients, staff and other students
whilst you are on placement. This agreement extends to disclosing information
both verbally and in the written form, which includes social networking fora such
as Facebook and Twitter.

You may also be asked to sign a confidentiality agreement by your practice
placement provider as part of your induction which you should sign in addition to
this agreement.

You should read the following statement, which is a typical confidentiality
agreement for NHS staff:

“You must not, either during or after the end of your placement, disclose any
confidential information relating to patients (all matters relating to a patient’s
diagnosis and treatment are strictly confidential), staff and other students
(including details of others student’s performance on placement) to any person
or make use of the information unless you are expressly authorised to do so, by
the organisation, as a necessary part of your duties. If you disclose or misuse
information during the course of your employment, the NHS Board and/or the
University will treat such conduct as Gross Misconduct”.

In addition, it is not permitted to access your own information. Neither can you
access other people’s information unless you have a legitimate reason to do so
as part of your practice education programme. Other people include, for
example: family members; neighbours; colleagues, or; any high profile patient
information. It is not permitted to ask your practice educators, or others who
work in the NHS, to access your information on your behalf.

Although you do not have a contract of employment whilst on placement, you
are required to uphold this statement as a condition of you being offered a
placement within the NHS. Any breach of the above statement or additional
information may result in the initiation of fitness to practice proceedings. For
more information on key documents this information relates to please see the
following publications:

      HCPC (2016) Guidance on Conduct and Ethics for Students:
       http://www.hcpc-uk.org/publications/brochures/
      HCPC (2016) Standards of Conduct, Performance and Ethics:
       http://www.hcpc-uk.org/publications/standards/

                                         8
   NHS Scotland Code of Practice: Protecting Confidentiality:
       http://www.wdhscp.org.uk/media/1256/revised-code-of-confidentiality-
       final.pdf

If you agree to this condition please sign the Form of Acceptance.

Signed:

Name (PRINT):                                                    Date:

                                        9
Guidance on attendance and absence during Dietetic Practice Placement
B

Students must normally complete a minimum of 1000 hours on practice
placement over the duration of their studies. This is normally achieved through
the successful completion of placement A (4 weeks or 150 hours), placement B
(12 weeks or 450 hours), and placement C (12 weeks or 450 hours).

To satisfy this requirement students are expected to work the full time hours of
a dietitian (normally Monday-Friday 9-5pm, or 8.30–4.30pm). Public holidays
will be granted in line with departmental policy. Study leave or half days will
not be given. Student must attend practice placements in line with the service
requirements of the practice educator and, where working hours fall outwith the
normal hours of work, the practice educator should provide appropriate notice.

Absence
Any absence from placement may impact on a student’s ability to fulfil the
required 1000 hours of practice-based education. In view of this, it should be
noted that due to the short duration of the practice placements, coupled with
continued service delivery demands within the NHS, which impinge on the ability
to facilitate additional placement days; absences other than those on the
grounds of sickness will not normally be sanctioned. Students who have
concerns with regards to absence on grounds other than sickness must discuss
these with their University Tutor in the first instance and must not approach
their Practice Educator.

Where absences due to sickness do occur these will normally be dealt with as
follows:

Placement B:
Loss of up to 5 placement B days
No action needs to be taken if the Practice Educator and University Tutor
considers that there is no detrimental effect on the student’s progress, i.e. they
have demonstrated competence in all of the learning outcomes for that
placement. If this is not the case the lost time must be made up.

Loss of more than 5 placement B days
The student must complete a minimum of 11 weeks; any lost time must be
made up to 11 weeks. No action needs to be taken beyond this if the practice
educator considers that there is no detrimental effect on student’s progress, i.e.
they have demonstrated competence in all the learning outcomes. If this is not
the case the rest of the lost time should be made up.

If the student requires a prolonged period of absence from their placement, the
period of training required will be determined in consultation with the Practice
Educator and University Tutor.

Notification of absences
Students should follow local NHS policy regarding the notification of any
absences to Practice Educators and provide medical certification where relevant.
The Practice Educator should notify the University Tutor of any absences as a
matter of course and record this on the end of placement form.

                                       10
Guidance on Extended Week Placements

In line with the BDA curriculum framework (2013) students must normally
complete a minimum of 1000 hours on practice placement. However it is
acknowledged that students’ progress at different rates and whilst it is expected
that most students will be able to meet the learning outcomes for placements
within the suggested time allocation i.e. placement A (150 hours), placement B
(450 hours) and placement C (450 hours), provision is made for students to
complete additional practice education hours if the placement learning outcomes
have not been met. Additional practice education hours will not automatically
take place within the same placement setting. Students can only be allocated a
maximum of 500 additional hours across the 3 practice placements and the
additional hours for each practice placement cannot be more than the original
placement length i.e. for placement A only 150 additional hours can be allocated,
for placement B and C only 450 additional hours can be allocated. Any additional
time taken in placement A reduces the additional time available for placement B
and subsequently placement C.

Example:
If a student requires an additional 50 hours for placement A then only 450 hours
additional time can be allocated to any future placements. This takes into
consideration the maximum allowance of 500 hours and the maximum additional
hours permitted for placement B.        If the same student then requires an
additional 250 hours for placement B then only 200 hours would be available for
placement C (taking into consideration the 50 additional hours for placement A).

Placement B
To successfully complete placement B, students must pass all learning outcomes
by providing evidence of competency. Where a student does not successfully
meet all the learning outcomes they will be required to complete additional time
to enable them to meet these. The additional time provided will be discussed
and agreed between the practice educator and university tutor. This will take
into consideration the rate of student progression and number of learning
outcomes not met. The additional hours provided will not be less than 37.5
hours (1 week) and not more than 450 hours (12 weeks). Any additional time
utilised during Placement A will also be taken into consideration when allocating
additional hours to ensure the permitted 500 hours is not exceeded. It is
prudent for students to plan for completing the maximum amount of time they
are permitted for their extended week placement, but it should be noted that the
extended placement can be stopped as soon as the required learning outcomes
are signed off.

Placement B activities
Where students have successfully completed the asset mapping and quality
improvement activities during the original 12 week placement (i.e. that these
activities were signed to confirm that they were completed and discussed to an
acceptable standard to meet the specified learning outcomes), students will not
normally have to repeat these activities during the extended placement week.
Where these activities were not completed to the required standard during the
original 12 week placement, the student will be required to undertake these
activities again.

                                       11
Good practice guide to appropriate dress

The appearance of students and staff plays an important role in the delivery of
person centred, safe, and effective care.

Person centred: all students are expected to present a smart and professional
image which is likely to inspire public confidence. Uniforms are provided to help
achieve this objective. Photo ID badges must be worn and visible unless
contraindicated by health and safety requirements.

Safe and effective: whilst involved in direct clinical care, dress will be in
compliance with the principles relating to the prevention and control of
transmission of infection, and health and safety regulations. Personal Protective
Equipment (PPE) is provided to help achieve this objective.

A good practice guide to appropriate dress is detailed below; however, you
should refer to your placement Health Board dress code policy for
specific guidance. Please note that dress code policies may be more, or less,
restrictive dependent upon the task, setting and service user population.

      Students should wear the uniform provided by their University.
      Uniforms must be clean, pressed and laundered.
      Uniforms should only be worn in the work environment.
           o Uniforms must be transported to and from work in a clean
              disposable bag.
      Fleeces/cardigans may be worn in the uniform colour but must be
       removed before patient contact.
      If a disability/medical condition, religious, ethnic or cultural requirement
       makes it difficult or impossible for a student to comply, the Practice
       Educator should be contacted for further advice.
      Footwear should be soft soled with closed toes.
      No badges other than ID and professional badges to be worn.
      Sleeves should be either short, ¾ length or rolled up away from the wrists
       prior to hand hygiene.
      Fingernails should be kept short and clean.
      False nails and nail varnish are not permitted.
      Jewellery and piercings may not be permitted or may be limited (refer to
       local policy)
      Hair must be clean neat and tidy
           o Longer hair must be tied or clipped back at all times in clinical
              areas.
      Make up should be kept light; false eyelashes are not permitted.
      Perfume/aftershave, if worn, should be subtle in nature.

                                        12
Placement B - Summary of learning outcomes
At the end of Placement B, in relation to individuals, groups, populations, students with decreasing supervision can:
Number Learning outcome title           Components of the learning outcome             Evidence and scope of practice
         (competency statement)         (written in outcome form)                      (where relevant)
B1       Demonstrate consistent         Acts in the best interests of service users.   Scope:
         professional behaviour in      Respects the confidentiality of service users. Throughout the duration of the
         accordance with legal and      Keeps high standards of personal conduct       placement with all service users,
         ethical boundaries,            demonstrated through appearance and            carers, Healthcare staff and
         requirements of HCPC and       behaviour.                                     Supervisors in all settings
         local standards/policies       Shows commitment to keeping professional
                                        knowledge and skills up to date.               Mandatory evidence (assessment
                                        Acts within limits of current knowledge and    tools):
                                        practice to ensure patient safety               Summative professionalism
                                        Understands value of reflection and               checklist x1
                                        demonstrates an ability to reflect.             Individual patient consultation
                                        Understands the concept and process of            tool x5
                                        consent.                                        Patient case presentation
                                        Adheres to infection control procedures.        Observation of practice tool x3
                                        Behaves honestly ensuring behaviour does        Reflective framework x5 (note
                                        not damage public confidence in the               that this includes those
                                        profession                                        completed as part of specific
                                        Works in line with organisational policies,       activities e.g. service user
                                        procedures and professional standards             activity, asset mapping activity
                                        (HCPC/BDA)                                        etc.)
                                        Can demonstrate personal leadership             Quality Improvement project
                                        qualities                                         assessment tool x1

B2        Demonstrates effective         Treats individuals with dignity and respect    Scope:
          verbal and non verbal          Listens to and demonstrates understanding      Across a variety of settings/dietetic
          communication skills using a   of service users story                         services/client groups (where
          variety of different methods   Demonstrates empathy, care and                 relevant applies to service users,
          and techniques                 compassion                                     carers, healthcare staff and
                                         Maintains a non-judgmental attitude            Supervisors)

                                                            13
Establishes good rapport
                                     Acknowledges service users views and           Mandatory evidence (assessment
                                     feelings                                       tools):
                                     Uses appropriate eye contact                    Individual patient consultation
                                     Uses appropriate tone of speech                   tool x5
                                     Uses appropriate volume of speech               Patient case presentation
                                     Uses appropriate language and vocabulary          assessment tool x1
                                     Responds to verbal cues                         Talk to service user group
                                     Shows awareness of own and others non-            assessment tool x1
                                     verbal communication                            Observation of practice tool x3
                                     Does not undermine, or appear                   Reflective framework x1
                                     condescending or confrontational                  (related to the service user
                                     Uses active listening skills                      activity)
                                     Responds appropriately to questions
                                     Documents appropriately according to local
                                     record keeping protocols

B3   Demonstrates applied            Can in a systematic manner, obtain, verify     Scope:
     knowledge and                   and interpret relevant data and information    Across a variety of settings/dietetic
     understanding of the            in order to make decisions about the nature    services/client groups
     identification of nutritional   and course of nutrition related problems
     need and assessment                                                            Mandatory evidence (assessment
                                                                                    tools):
                                     Can use referral pathways and criteria to       Individual patient consultation
                                     open a duty of care and to prioritise care.       assessment tool x5
                                                                                     Asset mapping activity
                                                                                       assessment tool x1
                                                                                     Patient case presentation
                                                                                       assessment tool x1

B4   Demonstrate applied                                                            Scope:
     knowledge and                   Can assimilate relevant data and information   Across a variety of settings/dietetic
     understanding of nutritional    to formulate/identify reasoned nutritional     services/client groups

                                                        14
diagnosis                      diagnosis(es) (problems)
                                                                                    Mandatory evidence (assessment
                                                                                    tools):
                                                                                     Individual patient consultation
                                                                                       assessment tool x5
                                                                                     Patient case presentation
                                                                                       assessment tool x1

B5   Demonstrate applied            Can demonstrate the required knowledge          Scope:
     knowledge and                  and skills to formulate safe, appropriate and   Across differing settings/dietetic
     understanding of planning      person centred intervention plans (where        services/client groups
     and implementing               relevant this will include the development of
     interventions                  co-produced person centred outcomes,            Mandatory evidence (assessment
                                    estimation of relevant requirements and         tools):
                                    development of a proposed intervention plan      Individual patient consultation
                                    mindful of service delivery issues).               assessment tool x5
                                                                                     Patient case presentation
                                    Can implement (communicate and                     assessment tool x1
                                    document) intervention plans.                    Talk to service users
                                                                                       assessment tool x1

B6   Demonstrate applied            Can demonstrate the ability to monitor and      Scope:
     knowledge and                  review dietetic intervention plans              Across a variety of settings/dietetic
     understanding of monitoring,                                                   services/client groups
     review and evaluation          Can demonstrate the ability to systematically
                                    compare current findings with previous          Mandatory evidence (assessment
                                    findings and evaluate overall effectiveness     tools):
                                                                                     Individual patient consultation
                                                                                     assessment tool x5
                                                                                     Patient case presentation
                                                                                     Talk to service user group
                                                                                       assessment tool x1

                                                       15
B7   Demonstrate applied        Can demonstrate the ability to participate in   Scope
     knowledge and              quality improvement processes to assure the     Across a variety of settings/dietetic
     understanding of quality   quality of service delivery                     services/client groups
     improvement and service
     evaluation processes                                                       Mandatory evidence (assessment
                                                                                tools):
                                                                                 Quality Improvement project
                                                                                   assessment tool x1
                                                                                 Asset mapping activity
                                                                                   assessment tool x1
                                                                                 Patient case presentation
                                                                                 Individual patient consultation
                                                                                   tool x5
                                                                                 Service user involvement
                                                                                   activity x1
                                                                                 Talk to service user group
                                                                                   assessment tool x1

                                                   16
‘Know, Can, Do’ Model

The ‘Know, Can, Do’ Model offers a guide to typical level of performance at each stage of the placement and should be used
in conjunction with the Student Progression Algorithm.

                   A         B                          C
Week               1 2 3   4 1 2 3 4 5 6 7 8 9 10 11 12 1                         2     3     4 5 6 7 8 9 10 11 12
Professional       K K C   D D D D D D D D D D D D D D                            D     D     D D D D D D D D D
behaviour
Communication      K K C D C      C   C   C   D D D D D D             D   D   C/D C/D C/D D D D D D D D                 D    D
Identification     K K K K K      K   K   C   C C C C C C             C   C   C   C   D   D D D D D D D                 D    D
of a nutritional
need, and
assessment
Diagnosis          K K K K    K   K   K   C   C   C   C   C   C   C   C   C   C   C     C     D D D D D D D             D    D
Intervention       K K K K    K   K   K   C   C   C   C   C   C   C   C   C   C   C     C     C C C D D D D             D    D
Monitoring and     K K K K    K   K   K   C   C   C   C   C   C   C   C   C   C   C     C     C C C D D D D             D    D
evaluation
Quality            K K K K    K   K   K   C   C   C   C   C   C   C   C   C   C   C     C     C   C   C   C   C   D D   D    D
improvement

Definitions:
Know = demonstrates with supervision (during observation, questioning or within portfolio evidence)
Can = demonstrates with decreasing supervision and support
Do = with minimal supervision, and within agreed boundaries

                                                              17
Induction Checklist

 Student NAME (PRINT):

                       Induction topic                                   Notes/Actions
Evidence of PVG        Protection of Vulnerable Groups – PVG              Competed on
Certificate/           Certificate                                        commencement
Indemnity Insurance    Indemnity Insurance                                of Placement A
                       Basic Life Support
Mandatory/Statutory    Management of Violence and Aggression/
Training               De-escalation Training
                       Hand Hygiene/ Infection Control
                       Adult and Child Protection Awareness
                       Manual Handling
Policies/ Governance   Contact details
Procedures                  Confirm student contact details
                               during placement
                            Check Matriculation card (record on
                               end of placement form)
                            Ensure student has appropriate ID
                               badge
                       Health and Safety
                            Raise awareness of local
                               information relating to placement
                               e.g. policy location, risk
                               assessments etc.
                       Uniform
                            Discuss dress code expectations
                               specific to the placement and refer
                               to local policies
                       Confidentiality/ Data Protection
                            Complete confidentiality form
                            Incorporate local emphasis on
                               patient confidentiality/ privacy/
                               dignity, notes, telephone
                               procedures, email, personal mobile
                               phones etc.
                       Social Media Policy
                            Ensure student reads local social
                               media policies (if applicable)
Emergency              Undertaken appropriate Fire Induction
Procedures             specific to placement site and working
                       areas
                            Emergency numbers
                            Location of extinguishers
                            Fire alarm and drill including testing
                            Evacuation points
                       How to call for crash team/designated
                       first-aider in Hospital and Community
                       settings
Security               Identification badge to be worn at all

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times
                  Details of local security arrangements
                       Personal belongings
                       Departmental security
                       Keys
                       Personal safety
Information       IT security information
Technology        Location of computers/ IT suite
                  Complete IT access form (if appropriate)
                  Induction to IT facilities
                  Ensure student is ‘logged out’ at end of
                  placement
Professionalism   Refer to HCPC Professionalism document
                  Expectations
                       Student
                       Practice educator
                       Refer to Quality Standards for
                         Practice Placements (QSPP)
                         information
Placement         Hours of work
information            Including signing in/ out
                         arrangements, sickness/ absence
                         reporting
                       Lunch/ breaks
                       Study leave
                  Any additional strategies or support
                  required by the student
                  Learning Outcomes for placement
                  including objectives or learning
                  requirements from previous placements
                  Learning Styles
                       Student
                       Practice educator
                  Supervision arrangements
                  Tutorials, attendance at seminars, training
                  etc.
                  Visits
                       From lecturer
                       With other appropriate
                         professionals/ departments
                  Arrangements for Half way review and
                  final assessment
Additional        Organisational and management
orientation to    structures
Workplace              Health Board level
                       Department specific
                  Location of
                       Offices/ reception
                       Treatment areas
                       Equipment stores
                       Stationery

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 Toilets
                        Changing facilities
                        Staff room
                        Dining room/ Bank/ shops
                        Library
                    Administration systems specific to area
                    Raising concerns/ Complaints procedure
Local Induction
Requirements (if
relevant)

Placement           Advise of placement evaluation
Evaluation          procedures

 Signed by Supervisor when complete:                          Date:

 Signed by Student when complete:                             Date:

                                       20
Guide to compiling your portfolio

This portfolio contains key information about your placement: the expectations
placed upon you; details of the tasks and activities that you will undertake; and,
copies of the assessment tools that will be used in your assessments.

Successfully completing tasks will be evidenced through completed assessment
tools that are approved by your Practice Educators, and these have been
mapped to each of the learning outcomes. You will therefore have to collect this
evidence over the course of your placement in order to demonstrate competence
in a range of settings, conditions, with individuals, groups etc. as appropriate to
your practice placement.

The evidence you collate in this portfolio must be presented well and organised.
Your reviewer must be able to find information quickly and easily. Developing
these good habits in keeping a portfolio whilst on placement will also benefit
your future practice since HCPC require all Registered Dietitians to maintain a
continuous, up-to-date and accurate record of their continuing professional
development activities.      To best achieve this, please take some time to
familiarise yourself with the learning outcomes and resources within the pack.

Your Practice Educator will design a programme of training that facilitates your
ability to demonstrate the learning outcomes. This will involve building your
confidence and experience in dealing with individuals, groups and populations
through the provision of specialist dietetic services. Your contribution to the
care of service users will develop gradually over time and, throughout all of
these experiences, you should request assessment and feedback on your
performance. You will also develop your practise by demonstrating the ability to
reflect on your experiences. Whilst in the early stages of placement, completion
of an assessment tool may not result in evidence that you intend to use to
demonstrate your competence but will enable you to determine your
competence in relation to the ‘Know, Can, Do’ model.

The specific activities within this portfolio will all be scheduled at some point
within your 12-week placement and your Practice Educator will keep you
informed of relevant deadlines. For the majority of time, however, you will be
working closely with the dietetic staff in the day-to-day provision of nutritional
care to individuals, groups and populations and each of these experiences
contribute to your overall assessment.

Guide to assessment tools and evidence
This section details which assessment forms are available to record your learning
and progress and for which learning outcomes they provide evidence. Some
assessment tools are compulsory and relate to specific assessed tasks. Your
portfolio of evidence, however, should include more than just the assessment
tools; documentary evidence must be included such that an independent
observer could assess the information contained within the portfolio. This may
be in the form of anonymised dietetic records, copies of your presentations,
reflective cycles, or other tools, such as the ‘Observation of Practice Tool’.

It is important to note that your portfolio must not include any form of
information that you did not devise yourself e.g. copies of diet sheets and

                                        21
information sheets given to you by your Practice Educator. Resources not
devised by you can be kept in a separate folder for reference.

Catering
This activity is part of your induction to your placement, therefore should be fully
completed by the end of week one or midway through week 2. During this
activity you will take comprehensive notes of all the tasks you have carried out
to enable your Practice Educator to sign you off for this task (within the
induction checklist). You will, where possible, complete this as a PAL activity.

Individual patient consultation tool (IPC)
This form should be used to assess your performance during clinical
consultations.    It can be used for formative (feedback) or summative
assessment. You should aim to do this at least once per week throughout your
placement, and asking your Practice Educator or peer to observe your practice.
This will help you to get feedback in a formative (informal) way, but will also
support your peer in becoming more familiar with the assessment criteria to
enhance their own practice. It is your responsibility to ask your peer/ Practice
Educator to complete this form.

It is likely that you will not present your IPC for summative (formal) assessment
until week 7 onwards as you need to demonstrate competence (‘Do’) for all
learning outcomes by the end of week 12. The decision as to whether this tool
will be used for a summative assessment will be decided by your Practice
Educator prior to the consultation (i.e. prospectively) and will be completed by
your Practice Educator.

You need to collect evidence of consultations with a variety of types of patients
in different settings as follows:

      For different client groups (e.g. elderly over 65years), adult (18-
       65years), children (0-16/18 years)
      For different clinical conditions/ dietary treatments (e.g. coeliac disease,
       diabetes   mellitus,    food   intolerance,    nutrition support,     weight
       management)
      In different settings (e.g. inpatient, outpatient, domiciliary visit, care
       home, day hospital)
      Both new and review patients

Your final portfolio should include only your best evidence, demonstrating
competence with a range of patient groups and with different interventions. You
are required to submit a minimum of 5 pieces of evidence (ideally you will
include as few service users as possible) to demonstrate competence in these
learning outcomes using the IPC. At least one (new patient) consultation should
show learning outcomes B1-B5 & B7 being demonstrated competently.

You must present your evidence (summative assessment forms) in a logical
manner. A blank summary sheet is provided within this portfolio to assist you.
This will enable you to generate a checklist to ensure sufficient evidence is
collected by the end of week 12 and to enable your Practice Educator to cross-
reference how the evidence relates to each of the learning outcomes. Having a
minimum of 5 IPCs (with at least one new patient consultation showing

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competence in learning outcome B1-5 &B7) in a range of client groups,
    conditions and setting will allow your Practice educator to assess if you have met
    the competencies to pass this element. For example:
Evidence   New/       Client Group    Condition/              Setting    B1    B2   B3      B4   B5   B6   B7
           Review                     Treatment
A          New        Older People    Nutrition support       IP         X     X     X      X
B          Review     Older People    Nutrition support       OP         X     X                      X
C          Review     Older People    Nutrition support       Care                   X      X         X    X
                                                              home
D          Review     Adult            Enteral feed           IP         X     X                 X    X
E          New        Adult            Allergy                OP         X           X           X         X
F          New        Adult            Weight management OP              X     X     X      X    X
G          New        Adult            IBS                    OP         X     X            X
H          Review     Paediatric       Nutrition support      IP         X     X                      X
I          New        Paediatric       Allergy                OP                     X           X         X
J          New        Adult            Low potassium          Dialysis   X     X     X      X    X
                                                              Unit
K          New        Adult            Eating Disorder        IP                     X           X         X
L          Review     Paediatric       Weight management OP              X     X     X           X    X    X
M          New        Older people Diverticular disease       Care       X     X     X      X    X
                                                              home
N          Review     Older people Enteral feed               Home       X     X                      X
    *Please note that a variety of client groups and settings and conditions is required.

    Service user involvement - Involving you: The CARE measure for
    Student Dietitians tool
    You will most likely start to use this tool from week 4 or 5 onwards, completing
    this task by week 10 or 11. In discussion with your Practice Educator, you will
    ask service users/carers to provide you with feedback on their experience of the
    health care they received from you. During your placement you should aim to
    complete 5 CARE measures but, as a minimum, you must complete 3 CARE
    measures. These can be from a variety of settings e.g. clinic/ home/ ward
    setting.

    Once you have obtained the 3-5 completed CARE measures you should reflect on
    this exercise and put your reflection into your portfolio along with the complete
    CARE measures. You will also do this again in C placement but your reflection
    should also include how your abilities have progressed since B placement.

    Asset Mapping
    You may be doing this activity with a PAL and will undertake this activity from
    week 2 completing this by week 10 or 11 at the latest. This activity can be
    completed in consecutive days or may be spread out over several weeks. You
    will need to document clearly and logically all the steps you have taken to carry
    out this activity so that you are able to share the information with your Practice
    Educator.

    It is worth noting that you will be doing this activity for the benefit of the
    department, therefore you will know more about the area you have researched
    than the dietetic department who you will share all your findings with. This
    information will then be used to signpost service users to appropriate groups etc.
    On completing this task, you will do a reflection to demonstrate what you have
    learnt and how you will use this learning in the future.

                                                     23
Talk to service user group Assessment tool
This form should be used to assess formal presentations that you deliver. This
may be to a group of patients/ clients or it may be a presentation to other health
care professionals. Within your portfolio of evidence, you should also include a
copy of your presentation.

Case presentation assessment tool
With the help of your Practice Educator, you will most likely identify a suitable
case study patient/ client/ service user at some point after week 3 or 4 of your
placement, and your presentation will not take place until around week 9 or 10.
You and the service user must complete the case presentation consent form and
this should be retained in the service user’s dietetic record. An appropriate case
study is someone who you have seen at least twice and who is reflective of your
stage of training in placement B, the types of patients seen in placement B and
whose dietetic care you have been directly involved with.

Your case presentation will be assessed by at least two dietitians and will usually
include the dietitian who is responsible for the service user’s dietetic care. Once
completed all relevant information should be kept in your portfolio.

Feed forward form
These forms should be completed at a minimum every two weeks with your
Practice Educator. Students who require more feedback, for example students
who are not yet meeting the ‘Know Can Do’ levels of performance must have
this form completed every week. There are elements that should be completed
by you (the student) and those which must be completed by the supervisor.
Any points raised must be supported by examples/ evidence (which may be a
verbal description of events) to ensure that there is clarity. Action points should
be agreed and ensure they are SMART (i.e. specific, measureable, achievable,
realistic and timely). Any actions should be evaluated to ensure progress is
made or to develop further action points as applicable. The feed forward form
may also be used as the basis for reviewing your progress more formally at
halfway through your placement (alternatively the Review of Placement B form
can be used for this). This ‘halfway assessment’ will likely involve a review of
your portfolio of evidence collated to date.

Professionalism checklist
This will be completed at the end of your placement – week 12 by your lead
supervisor, but may be formatively completed at your halfway assessment. This
checklist is based on your full 12 week placement and focuses on you
consistently demonstrating professional behaviour in line with the HCPC
Guidance on Conduct and Ethics for Students (2016)

Observation of Practice Tool
These forms can be used to provide additional evidence for a number of learning
outcomes but you may find that the tools are most useful to demonstrate
evidence of your competence in communication and professionalism.           For
example, you may undertake visits to departments, spend time with other
health and social care professionals, or indeed spend time working with
members of the dietetic team who are not directly assessing you e.g. dietetic
assistants, administrative staff etc.

                                        24
These experiences and contacts not only allow you to learn about the complex
health and social care environment and the implications for dietetic practice, but
are valuable in enabling you to demonstrate the learning outcomes with a wide
range of people and across environments. You must advise the person, in
advance, that you would like them to observe and make comment on your
participation, engagement, communication, professionalism, knowledge etc.

The form is largely open text so the observer may choose to make as much or
as little comment as they wish. This tool may also be useful as a formative
feedback tool to support improvement in future so you must be prepared for
constructive criticism.

Remember that you do not need to include every completed observation of
practice tool within your final portfolio; you should be selective in determining
which ones are your ‘best evidence’ and enhance areas where you perhaps don’t
otherwise have strong documentary evidence.

Your final portfolio should include at least 3 ‘observation of practice’ tools.

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Placement B Induction Activity: Catering

It is important that students are familiar with the catering provision for the
service they are working in. In view of this students are required to complete
the activities below as part of the induction process. The catering activities in
both placement B and C and should be completed by the end of week one of the
placement and should be signed off as complete on the induction checklist.
Where there is no meal provision service in a placement setting this should be
noted on the induction checklist. This situation will however be the exception.
Where students rotate between sites and where different catering systems exist
on each site the students should familiarise themselves with the differences in
catering process between the sites but completion of all tasks is not required
with each site move.

Where students have completed a previous placement in the same Health Board
they are not required to complete this activity in the subsequent placements.

Where students are completing their B placement and as such have already
completed catering activities in placement A, it may be that there are similarities
in the catering systems between the previous placement and the B placement.
In this situation it would be appropriate for the practice educator to discuss the
previous catering experiences and to then ask the student to complete only the
parts of the catering induction activity which the student may not have
experienced in previous placements. This will be at the discretion of the practice
educator.

Where possible this activity should be completed as a PAL activity.

The purpose of these activities are therefore to familiarise yourselves with:

  The catering system that is in place (e.g. production kitchen, cook freeze
   service, cook chill service, plated meal service, bulk service etc.)
  Timing of meal service/delivery
  The preparation and provision of therapeutic diets including the work
   undertaken in the diet bay (if applicable)
  The meal journey from the perspective of the patients i.e. from completion
   of menu to meal production to meal delivery
  Any differences between in meal provision (and therapeutic diet adaptations)
   across hospital sites e.g. between Acute & Community Hospitals
  The system for delivery of oral nutrition supplements to patients in both
   Acute & Community hospitals

Suggested time allocation: 8 hours (this can be spread over several days)

Make notes on each of the following tasks to ensure you are familiar with the
catering service and the dietitians role within this. Your notes could form the
basis of a student led discussion. To enable you to complete the activity you will
be allocated time to spend working in the hospital kitchen, with the diet cooks,
in the diet bay and on a ward.

Task 1
You should observe and where appropriate participate in the following: -

                                        26
   Identify the meal delivery system
      Observe how the menu analysts liaise with the diet cook (if there is one).
      Establish how the diet cooks’ work is generated.
      Make notes on the menu i.e. how long the men cycle is, number of
       choices at each meal time, provision of hot meals, snack provision, menu
       coding, choice of portion size etc. and establish how standard recipes are
       adapted for therapeutic diets.
      Establish which products are used for food enrichment (include quantities
       per portion) for both Acute & Community Hospitals
      Determine the portion sizes of the meals.
      Consider the timing of meal service and any time constraints posed by the
       meal service and how these are overcome.
      Establish how supplements and tube feeds (if applicable) are delivered to
       the wards in both Acute & Community Hospitals
      Determine what quality Control measures are in place e.g. use of standard
       utensils, temperature of trolleys, checking of trays etc.

Task 2
Identify the range of dietetic products used in the hospital and their nutritional
contribution to the hospital menu.

Task 3
To fully appreciate the meal journey you should follow a patient meal from the
point of order i.e. completion of the menu to the point of meal delivery. To do
this you should visit a ward to find out how menus are completed and you
should follow a meal trolley to a ward and observe meal delivery. In doing this
you should note the following:

      Establish how therapeutic diets are ordered at ward level including how
       many meals in advance meals are ordered
      Follow the meal trolley from the kitchen to a ward
      Observe practices when the trolley arrives on the ward (e.g. is the trolley
       plugged in? How soon prior to the meal service does the trolley arrive? Is
       the ward ready for the meal service?)
      Observe meal service – e.g. did the nurses wear aprons and did they use
       standard utensils? Is a red tray system in place? etc.
      Observe how patients were prepared for mealtimes e.g. were they given
       an opportunity to wash their hands, visit the bathroom etc.
      Observe where the patients sit to eat their meals
      Observe who served the meals to the patients
      Observe what fluids were provided at mealtimes
      Establish how are patients requiring assistance were identified and
       whether assistance was given (this should include all types of assistance
       e.g. prompting, assistance with opening packages, provision of
       appropriate cutlery and aids, assistance with feeding etc
      Observe whether protected mealtimes were in place and whether these
       were adhered to
      Establish where are supplements were stored on the ward and how these
       were distributed to patients
      Following the meal establish who cleared the plates away and observe
       whether left overs were recorded

                                       27
   For patients who should have food record charts completed observe
    whether these were completed and by whom
   Establish what provision is made for people who miss a meal
   Establish if snacks are available between mealtimes
   If possible speak to one patient about their meal time experiences

                                 28
Placement B Activity: Individual Patient Consultations

Contributes to learning outcomes: B1; B2; B3; B4; B5; B6;B7

Purpose
Throughout Placement B, you will have the opportunity to be involved in one-to-
one dietary counselling of service users, enabling you to develop your
communication skills and demonstrate appropriate knowledge.

Guidance
The tool should be completed by your Practice Educator or, for formative
assessment only, by your PAL partner.

On a regular basis, throughout your placement (for both formative and
summative purposes) you should request that your involvement in individual
patient consultations be observed. You are responsible for providing the Practice
Educator (or PAL) with a blank assessment tool, which you can obtain through
printing/ photocopying the following form. There is an expectation that you will
seek many opportunities to be assessed thereby enabling you to select from a
wide evidence pool for your summative assessment.

Your level of involvement in service user consultations will be developed
gradually over the course of the placement. The competency statements within
this assessment tool have been separated into to the various components of the
nutrition and dietetic care process. At the early stages of placement B, you may
not yet be progressing beyond the assessment phase of a consultation
independently. You may, therefore, find that not every section of this form can
be completed. In such a case, only the relevant sections of the assessment tool
for the stage of training and your involvement in the service user consultation
should be completed.

Each competency statement within each section of the nutrition and dietetic care
process should be assessed according to the following criteria:
N/A: Not applicable - no opportunity to demonstrate this competency.
Not yet met: Competency was relevant but needs more work; it was either not
demonstrated or not at the required standard yet.
Met: Competency was demonstrated at the standard required at the end of
Placement B.

The case summary should be completed as follows:
Setting: inpatient, outpatient, home visit, care home, dialysis unit etc.
Patient Group: older adult, South Asian, paediatrics
Intervention: nutrition support, IBS, low potassium diet, etc.
New/ Follow up
Additional info: carer present, interpreter, etc.

Notes for selection for your Portfolio
You are required to submit 5 competent individual patient consultation tools for
each learning outcome within your final portfolio for summative assessment.
Whilst demonstrating all learning outcomes within a single new consultation may
be ideal, and will minimise the total number of tools that you need to include,
please note that, in Placement B, you are not required to meet all learning

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