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Background Information
How does this program fit with adult learning theory?
This learning program is built upon solid adult learning principles:
- Capitalizing upon constructivism -
learning which occurs in the work setting is known to promote knowledge building.
- Inviting social constructivism -
fostering collaboration and ongoing partnership between the dietetic learner and their dietitian preceptor.
- Embracing reflective practice -
breaks between education sessions provide an opportunity to revise learning goals.
- Harnessing self-directed learning theory -
creating a learner-centred experience with inherent flexibility.
- Facilitating knowledge translation -
through practice in the work setting, to reduce gaps in effective clinical dietetic care.
References:
Owen TR. Self-directed learning in adulthood: a literature review. 2002 Morehead, Morehead State University. (ERIC Document Reproduction Service No. ED461050)
Lockyer J, Gondocz ST, Thivierge RL. Knowledge translation: the role and place of practice reflection. [Review] Journal of Continuing Education in the Health Professions 2004;24(1):50-56.
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For whom was this training program developed?
This training program is a continuing education program for food service supervisors and diet technicians (synonymous with nutrition technicians, nutrition assistants, dietitian assistants, dietary technologists etc.) who need to update or advance their knowledge and skills in direct patient care.
The first module of the training program (entitled Patient Visitation) was developed for all nutrition, food service or dietary staff who visit or interact with patients, residents or clients. It has also been utilized with volunteers who visit patients (e.g. to conduct food service surveys).
The second and third modules of the learning program are geared specifically to advancing skills for diet technician roles. It is geared to both entry-level and experienced diet technicians to help acquire new skills or polish existing skill-sets.
This learning program is not intended to replace formal education programs for food service supervisors or diet technicians who are at entry-level. It is a continuing education program.
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How can the learning program prepare foods and nutrition graduates for internship?
Several graduates of food and nutrition programs (i.e. degree programs) who are seeking health care experience as a diet technician prior to their internship have completed this learning program. It has been our recommendation that these individuals also write the qualifying examination to obtain membership in the Canadian Society of Nutrition Management (CSNM).
We have employed diet technicians (with nutrition degrees) who have acquired sufficient health care experience to successfully obtain an internship. This learning program enables diet technicians to work alongside dietitians, which fosters an excellent understanding of the dietitian’s role. The limitations of working at the level of a technician is understood because their work is supervised by dietitians. Diet technicians in direct patient care roles develop skills in nutrition screening, monitoring, patient interviewing and documentation in the patient health record. These skills are an important foundation for competency development in dietetic internships.
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Why are you marketing a diet technician training program?
In 2001, a formal policy and procedure was developed at Toronto Rehab and approved for diet technician documentation in the patient health record. This policy involved the development of two detailed guiding templates for performing nutritional interventions and completing nutrition screens. Once this was accomplished, the need for a formal training program became evident because the diet technicians were not prepared for their new role.
Although this training program was originally developed for in-house purposes, external feedback prompted us to make this training program available for purchase by other facilities. Since we invested significant time in the development of this education program, it would prove a worthwhile venture if diet technicians in other facilities might also reap educational benefits. As diet technicians take on new roles and provide greater support to dietitians, dietitians can focus on higher level clinical nutrition practices. Five dietitians, with varied professional backgrounds, participated in revamping the training program to suit any health care setting with a focus on key concepts that would endure over time.
We have a partnership with the hospital's marketing and public affairs department. Hospital legal counsel developed the agreement/disclaimer which allows unlimited users to access the program within the original purchasing organization. An individual can also purchase the program for their own exclusive use.
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What are the qualifications of the two dietitians who created this program?
Deborah Wildish has been the Manager, Clinical Nutrition (ARAMARK at Toronto Rehab) for over 15 years. She has a Master of Arts in Education from O.I.S.E. with a major in computer applications. Her thesis focussed on self-directed learning and the use of computer technology for learning. The development of this computer training program involved the application of adult learning principles to maximize the learning experience. It also required an understanding of the usability of computer technology for education to create an inviting learning environment.
Laura Hirano, is the dietitian and professional practice leader for the Complex Continuing Care program at Toronto Rehab. Laura is the dietitian preceptor for the Diet Technicians at Toronto Rehab.
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Why did you choose a self-directed learning approach?
Self-directed learning provides the capability for repetition to reinforce concepts and allows the learner to exercise more control over their learning experience by choosing when and where they will engage in learning. The learner can also select the appropriate pace for their learning experience. They can concentrate on specific sections until they have mastered the concepts and quickly review sections for which they have already attained proficiency. Finally, self-directed learning over a number of sessions enables the learner to build in time for reflection to further assess their learning needs.
This self-directed learning program can be used in three ways:
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To help diet technicians develop new skills in preparation for new roles. |
| 2. |
To serve as a "refresher" for diet technicians who are already practicing an advanced skill-set. |
| 3. |
Module 1: Nutrition Staff Performing Patient Visitation can be used for dietary aides, menu clerks or volunteers who interact with patients. |
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Why make the program available in electronic format only?
Providing the program electronically allows us to deliver the product to our customers without delay. As well, orders are coming in gradually meaning we cannot meet the volume requirements to reduce outside production costs (e.g. for professional labelling and packaging).
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Implementation
How can we customize this training program to our organization?
A User Guide has been developed to help both preceptors and learners customize the learning experience to fit their organization. This User Guide prompts both the preceptor and the learner to review and integrate resources and policies specific to a given organization. Within the learning modules, the learner is prompted to liaise with the dietitian for specific direction e.g. clinical practice guidelines at their facility.
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How can new learning be implemented into work practices?
Once the diet technician has completed each training module, including the written exercises, a practical "hands-on" component must follow. This can be carried out in many different ways. For some individuals, it may work best to divide the training module into sections, have the diet technician review the content and then practice the skill.
For example: the diet technician might be concentrating on "snacks between meals" (in module #2) and will practice visiting patients to apply this new knowledge.
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How did the diet technicians at Toronto Rehab obtain charting privileges?
2000: Conditional acceptance that diet technicians could document in the patient health record, provided that we:
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Develop an informative policy and procedure that: |
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delineates the role of diet technicians at Toronto Rehab |
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enables diet technicians to document the nutritional interventions they provide in the patient health record |
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Delineate an accountability framework with the following components: |
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dietitians are responsible for the nutritional care that diet technicians provide |
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mechanisms for ongoing communication between dietitians and diet technicians |
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diet technicians must hold membership in an organization e.g. Canadian Society of Nutrition Management |
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diet technicians must be adequately trained for the tasks they perform |
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Provide diet technicians with training using the three modules of the self-directed learning program. |
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Does this training program define competencies and skill sets?
The learning program was designed to provide flexibility for meeting different educational needs. Competencies and skill sets are derived from broader scope of practice statements and are defined by licensing and health care legislation, professional and educational organizations, and the governing body of each facility. Therefore, specific competencies and skill sets vary widely within and between countries.
This learning program is geared specifically to diet technicians in the work setting. Individual variation arises from the number of years and range of work experiences, and the individual's learning potential. The preceptor must work with each learner to carefully define the competencies and skill sets that must be acquired to enable new practices.
Therefore, the preceptor should link with the appropriate agencies to obtain the specific diet technician competencies and skill sets developed for their region and tailor these to the individual learner.
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How is the diet technician's learning experience evaluated?
The learning program was developed as an alternative to attendance at conferences. After each learning module is completed, a practical component must follow (within the specific work setting) to enable transference of new knowledge into practice. Both the preceptor and learner have a shared responsibility for ensuring appropriate competencies have been attained.
Evaluation is an ongoing process and is based upon defined competencies. Informal evaluation should occur continuously, in the form of questions and feedback. Written tools are available from various agencies to help measure or rate the integration of new knowledge into practice. Routine performance evaluations are also useful for identifying strengths and areas requiring further development. Therefore, the preceptor must select the appropriate combination of resources to evaluate the diet technician's performance.
Some clients have chosen to develop their own evaluation rating sheets and ward a certificate for completion of the learning program.
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External Interest
How can educational institutions utilize this learning program?
Educational institutions have expressed interest in utilizing this learning program for dietetic students (e.g. food service supervisors, diet technicians).
Two options exist:
- Purchasing one copy of the program to be utilized for background information ONLY.
The legal disclaimer does not pertain to educational institutions. An alternate agreement must be reached in writing. With this option, the program content could not be utilized with students in any form, including electronic, hard copy or overheads.
- Purchasing a site license and an annual user fee for subsequent years.
This option will allow the program to be utilized directly with students. For example, an online version could be arranged, accessible only by password for the duration of the course.
Please contact Deborah Wildish to discuss details further.
With what groups or members have you communicated?
• American Dietetic Association
• British Dietetic Association
• Caribbean Association of Nutritionists and Dietitians
• Canadian Society of Nutrition Management
• Dietitians Association of Australia
• Dietitians of Canada Caribbean Network
• Dietitians of Canada Clinical Nutrition Managers' Network
• Dietitians of Canada Gerontology Network
• Dietitians of Canada Long-term Care action group
• Dietitians of Canada Clinical Nutrition Leadership action group
• New Zealand Dietetic Association
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Who has purchased this learning program?
As of September 2007, more than 40 packages have been sold across Canada and internationally, including the United States, Australia and the Caribbean. Clients have ranged from large multi-site teaching hospitals to long-term care facilities; educational institutions; and individuals who are seeking diet technician positions.
Diet technicians with English as their second language (e.g. Francophones) who can read and understand English, have successfully utilized this learning program. Educational institutions have also purchased this learning program for background information in curriculum development.
Individuals have purchased the learning program to prepare them for entry into diet technician roles (e.g. food and nutrition graduates seeking health care experience) or food service supervisors who desire a refresher course to prepare for diet technician roles.
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Has this training program been featured anywhere?
Yes. Specifically:
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Practice Article (update) coming in Spring 2005 |
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New Zealand Dietetic Association News & Views December 2003 |
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Dietitians Association of Australia Newsletter August 2003 |
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Toronto Rehab Magazine Spring/Summer 2003 |
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Dietitians of Canada conference poster presentation in Calgary: May 2003
Experience Developing a Diet Technician Training Program |
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Practice Article (insert to Canadian Journal of Dietetic Practice and Research): Issue #20 Winter 2002 |
Where have you presented this training program?
Presentation at:
• Canadian Society of Nutrition Management Conference - Toronto - 2004
• Dietitians of Canada Gerontology Network - 2003
• Dietitians of Canada Clinical Nutrition Leadership Action Group - 2003
Resource display at:
• Dietitians of Canada CSO Regional Conference - Toronto - 2004
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Have you had any feedback from customers?
The response from customers has been very encouraging. There appears to be a defined need for diet technician training across Canada and even abroad. There are few educational events designed specifically for diet technician continuing education. Both dietitians and diet technicians are pleased that a program has been developed specifically for diet technician education. This self-directed learning program holds advantage over group education forums. Group education forums cannot make the learning experience highly relevant to an individual diet technician's learning needs within their specific work setting.
Any individual who can read and understand English can utilize this learning program. Some French speaking diet technicians have purchased the program. Answers to the written exercises can be written in any language and cross-checked with the English answer keys.
Large multi-site teaching hospitals have reported that even their "seasoned" diet technicians have benefited from this learning program. Furthermore, some sites will reuse the learning program annually as a "refresher" course.
Finally, the learning program is flexible enough to allow any dietitian to tailor it to their specific patients and integrate their clinical practice guidelines.
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Development Hurdles
Did you experience any development challenges?
Yes. Diet technicians have many different titles (nutrition assistants, nutrition technicians, therapeutic supervisors) and present with a wide range of skills and abilities. An individual might have worked their way up through the ranks of the dietary department or be an individual with a nutrition degree who has written a certification exam as a diet technician. It was decided to target the learning modules to the lowest skill-set.
There is also a broad range of dietitian practice within and between countries and even within a given facility. Dietitian practice impacts upon the roles of both the dietitian and the diet technician. It is virtually impossible to provide universal standards or measures. The learning modules provide specific examples but each facility must define their own specific parameters. For example, at what point is weight gain or weight loss a concern?
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How much time did it take to develop this training program?
Five dietitians contributed to the development and content review process. It took months of dietitian time, many hours were devoted outside of work. The cost "in time" developing this product is unlikely to be recouped through sales of this program. We hope that others can benefit from this significant time investment.
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Is the training program perfect?
No. The education program went through an extensive and rigorous review process. However, another dietitian will always find something to improve upon! Dietitians have an excellent focus on detail. There was a point at which we had to stop and go on with other work efforts.
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Technical Information
What are the minimum software and hardware requirements?
| Software Requirements: |
Microsoft PowerPoint version 97 or higher |
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Adobe Acrobat Reader version 4.0 or higher |
| Minimum Hardware Requirements: |
IBM compatible computer with a Pentium processor and 64 MB RAM. (Older computers will take longer to load and run the PowerPoint presentations.) |
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Is this program safe and secure to send in electronic format?
The self-extracting WinZip file is approximately 2.4 MB and can be quickly unzipped and copied to your desktop. The legal agreement/disclaimer also allows you to readily e-mail the unzipped file to other users within the original purchasing organization.
The five individual files have been checked for viruses and every reasonable effort has been taken to make these files virus-free. Please remember to run your antivirus program before installing these files to ensure that your computer system does not have any pre-existing viruses.
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How do you open the self-extracting WinZip file?
NB: No additional softward is required to open the WinZip file.
To Install on Your Desktop:
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Double click on the attached WinZip file folder icon. |
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Window appears: Opening Mail Attachment
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Prompt: What would you like to do with this file?
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Click on: "Open it" and click OK |
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Window appears: WinZip Self-Extractor
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Prompt: Unzip to folder
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Default: C:\Windows\Desktop\Diet Tec SDL Program
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Click on: Unzip |
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Displays: 5 file(s) unzipped successfully
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Click on: OK |
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Close the WinZip Self-Extractor box and close the e-mail message. |
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A yellow folder named: Diet Tec SDL Program, will appear on your desktop.
Doubleclick the folder and a window will open that displays the three PowerPoint modules, the User Guide and the Agreement / Disclaimer. |
To Install on Your Network:
Contact your IS department to install the files in a shared folder. Access can be provided by setting the permissions for specific users within your facility.
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Contact Information
How can I easily navigate to or share this information?
The training program website address is www.torontorehab.on.ca/diet-tec-learn
Who can I contact for further information?
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Deborah (Boyko) Wildish, RD, M.A.
Manager, Clinical Nutrition and Corporate Professional Leaders, Dietetics, ARAMARK at Toronto Rehab
wildish.debora@torontorehab.on.ca
416-597-3422 ext. 3682
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Laura Hirano, RD
Dietitian, Complex Continuing Care Program
ARAMARK at Toronto Rehab
hirano.laura@torontorehab.on.ca
416-597-3422 ext. 2137 |
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