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Practice A Placement Workbook
Student DietitianName……………………………………………………………………….
Practice Placement Educator/s …………………………………………………………………………………………………………………………………………………………………...
Date of Placement…………………………………………………………
Academic Year 2017/18 Page 1
Contents
1. Observing the Working Environment & Inter-professional experience 3
1.1. Dietary Assessment 31.2. Health and Safety 81.3. Communication in the healthcare setting 91.4. Ward experience (if applicable) 111.5. Care home experience (if applicable) 141.6. Professional practice in the healthcare setting 16
2. Catering Experience 192.1. Food products and portion sizes 192.2. Nutrient modified foods 212.3. Meal selection, service and delivery 242.4. Menu planning in the institutional setting 33
3. Dietetic shadowing 353.1. Sources of patient information 353.2. Health professionals who work closely with a dietitian 363.3. Observing dietetic practice 39
4. Additional Information 464.1. Assessment checklist for professionalism 474.2. Placement ‘A’ weekly review form 494.3. Supervising dietitian’s comments 51
5. Summary of specific aims achieved and review of placement A form (RPA) 52
6. Appendices 61Appendix 1: Verified witness statements 62Appendix 2: Reflection sheets 67
Academic Year 2017/18 Page 2
1.1 Dietary Assessment
Providing evidence for:
Specific Aim K5: To be able to demonstrate the ability to record, calculate and analyse individuals nutritional intake both by hand and computer assisted analysis
Task 1.
Liaise with a health care professional to identify a service user/patient who may require a food record chart and record what they eat and drink. If you are in an outpatient setting, use a 24 hour recall. Record their intake on the chart below.
Time Food/fluid Amount consumed Notes
Breakfast
Mid-morning
Lunch
Mid-afternoon
Dinner
Supper
Other
Task 2.
Academic Year 2017/18 Page 3
1.Observing the Working Environment & Inter-professional Experience
Either:
Consider and reflect upon the challenges health care professionals may experience when trying to keep a food record chart for a service user/patient. Can you think of any possible solutions?
Or:
Consider and reflect upon the limitations of using a 24 hour dietary recall? Can you think of any alternative methods?
Task 3.
Academic Year 2017/18 Page 4
Analyse the food record chart or 24 hour recall by hand and then by computer analysis for energy, protein, fat, carbohydrate (CHO) and two micronutrients you feel are appropriate to the service user/patient.
By handFood/fluid Portion Energy Protein Fat CHO Micro-
nutrientMicro-nutrient
Total:
Computer analysisFood/fluid Portion Energy Protein Fat CHO Micro- Micro-
Academic Year 2017/18 Page 5
nutrient nutrient
Total:
Task 4.
Add your totals to the table below to compare the results of both analyses.
Academic Year 2017/18 Page 6
Totals By hand Computer analysisEnergy
Protein
Fat
CHO
Micronutrient
Micronutrient
Discuss your results and possible reasons for any differences.
Academic Year 2017/18 Page 7
1.2 Health and safety
Providing evidence for:
Specific Aim K8: To be aware of health and safety issues in the working environment.
Task 1.
Consider the main health and safety issues in three areas of your placement (such as department/organisational office, outpatient clinic, ward, kitchen, canteen, care home, GP surgery). Discuss how these areas are managed with the relevant staff. Note the main points of your discussion below.
Identify six potential risks from these areas and list below:
1.
2.
3.
4.
5.
6.
Task 2.
If possible, visit the infection control team or discuss with the appropriate staff, the risks and control of infection within a relevant setting.
Use this discussion to briefly summarise the main infection risks within a healthcare setting and the systems in place to minimise these risks.
Academic Year 2017/18 Page 8
1.3 Communication in the placement setting
Providing evidence for:
Specific Aim C10: Have experience of communicating with patients and healthcare professionals
Specific Aim C11: To demonstrate an ability to converse with patients and healthcare professionals
Task 1.
Consider how you should introduce yourself to both service users/patients and staff. Consider and reflect upon how dietitians and other staff may introduce themselves and make some notes below.
Task 2.
Initiate conversations with service users/patients and colleagues. Provide written evidence of this such as using a verified witness statement (Appendix 1).
Task 3.
Towards the end of your three weeks on placement, write a reflective summary on your experiences of communicating with service users/patients and other staff. You should consider the following:
- The range of service user/patient groups and health care professionals a dietitian communicates with
- Positive and negative experiences of communication (describe some examples of each)
- Any challenges you had in communicating with people- What you have learnt from the experience and any changes you would consider
making to your communication as a result
Document your reflective summary on the next page.
Academic Year 2017/18 Page 9
Task 3. Reflective summary
Academic Year 2017/18 Page 10
1.4 Ward experience (if applicable)
Providing evidence for:
Specific Aim P16: Be able to identify those health professionals who work closely with a dietitian
Specific Aim P17: Be able to identify the key sources of patient information available to plan dietetic care
Specific Aim P18: Demonstrate an interest in and a commitment to the work of a dietitian
Task 1.
Complete the following worksheet if you are able to gain ward experience on your placement
1. Identify the different grades of nursing staff present on the ward and record their uniforms and their role in the care/treatment/rehabilitation of service users/patients below:
Grade Uniform RoleMatron
Ward Manager
Sister / Charge Nurse
Staff Nurse
Support Worker
Student Nurse
2. Identify other personnel on the ward as listed below:
Academic Year 2017/18 Page 11
Personnel Uniform RoleWard Clerk
Physiotherapist
Occupational Therapist
Therapy Assistant
Speech and Language Therapist
Pharmacist
3. Attend a ward round if possible on the ward your visit. How often does each consultant undertake a ward round? Who was present and when does it occur?
4. Attend a drug ward round. Approximately at what time do drug rounds occur, how long did it take and who undertook the round?
5. Attend a nursing staff handover. What times do hand overs occur? Consider the main points discussed at the hand over and any dietary/nutritional information.
Academic Year 2017/18 Page 12
6. If there is the opportunity, attend a multidisciplinary team (MDT) meeting. Who attended the meeting?
What was the purpose of the meeting?
What sources of information were used during the meeting?
7. List who records information in the following documentation and what type of information it contains:
Document Who records information Type of information Case notes/medical records
Nursing record
Drug chart
Bed end file
8. List any other sources of information that you observed.
**Complete a reflection sheet on your ward experience (Appendix 2)1.5 Care home experience (if applicable)Academic Year 2017/18 Page 13
Providing evidence for:
Specific Aim P16: Be able to identify those health professionals who work closely with a dietitian
Specific Aim P17: Be able to identify the key sources of patient information available to plan dietetic care
Specific Aim P18: Demonstrate an interest in and a commitment to the work of a dietitian
Specific Aim C10: Have experience of communicating with patients and healthcare professionals
Specific Aim C11: Demonstrate an ability to talk with patients and healthcare professionals
Task 1.
If you visit a care home during your placement, answer the following questions:
1. Please indicate the nature of the facility that you visited (such as a nursing home, residential care home, learning disabilities or mental health care home)
2. How long did you spend at the facility?
3. What types of staff work in and visit, a nursing home compared to a residential care home?
4. How do the needs of the residents differ in a nursing home compared to a residential care home? Include your thoughts on their diet/nutrition, physical, mobility and communication needs?
Academic Year 2017/18 Page 14
5. Is a nutritional screening tool used? If so, which one, when is it completed and by whom?
6. What information is recorded about the residents’ weight, food intake and dietary needs? Where and how often is this information recorded?
7. Does a dietitian visit the home? If so, how are the referrals made?
8. If possible, shadow a dietitian when they are assessing or reviewing one of the residents. How do they communicate the dietary treatment plan to the resident and the care home staff?
9. Are any of the residents on special diets? If so, discuss with the catering staff about how these are produced. Particularly ask about if foods are fortified with energy and protein and if any oral nutritional supplements are used.
**Ask appropriate questions when with dietitians and other health care professionals
- Verified witness statement to be completed following visits to care home (Appendix 1)
**Complete a reflection sheet on your care home experience (Appendix 2)
1.6 Professional practice in the healthcare setting
Academic Year 2017/18 Page 15
Providing evidence for:
Specific Aim P12: Be aware of the need to respect the point of view of patients and why it is important to avoid discrimination
Specific Aim P13: Demonstrate the ability to maintain confidentiality
Specific Aim P14: Be able to explain the reason and need for the HCPC Standards
Specific Aim P15: Demonstrate professional appearance and behaviour
Specific Aim P18: Demonstrate an interest in and a commitment to the work of a dietitian
Task 1.
Reflect on the experiences you have during your three weeks in the practice setting and answer the following questions:
1. Have you observed or been aware of potential discrimination against an individual? If yes, describe the event and make suggestions for preventing this happening in the future. If no, describe any processes that you have observed for avoiding potential discrimination.
2. Have you observed or been aware of any potential breaching of confidentiality? If yes, describe the event, the consequences of this breach and make suggestions for preventing this happening in the future. If no, describe the mechanisms that are in place for maintaining confidentiality in the practice setting.
3. Describe one situation where you observed or you applied the HCPC Standards of Proficiency- Dietitians.
Academic Year 2017/18 Page 16
http://www.hpc-uk.org/assets/documents/1000050CStandards_of_Proficiency_Dietitians.pdf
Task 2
Consider the following issues and note down your own thoughts on each:
1. The public’s expectations of the dietitians’ appearance, knowledge, skills and behaviour
2. What you think influences this expectation?
3. How do you think these expectations may change with age, gender, and cultural background?
Task 3Academic Year 2017/18 Page 17
Consider whether expectations and stereotyping influence attitudes and whether this may lead to potential discrimination.
How do you think this could be avoided?
Task 4
During your placement experience you will have the opportunity to shadow both dietitians and other health care professionals. You will need to collect verified witness statements from your time spent in different settings and with different professionals (Appendix 1).
Academic Year 2017/18 Page 18
The tasks in this section can be completed in a hospital or other institutional setting
2.1 Food products and portion sizes
Providing evidence for:
Specific Aim K1: Have a working knowledge of portion sizes of common foods
Task 1.
** For this task you will need the ‘Ready Reckoner’ that you completed as part of the K1 task (1.1 Portion sizes of common foods) in the campus based workbook**
If possible, take the opportunity to weigh out portions of the foods on your ready reckoner table within an institutional (hospital or other) setting. Record the weight and the nutritional content in the table on the next page.
Task 2.
Compare the portion sizes on your campus-based ready reckoner table and your institutional setting ready reckoner table. What differences are there?
Consider the implications this may have when assessing a service user/patient’s diet in an outpatient setting compared to an inpatient setting.
Ready reckoner: Portion sizes of common foodsAcademic Year 2017/18 Page 19
2.Catering Experience
Food Portion size (g) Energy (kcal) CHO (g) Protein (g) Fat (g)
Academic Year 2017/18 Page 20
Roast meat
Roast chicken
Fish fried in batter
Fish poached
Stewed meat
Curried meat
Dahl (curried lentils
Sandwich (meat filling)
Sandwich (cheese filling)
Sandwich (egg filling)
Pie (savoury)
Lasagne
Shepherds/cottage pie
Sausages
Potatoes-boiled
Potatoes-mashed
Potatoes-jacket
Chips
Rice-boiled
Pasta-boiled
Vegetables-various
Salad
Baked beans
Fruit-fresh
Fruit-canned
Sponge
Fruit pie
Custard
Milk pudding
Fruit ‘fool’
Instant whip dessert
Yoghurt
Jelly
2.2 Nutrient modified foods
Providing evidence for:
Academic Year 2017/18 Page 21
Specific Aim K4: Have a working knowledge and practical experience of producing both standard and modified recipes
Task 1.
1. What menu options are available for service users/patients/residents in this setting? Are special/therapeutic diets available and what are they?
2. If possible, observe the food production process in a hospital kitchen, or other institutional setting. From your observations or discussions with catering and dietetic staff, describe all of the information that the catering staff preparing therapeutic diets require to effectively provide these meals.
If possible, please note down a list of the therapeutic/special diets provided at your placement setting and bring with you to your placement debrief next year
Task 2.
Compare the appearance, texture and if possible, taste, of standard and modified texture foods produced. Try to undertake this task with soups, main courses and desserts. Complete the worksheet on the following page:
Aim K4, Task 2 worksheetFoods/fluids Texture Taste Appearance
Academic Year 2017/18 Page 22
Task 3.Discuss with the cook/catering team and your supervising dietitian/s the challenges surrounding the provision of therapeutic and texture modified diets in an institutional kitchen. Make notes of your discussion.
Academic Year 2017/18 Page 23
Task 4. Did you see any service users/patients/residents being given oral nutritional supplements/sip feeds on your placement?
If yes, which supplements were used and were these being taken as prescribed?
Did those service users/patients/residents who were prescribed oral nutritional supplements always receive them? If not, what were the reasons? Discuss your observations with staff and your supervising dietitian/s.
If possible, find out which nutrition company has a contract with the organisation for providing oral nutritional supplements. Bring this information with you to your placement debrief next year.
2.3 Meal selection, service and delivery
Providing evidence for:
Academic Year 2017/18 Page 24
Specific Aim K7: Appreciate the process of meal selection, service and delivery within an institutional food production unit
Specific Aim C11: Demonstrate an ability to talk with patients and healthcare professionals
Specific Aim P16: Be able to identify those health professionals who work closely with a dietitian
Task 1. Meal selection
1. How are service users/patients/residents informed of what menus/foods/fluids are available?
If possible, obtain a copy of the menu/s to bring to placement debrief next year
2. Who usually gives out the menus and assists service users/patients/residents in making their choices? (It is advised that you help with this process).
3. What are the potential challenges staff may experience when supporting service users/ patients/residents to make their menu choices.
4. When are the menus given out and completed in relation to the meal-time they are ordering for? What do you think about this? (You may ask the service users/patients/residents)
5. What times are the meals served?
Academic Year 2017/18 Page 25
6. What do you feel about these times? (You may wish to discuss this with the service users/patients/residents and with staff)
Task 2. Meal service and delivery
During your placement, gain an understanding of the catering system used at your placement.
1. What food production system is used? Such as cook/serve, cook/chill, cook/freeze.
2. Describe the advantages and disadvantages of the system used
3. Is food waste documented? If so, when does that occur within the food chain and who is responsible?
4. How is the food delivered to the service user/patients/residents? Such as plated service; bulk trolley service.
5. Who is involved in the distribution of the meals? (It is advised you help in this process if possible)
Academic Year 2017/18 Page 26
6. Does anyone assist service users/patients/residents with eating? If so who?
7. How are the service users/patients/residents who require feeding assistance identified?
8. What difficulties or problems did you observe in relation to feeding patients/residents? Think about how these problems could be overcome, discuss with your supervising dietitian/s and make notes below.
9. Who monitors the service user/patient’s/resident’s food and fluid intake at mealtimes?
Academic Year 2017/18 Page 27
10. Is a system of protected mealtimes in place? If yes, is this system adhered to? Discuss this with other staff and make notes below
11.Consider what factors (such as staff, environment, positioning) may reduce a service user/patient’s/resident’s food intake.
12.What options are available for service user/patients/residents who have missed a meal?
13.Make notes on the strengths and weaknesses of the meal service and delivery in your placement setting (it might be helpful to refer back to section 4.1 in the campus-based workbook/ the institutional catering lecture that you received). Make suggestions for improvement.
Task 3.
Many members of staff are involved in the delivery of good nutritional care to service users/patients/residents. In the table below, describe the staff roles (do not include registered health care professionals) and how they interact with the dietitian
Academic Year 2017/18 Page 28
Staff Describe how this group of staff are involved in the nutritional care of service users/patients/residents, & how they interact with the dietitian.
Task 4.
Talk to at least 3 different service users/patients/residents and complete the questionnaire on the following pages.
Collate your results. Consider what the problems with the current meal service may be and comment on your findings below:
Academic Year 2017/18 Page 29
Task 4 Service user/patient/residents questionnaire:
1. What do you think about the meals/food here?
Academic Year 2017/18 Page 30
2. Are you satisfied with the presentation of your meals? If not, please provide a comment
3. Do you think the food portions are:
Too small Acceptable Too large
4. Do you have enough time to prepare for your meals (e.g. wash hands)?Y / N
5. Do you have enough time to eat your meal?Y / N
6. What are your thoughts on the meal choices?
7. Do you always get what you ordered?Y / N
8. Do you require assistance with eating? Y / NIf yes, do you always receive it?Y / N
9. When you first arrived, were you asked about your food likes and dislikes?Y / N
Task 4 Service user/patient/resident questionnaire:
1. What do you think about the meals/food here?
Academic Year 2017/18 Page 31
2. Are you satisfied with the presentation of your meals? If not, please provide a comment
3. Do you think the food portions are:
Too small Acceptable Too large
4. Do you have enough time to prepare for your meals (e.g. wash hands)?Y / N
5. Do you have enough time to eat your meal?Y / N
6. What are your thoughts on the menu choices?
7. Do you always get what you ordered?Y / N
8. Do you require assistance with eating? If yes, do you always receive it?Y / NIf yes, do you always receive it?Y / N
9. When you first arrived, did anyone ask you about your food likes and dislikes?Y / N
Task 4 Service user/patient/resident questionnaire:
1. What do you think about the meals/food here?
Academic Year 2017/18 Page 32
2. Are you satisfied with the presentation of your meals? If not, please provide a comment
3. Do you think the food portions are:
Too small Acceptable Too large
4. Do you have enough time to prepare for your meals (e.g. wash hands)?Y / N
5. Do you have enough time to eat your meal?Y / N
6. What are your thoughts on the menu choices?
7. Do you always get what you ordered?Y / N
8. Do you require assistance with eating? If yes, do you always receive it?Y / NIf yes, do you always receive it?Y / N
9. When you first arrived, did anyone ask you about your food likes and dislikes?Y / N
2.4 Menu planning in the institutional setting
Providing evidence for:
Specific Aim K6: Appreciate the factors to be considered in all aspects of menu planning
Task 1: Consider the following questions and make notesAcademic Year 2017/18 Page 33
1. Refer back to section 4.1 (Institutional catering) in the campus-based workbook. Which 4 of the 6 factors that you considered to be most important in menu planning are most relevant for your placement setting?
1.
2.
3.
4.
2. Who is involved in designing and analysing the menus in your placement setting?
3. How does the catering team and the dietitians at your placement setting, ensure that the menu meets the requirements of service users/patients who are nutritionally well and those who are nutritionally vulnerable?
4. Can snacks be requested? If so, who requests these and what is the request process and delivery to the service user/patient?
5. If possible, please note down and bring a list of the available snack options to your placement debrief.
6. Review the menu for the institutional setting and identify the main sources of 3 vitamins and minerals likely to be deficient in an institutional diet
Academic Year 2017/18 Page 34
7. Identify the budget allocation for meals and beverages to feed each service/users/patient/resident per day and note below:
Bring this information to your placement debrief session next year
8. Compare your weekly expenditure of food and beverages (excluding alcohol) that you calculated within your campus-based workbook with the weekly budget allocation for a service user/patient/resident.
9. Consider the implications for the nutritional intake of service users/patients/residents in this setting and the implications for dietetic practice. Make notes below:
10.Discuss with your peers or supervising dietitian whether you think institutional budgets are adequate for ensuring a balanced nutritional intake. Identify the population groups that you think are most at risk from institutional diets
3.1 Sources of patient information
Providing evidence for:
Academic Year 2017/18 Page 35
3.Dietetic shadowing
£
Specific Aim P17: To be able to identify the key sources of patient information available to plan dietetic care
Task 1.
1. Choose 2 service users/patients, each from a different practice setting (e.g. inpatient, outpatient, home visit, care home, GP practice) and identify the key sources of information available to plan dietetic care. Note the sources below and comment on why this information was used:
2. Note the differences in key sources of information between the two settings. How might this impact on dietetic care?
Task 2.
Collect both social and medical information about 1 service user/patient from the medical/nursing notes and document this information on a written record card, mock record card or a electronic record. Observe your supervising dietitian using this information to plan the dietetic treatment for this service user/patient and discuss the interaction observed.
3.2 Health professionals who work closely with a dietitian
Providing evidence for:
Specific Aim P16: Be able to identify those health professionals who work closely with a dietitian
Specific Aim C9: Have an understanding of the methods by which dietitians communicate with other health professionals, patients and the general public
Academic Year 2017/18 Page 36
Task 1.
Throughout your time on placement you should try to identify all the other health professionals that the dietitians interact with. Record in the table on pages 37 and 38, including information on the communication method used, the purpose of the communication and where it took place.
Task 2.
1. Discuss with your supervising dietitian or dietetic assistant why the method of communication was used and whether an alternative format would have been acceptable or as effective. Make notes below.
2. Consider which communication methods were effective and which were less so, considering the strengths and weaknesses of different types of communication and how these can change the outcome.
Academic Year 2017/18 Page 37
Location/setting The health professional(s) involved
Method of communication
Reason for communication
What is the unique contribution of this profession to the care/treatment/rehabilitation of service users/patients?
In what areas does their professional practice overlap with that of a dietitian?
Academic Year 2017/18 Page 38
Location/setting The health professional(s) involved
Method of communication
Reason for communication
What is the unique contribution of this profession to the care/treatment/rehabilitation of service users/patients?
In what areas does their professional practice overlap with that of a dietitian?
Academic Year 2017/18 Page 39
3.3 Observing dietetic practice
Providing evidence for:
Specific Aim C9: Have an understanding of the methods by which dietitians communicate with other health professionals, patients and the general public
Specific Aim P12: Be aware of the need to respect the point of view of patients and why it is important to avoid discrimination
Specific Aim P17: Be able to identify the key sources of patient information available to plan dietetic care
Specific Aim P18: Demonstrate an interest in and a commitment to the work of a dietitian
Task 1
Complete the dietetic observation worksheets on the following pages.
OBSERVATION SHEET 1 - Observe a diet history being takenAcademic Year 2017/18 Page 40
Type of service user/patient and diet:
Soon you will be taking a diet history from a service users/patient, so try to concentrate on the diet history part of the consultation. Try to comment on the following, ready for discussion later. It may be worth practising taking diet histories from family, friends or colleagues.
1. How did the Dietitian explain to the service user/patient about the diet history? Why do you think this was done?
2. Describe what the Dietitian did when taking a diet history?
3. Did the Dietitian have any difficulties obtaining information from the service user/patient? How was this overcome?
4. What specific information was the Dietitian trying to obtain from the diet history? How do you think this helps with giving advice later?
5. Did the service user/patient seem at ease or not during the diet history? Why do you think this was?
Now write down something you have learnt from observing diet historytaking.
OBSERVATION SHEET 2 - Observe the Dietitian throughout the interview
Academic Year 2017/18 Page 41
Type of service user/patient/diet
Try to concentrate on observing the Dietitian in consultations. Look for what issaid as well as techniques used by the Dietitian. Comment on the following,ready for discussion later.1. How did the Dietitian start the consultation? What do you think were the
reasons for this?
2. What did the Dietitian do, to make the service user/patient feel more at ease?
3. What information did the Dietitian try to obtain from the service user/patient?
4. Were there any challenges in obtaining information? How did the Dietitian overcome these?
5. Did the Dietitian manage to build up a rapport with the service user/patient? If so how?
6. How did the Dietitian identify whether the service user/patient was ready to make dietary changes?
7. Did the Dietitian agree any targets or goals with the service user/patient? How was it done?
8. How did the Dietitian comply with the Code of Conduct Statement?
Write down one thing that you feel that you have learnt from observing the Dietitian today.
Academic Year 2017/18 Page 42
OBSERVATION SHEET 3 - Observe the service user/patient throughout the interview
Type of service user/patient/diet
Concentrate on watching the patient in the interviews on the wards and in clinics. Watch how they participate in the consultation and how they react. Try to comment on the following, ready for discussion later.
1. How was the interview started? Did the Dietitian put the service user/patient at ease? If so, how?
2. How did the service user/patient seem when they were first met by the Dietitian?
3. Can you describe any changes in body language in the service user/patient as the introduction took place and then as the interview progressed?
4. Do you think the service user/patient understood the reason for being prescribed the diet?a) at the beginning of the interview?b) by the end of the interview? What makes you think this?
5. Were targets or aims agreed with the service user/patient? Describe how this was done.
6. Do you think the service user/patient was ready to make the changes? Why?
7. How did the service user/patient react to the follow up arrangements?
8. How did the Dietitian comply with the Code of Conduct Statement?
Write down one thing that you feel you have learnt from observingService users/patients today.OBSERVATION SHEET 4 - Observe a new patient consultation Academic Year 2017/18 Page 43
Type of service user/patient/diet
Try to concentrate on the service user/patient interviews you will see in clinics, and on the wards. Look at the different stages of the interview itself, and what is said and done. Try to comment on the following, ready for discussion later.
1. How did the interview start? What did the Dietitian do and say? Why do you think this was said?
2. What was discussed next?
3. How important was it to take a diet history from the service user/patient? Why?
4. What was the main information, which the Dietitian was trying to obtain from the diet history?
5. What did the Dietitian do after the diet history?
6. Was any written information given? Why do you think this is important?
7. How did the Dietitian end the consultation?
8 How long did the consultation take? How was the time divided (approximately)?
Write down something you feel you have learnt from observing the Dietitian today.
OBSERVATION SHEET 5 - Observe a follow up consultation
Academic Year 2017/18 Page 44
Type of service user/patient/diet
Try to concentrate on observing follow up consultations. Look at the different stages of the consultation and what is said and done. Try to comment on the following, ready for discussion later.
1. How did the interview start? What did the Dietitian do and say? How did this differ from a consultation with a new service user/patient?
2. How did the Dietitian identify whether changes had been made by the service user/patient?
3. What did the Dietitian do next? What do you think were the reasons for this?
4. How did the Dietitian end the consultation?
Write down something you feel you have learnt from observing follow up consultations.
Task 2.Academic Year 2017/18 Page 45
Ask appropriate questions when observing dietetic practice and provide evidence of this, i.e. complete a verified witness statement and ask for it to be signed (APPENDIX 1)
Complete a reflection sheet on your experience of observing dietetic practice. (APPENDIX 2)
Task 3.
Reflection on a ‘service user/patient story’
During the course of your practice placement, choose one service user/patient ‘story’ to reflect upon. Try to choose something that you would be prepared to discuss with your course when you return to University next semester. Complete the worksheet below:
1. Describe the service user/patient story
2. How did it make you feel? (Were you surprised by what had happened? Did you feel any positive or negative emotions as a result?)
3. Evaluate how useful it was to have learned about the service user/patient story (i.e. did it develop your interest in an aspect of dietetics? Improve your understanding?)
Consider whether gaining insight into the experiences of a service user/patient will change your practice in the future? What have you learned from this?
Academic Year 2017/18 Page 46
Please bring this reflection to the placement debrief next year
4.1 Assessment checklist for professionalism
Providing evidence for:
Specific Aim K8: Be aware of the health and safety issues within the working environment.
Specific Aim C10: Have experience of communicating with patients and healthcare professionals
Specific Aim C11: Demonstrate an ability to talk with patients and healthcare professionals
Specific Aim P12: Be aware of the need to respect the point of view of patients and why it is important to avoid discrimination
Specific Aim P13: Demonstrate the ability to maintain confidentiality
Specific Aim P14: Be able to explain the reason and need for statement of conduct
Specific Aim P15: Demonstrate professional appearance and behaviour
Specific Aim P16: Be able to identify those health professionals who work closely with a dietitian
Specific Aim P17: Be able to identify the key sources of patient information available to plan dietetic care
Specific Aim P18: Demonstrate an interest in and a commitment to the work of a dietitian
Task 1.At week 3, complete the checklist on the following pages 47 and 48. It will be discussed and signed off by your practice educator/supervisor at the end of your placement. Where a skill and learning outcome has not been achieved and is not signed off, comments MUST be recorded.
Exceptionally positive aspects can also be noted under comments. You may want to use further verified witness statements (APPENDIX 1) to support this information.
This checklist should be kept as a record in your student portfolio. It is a useful reference to prepare you for future placements.
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4. Additional information
PROFESSIONALISM TOOL ASSESSMENT CHECKLIST FOR A PLACEMENT
Student’s Name:
List of skills demonstrating a professional attitude Learning outcome
Signature & date achieved
Comments
Appropriate time keepinge.g. adheres to departmental working hours, reliable and punctual in attendance
P15, P18
Demonstrates a pro-active attitudee.g. makes appropriate offers to help
P15, P18
Shows understanding that their actions reflect on the teame.g. can identify incident and understand implications of not doing this.
P12, P13, P14, P15
Demonstrates appropriate reflective skillse.g. during weekly feedback/reflective sessions
C10, C11, P15
Demonstrates respect for otherse.g. shows sensitivity to the needs of other staff for privacy etc., listens without comment at appropriate parts of the interview
C11, P12, P13, P14, P15
Understands and demonstrates the concept of safe practice and recognises own limitations e.g. incident reporting and health and safety issues
K8, P14, P15,
Takes responsibility for own learninge.g. seeks answers to questions without asking dietitian first.
P15, P17, P18
Demonstrates an enquiring attitude and then shares knowledge and experience with others
P15, P18
Can demonstrate practice in a non-discriminatory waye.g. can reflect on care provided to patient or groups to ensure equitable care
P12, P13, P14, P15
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List of skills demonstrating a professional attitude Learning outcome
Signature & date achieved
Comments
Demonstrates appropriate behaviour e.g. has appropriate relationships and rapport with patients and other health care professionals
P11, P15
Adheres to departmental dress codee.g. presents an appropriate image including hair, jewellery, tattoos, and wearing an ID badge)
P15
Demonstrates an appropriate level of confidence (neither over or under confident)e.g. shows an awareness of reasons why this is important
P14, P15
Maintains confidentialitye.g. adheres to data protection including electronic records and observes appropriate patient confidentiality.
P13, P15
Accepts constructive feedbacke.g. accepts and responds appropriately to comments
P15, P14, P18
Demonstrates an understanding for the need for appropriate and effective time management
P15, P18
Additional comments:
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4.2. Placement A - Weekly Review FormThis form will usually be completed weekly by the student dietitian and then discussed with the supervising dietitian. Actions to be taken should be identified in the review meeting and documented.
Student Dietitian: ………………………………………………………………………...
Supervising Dietitian: ………………………………………………………………………...
Date: ………………………………………………………………………...Week: ………………………………………………………………………...
1. Please give your views on the placement training this week.a. What have you found valuable this week?
…………………………………………………………………………………………...…………………………………………………………………………………………...…………………………………………………………………………………………...…………………………………………………………………………………………...
b. What went well and why?…………………………………………………………………………………………...…………………………………………………………………………………………...…………………………………………………………………………………………...…………………………………………………………………………………………...…………………………………………………………………………………………...
2. 2. What do you feel are the areas for improvement?
…………………………………………………………………………………………...…………………………………………………………………………………………...…………………………………………………………………………………………...
3. 3. Did you feel the feedback from the staff was adequate this week? 4. Yes / No If no, why not?
…………………………………………………………………………………………...
…………………………………………………………………………………………...
…………………………………………………………………………………………...
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4. What have you achieved this week (include progress on your work book evidence and learning outcomes). How might you use what you have learned?…………………………………………………………………………………………...…………………………………………………………………………………………...…………………………………………………………………………………………...…………………………………………………………………………………………...…………………………………………………………………………………………...…………………………………………………………………………………………...…………………………………………………………………………………………...…………………………………………………………………………………………...…………………………………………………………………………………………...…………………………………………………………………………………………...…………………………………………………………………………………………...…………………………………………………………………………………………...5. Do you have any further comments from this week?…………………………………………………………………………………………...…………………………………………………………………………………………...…………………………………………………………………………………………...…………………………………………………………………………………………...…………………………………………………………………………………………...…………………………………………………………………………………………...…………………………………………………………………………………………...…………………………………………………………………………………………...…………………………………………………………………………………………...…………………………………………………………………………………………...…………………………………………………………………………………………...…………………………………………………………………………………………...…………………………………………………………………………………………...6. Following your review with the supervising dietitian, are there any actions required or comments on your placement/workbook progress?
…………………………………………………………………………………………….…………………………………………………………………………………………….…………………………………………………………………………………………….………………………………………………………………………………………………………………………………………………………………………………………….
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4.3. Supervising Dietitian’s Comments
Week……………………..
Please comment on any area of the student’s placement from this week.
1. Student’s Strengths.…………………………………………………………………………………………...…………………………………………………………………………………………...…………………………………………………………………………………………...…………………………………………………………………………………………...
2. Progress on workbook completion.………………………………………………………………………………………...…………………………………………………………………………………………...…………………………………………………………………………………………...…………………………………………………………………………………………...
3. Please comment on professionalism and attitude.
…………………………………………………………………………………………...…………………………………………………………………………………………...…………………………………………………………………………………………..…………………………………………………………………………………………...…………………………………………………………………………………………...4. Any other comments, concerns or action plan.
…………………………………………………………………………………………...…………………………………………………………………………………………...…………………………………………………………………………………………...…………………………………………………………………………………………...…………………………………………………………………………………………...…………………………………………………………………………………………...Signature of Student Dietitian..................................................... Date / / Signature of Supervising Dietitian................................................ Date / /
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A PLACEMENT CLINICAL WORKBOOK – SUMMARY OF SPECIFIC AIMS ACHIEVED FOR PLACEMENT A & REVIEW OF PLACEMENT A (RPA)
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Dietetic student: …………………………………………… Date: ……………………
This form consists of two parts – the Summary of Specific Aims Achieved for A placement and the Review of A Placement
CLINICAL WORKBOOK – SUMMARY OF SPECIFIC AIMS ACHIEVED FOR PLACEMENT A
The placement supervisor should initial the boxes to confirm that specific aims have been achieved.
Evidence Associated A placement aims
Placement supervisor’s initials
Portion sizes of menu items
K1. Have a working knowledge of portion sizes of common foods
Food chart and analysis
K5. Be able to demonstrate the ability to record, calculate and analyse individuals’ nutritional intake both by hand and computer assisted analysis
Catering system whilst on placement
K6. Appreciate the factors to be considered in menu planning
Meal, selection, service and delivery
K7. Appreciate the process of meal selection, service and delivery within an institutional food production unit
Health and safety K8. Be aware of the health and safety issues within the working environment
Professionalism tool K8. Be aware of the health and safety issues within the working environment
C10. Have experience of communicating with patients and healthcare professionals
C11. Demonstrate an ability to talk to patients and healthcare professionals
P12. Be aware of the need to respect the point of view of patients and why it is important of avoid discrimination
P13. Demonstrate the ability to maintain confidentiality
P14. Be able to explain the reason and need for statement of conduct
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RPA
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Task Associated A placement aim
Placement supervisor’s initials
Professionalism tool cont.
P15. Demonstrate professional appearance and behaviour
P16. Be able to identify those health professionals who work closely with a dietitian
P17. Be able to identify the key sources of patient information available to plan dietetic care
P18. Demonstrate an interest in and a commitment to the work of a dietitian
Dietetic shadowing and observation
C9. Have an understanding of the methods by which dietitians communicate with other health professionals, patients and the general public
C10. Have experience of communicating with patients and healthcare professionals
P13. Demonstrate the ability to maintain confidentiality
P14. Be able to explain the reason and need for statement of conduct
Communication with other health professionals
C10. Have experience of communicating with patients and healthcare professionals
Conversing with patients and staff
C11. Demonstrate an ability to talk to patients and healthcare professionals
HCPC Standards of Conduct, Performance and Ethics
P14. Be able to explain the reason and need for statement of conduct
Identify key sources of information
P17. Be able to identify the key sources of patient information available to plan dietetic care
Verified witness statement
P18. Demonstrate an interest in and a commitment to the work of a dietitian
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RPA
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REVIEW OF PLACEMENT A
This review should be undertaken by the supervising dietitian with the student dietitian on completion of Placement A. Please use the attached form to summarise your findings, considering the following:
Is there evidence to demonstrate that all of the placement aims have been met? If not, please identify the omissions below:
Specific Aims Not Met:
KNOWLEDGE
Strengths:
Areas for Improvement:
Action Points:
COMMUNICATION
Strengths:
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RPA
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Areas for Improvement:
Action Points:
PROFESSIONAL PRACTICE
Strengths:
Areas for Improvement:
Action Points:
Are there particular areas that need to be developed upon return to university?
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RPA
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Name of Student
Signature of Student Name of Supervising Dietitian Signature of Supervising Dietitian Location of Placement(s)
Date From To
Number of Weeks Completed
After completion, a copy of this form should be given to the student for their portfolio. A copy should be emailed within one week of completion to:
Please email to katherine.lawson@nottingham.ac.uk
Kathy LawsonAdministratorThe University of NottinghamDivision of Nutritional SciencesSutton Bonington CampusLoughboroughLeicestershireLE12 5RD
Academic Year 2017/18
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APPENDICES
Appendix 1- Verified witness statementsAppendix 2 –Reflection sheets
Academic Year 2017/18 Page 61
VERIFIED WITNESS STATEMENT
Student Dietitian’s Name: ____________________________Date: _____________
Location/Health Professional ___________________________________________
Practice 18: Demonstrate an interest in and commitment to the work of Dietitians.
To ask appropriate questions when with Dietitians and other Health Professionals.
Be punctual and manage workload within time scale allocated.To be completed by the Dietitian or Health Professional
Punctuality
Did the student arrive on time? Yes No
Did the student undertake any assigned task in the Yes No time allocated?
Communication
Did the student introduce themselves? Yes No
Did the student initiate conversation? Yes No
Did the student use an appropriate level of language? Yes No
Did the student respond to non-verbal communication? Yes No
Did the student demonstrate the ability to listen? Yes No
Did the student respond appropriately to questions? Yes No
Outcome Was the student able to re-cap to you their understanding of your role and your interaction with Dietitians/Health Professionals?
Yes No COMMENTS
Signature of Student __________________________________ Date _____________
Signature of Health Professional ______________________________________
Job title/role_______________________________________________________
(PRINT NAME ______________________________________) Date ______________
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VERIFIED WITNESS STATEMENT
Student Dietitian’s Name: ____________________________Date: _____________
Location/Health Professional ___________________________________________
Practice 18: Demonstrate an interest in and commitment to the work of Dietitians.
To ask appropriate questions when with Dietitians and other Health Professionals.
Be punctual and manage workload within time scale allocated.To be completed by the Dietitian or Health Professional
Punctuality
Did the student arrive on time? Yes No
Did the student undertake any assigned task in the Yes Notime allocated?
Communication
Did the student introduce themselves? Yes No
Did the student initiate conversation? Yes No
Did the student use an appropriate level of language? Yes No
Did the student respond to non-verbal communication? Yes No
Did the student demonstrate the ability to listen? Yes No
Did the student respond appropriately to questions? Yes No
Outcome Was the student able to re-cap to you their understanding of your role and your interaction with Dietitians/Health Professionals?
Yes No COMMENTS
Signature of Student __________________________________ Date _____________
Signature of Health Professional ______________________________________
Job title/role_______________________________________________________
(PRINT NAME ______________________________________) Date ______________
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VERIFIED WITNESS STATEMENT
Student Dietitian’s Name: ____________________________Date: _____________
Location/Health Professional ___________________________________________
Practice 18: Demonstrate an interest in and commitment to the work of Dietitians.
To ask appropriate questions when with Dietitians and other Health Professionals.
Be punctual and manage workload within time scale allocated.To be completed by the Dietitian or Health Professional
Punctuality
Did the student arrive on time? Yes No
Did the student undertake any assigned task in the Yes Notime allocated?
Communication
Did the student introduce themselves? Yes No
Did the student initiate conversation? Yes No
Did the student use an appropriate level of language? Yes No
Did the student respond to non-verbal communication? Yes No
Did the student demonstrate the ability to listen? Yes No
Did the student respond appropriately to questions? Yes No
Outcome Was the student able to re-cap to you their understanding of your role and your interaction with Dietitians/Health Professionals?
Yes No COMMENTS
Signature of Student __________________________________ Date _____________
Signature of Health Professional ______________________________________
Job title/role_______________________________________________________
(PRINT NAME ______________________________________) Date ______________
Academic Year 2017/18 Page 64
VERIFIED WITNESS STATEMENT
Student Dietitian’s Name: ____________________________Date: _____________
Location/Health Professional ___________________________________________
Practice 18: Demonstrate an interest in and commitment to the work of Dietitians.
To ask appropriate questions when with Dietitians and other Health Professionals.
Be punctual and manage workload within time scale allocated.To be completed by the Dietitian or Health Professional
Punctuality
Did the student arrive on time? Yes No
Did the student undertake any assigned task in the Yes Notime allocated?
Communication
Did the student introduce themselves? Yes No
Did the student initiate conversation? Yes No
Did the student use an appropriate level of language? Yes No
Did the student respond to non-verbal communication? Yes No
Did the student demonstrate the ability to listen? Yes No
Did the student respond appropriately to questions? Yes No
Outcome Was the student able to re-cap to you their understanding of your role and your interaction with Dietitians/Health Professionals?
Yes No COMMENTS
Signature of Student __________________________________ Date _____________
Signature of Health Professional ______________________________________
Job title/role_______________________________________________________
(PRINT NAME ______________________________________) Date ______________Academic Year 2017/18 Page 65
VERIFIED WITNESS STATEMENT
Student Dietitian’s Name: ____________________________Date: _____________
Location/Health Professional ___________________________________________
Practice 18: Demonstrate an interest in and commitment to the work of Dietitians.
To ask appropriate questions when with Dietitians and other Health Professionals.
Be punctual and manage workload within time scale allocated.To be completed by the Dietitian or Health Professional
Punctuality
Did the student arrive on time? Yes No
Did the student undertake any assigned task in the Yes Notime allocated?
Communication
Did the student introduce themselves? Yes No
Did the student initiate conversation? Yes No
Did the student use an appropriate level of language? Yes No
Did the student respond to non-verbal communication? Yes No
Did the student demonstrate the ability to listen? Yes No
Did the student respond appropriately to questions? Yes No
Outcome Was the student able to re-cap to you their understanding of your role and your interaction with Dietitians/Health Professionals?
Yes No COMMENTS
Signature of Student __________________________________ Date _____________
Signature of Health Professional ______________________________________
Job title/role_______________________________________________________
(PRINT NAME ______________________________________) Date ______________
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Appendix 2- Reflection sheets
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Reflection sheetDate:
Academic Year 2017/18
Reflection sheetDate: WHAT?: Describe (factual terms) What happened and who was involved. You may wish to consider a specific incident (eg. a particular conversation with a patient during which they became upset) or perhaps a general experience (eg. attending a MDT meeting/ completing coursework). Give sufficient information so that the reader has enough of the context to be able to understand subsequent sections. SO WHAT?:Evaluate and analyseWhat was positive about the experience/ incident?What did you feel might have been better? What thoughts did you have at the time/ afterwards? How did you feel at the time/ afterwards? What have you learnt from the experience (about yourself and others)?What others factors affected the outcome/ why do you think a particular incident happened? Do think that, if appropriate, there was a satisfactorily resolution? NOW WHAT: Action Plan What alternative actions or approaches might have been taken by you/ others? What will you do if you encounter this situation again to increase the likelihood of a positive outcome/ minimise the risk of a negative outcome? Are there any steps that you need to take to in order for this to happen? (eg. your training needs, information that you need) action that you need to ensure that others take (eg. providing a cooler room)? (Ideally indicate a timescale for activity).Please do not feel that you have to answer every question in every section as some may be inappropriate to your situation. You should however address each section.
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WHAT?: Describe (factual terms) What happened and who was involved. You may wish to consider a specific incident (eg. a particular conversation with a patient during which they became upset) or perhaps a general experience (eg. attending a MDT meeting/ completing coursework). Give sufficient information so that the reader has enough of the context to be able to understand subsequent sections. SO WHAT?:Evaluate and analyseWhat was positive about the experience/ incident?What did you feel might have been better? What thoughts did you have at the time/ afterwards? How did you feel at the time/ afterwards? What have you learnt from the experience (about yourself and others)?What others factors affected the outcome/ why do you think a particular incident happened? Do think that, if appropriate, there was a satisfactorily resolution? NOW WHAT: Action Plan What alternative actions or approaches might have been taken by you/ others? What will you do if you encounter this situation again to increase the likelihood of a positive outcome/ minimise the risk of a negative outcome? Are there any steps that you need to take to in order for this to happen? (eg. your training needs, information that you need) action that you need to ensure that others take (eg. providing a cooler room)? (Ideally indicate a timescale for activity).Please do not feel that you have to answer every question in every section as some may be inappropriate to your situation. You should however address each section.
Reflection sheetDate:
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WHAT?: Describe (factual terms) What happened and who was involved. You may wish to consider a specific incident (eg. a particular conversation with a patient during which they became upset) or perhaps a general experience (eg. attending a MDT meeting/ completing coursework). Give sufficient information so that the reader has enough of the context to be able to understand subsequent sections. SO WHAT?:Evaluate and analyseWhat was positive about the experience/ incident?What did you feel might have been better? What thoughts did you have at the time/ afterwards? How did you feel at the time/ afterwards? What have you learnt from the experience (about yourself and others)?What others factors affected the outcome/ why do you think a particular incident happened? Do think that, if appropriate, there was a satisfactorily resolution? NOW WHAT: Action Plan What alternative actions or approaches might have been taken by you/ others? What will you do if you encounter this situation again to increase the likelihood of a positive outcome/ minimise the risk of a negative outcome? Are there any steps that you need to take to in order for this to happen? (eg. your training needs, information that you need) action that you need to ensure that others take (eg. providing a cooler room)? (Ideally indicate a timescale for activity).Please do not feel that you have to answer every question in every section as some may be inappropriate to your situation. You should however address each section.
Reflection sheetDate:
Academic Year 2017/18 Page 70
WHAT?: Describe (factual terms) What happened and who was involved. You may wish to consider a specific incident (eg. a particular conversation with a patient during which they became upset) or perhaps a general experience (eg. attending a MDT meeting/ completing coursework). Give sufficient information so that the reader has enough of the context to be able to understand subsequent sections. SO WHAT?:Evaluate and analyseWhat was positive about the experience/ incident?What did you feel might have been better? What thoughts did you have at the time/ afterwards? How did you feel at the time/ afterwards? What have you learnt from the experience (about yourself and others)?What others factors affected the outcome/ why do you think a particular incident happened? Do think that, if appropriate, there was a satisfactorily resolution? NOW WHAT: Action Plan What alternative actions or approaches might have been taken by you/ others? What will you do if you encounter this situation again to increase the likelihood of a positive outcome/ minimise the risk of a negative outcome? Are there any steps that you need to take to in order for this to happen? (eg. your training needs, information that you need) action that you need to ensure that others take (eg. providing a cooler room)? (Ideally indicate a timescale for activity).Please do not feel that you have to answer every question in every section as some may be inappropriate to your situation. You should however address each section.
Reflection sheetDate:
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WHAT?: Describe (factual terms) What happened and who was involved. You may wish to consider a specific incident (eg. a particular conversation with a patient during which they became upset) or perhaps a general experience (eg. attending a MDT meeting/ completing coursework). Give sufficient information so that the reader has enough of the context to be able to understand subsequent sections. SO WHAT?:Evaluate and analyseWhat was positive about the experience/ incident?What did you feel might have been better? What thoughts did you have at the time/ afterwards? How did you feel at the time/ afterwards? What have you learnt from the experience (about yourself and others)?What others factors affected the outcome/ why do you think a particular incident happened? Do think that, if appropriate, there was a satisfactorily resolution? NOW WHAT: Action Plan What alternative actions or approaches might have been taken by you/ others? What will you do if you encounter this situation again to increase the likelihood of a positive outcome/ minimise the risk of a negative outcome? Are there any steps that you need to take to in order for this to happen? (eg. your training needs, information that you need) action that you need to ensure that others take (eg. providing a cooler room)? (Ideally indicate a timescale for activity).Please do not feel that you have to answer every question in every section as some may be inappropriate to your situation. You should however address each section.
Reflection sheetDate:
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WHAT?: Describe (factual terms) What happened and who was involved. You may wish to consider a specific incident (eg. a particular conversation with a patient during which they became upset) or perhaps a general experience (eg. attending a MDT meeting/ completing coursework). Give sufficient information so that the reader has enough of the context to be able to understand subsequent sections. SO WHAT?:Evaluate and analyseWhat was positive about the experience/ incident?What did you feel might have been better? What thoughts did you have at the time/ afterwards? How did you feel at the time/ afterwards? What have you learnt from the experience (about yourself and others)?What others factors affected the outcome/ why do you think a particular incident happened? Do think that, if appropriate, there was a satisfactorily resolution? NOW WHAT: Action Plan What alternative actions or approaches might have been taken by you/ others? What will you do if you encounter this situation again to increase the likelihood of a positive outcome/ minimise the risk of a negative outcome? Are there any steps that you need to take to in order for this to happen? (eg. your training needs, information that you need) action that you need to ensure that others take (eg. providing a cooler room)? (Ideally indicate a timescale for activity).Please do not feel that you have to answer every question in every section as some may be inappropriate to your situation. You should however address each section.
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