New innovations in the development of practice placement education for student dietitians
3.2 The assessment scoring process should contribute to monitoring progress
Terms used in assessment of progress such as ‘competent’ and ‘very good’ are not defined and variation between dietitians on understanding of terms exists. If a student is assessed compared to a newly qualified dietitian, they do not receive any score in the early stages of placement; this is reported to be discouraging for the student and it does not give information on the progression towards competence. If, however, students are assessed for the stage of training, they are not compared to a predetermined set of criteria. Students then become distracted by a desire to achieve ‘very good’ and the idea of progression becomes hazy.
3.3 The assessment scoring process must be standardised and validated
The assessment process used has many positive aspects as it covers a wide range of skills and its structured format guides assessment. As it is completed weekly, it allows for a record of training and regular opportunity for feedback, discussion and reflection on practice. The comments section is considered by both the practice placement educators and students as the most valuable part of the assessment process. A lot of variation exists both between and within practice placement sites and a high level of subjectivity is recognised by both the practice placement educators and students. The assessment tool does not assess all the necessary skills (attitude, ability to reflect and self assess and ability to self direct are not included). However, the assessment tool was considered quite comprehensive in relation to all other skills. Case studies and projects were the preferred written work. Feedback for the most part was very good with strengths and weaknesses correctly identified and specific advice given on how to improve. However some students found the feedback inadequate and a lot of negative feedback was reported.
3.4 The processes used to monitor skill development need to be explicit, multidimensional and reflective of the complexities involved
A number of beneficial strategies for monitoring skill acquisition were identified: learning styles assessment, reflective logs, feedback, progression guideline, feed-forward and self assessment. The best indication for students on their progression was the level of supervision received but the comments section of the assessment form also featured strongly. Observation of practice was required by students as integral to understanding the standards expected of them. Lack of clear criteria for different stages of training was an issue and ‘trying to assess all things together’ added to the complexity. The rate of skill acquisition and development of competence was reported by the practice placement educators to ‘depend on the student’. It was possible to identify particular stages of training when competence is reached in certain skills, indicating a use for staged assessment criteria and outcomes (see Figure 1 and Figure 2). The practice placement educators believed that progression guidelines and staged outcomes could be useful if used in a flexible way as a guide to focus learning rather than define expected outcomes.