New innovations in the development of practice placement education for student dietitians
This study is an attempt to record current practice that exists in the practice placement education of Irish undergraduate dietetic students, highlighting good practice as well as the difficulties that can exist. In addition, it provides an interpretation of the understandings, attitudes and beliefs of those involved as a precursor to the development of practice placement education.
The good practice highlighted reflects recommendations in the literature (Williams, Klamen and McGahie 2003; Wilson 2007). Direct observation is carried out and followed by formative feedback with the use of a detailed assessment tool. However, an over-reliance on this assessment method was observed. A range of assessment methods leads to more objective assessment and provides better feedback to students on their rate of progression across a wider range of skills (Fry, Ketteridge and Marshall 1999). For example, skills such as reflective practice, self assessment and self-directed learning require methods other than direct observation to be assessed appropriately.
In summary, the main challenges to assessment of skill acquisition highlighted by this study and the strategies identified to deal with these challenges are linked to three principal issues:
- Standardisation – the variations in practice create much confusion and difficulty for both practice placement educators and students. The process requires standardisation at many levels: between training sites, within training sites, within tools used and grading system used. The process could benefit from suggestions in the literature such as use of a wider number of assessment tools.
- Validation – the assessment tool used was the source of much difficulty. Questions were raised about its construct validity but it was also identified that it did not contribute to monitoring of progress.
- Training of practice placement educators – a large number of educators in the workplace have had little or no formal training and they themselves highlighted the need for training. The training however needs to include collaboration on development of the assessment process. This will give ownership to the educators of the assessment process while simultaneously creating better understanding between the HEI and the practice placement sites.
The issues identified in this study have now been addressed with the development of practice placement learning outcomes and performance indicators, staged competence criteria for monitoring students on placement, staged formative and summative assessments and general guidelines for practice placement education. Training of practice placement educators and continuous evaluation of the practice placement assessment process must remain an integral component of the professional training of student dietitians.