Australian Dietetics Council and National Competency Standards for Entry Level Dietitians in Australia Official DAA Launch 27 May 2009 Darwin Convention

Australian Dietetics Counciland

National Competency Standards for Entry Level Dietitians in Australia

Official DAA Launch

27 May 2009

Darwin Convention Centre

AGENDATime Presenter Content

2.30pm-3.00pm Julie Hulcombe APD AN DAA President

DAA Strategic Plan and the Australian Dietetics Council

3.00pm-3.15pm Kay Gibbons FDAAChair, DSAAC and CODSR

ADC - Key Purpose, Guiding Principles and Implementation

3.15pm-3.30pm Claire Hewat APD ANChief Executive Officer

ADC - Announcing Dietetic Members

3.30pm-4.00pm A/Prof Susan Ash FDAAProject Manager, Mental Health in Tertiary Curricula for Dietitians Project

Competency Standards Development

Mental Health in Tertiary Curricula for Dietitians Project

4.00pm-4.30pm Kay Gibbons FDAA Dr Catherine Itsiopoulos APD AN, Registrar

Review of Competency Standards: DSAAC’s Role

Stakeholder Consultations

Main Changes

Implementation Process

Julie Hulcombe APD ANDAA President

• DAA Strategic Plan

• Implementation of DAA Business Plan

• DAA Committee Restructure

• Resourcing of National Office

• DAA as a Credible Self-Accrediting Body


• DAA Board in 2007 identified need for improved structures for Accreditation and Recognition Services, based on:

– Impending National Registration/Accreditation of Professions Scheme (COAG Initiative)

– Dramatic increase in dietetic programs (7 to 16 in past decade)

– Sustainability and ongoing quality of accreditation and recognition services


• DAA Board consulted stakeholders:– Dietetic Standards and Accreditation Advisory

Committee (DSAAC)

– Council on Dietetic Skills Recognition (CODSR)

– Universities (via DSAAC)

– Other DAA Committees

• DAA Board delegated DSAAC (with support from National Office) the responsibility for developing the Australian Dietetics Council

• ADC officially launched today and will commence operation on 1 July 2009

Governance Structure for Accreditation and Recognition Services

Australian Dietetics Council

DAA Board

DSR Examiner Pool(appointed by ADC)

AccreditationReviewer Pool

(appointed by ADC)

DAA Professional Services Unit (encompassing Business Unit)

PSDRegistrar

A&R Coordinator

Ongoing reporting ofaccreditation and

recognition activities

Skills recognition reference group

Accreditation reference group

ELCS reference group

Examination systems “MCQ” reference group

‘Ad Hoc’ reference groupsAppointed by ADC (examples shown below)

Provide advice and make recommendations

on accreditation and skills recognition

Seeks advice

Provide administrativeand professional support

Kay Gibbons FDAAChair, DSAAC and CODSR

• Evolution of the ADC

• Key Purpose

• Guiding Principles

• Overview of Membership Composition

• Implementation of ADC and Devolution of DSAAC and CODSR


Evolution of the ADC– Increasing workload pressures on DSAAC

and CODSR– Overlap of functions between DSAAC and

CODSR– Reporting requirements of DAA as assessing

authority to Department of Education, Employment and Workplace Relations

– Need for independent body to oversee accreditation and recognition functions of DAA

– Identified need for alternative structure for accreditation and recognition services

Key purpose of the ADC– Provide high level advice to DAA

Board ensuring DAA delivers accreditation and recognition services that are efficient, effective, equitable, accountable and transparent and are framed in a best practice model.


Guiding Principles:• Align with the COAG direction for the National Registration

and Accreditation of Health Professions scheme;• Enable transparency for members, clients, health services and

the Government;• Enable separation of policy and operational functions;• Enable broader representation;• Enable greater independence thus reducing potential conflict

of interest;• Support a move to a business model ensuring a more

sustainable service;• Support corporate governance principles and enables greater

accountability;• Link across other related DAA committees, such as the APD

and Membership and Reinstatement Advisory Committees.


Membership Composition:– Senior Academic Dietitians (3)– Senior Practitioner Dietitians (3)– External Representatives (3)

• Health Consumer representative• Professional Education

Representative• Other Professional with

Accreditation Expertise


ADC Implementation:– From July 1 2009 DSAAC and

CODSR will be disbanded and their roles and responsibilities will be assumed by the ADC.

– DSAAC final meeting in June 2009 and handover portfolio of responsibilities to ADC.


Claire Hewat APD ANChief Executive Officer

• ADC Process of Election of Membership

• Announcing Dietetic Members• Election of Non-Dietetic Members• Operational Support of the ADC• Recruitment of Accreditation

Reviewers and Examiners

Introducing the ADC Dietetic Membership

Senior Academic MembersProfessor Lynne Daniels PhD APDAssociate Professor Sue Ash PhD FDAAAssociate Professor Jane Scott PhD APD

Senior Practitioner MembersKay Gibbons FDAADr Judy Bauer AdvAPDSuzie Ferrie AdvAPD

ADC MembershipClaire Hewat APD AN

Election of non-dietetic members:– Advertisements through:

• Health Consumer Forum• Australian Universities Quality Agency• Adult Learning Australia

– Nominations to be presented to Board at July meeting and Board to elect representatives

Operational Support of ADCClaire Hewat APD AN

• Council to convene ‘ad-hoc’ working groups to undertake project activities;

• Support/resourcing by DAA National Office staff;

• Registrar and Accreditation and Recognition Coordinator responsible for day to day operations;

• Registrar to brief Council and prepare quarterly reports to DAA Board;

• Registrar and Accreditation and Recognition Coordinator report to Professional Services Manager.

Recruitment of Accreditation Reviewers and ExaminersClaire Hewat APD AN

Accreditation reviewers selection criteria:• Full APD status for at least five years• Significant experience in dietetic education (dietetic educator, student

supervisor and/or employer of new graduates)• High level analysis skills• Ability to meet assigned deadlines• Flexibility to attend interstate university site visits

Current pool = 13 existing members and 7 new applications

Examiner selection criteria:• Examiners of the DSR written examination - Has current

responsibility for significant amount of teaching and assessing at 3rd and/or 4th year level in content area.

• Examiners of the Oral examinations - Has current responsibility for significant amount of teaching and assessing at 3rd and/or 4th year level in content area.

Current pool = 7 universities + 6 additional members

A/Professor Susan Ash FDAAProject Manager, Mental Health in Tertiary Curricula for Dietitians Project

• DAA National Competency Standards for Entry Level Dietitians: Early Development

• Overview of Mental Health in Tertiary Curricula for Dietitians Project and Identification of Need for Revision of Competency Standards

• Overview of Competency Standards Revision Methodology

• Hand-Over to DSAAC for Final Revision and Sign-Off

• Next Steps: Revision of Range Variables

Competency Standards – the DAA experience

Competency standards in Australia contain the following:– A key purpose– Units and elements of

competency– Performance criteria– Range variables and evidence

guide

Usefulness of Competency Standards for dietitians

• Used for accreditation of university courses and thus curricula

• Underpin the APD program• Inform the assessment of

candidates from other countries wishing to practise in Australia

• Workforce planning and performance review

1990-93: Funding $100,000 DEETYAMethodology used– Steering group and task force of experts– functional analysis– critical incident interviews– consultation with key stakeholders

1998: Funding $10,000 DAAMethodology used– ethnographic and ethno-methodological research– description of core activities undertaken by entry

level dietitians– stakeholder survey but no formal consultation

Background to Competency Standards (CS) methodology

• DoHA National Action Plan on Mental Health– $1.9B to improve services for people with

mental illness, their families and carers– Mental Health in Tertiary Curricula

($5.6M/5y)

• DoHA/DAA/QUT Mental Health in Tertiary Curricula for Dietitians Project– DAA successfully bid for $150,000 to

identify gaps in Mental Health training and revise Competency Standards

– DSAAC and Mental Health Steering Group supervised project

2007-2008 Project Background

2008: Funding $150,000 DoHAMethodology used

• DSAAC and Steering group • Stakeholder survey with a mental health

focus• Core activities• Critical incident interviews involving a mental

health issue• Thematic and functional analysis to develop a

first draft• Consultation process with universities and

key stakeholders• Report back to DSAAC and Steering group

Background

Part A – Review of Competency Standards

• Explore the core activities to review the scope of competency, knowledge, skills and attitudes of entry level dietitians

Part B – Investigation of Mental Health competencies

• Candidates chose critical/demanding incident related to a mental health issue, to validate competencies and highlight Mental Health focus

In-depth interviews

• Purposive sample– Work setting

– Geographical location

– Gender

• SettingsClinical n=6 Community n=5

Private Practice n=2* Mixed n=2

Rural n=2 Industry n=1

Research n=1

Methodology- Sample characteristics

• Standard questions• Participants received questions prior to

interview• Part A = approx 1 hr• Part B = 20-30min• Taped & transcribed

Methodology - Interview

Core activities: 2008• Coordinating care for individuals (seeing

clients) – Nutrition screening– Cultural competency/related food habits– Counselling/education– Social/demographic factors

underpinning food habits• Community Nutrition/Health Promotion

– Group activities – Corporate Activities– Food skills

• Resource Development

Core activities: 2008

• Interpersonal skills / communication• Networking/Team Skills• Professional Practice Skills • Management Skills • Food Industry

– Food technology/food science– “Broader nutrition” knowledge

• Food Service – Quality Activities

• Research & evidence based practice

• Nutrition screening and assessment• Cultural competence• Social/environmental/political awareness

leading to appreciation of food security• Networking and team skills• Interpersonal skills / counselling

communication– including psycho-dietetics, CBT,

motivational interviewing, chronic disease self management techniques

Core Activities Analysis New themes

• Corporate nutrition• Business/Management skills

– including maintenance of self funded positions

• Advocacy and marketing skills• Mentoring and reflective practice• IT skills especially related to private practice

and research, including use of internet and databases

Core Activities Analysis New themes

Critical Incident Interviews Key Themes

– The Dietetic Process• Mental Health/Nutrition• Structure/Tangibility

– Dietitian Characteristics• Patient Focus• Experience with MH Issues

– Counselling skills• Empathy• Rapport building• Trust

– Empowerment

Critical Incident Interviews Key Themes

• Communication & Liaison– Networking– Advocacy– Confidence & Power

• Role & System Issues– Role delineation– Responsibility/Duty of care– Management Support

• Training Issues– Entry level– CPD– Other health workers

Themes Competencies

MH Themes

MH Knowledge, Skills & Attitudes

Correlate with core activities

Integrate into Competency Standards(Units, elements, performance criteria, range

statement, KSA)

Knowledge Mental Health Issues UNIT 1

MH / Nutrition Interface UNIT 1, 4

Role delineation UNIT 9

Skills Communication/Counselling UNIT 2

Advocacy UNIT 9, 6

Referral UNIT 1, 4

Translate research into evidence-based practice

UNIT 7

Working in multi-disciplinary teams

UNIT 2, 4, 9

Attitudes Empowerment UNIT 2 , 4

Empathy UNIT 4

Collegiality UNIT 2,4,9

Commitment to reflective practice & PD

UNIT 7, 9

Non-judgemental attitude UNIT 2,4,9

Revision of Entry Level Competency Standards

Methodology1. Identify gaps in current ELC standards

• Interviews with new graduates (n=19) core activities analysis

• Review current DAA ELC standards• Review current overseas standards

– NZ, Canada, UK & US• Review other allied health standards

2. Thematic and Modified Functional Analysis3. Draft model revisions4. Consultation with key stakeholders

Foundation Competencies

Unit 1Underlying knowledge

Demonstrates knowledge sufficient to ensure safe practice

Unit 7Scientific approach

Demonstrates basic skills in research and evaluation

Unit 8Professionalism within the organisation

Demonstrates an organised, professional and ethical approach to work

Core Competencies

Unit 2Interpretation of nutritional information into lay language

Interprets and translates scientific knowledge, principles and policies related to nutrition into practical information

Unit 3Collection, analysis and assessment of nutrition/health data

Collects, organises and assesses data relating to the nutritional status of individuals and groups

Critical Practice

Unit 4Individual case management

Manages nutrition care for individuals

Unit 5Community health

Develops and manages nutrition components of health promotion

Unit 6Influencing the food supply

Influences and contributes to activities promoting a safe and nutritious food supply

Pre 2009 Model

Key Changes

• Changes to existing units– Unit 2 – Interpretation of nutrition information

into lay language Nutrition Communication

– Unit 5 – Community Health Community Nutrition

– Unit 7 – Scientific approach Research & Evaluation

– Unit 8 – Professionalism in the organisation Professionalism, advocacy, innovation & leadership

• Addition of Unit 9 - Management & Business Skills




Unit 7Research & EvaluationIntegrates scientific information and research into practice

Unit 8Professionalism, advocacy, innovation and leadershipDemonstrates a professional, ethical and entrepreneurial approach, advocating for excellence in nutrition and dietetics

Unit 9Management and Business SkillsApplies business principles to the provision of nutrition services, programs and products

Core Competencies

Unit 2Nutrition CommunicationDemonstrates effective and appropriate skills in communicating information, advice, education and professional opinion to individuals, groups and communities

Critical Practice

Unit 4Individual case managementManages nutrition care for individuals

Unit 5Community nutritionPlans, implements and evaluates programs in the community

Unit 6Influences the food supplyAdvocates and contributes to activities promoting nutrition and a safe and nutritious food supply

Proposed model

Unit 3Collection, analysis and assessment of nutrition/health dataCollects, organises and assesses data relating to the nutritional status of individuals and groups

• Stakeholder survey re mental health (Oct/Nov 2007)

• Draft unit outline approved by DSAAC March 2008

• Key stakeholder consultation May/June 2008• Universities; Interest Groups; DAA

Committees; Personnel previously involved in dietetic competency standard development

• 30 responses• Conference workshop• Post conference: revised draft available for

member comment 1-12 June 2008

Consultation July 2007 - June 2008

• Addition of Management & Business Skills Unit - overall positive

• Elements & performance criteria in units 5-9 gained most comments

• Unit 6 & 8 – beyond entry level• Many issues around advocacy for

the food supply and industry and where it should fit

• Concerns about having to substantially restructure courses & extend practicum to meet accreditation requirements

Key stakeholder feedback

• Revised draft of Competency Standards, including Range Variables and Evidence Guide presented to DSAAC mid June 2008

• DSAAC makes final changes to standards• Report to DAA Board & DoHA June 30

2008• End of this phase of project but

consultation continued by DSAAC until November 2008 with stakeholders

• Next step – revision of range variables and evidence guide

On-going Consultation




Unit 7Research & EvaluationIntegrates scientific information and research into practice

Unit 8Management

Applies management principles to the provision of nutrition services, programs and products

Unit 9Professionalism, advocacy, innovation and leadership

Demonstrates a professional, ethical and entrepreneurial approach, advocating for excellence in nutrition and dietetics

Core Competencies

Unit 2Nutrition CommunicationDemonstrates effective and appropriate skills in communicating information, advice, education and professional opinion to individuals, groups and communities

Critical Practice

Unit 4Individual case managementManages nutrition care for individuals

Unit 5Community, Public Health Nutrition and Advocacy for Food SupplyPlans, implements and evaluates programs with communities as part of a team

Unit 6Food Service ManagementManages component of food service to provide safe and nutritious food

2009 Competency Standards

Unit 3Collection, analysis and assessment of nutrition/health data

Collects, organises and assesses data relating to the nutritional status of individuals and groups

• Kerryn Dowding, Project Officer• Susan Phillips and Dr Jane Shakespeare

Finch, project team in research analysis• DAA DSAAC and National Office Staff• Mental Health in Tertiary Curricula for

Dietitians Steering Committee• Commonwealth Department of Health

and Ageing• Queensland University of Technology• Project participants

Mental Health in Tertiary Curricula for Dietitians Project

Acknowledgements

Competency Standards ReviewKay Gibbons FDAADr Catherine Itsiopoulos APD AN

• DSAAC’s Role in Review and Finalisation of Competency Standards

• Stakeholder Consultations

• Main Changes/Improvements

• Implementation Process

• Acknowledgements

• Questions?

DSAAC review of Competency Standards:– MH Project team submitted CS draft to

DSAAC in June 2008;– DSAAC team consulted with universities

nationally;– Extensive consultation with other

stakeholders;– Intensive reviews at monthly meetings;– Final version submitted to DAA Board

February 2009 for approval.


Key improvements in competencies:– Addition of MH competencies across all

units of competency;– Stronger focus on management skills;– Greater articulation of FSM;– In-depth description of community & public

health;– Enhanced individual case management

reflecting diagnosis / Mx of malnutrition;– Greater focus on cultural competency.


Implementation process:– Officially launched today;– Uploaded on DAA website 28 May;– Universities submitting provisional or

full accreditation reports after 28 May expected to use revised CS;

– Universities currently under review may need to demonstrate plans for implementation of revised CS;

– If in doubt contact Registrar at DAA National Office


Competency Standards ReviewAcknowledgements

• Mental Health in Tertiary Curricula for Dietitians Project Team:– A/Professor Susan Ash and Kerryn Dowding

• DSAAC review team:– Kay Gibbons, A/Professor Peter Williams,

Professor Lynne Daniels and DSAAC members

• Dietetic staff at universities;• National Office staff:

– Dr Catherine Itsiopoulos, Nerida Bellis, Annette Byron, Fiona Engeler.

QUESTIONS?

Documents

Australian Dietetics Council and National Competency Standards for Entry Level Dietitians in Australia Official DAA Launch 27 May 2009 Darwin Convention