It Takes Two: Top Tips for Interns and Preceptors

DSC07393It’s the time of year when dietetic interns prepare to transition from students to professionals. As I reflect back on the past eight months, I can’t believe how much things have changed. At the beginning of the program, I timidly met with preceptors to learn the basics of nutrition assessment and charting, unsure how to interact with other dietitians, professionals, and patients. As time went by, I became more confident in my skills, only to be thrown into another unfamiliar area. Although more confident now than when I started, I still wonder how I will ever feel fully ready to fly. What I do know, however, is that when I make the leap, I will be okay. This is in part because of the hard work I have put into this internship, but also in part thanks to the many amazing preceptors I have come to know. Whether intern, preceptor, or a dietitian who doesn’t regularly work with students, I think we can all use a reminder of ways to help create successful nutrition professionals.

Let’s start with interns. Here are my top 6 tips for getting the most out of your internship:

  1. Ask questions, but be willing to do some of your own research.
    The internship is a time of learning, so don’t be scared to ask if you are confused. However, if you are curious about something you could easily look up, it shows initiative to do your own research. For example, if you have already researched the physiology of bone mineral disease in kidney patients but you are still confused, don’t be shy in asking your preceptor to explain it. On the other hand, if you can’t remember which vitamin supplements are recommended for bariatric patients, try looking this up on your own because it is easily accessible on the Internet. Even better, you could say, “I want to learn more about bariatric vitamin and mineral supplementation. Do you know any good resources for finding this information?”
  2. Take advantage of the wealth of knowledge your program directors and preceptors have.
    The internship is also a unique time where you’re surrounded by people whose job it is to help you achieve your full potential. Seek their advice and get to know them; you never know when one of them will inspire you. Ask about how they landed in the area in which they now work or talk to them about what they wish they had done differently (if anything).
  3. Focus on what is most useful to you from the readings and assignments.
    It’s easy to get caught up in completing assignments and readings just for the sake of finishing them. However, you will learn and remember more if you focus on the things that help you better understand the subject at hand (and not what you think your preceptor wants you to know). On assignments, it may be useful to make your own note sheet separate from what you will turn in so you can add information related to the questions that will be helpful in practice.
  4. Instead of looking at assignments, projects, volunteer opportunities, etc. as work, look at them as opportunities to build your resume and increase your knowledge.
    Again, it’s easy to get caught up in the cycle of completing assignment after assignment, but try to think about how each opportunity will impact your future. For example, while my capstone research project was difficult and time-consuming, I can now say I presented my research at the VAND annual meeting and can demonstrate to future employers that I have valuable research skills.
  5. Be willing to volunteer.
    I know, you’re busy. But volunteering will give you a chance to put what you’re learning into practice in a non-traditional setting. Volunteering is also a great resume booster and way to meet other students and professionals.
  6. Find something you enjoy outside the internship.
    When you just can’t look at another piece of internship-related work, it’s nice to have something else to do. Many interns have joined workout or yoga classes, made friends at church, discovered new areas to hike, or taken up new hobbies. Whatever it is you enjoy doing outside nutrition, DO IT!

Now for the preceptors. Here are my top 6 tips for being an effective teacher:

  1. Get to know the interns.
    Most of our waking hours are spent focusing on the internship, so it’s nice for someone to make the effort to get to know us as human beings. Doing this will make us more comfortable working with you, which will make us more likely to ask questions and challenge ourselves in rotation.
  2. Think about the experiences your intern has and/or has not had.
    Either by sitting down with your intern at the beginning of the week or by looking at the intern schedule, it’s helpful to know which rotations your intern has gone through. Acknowledging the intern’s experiences will let them know you understand for what they may or may not be ready.
  3. Introduce your intern to the people you work with.
    Consider the fact that interns have to work on new floors/in new buildings with people they don’t know regularly. Add that to the fact that they are likely still a little unsure of what they are doing, and it can be scary to start a new rotation. Introducing the intern to your co-workers helps make them feel like part of the team and will make them more likely to get involved with interdisciplinary care.
  4. Try not to focus on the format/style of the note, and instead focus on the content.
    Do your best to remove your own style bias from the equation. While it is helpful to get some pointers on proper wording and formatting of notes in the first few months, most interns have found their own style after a few months. Remember that everyone has their own way of writing notes (as do you!), and pointing non-content-related details of notes may take away from important discussions about note content.
  5. Find a balance between challenging your intern and leaving them feeling overwhelmed and/or stranded.
    One of my preceptors told me on my first day of rotation that I would be leading a counseling session later that afternoon. This was about my third week of rotation, so I was terrified. However, this preceptor gave me adequate time to prepare for the session and ensured that she would jump in if I had questions. Although it was scary, she made sure I wasn’t overwhelmed and was very encouraging. Sometimes we need a little push, but make sure you offer proper support instead of leaving us feeling stranded.
  6. Make time for a one-on-one meeting at the end of the rotation.
    Although getting feedback can be intimidating, it is also extremely useful. You might point something out that your intern had never thought of. When providing feedback about your intern’s performance, try the sandwich method: highlight something the intern did well, provide any constructive criticism, and close by providing another meaningful piece of positive feedback. Here is an example: “I was really impressed by how you took the initiative during rounds to advocate for the role of nutrition in our patient’s care. That showed a lot of confidence! For your next rotation, I might work on your understanding of lab values and ways in which dietitians can intervene. However, it was great when you were able to recommend that vitamin D supplement for Mr. Smith! Keep up the great work.”

As we all know, whether intern or preceptor, the dietetic internship experience is both challenging and rewarding. Interns are asked to work 40 hours each week learning clinical nutrition skills and attending class, while working tirelessly outside rotation on assignments. Preceptors, likewise, hold full-time jobs with full patient loads, while being required to take time out of their busy days to act as teachers and mentors. However, it is because of everyone’s hard work that dietetics is one of the fastest growing fields in America. So I guess it’s true what they say: sometimes the richest things in life are also the most challenging.

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Diana Gulotta is a Dietetic Intern at the University of Virginia Health System in Charlottesville, VA. A Wisconsin native (Go Pack Go!), Diana graduated with Highest Distinction from the University of Wisconsin-Madison in 2015 with a degree in Dietetics. In her free time, Diana enjoys singing, hiking, cooking, and reading.  She is pictured here with her internship class and Internship Directors.

 

 

As April is National Preceptor Month, stay tuned to the blog this week as interns in Virginia highlight those preceptors who have had a great impact on their learning this year!

Poster Presentations as a Dietetic Intern: Monica Hershey shares her experience!

Monica PosterAt the 2016 VAND Annual Meeting held this year in Fairfax, VA, selected VAND members presented posters on research they had recently conducted. It was a pleasant surprise to see the number of dietetic interns chosen to participate in this year’s session, as well as a number of nutrition professionals. Dietetic interns and Registered Dietitians from across the state of Virginia were present at the session, with posters reporting on quality improvement projects, patient satisfaction studies, program research and development, development of nutrition-related screening tools, community resource development, clinical research studies and more. The poster session was heavily attended, giving poster presenters a chance to share something they are passionate about, or at least something they have put a great deal of work into, with many of their professional peers. The poster session provided networking opportunities for interns and established nutrition professionals alike, as well as the ability to gather new perspectives on poster topics.

As a dietetic intern and first-time poster presenter, I was not sure what to expect. However, the more people came by my poster, the more passionate I became about the work I had completed over the last 6 months. My research, completed as a “capstone project” through my internship program with the guidance and oversight of a preceptor, focused on whether the Braden Scale was a positive predictor of nutrition risk in acute care patients, and if it should be used as a nutrition screening trigger for RD services. Consisting of prospective medical chart data collection as well as a nurses’ survey, we obtained data from 121 patients and 50 members of the nursing staff. Our data indicated opportunities for improvement in how the Braden Scale is completed at our facility, as well as how RDs and patients alike would be impacted with the addition of a RD trigger based around Braden Scale scores. It was a privilege of mine to work with both Wendy Phillips and Kate Willcutts on this project, and it was an honor to stand before my professional role models and peers, discussing the importance of quality patient care in the acute care setting. I was able to meet and network with new people, gain new perspectives on my research, and hear how my research could impact nutrition practice in various settings. It was particularly valuable for me to hear from RDs currently employed in an acute care setting about how my findings are consistent with what they thought, but never had proof of being true. Other intern presenters I spoke with after the conference echoed these statements, some adding they didn’t expect so many people to be interested in their projects, that it helped them realize what they had accomplished, and that they felt as though they were making a difference as a result of their work!

To current and future dietetic interns…I highly recommend taking advantage of research opportunities with your dietetics program if possible, and participating in poster sessions like the one at VAND!  The personal and professional growth you experience as a result is absolutely worth the hard work. The number of young people interested in nutrition research was extremely encouraging to see, affirming the future of our field is in good hands. I cannot wait to see where the future of dietetics research is headed and look forward to participating in more poster sessions as my career blooms!

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Monica Hershey is currently a dietetic intern at the University of Virginia Health System in Charlottesville, VA. Monica earned her undergraduate degree in nutritional sciences at Penn State University. Upon graduation, Monica would like to work as a clinical RD at a large medical facility on the East Coast, with hopes of working as a renal dietitian in the near future. Her personal interests include hiking with friends, recipe-less cooking and exploring all the fun that Charlottesville has to offer!