Bowling Green State University Dietetic Internship Program Rotation: WIC Clinics _____ Readings completed _____ Pre-rotation self-assessment journal entry _____ Complete WIC works on-line module _____ Complete CDC growth chart module _____ Affiliation Agreement signed and submitted ______Health documentation submitted to site as needed Intern: Facility:

Goal/Objective initial Planned Experience Comments/Alternative Experiences

DI 4.4 Participate in public policy activities, including both legislative and regulatory initiatives. . Review information on the Child Nutrition and discuss with preceptor, director to review Identifies federal, regional, state WIC Reauthorization Act. journal entries and local governmental . Review laws and regulations related to WIC: structures and regulations that Subpart C 331-346, Subpart D 349 – 359, Subpart E 359 – 363 and any state specific information. influence the WIC program. . journal entry - how is program funded? . discuss funding issues as they apply to current legislation if appropriate with preceptor . review regulations that effect program administration - summarize in journal entry . Review WIC Authorized Food Lists – discuss how discuss with preceptor, director to review Identifies political/regulatory change in foods has impacted agency – journal journal entries considerations involved in entry agency planning and decision . Discuss key players responsible for making. agency/program planning with preceptor – make journal entry. . Review organizational chart – note where RD’s are located. . Review agency policy manual if possible. Evaluation of competency 1= competency attempted, minimal success 4= competency met at entry level Intern rating 2= competency partially met 5=competency surpasses entry level 3= competency nearly met at entry level NA = not attempted or observed DI 4.9 Obtain and analyze financial data to assess budget controls and maximize fiscal outcomes. . review qualifying financial criteria on-site discuss with preceptor, director to review Analyze financial information . review program application form journal entries relevant to program operations. . discuss the following with preceptor if possible - mean income of participants, other forms of assistance they may be receiving - journal entry . review budget with preceptor (note: salaries are proprietary information - make journal entry Evaluation of competency 1= competency attempted, minimal success 4= competency met at entry level Intern rating 2= competency partially met 5=competency surpasses entry level 3= competency nearly met at entry level NA = not attempted or observed DI 2.2 Demonstrate professional writing skills in preparing professional communications (e.g. research manuscripts, project proposals, education materials, policies and procedures). . review know your learner, low literacy or cultural discuss with preceptor, director to review Identify educational needs of references as needed journal entries target population, including . review WIC Works Sharing Center web site for cultural considerations. ideas on classes, other resources for this audience . review “Early introduction of solid foods among urban African-American participants in WIC. . discuss classes offered – how were topics determined? Journal entry

. under preceptor direction, develop handout or reviewed by preceptor Develop educational materials bulletin board to be used in counseling or as part that meets needs of population. of a class if needed . add to portfolio Evaluation of competency 1= competency attempted, minimal success 4= competency met at entry level Intern rating 2= competency partially met 5=competency surpasses entry level 3= competency nearly met at entry level NA = not attempted or observed DI 3.1a. Assess the nutritional status of individuals, groups and populations in a variety of settings where nutrition care is or can be delivered. . review WIC Participant and Program discuss with preceptor Identify general needs and Characteristics characteristics of WIC . review WIC formulary, foods available on voucher population. program . review relevant chapters in Nutrition in Diagnosis discuss with preceptor Review normal nutrition needs Related Care, Nausea and Vomiting of Pregnancy, of this population (pregnancy, Picky Eating: A Toddler’s Approach to Mealtime lactation, infancy, early as needed childhood) . review positions of the American Dietetic Association – Nutrition and Lifestyle for a Healthy Pregnancy Outcome and Breaking the Barriers Toward Breastfeeding as needed . . review VENA (Value Enhanced Nutrition preceptor to assess counseling skills, director Screen/assess WIC clients Assessment) Guidelines – appendices provide to review journal entries according to facility criteria guidelines for specific populations or site specific method for assessment of clients . complete the CDC Growth Chart On-Line Training Module . review policies and procedures regarding client assessment including forms . observe WIC personnel assess clients . under supervision of preceptor assess clients . assess clients independently, if possible . journal entry summarizing 3 cases – include PES statements for each one Evaluation of competency 1= competency attempted, minimal success 4= competency met at entry level Intern Rating 2= competency partially met 5=competency surpasses entry level 3= competency nearly met at entry level NA = not attempted or observed DI 3.c Plan and implement nutrition interventions, to include prioritizing the nutrition diagnosis, formulating a nutrition prescription, establishing goals and selecting an managing intervention. DI 3.d Monitor and evaluate problems, etiologies, signs, symptoms and impact of interventions on the nutrition diagnosis. . with preceptor assistance analyze and interpret 24 preceptor to assess counseling skills Develops and implements care hour recalls, food frequencies and anthropometric plan based on nutritional status. measures . independently analyze and interpret 24 hour recalls, food frequencies and anthropometric measures . develop care plan for client using food package Evaluation of competency 1= competency attempted, minimal success 4= competency met at entry level Intern Rating 2= competency partially met 5=competency surpasses entry level 3= competency nearly met at entry level NA = not attempted or observed DI 2.3 Design, implement and evaluate presentations considering life experiences, cultural diversity and educational background of the target audience. . Review limited resource client module from intro discuss with preceptor Assess educational needs of course and cultural diversity module as needed target audience. . review existing classes . develop learning objectives and class on topic self-evaluate using program evaluation form, Develop and present class based given by preceptor, develop educational materials preceptor to evaluate class presentation on assessed needs. as needed . present class if possible - summarize experience in journal entry Evaluation of competency 1= competency attempted, minimal success 4= competency met at entry level Intern Rating 2= competency partially met 5=competency surpasses entry level 3= competency nearly met at entry level NA = not attempted or observed DI 1.4 Evaluate emerging research for application in dietetics practice . review Pediatric and Pregnancy Nutrition discuss with preceptor, director to review Discuss research aspects of Surveillance System web-site. How does this state journal entries clinic programs compare to surrounding states regarding breastfeeding practices and LBW babies? – journal entry . review research studies described on the WIC website . review research aspects of clinic programs (if any) with preceptor and assist in data collection, if applicable . discuss role of nutrition in treatment and recovery from chemical dependency Evaluation of competency 1= competency attempted, minimal success 4= competency met at entry level Intern Rating 2= competency partially met 5=competency surpasses entry level 3= competency nearly met at entry level NA = not attempted or observed DI 4.1 Use organizational processes and tools to manage human resources . review financial statements for agency as available discuss with preceptor Applies resource management, . assist with writing grant application or review including grant application, existing applications as available –journal entry identifying funding sources and reading fiscal reports.

. participate in strategic planning if possible - discuss with preceptor Uses management principles for journal entry . observe and interview various members of the effective community multidisciplinary team - journal entry assessment, program planning, . identify criteria for implementing Quality implementation and evaluation Assurance plan for the local agency and/or and applies them to community- community based public health nutrition . participate in conducting a community needs programs. assessment, including socioeconomic data or review needs assessment if available - journal entry

. identify related agencies appropriate for client Utilizes referral process and referral -summarize in journal entry makes appropriate community . makes appropriate referrals referrals.

Evaluation of competency 1= competency attempted, minimal success 4= competency met at entry level Intern Rating 2= competency partially met 5=competency surpasses entry level 3= competency nearly met at entry level NA = not attempted or observed

Were competencies generally met? yes no Comments:

Preceptor Signature: Date:

Intern Signature:

Post rotation checklist: Goals and objectives signed by preceptor and intern to be mailed or faxed to director Post rotation evaluation form completed by preceptor, signed by intern, to be mailed or faxed to director Submission of journal entries to director via mail or electronically Evaluation of distance internship program by preceptor (under resources, preceptor web page) Complete intern feedback form and submit electronically. (under course documents, evaluations folder)