Australian Dietetics Council and National Competency Standards for Entry Level Dietitians in Australia

1. Australian Dietetics CouncilandNational Competency Standards for Entry Level Dietitians in Australia Official DAA Launch 27 May 2009 Darwin Convention Centre

2. AGENDA

3. 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

4. Julie Hulcombe APD ANDAA President • 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

5. Julie Hulcombe APD ANDAA President • 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

6. Governance Structure for Accreditation and Recognition Services

7. 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

8. Kay Gibbons FDAAChair, 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

9. Kay Gibbons FDAAChair, DSAAC and CODSR 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.

10. Kay Gibbons FDAAChair, DSAAC and CODSR 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.

11. Kay Gibbons FDAAChair, DSAAC and CODSR Membership Composition: • Senior Academic Dietitians (3) • Senior Practitioner Dietitians (3) • External Representatives (3) • Health Consumer representative • Professional Education Representative • Other Professional with Accreditation Expertise

12. Kay Gibbons FDAAChair, DSAAC and CODSR 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.

13. 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

14. Introducing the ADC Dietetic Membership Senior Academic Members Professor Lynne Daniels PhD APD Associate Professor Sue Ash PhD FDAA Associate Professor Jane Scott PhD APD Senior Practitioner Members Kay Gibbons FDAA Dr Judy Bauer AdvAPD Suzie Ferrie AdvAPD

15. 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

16. 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.

17. 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 significantamount of teaching and assessing at 3rd and/or 4th year level in content area. Current pool = 7 universities + 6 additional members

18. 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

19. 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

20. 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

21. Background to Competency Standards (CS) methodology 1990-93: Funding $100,000 DEETYA Methodology used • Steering group and task force of experts • functional analysis • critical incident interviews • consultation with key stakeholders 1998: Funding $10,000 DAA Methodology used • ethnographic and ethno-methodological research • description of core activities undertaken by entry level dietitians • stakeholder survey but no formal consultation

22. 2007-2008 Project Background • 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

23. Background 2008: Funding $150,000 DoHA Methodology 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

24. In-depth interviews Part A – Review of Competency Standards • Explore the core activitiesto review the scope of competency, knowledge, skills and attitudes of entry level dietitians Part B – Investigation of Mental Health competencies • Candidates chose critical/demanding incidentrelated to a mental health issue, to validate competencies and highlight Mental Health focus

25. Purposive sample Work setting Geographical location Gender Settings Clinical n=6 Community n=5 Private Practice n=2* Mixed n=2 Rural n=2 Industry n=1 Research n=1 Methodology- Sample characteristics

26. Methodology- Interview • Standard questions • Participants received questions prior to interview • Part A = approx 1 hr • Part B = 20-30min • Taped & transcribed

27. 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 

28. 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

29. Core Activities Analysis New themes • 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

30. 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

31. 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

32. 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

33. Themes Competencies MH Themes MH Knowledge, Skills & Attitudes Correlate with core activities Integrate into Competency Standards(Units, elements, performance criteria, range statement, KSA)

35. Revision of Entry Level Competency StandardsMethodology • 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 • Thematic and Modified Functional Analysis • Draft model revisions • Consultation with key stakeholders

36. Pre 2009 Model

37. 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

38. Proposed model Unit 3 Collection, analysis and assessment of nutrition/health data Collects, organises and assesses data relating to the nutritional status of individuals and groups

39. Consultation July 2007 - June 2008 • 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

40. Key stakeholder feedback • 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

41. On-going Consultation • 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

42. 2009 Competency Standards Unit 3 Collection, analysis and assessment of nutrition/health data Collects, organises and assesses data relating to the nutritional status of individuals and groups

43. Mental Health in Tertiary Curricula for Dietitians Project Acknowledgements • 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

44. 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?

45. Competency Standards ReviewKay Gibbons FDAADr Catherine Itsiopoulos APD AN 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.

46. Competency Standards ReviewKay Gibbons FDAADr Catherine Itsiopoulos APD AN 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.

47. Competency Standards ReviewKay Gibbons FDAADr Catherine Itsiopoulos APD AN 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

48. 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.

49. QUESTIONS?