module specification

This module provides an opportunity for learners to further develop their understanding and practice of the dietary management of disease. It also enables learners to develop their skills in undertaking one to one consultations, through development of their communication skills and application of the Nutrition and Dietetic Care Process. This module forms an essential part of practice based learning preparation and provides an opportunity for learners to illustrate their understanding of the requirements by the Health and Care Professions Council, including the expectations of professional behaviour and demonstrate an ability to practise within the ethical and legal boundaries of the dietetic profession. Learners must pass this module before progressing to practice based learning 2 (dietitians).

The aims of this module are aligned with the qualification descriptors within the Quality Assurance Agency’s, Framework for Higher Education Qualifications. More specifically the module aims to develop key knowledge, skills and professional attributes required to implement the Nutrition and Dietetic Care Process for individuals with a range of clinical conditions.

This module aims to provide learners with the qualities and transferable skills necessary for employment requiring: the exercise of initiative and personal responsibility; decision making in complex and unpredictable contexts; and, the learning ability needed to undertake appropriate further training of a professional or equivalent nature.

DT5W51 Practice based learning 1 (Dietitians)
DT5002 Clinical Dietetics 1

The specified learning outcomes will be developed around a framework based on the following subject matter:
1. The dietetic management of the following clinical disorders:
1.1. Inflammatory Bowel Disease LO1, LO3, LO4
1.2. Irritable Bowel Syndrome
1.3. Acute and Chronic Pancreatitis
1.4. Liver Disease
1.5. Renal Disease
1.6. Disorders related to mental health
1.7. Cancer
1.8. HIV/AIDS
1.9. Cystic Fibrosis
2. Development of communication skills and consultation practise:
2.1. Framework for setting up an interview and eliciting information from a service user. LO1, LO2, LO3, LO4
2.2. Active listening skills and attending behaviour, motivational interviewing, interpersonal skills and cognitive behaviour therapy approaches to facilitate change.
2.3. Self-refection of performance and impact.
2.4. Different methods and styles of communication required for interacting in a variety of situations and settings. This includes the use of e-health (tele-health, tele-care and assistive technologies) including the use of communications technology.
2.5. The dietetic consultation process.
2.6. Practice based learning preparation. LO1, LO2, LO3, LO4
2.7. Current professional standards and code of conduct documents.
2.8. Model and Process for Nutrition and Dietetic Practice
3. Development of key applied clinical skills and dietetic practise; using simulated practice, problem based learning, lecture, tutorial and directed learning:
3.1. Interactive case study learning using ward, kitchen and clinic based activities encompassing disorders of the gastrointestinal tract and cancer. LO1, LO2, LO3, LO4
3.2. Facilitating learning and promoting self-care, including the theories of behaviour change and behaviour modification for individuals.
3.3. Developing skills in dietary and nutritional assessment including sources of nutrients, food portion sizes, the diet of the UK population.
3.4. Use of food tables and dietary analysis software will be further developed.
3.5. The influences of  food choice and eating behaviours of individuals and groups such as but not exclusively demography, religion, the wider determinants of health and health behaviours.
3.6. The rationale for the modification of energy and nutrient intake. LO1, LO2, LO3, LO4
3.7. Use of current nutrient exchange systems as applied to the conditions within the syllabus.
3.8. Methods of fortifying and modifying foods and diet as applied to the conditions within the syllabus.
3.9. The development of therapeutic diets including recipes and the use of special dietary products applied to conditions within the syllabus.
3.10. The psychological background to health behaviours including theories of human behaviour, behaviour change, behaviour modification.
3.11. The principles of person centred care as applied to dietetic practice for the conditions covered within the syllabus. Includes advocacy, trust, consent, the right of service users to make decisions, accountability and demonstration of core NHS values.
3.12. Broad knowledge and understanding of psychology in relation to the conditions covered within the syllabus. Includes professional and client relationships and the psychological implications of long-term health conditions.
3.13. The psychological aspects of disordered eating.
3.14. Safe and effective dietetic practise understanding scope of practice, including an awareness of their limitations and when it is appropriate to seek advice or refer to another professional
3.15. Workload management and effective use of resources
3.16. Duty of care and upholding high quality care; including challenging situations and at times of personal incompatibility
3.17. Confidentiality, information governance, appropriate information sharing within professional legal and ethical boundaries
3.18. Informed consent
3.19. The legal and ethical implications of dietetic and clinical care including the withdrawal of feeding
3.20. Fitness to practice including maintenance of high standards of personal and professional conduct and one’s own health. Ensuring currency of knowledge.
3.21. Assessment skills to inform clinical and professional judgements
3.22. Problem solving, clinical reasoning, decision making
3.23. Safe working practices, including the selection of appropriate hazard control and risk management, reduction.
3.24. Selection and correct use of personal protective equipment.

On completing this module learners will be able to:
1. Critically assess information required to competently assess individuals with a range of clinical conditions and demonstrate an ability to critically review and evaluate information underpinning the dietary management of disease.
2. Collect and critically reflect on relevant clinical and dietary information whilst demonstrating an ability to communicate action plans and monitoring strategies effectively.
3. Formulate appropriate nutrition and dietetic diagnoses with justification and be able to develop and evaluate suitable dietetic management outcomes and interventions for reviewing and monitoring dietetic care.
4. Illustrate understanding of the requirements by the Health and Care Professions Council and demonstrate an ability to practise within the ethical and legal boundaries of the dietetic profession.

Assessment will comprise:
1. An observed, structured clinical examination (OSCE) (80 minutes – this is the time of the simulated examination; learners will also reflect on the experience and submit the extract for marking).
2. A time constrained in-class test (60 minutes)
3. Attendance & contribution (minimum of 80% attendance, submission of relevant written reflective accounts associated with individual patient role plays and contribution to simulated learning activities – practicals based in the kitchen, ward and clinic area), Pass/Fail.

The criteria for assessment will include the following:
• The ability to plan, justify communicate and evaluate appropriate dietary assessments, diagnosis and treatment plans in relation to disease presentation and pathology, lifestyle and the wider determinants of behaviour and health.
• The translation of these into practical meal and dietetic treatment plans.
• Demonstrate in the design and evaluation of treatment plans, understanding of the requirements by the Health and Care Professions Council. This will include demonstration of the understanding of the expectations of professional behaviour and the ability to practice within the ethical and legal boundaries of the dietetic profession.

Learners must obtain at least 40% to pass this module. In addition learners must normally obtain at least 35% in each component of assessment within this module. A mark of between 35% and 39% may be compensated by other components. If the module is passed on reassessment, then the maximum mark awarded will be 40%.

 Bauer K, Liou D and Sokolik C (2015) Nutrition Counselling and Education Skill Development (3rd edition). London: Brooks Cole
British Dietetic Association (2016). Model and Process for Nutrition and Dietetic Practice, available at https://www.bda.uk.com/publications/professional/model_and_process_for_nutrition_and_dietetic_practice_ (accessed February 2018).
British Dietetic Association (2017). Code of Professional Conduct, available at https://www.bda.uk.com/professional/practice/professionalism/code_of_conduct
accessed February 2018).
Curry K and Jaffe A (1998) Nutrition Counselling and Communication Skills, WB Saunders
Food Standards Agency & Public Health England (2014) McCance and Widdowson’s The Composition of Foods (7th Edition). Cambridge: Royal Society of Chemistry
Gable J & Herrmann T (2016) Counselling Skills for Dietitians (3rd edition). London: Wiley-Blackwell.
Gandy J (2014) Manual of Dietetic Practice, 5th Edition. London: Wiley-Blackwell
Geissler C and Powers H (2017) Human Nutrition, 13th Edition. Oxford: OUP
Health and Care Professions Council (2013) Standards of Proficiency
http://www.hpc-uk.org/assets/documents/1000050CStandards_of_Proficiency_Dietitians.pdf
(Accessed: 10 June 2013)
Health and Care Professions Council (2008) Standards of Conduct, Performance and Ethics [Online].  Available at:  http://www.hpc-uk.org/assets/documents/10003B6EStandardsofconduct,performanceandethics.pdf (Accessed: 10 June 2013)
Mason P, Butler C (2010) Health Behaviour Change: A Guide for Practitioners (2nd edition). London: Churchill Livingstone
Todovoric V and Micklewright A (2011). A Pocket Guide to Clinical Nutrition, 4th Edition. Birmingham: The Parenteral and Enteral Group of the British Dietetic Association

Online resources:
BMJ Best practice [electronic resource] accessed via the university library: http://catalogue.londonmet.ac.uk/search/?searchtype=X&searcharg=bmj+best&searchscope=1&sortdropdown=r
Composition of foods integrated dataset (CoFID) available at: https://www.gov.uk/government/publications/composition-of-foods-integrated-dataset-cofid