Hi! I am Laurel Burton and September, 2014 marks a new and exciting year for me. This is my first year in the UBC Dietetic’s program, as well as my debut as a blogger. I am so excited to start the next three years of my nutrition education. Stay tuned for more posts as I gain knowledge and experience in the field of Dietetics!
I have taken a few moments to reflect on my first year in the UBC Dietetics Program. Please see the link below to read about my thoughts and experiences thus far. I am so happy with how the first semester has gone and I am very excited to continue on in the program.
For two years I volunteered as an activities coordinator at the Inpatient Eating Disorders Program at St. Paul’s Hospital. My role was to implement post mealtime anxiety management activities using arts, crafts and games for the patients in the unit. I interacted with a range of clients with diverse needs and I began to learn how to support clients with high levels of anxiety. Each week I would bring a new activity to the unit and we would sit in a group and complete the activity immediately after dinner time, which is a time of high anxiety and stress for these clients. I was also fortunate to have the opportunity to shadow the dietitian on the unit and she allowed me to sit in on one-on-one meetings she had with each patient. This opportunity exposed me to specific medical and nutrition terminology that will be important for me to know and understand in the future. For example, I was able to learn the basics of nutritional support such as the assessment of tube feeding requirements and meal plan modification, since each client has differing needs. Although I still have much to learn in this area, this volunteer work was a good way to start this learning. Shadowing Kara in the Eating Disorders Unit helped me start to think about the nutrition care competencies that I will be working on. Although I am not an expert in any of them yet, I have started to observe these competencies in action, which will help with future learning.
One of the competencies that I have decided to focus on for the 2014/2015 academic year is identifying signs and symptoms of nutrient deficiencies and excesses. The reason I would like to focus on this one is because, although I had a small amount of exposure to this in my volunteering at St. Paul’s, I am not confident in this area and would like more knowledge and practice. I intend to contact the new dietitian on the unit and ask if it would be possible for me to speak with her about this particular competency.
The following competencies were touched on during my volunteering in the Eating Disorders Unit:
Nutrition Care
Obtain and interpret food and nutrient intake data –> I have not mastered this competency, but this volunteer role allowed me to begin the learning process. The nurses and dietitian showed me how the information was stored and briefly discussed how the data was to be interpreted
Develop or modify meal plans
Identify the roles of team members in supporting the implementation of a care plan.
Identify strategies to communicate nutrition care plan with client, inter-professional team and relevant others
Identify necessary changes to nutrition care plan
In preparation for applying to the UBC Dietetic Program, I did a lot of volunteering, work and job shadowing which all contributed to my current knowledge of the profession. While all my experiences have been educational, there are a few that stick out in my mind as extremely valuable and which have contributed greatly to my success in the program. About 15 months ago I began volunteering in the Downtown Eastside at the Cross- Town addictions clinic on Hastings and Abbott Street. At the position I work alongside the social workers, nurses and dietitian. At the addictions clinic, a study was being done to assess long-term opioid medication effectiveness (SALOME), and my role was to visit with the clients before and after self-injectoin, to make coffee and to complete any tasks the nurses, social workers and dietitian needed done. Within this role, I was introduced Jen, the dietitian that I volunteered with on a few occasions. She works in both the Immunodeficiency Clinic at St. Paul’s and at the Addictions Clinic. I shadowed Jen at the addictions clinic and helped with a few lunchtime meal programs, where food would be purchased for the study participants. I also had the opportunity to speak with Jen about her position as a Providence Health dietitian, and she explained her various roles within the Immunodeficiency clinic. I also helped out at a cooking class she holds at the Immunodeficiency Clinic, where I helped HIV+ participants prepare and cook healthy meals. This cooking program was designed to help low income patients living with HIV to learn about healthy food and to learn important cooking skills.
This volunteering experience with Providence Health has helped expose me to an area of dietetics in which I am particularly interested. I would like to work within the Downtown Eastside as an advocate for this marginalized population, and to help find ways to create sustainable meal programs that offer nutritious, safe and acceptable food to the community. The importance of nutrition advocacy has been forefront in my work at the Cross-Town clinic, and I have learned a lot about increased nutrition needs for chronic disease sufferers. Jen helps educate participants about food and healthy eating, and during my volunteering I was able to witness this. In addition, I also learned that nutrition education can be met with some resistance, so it is important to present information in a way that meets the specific needs of each patient. In an environment where healthy eating is not necessarily a priority, educating patients about nutrition requires first gaining trust and creating a safe environment. I think that this volunteer opportunity has afforded me opportunities to work on the competencies that are required for successful completion of the dietetics program and it certainly made me more confident applying to the program. Specifically, I have been able to hone my communication and collaboration skills in this setting, because it is vital to establish trust and rapport with participants if they are to feel comfortable in your presence. Since this is a marginalized population it was very important for me be respectful and to treat everyone with the utmost digit and care that they deserve.
Specifically, below are a list of the specific competency performance indicators I worked on:
Professional Practice
Maintain client confidentiality and and privacy
Ensure informed consent
Demonstrate knowledge of the elements of professional boundaries
Demonstrate knowledge of the role and features of job description
Communication and Collaboration
Use appropriate communication technique(s)
Demonstrate knowledge of opportunities for and barriers to, communication
Speak clearly and concisely in a manner responsive to the needs of the listener(s)
Establish rapport
Communicate in a respectful manner
Recognize opportunities to contribute to the learning of others
Assignment
One of the first assignments I had in my Dietetics Practicum class was the student lead tutorial. My group focused on Inter-cultural Communication, which proved to be a very complex and interesting subject. We chose this topic as it is quite relevant and important for healthcare professionals, especially in a multi-cultural city such as Vancouver. With the multiple interactions we have each day, there are so many people we communicate with who may, for various reasons such as ethnic, cultural or religious, communicate slightly differently than us. As a future Dietitian it is important to start thinking about potential differences in, or barriers to, communication. Within our Dietetics class of 35 students, there are 16 cultures represented, including different Asian cultures, German, English, Indian, Greek and Ukranian, to name a few. In the beginning stages of our research we explored the Dietitians of Canada website to find any relevant research or competencies that related to this topic. There are many communication topics included in the competencies, so we chose a few that relate specifically to inter-cultural communication and used these as the basis for our tutorial. One issue we realized quite early on was the vastness of the topic we chose. While this made it very interesting, it was also a challenge to focus the tutorial on a specific area. After much discussion and work, we chose to let the competencies guide our discussion, and we paired this with Principles for Effective Inter-Cultural Communication.
Reflection
I felt that the tutorial was successful, and I was very happy with how our group chose to run it. We wanted to make sure that we added a good amount of information for the class to learn, but we also wanted to ensure that the tutorial was engaging and interactive. It was definitely an assignment that I was nervous about. I have done many presentations in my academic career, but I have never been responsible for leading a tutorial or learning session. I think this activity is an excellent way to get us thinking about the education side of Dietetics. I know that for me, one of the most attractive parts of the profession is the opportunity to be able to share what I am learning about nutrition and health, and this tutorial was a good way to start thinking about how this can be done. It is an interesting experience teaching something to someone who is hearing your information for the first time. What I mean by this is, it is important to be acutely aware that, while I may have spent a lot of time learning the topic and doing research, the audience to which I am directing this information may not have the same level of knowledge of this topic as I do. This is definitely something to keep in mind in my future profession, as I will be responsible for educating people about information and knowledge that I have gathered over a number of years. It will be important to present the same information in multiple ways because not everyone learns the same way. In our tutorial we had some slides of information, as well as a handout and an interactive activity where the class had group discussions about a case study. This way, we felt that multiple learning methods would be catered to, thus creating a better learning environment for everyone. This is a skill that I will certainly take into my future profession.
Another aspect of the tutorial assignment that I found quite valuable was the feedback session at the end. This was an opportunity for the professor ( in this case it was Kara Vogt), and our fellow students to talk with us about our performance, as well as strengths and weaknesses of the presentation. The feedback was all constructive, and it seemed that the class found our case study interesting and were happy with how we broke the information down and made it relevant. They liked the wheel we used to show the cultures represented in our own class. There were some areas that we could have strengthened as well, and this included having an Objectives slide at the beginning of our presentation. This slide would have given the class a nice, focused breakdown of what we were going to discuss, which would have helped direct the learning a bit better. Additionally, it was pointed out that, at the end of the tutorial, it would have been beneficial for us to have included a wrap-up slide that briefly touched upon the topics we had discussed. These are areas for improvement that I will certainly keep in mind for any future presentations I do.
I am happy with how the tutorial went and I think that these experiences will only help to strengthen by abilities and skills as a professional Dietitian in the future.
On Tuesday I went to a seminar that addressed quality of life for those suffering from feeding, eating and swallowing issues. The seminar featured leading experts in the field of nutrition, dental hygiene, occupational therapy and speech language pathology. The session too place at the Djavad Mowafaghian Centre for Brain Health at UBC. The panel discussed their individual roles within their respective professions as well as their roles as part of an interdisciplinary team. During the informal discussion, each panel member shared how they became involved in eating, feeding and swallowing, and they also shared some experiences they have had within their respective professions. The panel included Jan Duivestein, and Occupational Therapist and instructor at UBC, Kathryn Wishart, a Speech Language Pathologist, Nishi LalBirdi, a Dental Hygenist and Peter Lam, a Registered Dietitian. After the introductions and brief chat about eating, feeding and swallowing, we all participated in a case study that had us work in groups with students from other healthcare professions. The case was about a man who had been involved in an electrical accident and what his immediate care issues were as well as out team’s care plan for him.
I really liked that there was a dietitian on the panel for this event because it allowed me to actively think about where I would fit in an interdisciplinary team such as this one. It was helpful that each panel member discussed their specific roles within the framework of eating, feeding and swallowing, because hearing what the dietitian is responsible for in comparison to the rest of the healthcare professionals allowed to me recognize the importance of each role. After initially reading the case, the panel members got together and discussed what they would do, as did we in our specific groups. Listening to the panel share their steps in working through the care plan was interesting, because there were some similarities to what we would have done, as well as differences. What struck me was that the panel was very candid about discussing the fact that there are often disagreements and arguments within an inter professional team, and I think that this was a valuable discussion to have. While it is certainly important to be confident in your skills and experiences within your field, I can imagine that, as a professional within a group of other professionals, disagreements happen frequently.
When we started with the case study it was initially a little intimidating since there were students from so many backgrounds such as nursing, occupational therapy (OT), speech language pathology (SLP), audiology and dental hygiene. I was quite quiet at first while the group discussed possible ideas for the patient’s care plan, and there were a lot of ideas put forward as to what would be the most important initial treatment. I became more comfortable as the discussion went on, and it was really interesting to practice putting my experience into a plan. Although I still have a lot of learning to do in the field of healthcare and dietetics, I felt as if I was able to contribute.
In my group I was the only Dietetic student, but there were many others involved with the event on different teams. It was interesting to hear the ideas put forth by other Dietetics students, and many of them were similar to what I had suggested. Overwhelmingly I found that our collective priority was to ensure that the patient was maintaining adequate nourishment during his treatment. This may seem obvious, but in my own group adequate nutrition and food intake was much less of a discussion among the other healthcare students, so it was reassuring to hear that other dietetic students were thinking along the same lines as me. It was also quite educational to hear what other healthcare students would do with this case, and I think one of the most valuable lessons to come from the activity was to learn how to bring all the different ideas together into a coherent and successful care plan that was patient-centered. I think that my group did that well, considering we are all still learners. Having the panel of professionals explain their action plan gave us all a point of references for improvement and growth.
I am quite happy with what I learned at this IP education session; it is remarkable what you can pack into 1 hour of learning. I felt that the hour was very organized and flowed very nicely given the amount of information that was shared. There is still a lot of learning I have to do and questions that need to be answered by my future experiences. For example, knowing what the general order is of creating a care plan, and which professionals make the first decisions. I know many questions will be answered in my future years of school and into my internship, but I think it’s also important to realize that not every question will have been answered by the time I am a working professional in the field of Dietetics, but that is ok.