Keene State College Dietetic Internship

Internship requirements Intern Name: Claudia Gumina

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Date: 11/3, Updated

, Updated

, Updated

List supervised practice settings where you addressed the following conditions Overweight and obesity Diabetes Cancer HHH - Assessed the diet of patients with cancer and related conditions Cardiovascular Gastrointestinal Renal diseases Other conditions specific to your personal learning goals List classes, homework, and supervised practice settings where you learned about and/or worked with the following populations Ethnically diverse Diverse in abilities or needs (physical or mental) HHH - Older citizens with different needs for assistance Extended care skilled nursing (includes SNF in hospitals), assisted living, WIC training, home care, WIC clinic, rehab, or other Head Start, EFNEP (Cooperative Ext),

Low-income, nutritionally at risk women, infants, children Child care / Adult care Feeding Program, Other -

Keene State College Dietetic Internship

Internship Requirements - Community PRESENTATIONS Site Children:

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Documents required in portfolio Site Summary, COP, Presentation Eval form, Handouts, RCA*, TL report* Adolescents: Site Summary, COP, Presentation Eval form, Handouts, RCA*, TL report* Adults Site Summary, COP, Presentation Eval form, Handouts, RCA*, TL report* Elderly: Site Summary, COP, Presentation Eval form, Handouts, RCA*, TL report* Any age group: Site Summary, COP, Presentation Eval form, Handouts, RCA*, TL report* Any age group: Site Summary, COP, Presentation Eval form, Handouts, RCA*, TL report* Rotation Competency Assessment (RCA) required for sites > 20 hours or with 2+ presentations. In some cases the Professional Development Evaluation (PDE) is used instead. Two team leader reports are required throughout the internship year.

Presentation Title/Topic

Completed

TL?

Educational Handouts Children:

Site

Presentation Title/Topic

Completed

TL?

Documents required in portfolio

Site Summary*, Educational Material, Peer Evaluation, Revised Ed. Material Adolescents: Site Summary*, Educational Material, Peer Evaluation, Revised Ed. Material Adults Site Summary*, Educational Material, Peer Evaluation, Revised Ed. Material Elderly: Site Summary*, Educational Material, Peer Evaluation, Revised Ed. Material *Most education materials will be completed as part of a presentation/project for a site, they should be mentioned in the site summary for that site.

Keene State College Dietetic Internship

Other Community Requirements, Elective, Simulation Site Presentation Title/Topic Print media / article Electronic media Counseling Health Fair or Event display Community trainings and simulation Phoenix House needs assessment, objectives writing, and presentation development training Cooking Matters training WIC training

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Completed

TL?

Documents required in portfolio Site Summary, copy or link to published article or newsletter Site Summary, COP, script Site Summary, Counseling Skills Eval, PDE Site Summary, COP, Health Fair Evaluation form

Simulation

9/6/13

NA

NA

Simulation Simulation

9/20/13 9/30/13

NA NA NA NA

Site Summary Site Summary

Community Elective List presentations or project descriptions not already listed above, include project Include site summary and other descriptions and estimated hours documentation as needed Project / title (approx hours) Site Completed

Keene State College Dietetic Internship Internship Requirements: Food Service

Assignment: list topic Food Service Experience Questions 30-hour Alternative FS Comparison Essay Food Service Meal Project: Equipment Proposal: Systems Analysis: Employee In-service: Overall Food Service Evaluation Site Havenwood Heritage Heights Kurn Hattin Homes Havenwood Heritage Heights Havenwood Heritage Heights Havenwood Heritage Heights Havenwood Heritage Heights 10/16 10/5 10/5 10/15 Completed 10/1

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Documentation Required in Portfolio Questions and answers to all sections for primary FS site 2-3 page essay comparing FS sites, as described in handbook Final Report: summary of event as described in handbook. Written proposal Report on systems analysis and recommended improvements Outline of in-service Site Summary Primary Food Service site Food Service Management Skills Form added at 60 hours and upon completion Professional Development Eval Form at 60 hours and upon completion. Site Summary 2nd Food Service site PDE form for 2nd Food Service site. Intern self-evaluations using Skills and PDE forms Food service rubric completed by internship staff

Keene State College Dietetic Internship Internship Requirements: Clinical

Assignment: list topic Case Study: Billing Assignment: Formulary Assignment: Clinical Packets: Overall Clinical Evaluation Site Completed

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Documentation Required in Portfolio Copy of PowerPoint slides and any handouts, Case Study evaluations Assignment write-up as described in handbook Assignment write-up as described in handbook Completed clinical packets, corrected based on classroom discussion Site Summary Clinical Task Checklist Clinical Skills Evaluation Form at ~15, 35 days and upon completion Professional Development Eval Form at ~15, 35 days and upon completion Intern self-evaluations using Skills and PDE forms

Internship Requirements: IS
Assignment: Independent Study Project Presentation / Display Grant Proposal Project and Community Partner Completed Documentation Required in Portfolio Independent Study evaluation form completed by self, preceptor, DI staff. Presentation or display materials. Summary of research Completed grant proposal

Keene State College Dietetic Internship Quarterly Advising Meetings THIS SECTION TO BE COMPLETED BY INTERNSHIP STAFF
Completed for each Advising Meeting Self Assessment 2nd November 3rd February 4th April 5th End of Program *

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Documentation Required in Portfolio

Internship Requirements Site Sheet Site Summaries for all sites Weekly paperwork Professional Evaluation Community Evaluation Portfolio Evaluation

Intern completes: Internship Self Assessment Form *(Intern will complete the ADA professional self reflection and PDP sections 1 & 2 for their FINAL advising meeting) Intern completes: Internship Requirements Site Sheet Intern completes: Site Summaries for each site worked Intern completes: Weekly timesheets and journals Advisor completes: PDE Form Advisor completes: Community Skills Evaluation Form Advisor completes: Portfolio Evaluation Form

Advising Meeting Notes (initial): November February April Final -