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Regulation Matters 2022 - Issue 1, May

5 Questions about the CDO Quality Assurance Program

The CDO Practice Advisory team occasionally receives inquiries from members who want to know the basics of the College's Professional Practice – Quality Assurance1 (QA) Program and the Self-Directed Learning (SDL) Tool. The QA Program is designed to support dietitians' professional development and continuous improvements in a manner aligned with right touch regulation2.

RDs can feel confident that the Quality Assurance Program is non-punitive and designed to assure dietitians' knowledge, skills, and judgment over the years of practice. To ensure these quality assurance tools are defensible, fair, valid, and reliable measures of continued competence (desired outcome), we use evidence-informed processes to support design, development, delivery, and evaluation quality assurance tools.

There are four components to the QA Program:
  1. Self-Directed Learning (SDL) Tool
  2. Jurisprudence Knowledge & Assessment Tool (JKAT)
  3. Peer and Practise Assessment (PPA)
  4. < 500 Hours of Practice

Here are five questions that will help provide an overview of the QA Program and SDL Tool. The Practice Advisory team welcomes your inquiries and is ready to assist you if you have further questions.

1. What is the Self-Directed Learning Tool?

The SDL Tool is a well-established learning strategy that allows individuals to take charge of their learning process. Typically, individuals assess learning needs, identify goals, select plans, and evaluate learning performances and outcomes. Individuals take the initiative and responsibility for their Learning. It also requires that dietitians engage in Reflective Practice. The SDL Tool supports the self-directed reflective process.

Dietitians are required to submit two learning goals and their action plans to show that they are engaged in continuous learning. Sometimes we see goals written as "notes to self" but learning goals should be written so that anyone who reads them can understand them. Therefore, the SDL tools support a SMART process which can lead to Smart GOALS.

2. Why is reflecting on risks crucial to identifying areas for continuous learning and improvements?

A dietetic practice may have inherent risks. As professionals, we must identify where the risk potential exists concerning lacking specific knowledge, skills, and judgment. Therefore, reflection and identifying risk in day-to-day practice are vital to ensuring safe, ethical, and competent practice.

Dietitians are asked reflective questions to identify which aspect of their competency would help mitigate this risk. For example, risks related to:
  1. Knowledge, skill, or judgment
  2. Interprofessional collaboration, communication
  3. Policy development, organizational management, leadership
  4. Other

Once a risk is identified, dietitians can also identify protective factors to mitigate the risk. For example, a protective element can be developed to enable continuous learning to help manage any potential risk in practice.  Dietitians must annually submit two learning goals and action plans to show that they are engaged in constant learning.

3. Are there other resources to help with reflection and writing SMART goals?

The Integrated Competencies for Dietetic Education and Practice (ICDEP) reflects current dietetic practice and includes cultural safety, Indigenous health, and diversity competencies. The development and use of consistent, robust, evidence-based national competencies directly contribute to the College's public protection mandate by ensuring that dietitians are safe, ethical, and competent at entry-to-practice. In addition, dietitians can consider areas where they would like to improve their knowledge and skills to fill gaps and grow their ongoing competence. Reflecting on practice is essential and may bring up new or continuous learning.

Additionally, with the support of the QA Committee, we have updated resources available to members on the CDO website. New writing guides and templates provide updated examples of acceptable and unacceptable goals. Dietitians are expected to write SMART goals that they intend to complete annually. The SMART process provides a simple model with five elements: Specific and strategic; Measurable; Attainable; Relevant/results-oriented; and Timely.

4. Is a performance goal such as a task goal the same as a learning goal?

There are two types of goals: performance goals (short-term objectives set for specific duties or tasks) and learning goals (written in SMART format). Performance goals focus on getting results; learning goals focus on acquiring specific knowledge and skills before setting a performance-outcome goal. Therefore, in the learning stages, a dietitian needs to focus on discovering and mastering the particular knowledge and skills required to perform the task, process or activity well, rather than focusing directly on the actual performance — task, function, process or activity.

It's not about doing the performance goals (e.g., work tasks, processes, or activity). Instead, it's about the learning associated with the work task, function, or activity. For example, simply attending a workshop wouldn’t be suitable as a goal, rather its learning that comes from the workshop's content — it is the specific learning outcome that can be applied to practice that matters.   

SMART learning goals can help people progress to where performance-outcome goals increase one's effectiveness. The focus of a learning goal is to improve one's knowledge (ability); the direction of a performance goal is to increase one's motivation to implement that knowledge. Therefore, both learning and performance goals are needed to succeed in practice. SMART Goals are outcome-focused to achieve learning. Setting SMART learning goals means dietitians can focus their efforts on learning and increasing their chances of achieving the knowledge they want in their practice.

5. What happens after I submit my annual learning goals?

An annual review of the SDL Tool includes a random selection of 2.5% of the general membership, anyone who missed the submission deadline, and anyone who had to resubmit last year. SDL Tools are reviewed and, if not sufficient, members must resubmit them. The QA Committee offers feedback to support the dietitian in their resubmission. While this review assesses the completeness of the written SMART goals, dietitians selected to undergo Peer and Practice Assessments (PPA) will have to show the learning outcome achieved measurability and application to their learning goals for that year.

Summary

The QA program is designed to assure that dietitians' knowledge, skills, and judgment remains current over the years of practice. The purpose of the Self-Directed Learning (SDL) Tool is to guide Registered Dietitians' reflection on their practice and professional competence and require them to develop plans for professional improvement.
 
  1. Under the Regulated Health professions Act, 1991 for all regulatory Colleges in Ontario, the Health Professions procedural code section 80 of the Code – Schedule 2 of the RHPA - 2007, c. 10, sched. M, s. 58, sets out the minimum requirements for a quality assurance program.

2.  “Right touch” regulation is an approach to regulatory oversight that applies the minimal amount of regulatory force required to achieve a desired outcome. (Professional Standards Authority. Right Touch Regulation. https://www.professionalstandards.org.uk/publications/right-touch-regulation).