Imagine launching a dietetic internship program during a pandemic. All learning activities designed to meet secondary accreditation requirements were planned to take place onsite alongside preceptors in a variety of clinical, food service management, and community nutrition settings. Now, a sudden pivot or redirection of plans is necessary due to some some training sites shifting to fully online learning experiences, while many others are transitioning to a hybrid model of supervised practice.
As I contemplate my inaugural year as a dietetic internship director one year into the COVID-19 pandemic, the following questions guide my reflective thinking specific to digital learning:
- How has remote learning afforded new opportunities for digitally-based learning experiences?
- How has the COVID-19 pandemic increased opportunities for social presence amongst dietetic interns and, hence, the dietetics profession?
- How has the COVID-19 pandemic influenced dietetic intern creativity in expanding nutrition-centered communications through utilization of digital platforms, tools, and media?
These questions align with the International Society for Technology in Education’s Standard 6 Creative Communicator: How can students communicate clearly and express themselves creatively for a variety of purposes using the platforms, tools, styles, formats and digital media appropriate to their goals? Specific goals that align with Standard 6 include the following:
- 6a: “Students choose the appropriate platforms and tools for meeting the desired objectives of their creation or communication.”
- 6d: “Students publish or present content that customizes the message and medium for their intended audiences” (ISTE).
With many of our program’s learning activities transitioned to virtually-based activities over the past year, our dietetic interns have had an unexpected benefit in their learning due to expanded knowledge and skill-building using digital platforms and tools. Some of these virtual learning experiences have included the following:
- Learning to counsel and educate patients via digital technology
- Providing food demonstrations using synchronous online tools, such as Zoom, or uploading pre-recorded food demonstrations to websites and social media platforms
- Teaching in real time via Zoom using interactive instructional methods and digital tools to enhance the learning experience
- Planning and facilitating live Instagram takeovers
One example of an assignment interns completed this quarter in our DI Seminar was a virtual teaching project aligned to the following learning outcomes:
- Students will gain experience teaching a synchronous session via Zoom.
- Students will become familiar with learner-centered teaching by identifying, describing, and using learner-centered pedagogy.
- Students will learn to use at least two digital tools into their interactive class session.
It is essential that future dietetics professionals are familiar with and comfortable utilizing digital platforms and tools to provide nutrition education to the public. This teaching project enabled our interns to present 30-minute lessons on subjects meaningful to their peers while incorporating digital tools into an interactive format.
Due to the pandemic, it is my impression that our dietetic interns have gained valuable skills in digital technology that may not have been part of the program if all of their supervised practice experiences had been in person. One example is exposure to telehealth, an innovative option for providing medical nutrition therapy services to patients using digital technology. For now, telehealth gives patients assurance that they can avoid coming into contact with COVID-19 during appointments by meeting with their provider virtually. However, this technological advancement was available prior to the pandemic, and it is unlikely to dissipate once the pandemic is behind us as it provides many conveniences to patients, including no commute time, no parking fees, no time wasted in waiting rooms, and an increase in provider options since office location is no longer a consideration.
In addition to our program’s experiences, I am also interested in exploring how the pandemic has positively affected other dietetic internship programs by enhancing skill-building in digital technology and expanding the social presence of the dietetics profession.
In a paper titled, “Creating engaged community scholarship through alternate experiential learning in dietetics education,” the authors discuss their experiences pivoting to remote supervised practice experiences at the University of Kentucky. Their experience is different from ours since their program was currently in motion when they switched from onsite to a 100% virtual learning environment in March 2020. The authors mentioned that they collaborated with both internal and external stakeholders to redesign their program to give interns the needed learning experiences in a virtual environment.
Changes made to the University of Kentucky’s curriculum, which integrate digital technology, enhanced utilization of digital tools and platforms, and increased social presence include the following:
- Online case studies were completed in lieu of working with patients in person
- Guest speakers provided frequent presentations via digital platforms on a variety of nutrition topics
- Nutrition education materials were developed and made accessible to consumers online
- Consumer public service announcements and podcasts were developed and shared with the public
- Nutrition education classes were provided to the public using a variety of digital platforms
- Facebook Live events were planned and executed
- Cooking demonstrations were recorded and uploaded to social media platforms (Combs & Schwartz, 2020).
Further, in a paper titled, “Building a ship while sailing: Transition to a virtual dietetic internship in response to COVID-19,” the authors presented information on learning activities their interns experienced virtually, which are stated below:
- Virtual medical nutrition therapy simulations
- Job interviewing practice
- Online group discussions with preceptors
- Virtual panel discussions (Cummings, McGuire, Larimer & Stadler, 2020)
Moreover, in an article titled, “Student placement adaptability during COVID-19: Lessons learnt in 2020,” the authors share their experiences with transitioning Australia’s University of the Sunshine Coast’s Dietetic Internship program to virtual learning. The article is focused on intern experiences when transitioning clinical nutrition experiences from the in-person setting to virtual telehealth sessions (Pelly, Wiesmayr-Freeman, & Tweedie, 2020).
Combs & Schwartz (2020) discuss how the transition to remote learning increased the amount of time students were spending working online in isolation, as compared to previous experiences when they were working in person with preceptors, their peers, patients, and clients. In response to a need for socialization, the director implemented weekly synchronous meetings where interns shared progress on assignments with each other. In addition, group projects were implemented to increase social interaction. Specialists were also invited to synchronous class sessions where interns would receive feedback on projects in real time, and these interactions enabled interns to practice communicating with professionals in their field (Combs & Schwartz, 2020).
Similarly to the University of Kentucky’s program structure, our program includes a weekly, 2-hour synchronous seminar class. During this time, interns interact with each other to provide updates on their supervised practice experiences, discuss dietetics-related topics and research, and collaborate in breakout sessions. Guest speakers are also invited to interact with interns and to share their professional experiences.
Pivoting both new and existing programs in directions that were unforeseen prior to the COVID-19 has resulted in many benefits to dietetic interns. “The knowledge and skills developed through this change are relevant to future work opportunities for graduates and are representative of the future thinking for dietetic education and training which include use of technology, digital literacy and communication skills” (Pelly, Weismayr-Freeman, & Tweedie, 2020).
Not only have there been numerous opportunities to develop skills in digital technology, interns have also been immersed in an era of supervised practice that requires increased flexibility, adaptability, and resourcefulness. COVID-19-era interns will become especially resilient Registered Dietitian Nutritionists, and may feel that they have the grit to accomplish almost anything!
Combs, E.L., & Schwartz, A.K. (2020) Creating engaged community scholarship through alternate experiential learning in dietetics education Experiential Learning & Teaching in Higher Education: A Journal for Engaged Educators, 3(1): 22-25.
Cummings, J., McGuire, J., Larimer, S., and Stadler, D. (2020). Building a ship while sailing: Transition to a virtual dietetic internship in response to COVID-19. J Acad Nutr Diet, 120 (10): A127.
International Society for Technology in Education. https://www.iste.org/standards/for-students
Pelly, F., Wiesmayr-Freeman, T., Tweedie, T. (2020). Student placement adaptability during COVID-19: Lessons learnt in 2020. Nutr Diet, 77:481-483.