Strategies for a Successful Internship

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Success is defined differently by different people. What does success in internship mean to you? Before reading on, jot down a couple thoughts on what a successful internship would look like to you.

Below are some examples of success outline by past interns:

  • "If in the time I had I was able to complete my assignments, ask a ton of questions, learn something new, and improve on some of my existing skills, then I feel like it was a successful placement"
  • "My weekly improvements are noted by preceptors and I'm able to take over most of the caseload by the end of a rotation"
  • "Feeling confident enough to be able to answer questions posed by preceptor related to a client or other theoretical questions"
  • "I’m not going to become an expert in two weeks but if I’m consistently improving and learning new things, then I am happy."


Preceptors also have ideas about traits or behaviours demonstrated by successful interns:

Preceptor defined characteristics of successful dietetic interns


How will you be successful during internship?

Read on for tips and strategies that will help you on your internship journey!


Internship is a busy time. Feeling overwhelmed and stressed out is common! Avoid early burnout by taking time for yourself, and engaging in self care.

Tips and Tricks

  • Schedule "you time" - You know you'll be stressed - so plan for it. Routinely plan and engage in personal activities that make you feel good and boosts self confidence. Examples include exercise, visiting friends or family, cooking a nice meal, baking, watching a movie, or any other hobby.
  • Take mental breaks - Don't study all the time! You are much more likely to burnout early if you spend all of your time studying and engaged in internship tasks. Furthermore, you actually become less effective in your learning if your brain doesn't take a break.
  • Prioritize your learning - Internship is a learning process... so prioritize your knowledge gains. Some strategies are to study for your upcoming rotation the weekend(s) before and just stick to the key points. Be in contact with your preceptor who can tell you which areas to focus on. Ask interns at different sites for useful resources.
  • Stay organized - Keep track of important dates by using a journal or agenda, Make use of the Google Internship calendar. Staying organizing will help you manage your time.
  • Know your limits - Be realistic about how much you can handle. If you'll be working during internship, see if it's possible to cut down your hours. Hold a job that you are comfortable with and avoid starting a new job that may be stressful.
Intern work life balance

While you will still be a student during internship, you are also preparing yourself for a career. Behaviours and habits will have to change accordingly.

Professional Learning

Your learning will take place in a different environment than your university courses. As you will be taking on the roll of both student and professional, it is important that you adopt professional habits

Behaviours of a Learning Professional
  • Be Confident - in your knowledge and ability to problem solve
  • Ask - Asking for help when you need it (not after)
  • Stay Organized – of your knowledge, schedules, and deadlines
  • Have Integrity – your actions and behaviours are how you represent yourself, and will most certainly affect your future career
  • Be Proactive – learning in a professional environment means you need to be proactive in what you want/need to learn
  • Form Working Relationships – by communicating with other healthcare team members, they will see you as an important member of the team and approach you for your expertise
Tips and Tricks
It can be intimidating talking to experienced health professionals in other disciplines. It will become easier as you continually talk to them. It also may be helpful to jot down notes so you know what to say to them to get the info you need. - Intern


"Avoid negativity, you don’t need to pretend all is well all the time but be gracious, charitable in your judgments, and consider what it would be like to walk in [your preceptor's] shoes." – Coordinator

“Internship is much more than a course. Internship is your introduction into the profession of dietetics and the workplace and most assignments have a "real world" context and need to be approached as such (especially with your preceptors), not just as an assignment.” - Intern

The above tips will align you with the following competencies:

  • 1.01 Comply with federal and provincial / territorial requirements relevant to dietetic practice: E, F
  • 1.04 Practice within limits of individual level of professional knowledge and skills: B, C, D
  • 1.06 Use a systematic approach to decision making: F, H
  • 1.08 Manage time and workload effectively


Proactive Learning

A big difference between a student learner and a professional learner is how to approach the learning process. University courses often present information allowing students to be passive learners. In the workplace learning becomes your responsibility and you must become a proactive learner.

Behaviours of a Proactive Learner
  • Take Initiative – if you don’t know something, look it up or ask! Don’t wait for someone to give you the answer
  • Manage Your Knowledge - You are responsible for keeping your knowledge organized. Stay on top of material by making cheat sheets, binders, etc. (See more on Managing Knowledge below)
  • Timely Learning – Put recently learned information immediately into practice
  • Actively Seek Feedback – Feedback is a great way to learn what went well and what can go better (See more on Feedback below)
Setting Expectations

An important part of communication during internship is setting expectations. It is important to establish what expectations are with both internship coordinators as well as with new preceptors at the start of each rotation. Ask for clarification at any point if you aren't sure what is expected of you.

It is also important to be familiar with the evaluation forms for each module to ensure that you know what you are expected to learn and develop over each rotation. In case a preceptor does not cover something in your rotation that you know you are required to cover during the module, you can bring this up with them. It is important to own your education, and knowing what is expected of you throughout internship is key to succeeding.

What Details
Rotation Preparation - How and what to prepare
- Resources/reading that can assist in preparation
Scheduling - Your schedule
- Your preceptor's schedule
- Working hours
- When your preceptor prefers to receive questions about patients
Learning Goals - Personal learning goals for the rotation (may include learning goals from past rotations)
- Preceptor’s learning expectations for you
- Learning expectations outlined by the module evaluation forms
- Discuss ways to ensure these goals are met
Role Expectations - Expectations for your preceptor
- Level of independence throughout the rotation
- Preceptor expectations of you
Feedback - When and how you prefer to receive feedback
- When and how your preceptor prefers to give feedback
- e.g. after each each patient or activity? Daily? Weekly?
Learning Styles - How you prefer to learn
e.g. watching first; hands on right away; aurally; reading or writing; a combination of these)


What to do when encountering something new

Encountering something you’ve never seen before can be intimidating and nerve racking. Follow these steps for success when you encounter something new:

Encountering 1 graphic
Tips and Tricks
“When asking questions, be sure to do your own research/study up as much as you can about the topic before asking. This shows initiative and helps preceptors better understand what specific parts you don’t understand about a broad subject" - Intern

"Explain your thought process so the RD understands where you’re coming from. It’s been awhile since they were in school etc and they likely have an approach to how they would normally go about something, however, you’re there with a new, different perspective. Tell them what that is, and explain how you arrived at that. If it’s reasonable, they’re not going to say it’s wrong!" - Intern
Be open to new experiences and be okay with not knowing every answer, but do know how to draw upon previous knowledge. “Expect that you won’t know everything, and that it’s okay to ask” –Intern

The above tips will align you with the following competencies:

  • 1.04 Practice within limits of individual level of professional knowledge and skills: B, C, D
  • 1.05 Address professional development needs: A-D
  • 1.09 Use technologies to support practice.
  • 1.11 Assess and enhance approaches to dietetic practice: C, E, F


Flexible Learning

Students have much less control over their lives during internship. Hospitals and patients are a lot more unpredictable and chaotic than classrooms and peers. Maintaining flexibility, or “rolling with the punches” during your internship will help ensure success.

Behaviours of a Flexible Learner
  • Being comfortable with less control of deadlines, schedule, and environment
  • Adapt knowledge to patient needs and varying levels of comprehension
  • Quickly adapt to new environments by any identify similarities between settings
  • Reduce self pressure and let go of mistakes
Tips and Tricks
“There will be surprises and things will just come up; we are used to carefully selected case studies, in real life ‘people are much more complex than a textbook’”- Intern

"Just go with it. Roll with the punches, take it in stride- whatever silly mantra you want to repeat, repeat it! You will learn in every situation regardless. Be open to all learning opportunities and know that in the future these opportunities will serve even if in the moment it doesn't feel like it is. Take the time to listen and make notes- battle through the tough times." – Intern
"Do not treat internship like a test- this is not the point of internship. It is not meant to test what you know, it is meant to be part of your learning. I think a lot of people lose sight of this. If I had treated it like a big job interview/exam, I’d be more likely to have had stress and anxiety throughout the experience.” – Intern

The above tips will align you with the following competencies:

  • 1.07 Maintain a client-centred focus: B-E
  • 1.08 Manage time and workload effectively


Check out this Podcast for real life internship scenarios and corresponding strategies for success!




Knowledge Expectations

Interns are expected to have a certain level of foundational knowledge before beginning internship. The Integrated Competencies for Dietetic Education and Practice (ICDEP) outlines this foundational knowledge. Interns achieve these competencies throughout internship and in required program courses prior to internship. The UBC Program Competency Coverage Chart indicates in which modules or professional practice courses each competency should be covered.

Preparation

There are varied opinions about whether some studying over the summer would be beneficial. Interns should consider their own situations and areas of their knowledge they feel should be strengthened prior to internship. It may be useful to review the Required Skills for Dietetics document.

It should be noted that site specific resources are provided, so interns shouldn't feel anxious about knowledge gaps particular to their placement prior to internship.

Preparing Learning Resources for Internship




Prepare a toolbox of resources that can be referred to on a ‘just-in-time’ basis. This will be used throughout the internship when there are gaps in knowledge or skills. Keep in mind that this toolbox will be added to, and filled in with resources from preceptors and hospital databases as you go through internship. Therefore, do not spend too much time curating it beforehand.

Useful Resources for Internship

NOTE: Resources listed were identified by FNH 480 students, current interns, and preceptors in 2016.

Websites:

  • General
  • Medications
  • Physiology Refresher

Course Material:

  • FNH 470/475
  • Nutritional Primers (Anemia, Hydration Status, Nutritional Status)
  • Desirable Lab Values & Routine Lab Tests of Nutr Importance
  • NCP Codes & Sample PES Statements
  • Jan Greenwood - Tubes, PN, EN
  • Nelms Textbook
  • FNH 340
  • Food Safety Plans, Recipe Development etc.
  • Food Safe II Workbook
  • FNH 471
  • Course Package
  • WHO Growth Charts

Dietetics Wiki:

Library Resources

  • Online
  • Libraries
  • Other Universities
  • If located in a city where there is another university, interns have reciprocal library borrowing privileges which would allow them to borrow books. Interns must obtain a COPPUL card from Koerner Library before leaving UBC (see the section on Application Process)or by contacting David Harakal (Head Librarian - david.harakal@ubc.ca) in August, when registration has been updated for September. The new COPPUL card will be emailed to you as a PDF and the physical copy mailed to you.


Preparing for a New Rotation

Contact preceptor a week or so in advance to request any required and/or recommended readings/resources for the rotation. Complete the readings (or case studies) prior to starting the rotation, and set time each day to complete assigned work or to study a topic for the next day (if applicable). Some hospitals have wards that outline the general duties of the RD, structure of the ward, priorities for intervention, etc. It’s helpful to review these prior to starting a new rotation.

"I prioritized my learning according to the population that I was dealing with. I emailed every preceptor prior to my rotation with them to discuss the common conditions that they encounter." - Intern at Vancouver Coastal Health


One way to prepare for each rotation is to critically assess your knowledge base before day one of your new rotation. Here is a useful tool to help organize your current knowledge and assess any top priority learning needs. Print out this Internship Rotation Knowledge Template and fill it out prior to the start of each rotation.
File:480-Interhsip-template.docx-2.docx

Finishing a Rotation

The main thing here is meeting the competencies by the end of each module, and ideally for each placement (where feasible). At the end of the day, every intern is on a slightly different learning course. Some will have achieved all competencies in a placement, while others may need a bit more time to build on their knowledge and skills to meet their competencies by the end of the module.
At the end of each rotation you set goals for the next one on the evaluation forms. Discuss these with your new preceptor so they can help you to find opportunities to work on your goals. You can print out the goal setting sheet and share it with your preceptor.

Setting Goals

Try to develop SMART goals prior to each placement. Think about:

  • The conditions you want to see.
  • Increasing independence.
  • Liaising with medical staff.
  • Developed skills & knowledge each day of the rotation.
  • Communication during interdisciplinary rounds.

Read through the learning objective goals & competencies for each placement beforehand (especially food service) to make sure you complete your requirements. Develop learning goals which will help you meet the competencies for each module. Be open and upfront about your goals with your new preceptor on the first day or two. Collaborate with your preceptor on how these goals can be achieved during this placement, and if not, discuss other options or talk to your coordinator early.

Identifying Knowledge Gaps

Suggestions from previous interns and preceptors: File:Managing Knowledge Podcast.mp3

  • "Take responsibility for your learning. You can do this in many ways such as reflecting often on your learning needs and goals throughout each module, collaborating with your preceptor on how you can achieve these and make adjustments. If possible, reach out to your internship coordinators for advice on how to meet your learning needs, and to develop learning plans if needed. Address any performance gaps early!"
  • "I would do research or additional readings if my preceptor had noticed any weakness in my knowledge base, or if there was anything that peaked my interest that day."
  • "Make sure to review any checklists/tasks with your preceptor mid-week or mid-rotation, to make sure you accomplish all that you need to by the end of the week/rotation."

Actions

Being pro-active:

  • Seek improvement and be self-aware of your areas for improvement. If there is something that you think you aren’t getting enough practice/exposure to, discuss it with your preceptor and ask if there are opportunities to practice or gain more exposure.
  • Ask questions but show initiative - look things up yourself first. Use your resources! Keep a toolbox of resources that preceptors and others share with you throughout your internship. Find out where to go for reliable information.
  • Try out your preceptor’s suggestions and report back on results1.
  • Keeping track of your goals to ensure that you are on the right track (i.e. if you notice that there are no enteral feeding opportunities in the first week, talk to your preceptor about reaching out to other RDs in that hospital in week 2).
  • Applying what you learn to new settings and situations to help you develop confidence in knowledge and skills.
  • Taking informed risks (for you, not the client), stretch beyond your usual comfort level1.
  • If your preceptor seems too busy to be there for you, be assertive and let your preceptor know what you need from them in order to succeed1.


Common Barriers & Solutions:

In the moment problem solving. - Remember that it is okay to take a moment to think about your answer, you are learning!
Not learning/experiencing all parts of internship as well as you would have liked. - Bring along a notebook to make note of what you need to look up or areas you need to read up on.

Open Communication


Communicating with your preceptor

"Be honest, trustworthy and transparent when communicating with your preceptor." - Intern


Open communication with preceptors and coordinators will make it easier for you to meet your expectations and overcome challenges throughout internship, while also allowing a trusting relationship to develop. Open communication requires transparency on both sides, by sharing concerns and ensuring that expectations are clearly set and understood by both sides.

Poor communication → unclear expectations and/or perceptions, disconnected preceptor/intern working relationships, and missed learning opportunities

Open communication → defined expectations, clear set boundaries, a basis for feedback, and effective preceptor/intern working relationships

"Placement expectations can cause stress. There are times when interns are unsure what they are expected to achieve during their placement or module (i.e. near the end of NC II, before NC III). If the preceptor and intern don’t have open communication about these issues and aren't familiar with the module forms or reach out to their coordinator when needed, this can impact the interns’ success and sense of accomplishment during that placement." - Intern

If there is anything specific you’re interested in seeing or doing, don’t be afraid to ask and do so early on (e.g. observing a surgery, visiting a community organization, etc.)

Also, it is important to communicate with preceptors about your needs and learning style and learn to go with the flow and adjust to different teaching styles and learning environments. Checking in regularly with preceptors is important to understand whether your performance meets the expectations. At the end of the internship, showing appreciation for preceptors’ time and efforts is a good way to build long term relationship (Danielle Billey, Registered Dietitian).

Communicating with other Health Professionals

Communication with other healthcare professionals on the team can be challenging. Three key messages from interns and dietitians in succeeding in working with other health professionals are: 1) Be respectful and hold your own opinions, 2) Be engaged in people’s lives, and 3) Be willing and giving.


It can be intimidating voicing your opinion, especially as dietetics students. Some health professionals are very welcoming and receptive while others may be more closed-off and label you as a “dietetic intern”. It is important to think through the questions, take initiative to seek out the answers and be able to self-teach.Then, expressing your ideas openly with other health professionals makes you appear confident and demands respect. Discussing issues openly allows you to provide input, get feedback and invite different perspectives (Tiffany Yeung, Registered Dietitian).

It may be difficult to know how to answer a question asked by a doctor or other health professional which you do not know the answer to. Here is some advice from a current intern on how to respond in a situation like this:


"I would encourage you to say something like 'I need to review the patient's chart and then I'll get back to you about that' or 'Let me consult with my preceptor and I'll let you know' - never give them an answer that you are unsure about in case it is wrong. This will reflect poorly on you and that team member may not want to come to you for information again. And more importantly, it may put the patient in danger. If you don't know, communicate that, but let them know that you will find out." (Roberta Wozniak, Dietetic Intern).

A Guide to Successful Communication

Successful Communication

Content Courtesy of:

  • Tiffany Yeung, RD, Sodexo, personal communication, May 2016
  • Danielle Sanders, Dietetic Intern, personal communication, May 2016
  • Roberta Wozniak, Dietetic Intern, personal communication, May 2016
  • Connie Zhou, Dietetic Intern, personal communication, May 2016

Conflict Management & Mitigation

Within any setting working with others, conflict or disagreement will surely occur at one point or another. It is key to be courteous to your fellow colleagues, and work constructively to deal with any road block that you may encounter.

A Conflict Management Technique: Learning Conversations: Learning Conversations

5 Styles of Conflict Management: 5 Styles of Conflict Management

Team Collaboration

In the current health care system, delivery of effective treatment depends on professionals working together towards improving the patient’s health. Inherent differences between professions such as knowledge, experience, values, and perspectives can lead to disagreement, but it is important to show respect even when disagreeing.

When you are in disagreement with a colleague, go through these actions to try and come to a solution:

1. Understand – ask why your colleague thinks their way is better, or why they think your way would not be ideal
2. Explain – provide details about your preferred choice, using evidence to back your argument and validate your suggestion
3. Seek help – If you need advice, find another professional not directly involved in the patient care team to ask for objective input
4. Reach an agreement – after promoting understanding of either side, offer a conclusion that is hopefully acceptable to both you and your colleague


"Be self reflective. Be brutally honest with yourself about what you bring to a situation and take responsibility for that. How did you react? what was your tone of voice? How did you come across to the other person?" - Danielle Sanders, Dietetic Intern

Interaction with Superiors

It can be intimidating working alongside full-fledged health professionals, as well as having a preceptor evaluating your performance. Even so, just remember a few things:

- Don’t be afraid; internship is an opportunity to learn, not an environment where you’re expected to be perfect.
- If you have difficulties, voice them so that you can get help, rather than trying to solve it yourself and needing help fixing your mistakes later

Receiving Feedback

POWTOON -"Receiving Feedback" -

Take a look at this short animation to get
a better idea of how to effectively receive feedback


Feedback is part of the learning process, and when used constructively, can be extremely valuable and vital to success. Take advantage of any opportunity to receive it! As you are still learning during internship, you should receive feedback frequently.

Feedback can take many different forms. It can be:

  • formal or informal
  • immediate or scheduled
  • specific or general
  • reinforcing (“you did ___ well”) or constructive (“you could do ____ this better”), or a combination of both

Ideally feedback is best when immediate, relevant, and provided at regular intervals. Asking for feedback as soon as possible after an event or activity will lead to more clarity and relevance. Both you and your preceptor will have a clear idea of the event the details won't be lost like they might be if discussed further away from the event. (Source)

As you become more familiar with the process of receiving feedback throughout internship, you will learn more about how you prefer to receive it. Remember: Consistency is key! Below are some tips and tricks for how to effectively receive feedback.

How to Effectively Receive Feedback

Receiving feedback isn't always a comfortable situation. The most important thing to remember is that the purpose of feedback is to help you improve and move forward. It is your choice whether you use any piece of feedback that is given to you.

What When Who Details
1. Set Expectations for Feedback Beginning of a rotation Preceptor
You
  • see Setting Expectations chart
2. Receive Feedback Throughout rotation You
  • be an active listener (demonstrates appreciation for feedback)
  • have open body language
  • filter criticism that may not be constructive or relevant to your growth as an intern
3. Clarify Feedback Before leaving the feedback session Preceptor
You
  • paraphrase or summarize what was said to you (active listening)
  • ask for specific examples/actions for improvement when necessary
  • ask for clarification using open ended questions
  • try to gain understanding of your preceptor's perception when given feedback you don’t agree with: Use open ended questions to clarify rather than defending or justifying your actions
4. Reflect on Feedback Throughout rotation You
  • Take the time to consider the situation from another person's perspective (especially if you do not agree with feedback that has been given to you)
  • Assess your own performance; be honest
  • Consider and reflect on other sources of feedback (past preceptors, coordinators, fellow interns)
  • Look for "trends" or things that have come up in past feedback sessions or with different preceptors to help identify key areas for improvement
  • Keep a record of what you are doing well and what you need to improve on
  • Consider how the feedback you receive relates to your goals and learning outcomes or competencies

Questions to Promote Reflection: What worked well? What could work better? How can I improve for next time? What do I need to make the improvement happen? How will I know I have made the improvement? How long will it take to accomplish? How will I remember for next time?

5. Utilize Feedback Throughout rotation You
  • Consider rewriting or developing new goals based on feedback
  • Use suggestions and resources from preceptors to fill your knowledge gaps, meet your goals, and improve your performance
  • Don't be afraid to try out something different to find what works best for you
“Seek out feedback daily or weekly, whichever you decided upon. Ask about things you’re doing well and things you need to improve on” - Dietetic Intern


VIDEO CLIP - "Receiving Feedback" Review this short clip of Jenny receiving feedback from her preceptor. While watching take note of what she did well and what she could have improved on.

Additional Resources

Build Lasting Connections

Another important aspect is building upon connections made with people you have met during internship. Demonstrate your aptitude in the field, or do small things like the ones listed below as steps to showing your sincerity and appreciation for the opportunities you've had:

- Show a strong desire to learn new things
- Develop a strong understanding of the work environment, or "culture" of the workplace
- Write a "thank you" card to preceptors or colleagues for their help (at the end of a learning module, for example), or send a brief "it was nice to meet you" e-mail after making a new connection at a networking event or conference
- Learn more about your colleagues in their personal lives
- Actively participate in events, potlucks, conferences, etc.
- Be positive!

The Importance of Self-Reflection

  • “In my first rotation I started a journal to document my experience, and had categories for what I learned, what I can improve on, new goals, cool patients/conditions I learned about or wanted to learn about, questions my preceptor had for me that I couldn't answer at the time, medication/nutrient interactions, etc. This journal was really great for self-reflection initially however I found I couldn't commit to spending that time after the internship day to do that reflection, but I wish I had continued because it was great to be able to reflect back to think what could I have done differently, how can I improve tomorrow, what questions did I have because of this.” - Intern


  • “I started a weekly internship blog where I just reflect back on my week and set my own general goals and things that I know I can work on. I actually really appreciate my weekly reflection but I tend to forget a lot, so I would encourage a day-to-day reflection!” -Intern


1 University of Western Ontario. Preceptor Education Program Module. Retrieved from (using preceptor's login): https://owl.uwo.ca/portal/site/edc3ab16-818e-4173-88f4-e24cad89cf4b/page/ca8b7528-1826-4641-a2e2-57f8b7139a2d

source: http://wiki.ubc.ca/Dietetics:Successful_Internship