COVID-19 for Program Directors FAQs

This page provides answers for questions from programs during the 2020 COVID-19 pandemic.

Program Directors FAQs 2017 Accreditation Standards

Updated July 7, 2021

What are ACEND's requirements for a minimum number of supervised practice hours for programs accredited under the 2017 Standards during the COVID-19 pandemic?

During this emergency, the ACEND Board voted to temporarily reduce the required number of supervised practice hours from 1200 hours to 1000 hours for programs leading to the RDN credential (DI/CP/IDE/FDE/DPD with ISPP) and 375 hours for DT programs. ACEND has provided the following guidance to assist programs:

A major program change does not need to be submitted by programs making this change, although the change in the number of hours required by the program would need to be explained in the next self-study report.
The temporary reduction applies to all students/interns who complete the program anytime between January 1, 2020 and June 30, 2022.
The temporary requirement to allow only 600 hours (versus 900) and 225 (versus 350) in authentic, professional work settings remains. This means that RDN programs that decide to decrease their hours to 1000 must ensure at least 600 of the hours remain in authentic, professional settings and DT programs that decrease their hours to 375 must ensure 225 hours remain in authentic, professional settings.
Non-degree granting dietetic internships can graduate interns after each intern has completed at least 1000 hours with 600 in authentic professional experience and met the competencies. At this time, all interns in one program do not have to complete the same number of hours as long as each intern meets the 1000 hours requirements and has met the competencies.
Verification statements can be issued in degree granting programs after students/interns have met these new supervised practice hours requirements, demonstrated achievement of the competencies, completed required nutrition and dietetics coursework and the degree.

If we use simulation hours or alternate experiences such as case studies, do these need to be an equivalent number of hours? For instance, if students/interns miss 32 hours in a week at supervised practice do we need to ensure that the alternate activities are an equal number of hours to complete?

The ACEND standards do not dictate a specific number of hours in various experiences, and alternate hours do not need to be equivalent in number of hours missed at a certain type of facility. However, the program must provide 1,000 hours (CP/DI/IDE/FDE programs) and 375 hours (DT programs) of supervised practice. Therefore, in emergency situations, programs have the flexibility to make decisions with regards to their curriculum and distribution of supervised practice hours as long as they follow their institution's and/or program's policies and procedures.

How do I determine the number of hours to count toward alternate supervised practice activities, such as webinars, case studies or other experiences?

When using alternate experiences, program directors will need to use professional judgment to determine what would be a reasonable amount of time to complete an activity when assigning supervised practice hours to alternate experiences. This may be based on any number of methods including, but not limited to, judgment based on the complexity of the activity, average reported time by previous students/interns, estimated time by a number of experts (faculty, preceptors, advisory board members, etc.), or estimated time of how long the activity will take a preceptor in real practice.

As no two students/interns are alike, there will be variances in the amount of time each student/intern takes to actually complete an activity. Even so, a program must make the required number of hours consistent across all interns/students. For example, a program director should not give one student/intern 5 hours to do a case study and another student/intern 1 hour to complete the same activity but instead may give all students/interns 3 hours to complete the activity.

Do all students/interns need to complete the same activity to meeting a specific competency?

ACEND does not require that all students/interns receive the same activities to meet a competency or set of competencies (or core knowledge for DPD programs); Standard 6, required Element 6.3c states that programs must ensure comparability of experience when different learning methods are used.

We have different students/interns needing different competencies since they were all in different places. So now the challenge is trying to have activities that will help them all meet what they have left.

Using major projects (e.g., theme meal, community assessment, quality improvement, progressively complicated case studies that incorporate cultural competence, income, population groups, etc.) that address several competencies may be helpful when students/interns need different competencies to be met. One suggestion to ensure core knowledge and competencies are being met, programs may want to develop a simple table with all the competencies that have not been met by the class of students/interns in column one and the experiences to meet these competencies in column 2. The third and fourth columns may include the estimated number of hours in alternate and professional practice, respectively.

What type of documentation, if any, will be required for alternative experiences? Will this need to be reported to ACEND?

Programs may use any number of formats to document their alternate experiences, including adapting the ACEND template RE 1.6 Planned Supervised Practice Hours. A general explanation of the plan during this emergency and how the core knowledge and competencies are being met may help inform future emergencies.

ACEND is not requesting a report documenting these experiences; however, if requested programs will need to have the information available for review teams during their upcoming site visit.

Can students/interns complete the entire long-term-care rotation using case studies? Per our institution guidelines, we cannot role play face-to-face. Could this be done via internet?

The ACEND standards do not dictate a specific number of hours in various experiences nor the types of activities that may be completed using alternate experiences. Therefore, programs have the flexibility to make decisions with regards to their curriculum as long as they follow their institution's and/or program's policies and procedures.

Programs may use a number of activities to simulate professional practice, including conducting role-plays using Zoom or other conferencing software, interviewing a family member or friend using Facetime or Skype, videotaping experiments conducted at home, recording a presentation, and many other possibilities. Making full use of available technologies such as cellular phones, e-mails and/or the internet are encouraged.

Our state requires only 900 hours of supervised practice for RDN licensure. Can we limit the program to only 900 hours for program completion?

DI/CP Programs must meet the minimum 1,000 hours that the ACEND Board approved, regardless of the program's state licensure requirements. Programs must consider state licensure across the U.S. and its territories to allow graduates to be mobile and work anywhere in the U.S., including using telehealth.

What specifically counts as alternative hours in rotations such as Long-Term Care, WIC, Community Food Assistance, and School Food Service, etc.?

Alternate experiences are activities that simulate what a nutrition professional does in the real-world. They are active experiences rather than passive such as giving a presentation (live, recorded or online), developing menus or educational materials for a specific population, creating and administering a survey, analyzing data or menus, interviewing/counseling a "patient" (could be a family member, classmate, acquaintance), performing inventories (perhaps on a student's own pantry), creating a research poster in PowerPoint, executing a theme meal for one's friends and/or family and many other actual experiences.

How should students/interns track alternative hours? Do they track the time they spend on each activity or do I assign a set number of hours that each activity/case study/simulation is worth?

ACEND does not specify the number of hours for each activity. Programs must assign a set number of hours to each alternate experience and should not leave it up to students/interns to assign their own hours. This should ensure that the hours counted are consistent across all interns/students.

Note, when using alternate experiences, program directors must determine the number of hours and make them consistent across all interns/students. For example, a program director should not give one student/intern 4 hours to do a case study and another student/intern 1 hour to complete the same activity.

Can watching a webinar count as alternate supervised practice hours?

Programs must make the determination of what counts as supervised practice. ACEND can provide guidance but it's out of our scope to prescribe specific learning activities. The guidance questions to ask are:

Is this realistic/practical work that occurs in a professional work setting?
Does the activity build skills that contribute to the achievement of a specific competency?
Are you able to justify why you count this as a supervised practice hour? As a program director you are responsible for assuring the competence of all your program graduates who receive a verification statement.

The time spent on learning activities such as viewing professional webinars, live presentations at FNCE, etc., may be counted as long as there is a built-in component that shows that the student/intern was engaged in listening and can apply the information to practice. This activity could be a case study based on information gained or discussion with peers, preceptor or program director and you would determine the supervised practice hours based on the questions above.

One example is an interactive webinar that has the student/intern practice the activity as they go along and the entire time (webinar + practice time) would count as supervised practice hours. For example, if using a recorded session on tube feeds and TPN where the interns/students watch a portion of the module and then, given a patient, they determine the correct tube feeding, rate, etc. As the module progresses, the patient develops complications and the students/interns take the time to readjust their recommendations to meet those complications. The program may count the entire time as supervised practice hours.

Will ACEND recommend specific activities for students/interns that can count towards supervised practice hours? Can ACEND provide examples of alternate experiences to achieve the competencies?

Per USDE's oversight of ACEND as an accreditor, it is out of our scope to provide specific activities for program directors to provide students. ACEND requires all accredited programs to follow their institutional and/or program policies and procedures in any instance that may affect the program. If needed, the program may consider alternate experiences, moving courses online or other ways to provide the education to its students or interns and that this is acceptable to ACEND.

We encourage program directors to share ideas with each other.

May I use a different assignment or learning activity than what was originally identified to measure a student's/intern's achievement of the competency (CRDN, CNDT) or knowledge requirement (KRDN, KNDT)?

During COVID-19 emergency, if a program needs to temporarily use a different activity to measure a student's/intern's achievement of the competency or knowledge requirement they can do so. It is up to the program to ensure each student/intern achieves the student learning objective and has met the competency or knowledge requirement in order to issue the verification statement regardless of what learning activity is used to measure achievement.

If I change the activity for this period, do I need to update and assess it in my SLO plan?

If the SLO is indicated in your plan to be measured this year you should include the results if at all possible and indicate that a different activity was used. If circumstances due to COVID-19 don't allow data collection you would just need to explain this in your next report. As a reminder, the ACEND standards don't require that all SLOs be assessed each year. Standard 6, Required Element 6.1 states that programs are expected to assess at least one SLO from each domain annually. Within the accreditation cycle, all SLOs must be assessed at least once. SLOs that are not met should be assessed annually until resolved.

Does studying for an exam count towards alternative supervised practice hours?

Studying for an exam cannot be counted as alternate supervised practice hours.

Can the completion of modules that include a quiz to measure knowledge on a topic be counted as alternate experiences?

A quiz that measures knowledge gained from completing modules would not be counted as alternate supervised practice activities. If a practice-based activity is incorporated with the modules or as part of the exam, then this may be counted as an alternate experience. Programs must ensure that the module and quiz questions are practice-based and measure ability and/or provide active practice to the intern/student.

What is the difference between alternate and real-life experience?

Generally, alternate experiences are activities that simulate what a nutrition professional does in the real-world. They are active experiences rather than passive. Educators must use professional judgment for what counts as alternate supervised experience or professional/real-world, authentic, experience. A single activity may be modified to meet various requirements. Preceptor activities conducted remotely where the student is doing professional work but is supervised by a preceptor working remotely may be counted. For example:

Reading a chapter on negotiation

Alternative experience: Role-playing negotiating a pay raise
Professional, authentic experience: Negotiating a theme meal menu with a chef

Watching a webinar on tube feeding

Alternative experience: Watching an interactive webinar on tube feeding with various activities completed along the way
Professional, authentic experience: Assisting preceptors virtually by calculating tube feeds for patients at home or at a clinic

Developing a lesson plan for 8th grade

Alternative experience: Developing a lesson plan and delivering it to a fellow college students or family member(s) in 8th grade (or other grades)
Professional, authentic experience: Developing a lesson plan and delivering it to an 8th grade classroom using WebEx

Practicing calculations for anthropometric assessments

Alternative experience: Completing a pediatrics case study with a standardized patient
Professional, authentic experience: Counseling a child using video chat or telephone

Watching a TED talk on ethics

Alternative experience: Watching a TED talk on ethics and holding a discussion with a preceptor
Professional, authentic experience: Exhibiting ethical behavior in practice evaluated by a preceptor/faculty after observation

Is authentic, real-life professional experience always in-person or can it be completed virtually?

Authentic activities in real-world professional settings do not need to be in-person, but they must include real clients/patients and entail real-life situations. Preceptors or program directors may supervise these activities. For example, the preceptor may assign cases remotely and review intern documentation delivered via email or a student may present their research proposal remotely to a group of faculty. Other examples of remote authentic work experiences include, but not limited to, using telehealth to counsel clients/patients, developing educational materials remotely for a community site, and creating menus for a foodservice facility.

How many "enhanced" case studies would we all need to review with a student/intern to "equate" an end of rotation staff relief (where they typically see 8 patients/day)? How can students/interns complete staff relief?

ACEND Standards do not include a requirement of staff relief. Only that programs must address the core knowledge and competencies and ensure students/interns meet them. It is not the number of experiences that matters, but the quality of the alternate experiences and ensuring the KRDNS/KNDTs/CRDNs/CNDTs are being met. To ensure core knowledge and competencies are being met, programs may want to develop a simple table with all the competencies that have not been met in column one and the experiences to meet these competencies in column 2. The third and fourth columns may include the estimated number of hours in alternate and professional practice, respectively.

Can we use actual patient case studies or is that a violation of HIPAA Guidelines?

ACEND's expectation is for programs to follow HIPAA guidelines at all times and any patient documentation must be completely de-identified.

If I have a new preceptor who has offered to provide remote supervised practice with my students/interns during this time, do we need an affiliation agreement?

For temporary alternate supervised practice activities that does not involve taking on risk (e.g. working with patients remotely), programs may move forward without an agreement given the circumstances. If this becomes a long-term rotation, then we would request that you follow your affiliation agreement policy.

Can verification statements be electronically signed and distributed?

Program directors can electronically sign a verification statement using a digital signature that can be authenticated. Digital signatures can be easily obtained in Adobe Acrobat and are the most secure way to sign an electronic verification statement. As soon as possible after program completion, program graduates who successfully complete program requirements can be provided a verification statement via email with an authenticated digital signature, or a hand-signed copy scanned in color. Photocopies are unacceptable.

Below you can find useful links to instructions on how to create a digital signature in Adobe Acrobat:

Can interns be compensated for hours counted toward their supervised experience?

Refer to Standard 10, Required Element 10.2f for having policies in place to define compensation practices.

Can relevant, nutrition paid employment count towards supervised experiences? Two of my dietetic interns have jobs that could meet several competencies.

Refer to Standard 10, Required Element 10.2i for assessment of prior learning.

For questions specific to your institution, access ACEND^®'s Emergency and Disasters policy found in ACEND^®'s Policy and Procedures Manual, Section 4.7.

View the P&P Manual

As always, programs are encouraged to contact their ACEND managers for further clarifications.

Program Directors FAQs FEM Accreditation Standards

Updated July 7, 2021

If a program's number of supervised experiential learning hours for program completion is greater than the required minimum of 1000 hours, during this time, is it okay if the program only provides the minimum 1000 hours to achieve all competencies without submitting a substantive program change to ACEND?

During this emergency, FG programs may decrease the number of hours as long as the minimum of 1000 hours is met for FG programs and student/students demonstrate achievement of the competencies.

Is a program that provides graduating students over 1000 hours of supervised experiential learning hours allowed to provide a verification statement for student who have completed the 1000 hours (minimum)? Or will we need to build alternative options to also cover the gap the additional planned hours in order to be compliant?

If your FG program offers more than 1000 hours you can limit it to just 1000 hours for program completion. You can provide the verification statement after the student completes 1000 hours as long as the student has met the competencies.

If we use simulation hours or alternate experiences such as case studies, do these need to be an equivalent number of hours? For instance, if students miss 32 hours in a week at supervised experiential learning do we need to ensure that the alternate activities are an equal number of hours to complete?

The ACEND FEM standards do not dictate a specific number of hours in various experiences, and alternate hours do not need to be equivalent in number of hours missed at a certain type of facility. However, the FG program must provide 1000 hours of supervised experiential learning. Therefore, in emergency situations, programs have the flexibility to make decisions with regards to their curriculum and distribution of supervised experiential learning hours as long as they follow their institution's and/or program's policies and procedures.

How do I determine the number of hours to count toward alternate supervised experiential learning activities, such as webinars, case studies or other experiences?

When using alternate experiences, program directors will need to use professional judgment to determine what would be a reasonable amount of time to complete an activity when assigning supervised experiential learning hours to alternate experiences. This may be based on any number of methods including, but not limited to, judgment based on the complexity of the activity, average reported time by previous students, estimated time by a number of experts (faculty, preceptors, advisory board members, etc.), or estimated time of how long the activity will take a preceptor in real practice.

As no two students are alike, there will be variances in the amount of time each student takes to actually complete an activity. Even so, a program must make the required number of hours consistent across all students. For example, a program director should not give one student 5 hours to do a case study and another student 1 hour to complete the same activity but instead may give all students 3 hours to complete the activity.

Do all students need to complete the same activity to meeting a specific competency?

ACEND does not require that all students receive the same activities to meet a competency or set of competencies and/or performance indicators; Standard 5, RE 5.2c FEM states that programs must ensure comparability of experience when different learning methods are used.

What type of documentation, if any, will be required for alternative experiences? Will this need to be reported to ACEND?

ACEND is not requesting a report documenting these experiences; however, if requested programs will need to have the information available for review teams during their upcoming site visit.

Can students complete the entire long-term-care rotation using case studies? Per our institution guidelines, we cannot role play face-to-face. Could this be done via the internet?

Programs may use a number of activities to simulate professional experiential learning, including conducting role-plays using Zoom or other conferencing software, interviewing a family member or friend using Facetime or Skype, videotaping experiments conducted at home, recording a presentation, and many other possibilities. Making full use of available technologies such as cellular phones, e-mails and/or the internet are encouraged.

Our state requires only 900 hours of supervised experiential learning for licensure. Can we limit our FG program to only 900 hours for program completion?

Programs must meet the minimum 1,000 hours that the ACEND Board approved, regardless of the program's state licensure requirements. FG programs are able to limit their SEL hours to 1,000 hours, as long as at least 600 hours are in authentic professional work settings.

What specifically counts as alternative hours in rotations such as Long-Term Care, WIC, Community Food Assistance, and School Food Service, etc.?

How should students track alternative hours? Do they track the time they spend on each activity or do I assign a set number of hours that each activity/case study/simulation is worth?

ACEND does not specify the number of hours for each activity. Programs must assign a set number of hours to each alternate experience and should not leave it up to students to assign their own hours. This would ensure that the hours counted are consistent across all students.

Note, when using alternate experiences, program directors must determine the number of hours and make them consistent across all students. For example, a program director should not give one student 4 hours to do a case study and another student 1 hour to complete the same activity.

Can watching a webinar count as alternate supervised experiential learning hours?

Programs must make the determination of what counts as supervised experiential learning. ACEND can provide guidance but it's out of our scope to prescribe specific learning activities. The guidance questions to ask are:

Is this realistic/practical work that occurs in a professional work setting?
Does the activity build skills that contribute to the achievement of a specific competency?
Are you able to justify why you count this as a supervised experiential learning hour? As a program director you are responsible for assuring the competence of all your program graduates who receive a verification statement.

The time spent on learning activities such as viewing professional webinars, live presentations at FNCE, etc., may be counted as long as there is a built-in component that shows that the student/student was engaged in listening and can apply the information to experiential learning. This activity could be a case study based on information gained or discussion with peers, preceptor or program director and you would determine the supervised experiential learning hours based on the questions above.

One example is an interactive webinar that has the students practice the activity as they go along and the entire time (webinar + experiential learning time) would count as supervised experiential learning hours. For example, if using a recorded session on tube feeds and TPN where the students watch a portion of the module and then, given a patient, they determine the correct tube feeding, rate, etc. As the module progresses, the patient develops complications and the students take the time to readjust their recommendations to meet those complications. The program may count the entire time as supervised experiential learning hours.

Will ACEND recommend specific activities for students/students that can count towards supervised experiential learning hours? Can ACEND provide examples of alternate experiences to achieve the competencies?

We encourage program directors to share ideas with each other.

May I use a different assignment or learning activity than what was originally identified to measure a student's achievement of the competency?

During COVID-19 emergency, if a program needs to temporarily use a different activity to measure a student's achievement of the competency or knowledge requirement they can do so. It is up to the program to ensure each student has met the competency in order to issue the verification statement regardless of what learning activity is used to measure achievement.

Does studying for an exam count towards alternative supervised experiential learning hours?

Studying for an exam cannot be counted as alternate supervised experiential learning hours.

Can the completion of modules that include a quiz to measure knowledge on a topic be counted as alternate experiences?

A quiz that measures knowledge gained from completing modules would not be counted as alternate experiential learning activities. If a practice-based activity is incorporated with the modules or as part of the exam, then this may be counted as an alternate experience. Programs must ensure that the module and quiz questions are practice-based and measure ability and/or provide active practice to the student.

What is the difference between alternate and real-life experience?

Reading a chapter on negotiation

Alternative experience: Role-playing negotiating a pay raise
Professional, authentic experience: Negotiating a theme meal menu with a chef

Watching a webinar on tube feeding

Alternative experience: Watching an interactive webinar on tube feeding with various activities completed along the way
Professional, authentic experience: Assisting preceptors virtually by calculating tube feeds for patients at home or at a clinic

Developing a lesson plan for 8th grade

Alternative experience: Developing a lesson plan and delivering it to a fellow college students or family member(s) in 8th grade (or other grades)
Professional, authentic experience: Developing a lesson plan and delivering it to an 8th grade classroom using WebEx

Practicing calculations for anthropometric assessments

Alternative experience: Completing a pediatrics case study with a standardized patient
Professional, authentic experience: Counseling a child using video chat or telephone

Watching a TED talk on ethics

Alternative experience: Watching a TED talk on ethics and holding a discussion with a preceptor
Professional, authentic experience: Exhibiting ethical behavior in practice evaluated by a preceptor/faculty after observation

Is authentic, real-life professional experience always in-person or can it be completed virtually?

Authentic activities in real-world professional settings do not need to be in-person, but they must include real clients/patients and entail real-life situations. Preceptors or program directors may supervise these activities. For example, the preceptor may assign cases remotely and review student documentation delivered via email or a student may present their research proposal remotely to a group of faculty. Other examples of remote authentic work experiences include, but not limited to, using telehealth to counsel clients/patients, developing educational materials remotely for a community site, and creating menus for a foodservice facility.

How many "enhanced" case studies would we all need to review with a student to "equate" an end of rotation staff relief (where they typically see 8 patients/day)? How can students complete staff relief?

ACEND Standards do not include a requirement of staff relief. Only that programs must address the core knowledge and competencies and ensure students meet them. It is not the number of experiences that matters, but the quality of the alternate experiences and ensuring the competencies are being met. To ensure competencies are being met, programs may want to develop a simple table with all the competencies that have not been met in column one and the experiences to meet these competencies in column 2. The third and fourth columns may include the estimated number of hours in alternate and professional practice, respectively.

Can we use actual patient case studies or is that a violation of HIPAA Guidelines?

ACEND's expectation is for programs to follow HIPAA guidelines at all times and any patient documentation must be completely de-identified.

If I have a new preceptor who has offered to provide remote supervised experiences with my students during this time, do we need an affiliation agreement?

For temporary alternate supervised experiential learning activities that does not involve taking on risk (e.g. working with patients remotely), programs may move forward without an agreement given the circumstances. If this becomes a long-term rotation, then we would request that you follow your affiliation agreement policy.

Can verification statements be electronically signed and distributed?

Below you can find useful links to instructions on how to create a digital signature in Adobe Acrobat:

Can relevant, nutrition paid employment count towards supervised experiences? Two of my students have jobs that could meet several competencies.

Referto Standard 9, RE 9.2i for assessment of prior learning.

Can students be compensated for hours counted toward their supervised experience?

Refer to Standard 9, RE 9.2f for having policies in place to define compensation practices.

For questions specific to your institution, access ACEND's Emergency and Disasters policy found in ACEND's Policy and Procedures Manual, Section 4.7.

ACEND Policy and Procedure Manual

As always, programs are encouraged to contact their ACEND managers for further clarifications.

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