Precepting During the Pandemic: Your Stories

Over the last year, the COVID-19 pandemic has presented unprecedented challenges for food and nutrition practitioners, including preceptors. We want to hear your story. Submit it here.

Mary Pat Hughes, MS, RD, CDN

My experience with Pace University dietetic intern Danielle Broder was a true pleasure from the first day in September until her final day. She was a delight and reminded me of why I became a dietitian. She was smart, hardworking, inquisitive and a joy on all levels. I front-loaded her hours due to her long commute and the thought that she may be restricted due to COVID-19.

My background is very diverse, and I was able to connect Danielle with dietitians in the field of recipe development and private practice to widen her experience in the field of dietetics. At every opportunity to be exposed to something new, Danielle embraced the idea with a willingness to learn and contribute. One of her experiences resulted in an elective rotation in her program at Pace University.

Danielle was a total bonus for the Phelps Northwell community and our bariatric program. She was amazing with the patients and it was so exciting to see her grow time after time. She was a blessing to me and a joy to see her blossom. Yes, it is work on our part but, it was worth it and clearly exciting to help shape the future of the field.

Mary Pat Hughes

Mary Pat Hughes, MS, RD, CDN, with Pace University dietetic intern Danielle Broder

Ellen Bowser, MS, RDN, LDN, RN, FAND

My first concern was our interns' safety during the initial shutdown. I wanted to keep their anxiety as low as possible, as I knew they couldn't learn when they were worried about their and their family's health. We switched from in-person to Zoom calls in March 2020. We scheduled meetings each day, worked on case studies and discussed patients seen via telehealth. My interns did a great job searching new learning experiences and they shared their resources.

Debra Tindle, RD

My team and I have been dedicated to quality dietetic intern mentoring for over 20 years. This past year has been a true test of our flexibility and creativity with regards to mentoring during the COVID-19 pandemic. A majority of our rotations shifted to a virtual, electronic or phone mentoring system.

Some of our usual rotation activities (bariatric surgical observations, Nutrition Focused Physical Exams, Motivational Interviewing) had to be modified using webinars and partner practicing in place of hands-on. And our community presentations changed to webinars.

Debra Tindle

Fountain Valley Hospital RDN Team

We were fortunate to have a supportive facility to allow some limited face-to-face intern mentoring for clinical and foodservice applications, including supervised practice using the electronic medical record for required competencies. This facilitated our interns to complete their case studies and their foodservice theme days, which encompass a significant part of their learning processes. Our facility also supported our creation of a video submission to ACEND in lieu of an onsite visit, due to COVID-19 concerns.

Our team continues to provide dietetic intern mentoring to promote the profession of dietetics and food administration and has great satisfaction with the interns' successful passage of the RDN Exam. It is exciting to see the prediction of the need for RDNs increasing as much as 8% over the next five to 10 years, and that we can contribute to a viable RDN source!

Lynette Maxey, CDE

First, I love being a preceptor! I am at a critical access hospital in Northern Rural Michigan. Last year, during the initial phases of the pandemic, I found that I really needed to get creative. I had a dietetic intern coming for her community nutrition rotation. The hospital system I work for had just decided there would be no community outreach for the foreseeable future. I came up with appropriate community-based educational sessions: I set up meetings, tours and experiences with a local farmer who supplies to Gerber to discuss pesticides and farming practices. Additionally, I set up a meeting and tour with a local Mennonite organic dairy farm (Cream Cup Dairy) that makes yogurt, ice cream, cheese and assorted milk. They use old-fashioned glass bottles, so we got to see how the 1950s bottle washer sanitized them. I also set up a meeting with our local state representative to discuss nutritional issues in Michigan. For the next round of community nutrition interns, I have lined up the same farmer to talk about how he tests the Brix level of apples and the storage process, along with the O2 controls. I have lined up another meeting with the state representative regarding licensure in Michigan. I have also lined up a tour of Moomers Homemade Ice Cream to see their process. We also will be live-streaming a plant-based cooking class. My dietetic interns have other assorted projects to ensure that they have a good understanding of what community nutrition entails and can be.

Jackie Walters, RD, LD

An exceptionally motivated and enthusiastic student was assigned to my program by the University of Kentucky, where I work in the USDA-funded SNAP-Ed and EFNEP programs. Working from home, with limited access to our office facilities, her experience was almost entirely virtual. We met at the office initially, socially distanced, to plan her strategy for meeting her competencies and to make sure she knew how to access the necessary online resources. After that, she participated in many Zoom meetings and contributed to several projects. In fact, she made substantial contributions to our program mission. She served on a team to design, create and implement Extension educational materials about the 2020-2025 Dietary Guidelines. She created social media posts that were shared on Extension pages statewide, resulting in a total reach of almost 7,500 in one month. She also provided an online training about the 2020-2025 Dietary Guidelines to more than 150 paraprofessionals and professionals.

Feeding Tiny Bodies

Example of flyer designed by this student in her community nutrition placement.

As a result, one of the Extension agents requested her as a guest speaker for a virtual community event. She collaborated with another team member to deliver an online cooking presentation for people with disabilities. She served on a team that revised a long-standing Extension publication, requiring testing of recipes and meeting virtually to display and discuss results. During this time, our program engaged in a collaboration with Central Kentucky Community Action Council to provide nutrition information for food boxes to be distributed to families with children enrolled in Head Start programming. She designed flyers to be customized with contact information for each county Extension agency and arranged the distribution of materials on a weekly basis. The flyers were so appropriate and effective that local offices began requesting to use them. Flexibility, creativity, access to and willingness to learn virtual communication platforms and graphic design programs, enthusiasm, teamwork, and willingness to work a little longer all contributed to this intern's successful execution of this community nutrition placement. I honestly believe she got more from her experience than many students who enjoyed pre-pandemic placements.

Lorna D. Wyatt, MS, RD

At our LTC community, we continued to host two students during the beginning of the pandemic. One was a senior dietetics student whom we later went on to hire and the other was a junior student doing her LTC rotation. Luckily, our administrator chose to treat them as colleagues and just required them to be tested along with the staff per facility policy. Both students were eventually pulled out of our facility by the university.

Later and well into the pandemic, we hosted another junior student for her LTC rotation who was grateful to have the opportunity to see residents in person, something she had not had the opportunity to experience until she came to us. Happily, she was able to complete her rotation with us before our facility closed its SNF and LTC services.

I have always been happy to host dietetic students. Even though it is an investment of my time, I am happy to contribute to the future of our field and feel a personal reward seeing the students learn, progress and gain confidence.

Ayeza Umar

Amid the uncertainty and ambiguity, the last year was full of anxiety and agitation for all professions. Dietitians were no different and had to face many challenges, whether it was to meet the nutritional requirements of a COVID-19 patient or to mentor interns in a hospital setting.

In the last 11 years of my clinical experience, it was the first time I thought of risking the lives of the students who joined the internship program. Initially, as per our hospital policy, we stopped induction of students in the internship program for the first six months after the COVID-19 pandemic began. But gradually, as we got access to PPEs, we gained confidence and started enrolling a limited number of students.

Ayeza Umar with dietetic intern.

I have trained 13 students in the last six months. In a country like Pakistan where there are limited resources in health care, it is challenging to train students and equip them with the latest evidence-based practice guidelines. I always appreciate my students who have been so brave to join the internship program during the pandemic and, at the same time, I am proud of myself to be able to continue this journey of passing on knowledge to the next generation. I hope my students will continue working hard and that the field of nutrition continues to flourish in Pakistan.

Kimberley Asman

I work as an in-store retail dietitian. During the pandemic, we successfully shifted all our offerings to virtual. This includes kids and adult cooking classes, nutrition workshops, store tours, consultations and community events such as scout troop cooking classes or library recipe demonstrations. As a preceptor, I have had to adapt to find ways for my dietetic interns to be able to work with me and gain useful experiences in the virtual setting. Some dietetic interns are partially in-person, while some are completely virtual. For all virtual events, my interns have been able to participate from their home.

An intern who was partially in person was able to get ingredients in store and cook along with me in classes, helping to lead recipes. For an intern who was fully virtual, it was more of a challenge to find ways for them to contribute without cooking during class, as I was unable to provide ingredients in store. This led to finding creative ways they could assist; they were able to find nutrition tips and information about each ingredient used and provide that information during class. Both experiences led to each intern learning useful skills, including how to lead a recipe or how to tailor nutrition tips and education to various age groups.

To ensure the intern and I are working together and accomplishing all needed competencies for their internship, I have had to stay highly organized in determining their projects, and communication became key. Because we are not always together, virtual video chats and email have become essential and have helped it to feel like we were working closely together. While being virtual has been a large change from having interns assist with events in person, it has led to excellent new learning experiences that have left them more prepared for working as a registered dietitian in a post-COVID world.

Eileen Cress, EdD, RDN, LDN

This past year was unprecedented in what the world was going through, but at our facility, James H. Quillen VA Medical Center, we were unwavering in our goal to provide the best possible internship experience despite the pandemic. To make this happen, our dynamic team of preceptors sprang into action and implemented numerous changes: They modified plans to provide telehealth appointments that the interns could link to from a different location; offered Healthy Teaching Kitchens from office and home locations via telehealth; and provided phone consult opportunities and video connect appointments, so our interns could gain experience providing MNT in different settings.

Our clinical preceptors went the extra mile to research and teach the interns about nutritional needs of COVID-19 patients. Additionally, our preceptors were able to provide guidance on how to complete parts of a NFPE via telehealth. It is possible and the interns were able to see that firsthand. Our team also provided the same quality foodservice management rotation as usual, where the interns communicated with their preceptor via TEAMS when unable to meet in person. In this rotation, the interns were able to provide two distinct and amazing theme meals: A Night in Paris and Medieval Times. Our patients had to be in lockdown for months, so these meals were very special to them, and they were thrilled about the theme decorations and menu items.

Our preceptors went above and beyond the call of duty to continue our level of training despite numerous challenges. As I walked away from the medieval-themed meal, a patient thanked me for guiding the interns and stated, "you made us feel like the kings and queens that we are." To me, that says it all. It was a very positive experience for the interns to learn what a difference our profession can make in the lives of others and to see how the technology of today can keep us in touch with patients at all times.

Ricci-Lee Hotz, MS, RDN

During the pandemic, we all have had to make adjustments in the ways we interact with our clients, getting comfortable working from home (if we are lucky enough to do so) and, of course, trying to figure out how to still provide intern rotation experiences that meet their needs while working virtually.

I have had three interns over the course of the pandemic, and it has been a great experience of learning and adapting. The interns joined me over Zoom, shadowing on client visits (with client permission), created video presentations and worked on online content, as well as learning techniques of running a practice and how you can adapt when services have to be offered virtually.

I have loved the open-mindedness of the interns I have worked with and feel they were still able to get much of the same experiences they would have been able to get in person from the comfort of their own homes. There are so many interns struggling to find rotations through the pandemic, and I really encourage those who would usually precept to be open to adapting to provide those opportunities to the individuals trying to get into our incredible field of dietetics.