Lisa Edwards

Aim: To evaluate the effectiveness of training sessions for health professionals concerning folic acid in pregnancy. Methods: Training sessions were held for Community Health Professionals to disseminate the current Department of Health recommendations about folic acid. The professions targeted were those who were more likely to come into contact with women of child-bearing age, e.g. midwives, health visitors, practice nurses and family planning staff. Altogether 24 1-h training sessions were held reaching 189 staff. Each session consisted of factual information, a brainstorming session about what pregnant women eat and a nutrition game involving calculating a day’s intake of folic acid. Questionnaires were used to evaluate the level of knowledge before and after training. Feedback about the sessions was also obtained from participants. Results: With every group trained there was an improvement in knowledge. The greatest change was that staff realized how difficult it is to consume the recommended amount of folic acid from food alone. Before the training session 42% of the health professionals thought that women could eat enough folic acid and after the training this had fallen to just 1%. Conclusion: The training sessions produced positive changes. In addition, the process of evaluation, which is increasingly recognized as important for dietitians, was found to be rewarding. Key words: Community Health Professionals, evaluation, folic acid, nutrition education.

Pre-registration education of dietitians involves academic periods of study with integrated practice-based placements based on a curriculum and competency model set out by the British Dietetic Association (BDA, 2020a) and the Health and Care Professions Council (HCPC, 2017). There is increasing awareness of the challenges of healthcare placements, the changing needs of the NHS and the demand to expand healthcare training and reduce attrition to ensure a good supply of suitably qualified dietitians available to work in healthcare. Providing appropriate placement preparation and support to students and their practice educators is therefore of importance. The main research question was to explore how dietetic students and practice educators experience current preparation for practice placements and how well it equips students for a successful placement and working in the NHS. Focus groups were conducted with dietetic students post-placement, and with practice educators to explore current preparation for placement and whether anything more could be done to enhance completion and success. Inductive-deductive thematic analysis was undertaken to analyse the findings. Two focus groups with students were held gathering data from five undergraduate and five postgraduate students. Four focus groups were held for practice educators and in total there were thirteen participants. The key findings showed congruence amongst the students and the practice educators in some aspects of pre-placement preparation and education. Five themes were identified: 1: Finding the right support, 2: Professional socialisation and expectations, 3: Development of competence in the practice setting, 4: Factors outside placement, and 5: Interaction with peers and sharing experiences. Putting academic knowledge into practice, being made to feel part of the team, and feedback mechanisms were not cited as concerns. However, the key findings included that the changing nature of the NHS and the concurrent changing roles of dietitians means that many students now spend time in specialist areas and gaps in understanding expectations of the required level of competence were raised as a concern by the students and the practice educators. Placement preparation in terms of professional socialisation and the pace of working in the NHS were also raised as key issues. The students cited the needed more information on who to liaise with and approach if they experience challenges on placement, and the practice educators requested more guidance on how to support students with additional or diverse learning needs. The thesis concludes with recommendations for dietetics to review and restructure placement preparation and the initial 3-week introductory placement. The students need more information on who to go to if they experience challenges on placement, and practice educators need more guidance on how to support these students. More information needs to be provided to support practice educators in terms of what constitutes reasonable adjustments, and expectations of those dietitians working in more specialist areas. The role of Bourdieu’s theory of capital, habitus and field is explored as a possible model for guiding and enhancing placement preparation. The findings may be applicable for other healthcare students and staff, and other training that involves placements such as education.