Quality Assurance Program
Peer and Practice Assessment
The purpose of the College of Dietitians of Ontario Peer & Practice Assessment (PPA) is to:
- Provide assurance to the public and other stakeholders that Registered Dietitians (RDs) in Ontario practice safely, competently and ethically; and
- Where there is a need, assist RDs in improving their individual competence in a positive and supportive environment using processes that are flexible and acceptable to members.
The PPA evaluates whether the knowledge, skills, judgment or practice performances of an RD meet established standards. Behavioural-based questions are used to assess an RD’s practice performance with respect to the Essential Competencies for Dietitians in Canada. These questions form a semi-structured interview conducted by a Registered Dietitian Peer Assessor.
Practice enhancement strategies are used when standards are not met. Both assessments and enhancement are designed to be flexible, acceptable and positive experiences for the RD.
Under the RHPA, Registered Dietitians (RDs) are required to participate in the College’s Peer & Practice Assessment (PPA) when selected. RDs are expected to cooperate fully with the Quality Assurance (QA) Committee and/or the College Assessor, which means that they are required to do any or all of the following:
- Permit the Assessor/s to enter and inspect the premises where they practice;
- Permit the Assessor to inspect their records of the care of patients;
- Give the QA Committee or the Assessor the information requested with respect to the care of patients or with respect to their records of the care of patients in the form the Committee or Assessor specifies;
- Confer with the QA Committee or the Assessor if requested to do so; and/or
- Participate in a program designed to evaluate the knowledge, skill and judgment of the RD.
If an RD does not fully participate in the PPA or cooperate with an Assessor or the QA Committee, the Committee may refer the matter to the College’s Inquiries, Complaints and Reports Committee for consideration of professional misconduct.
1. Random Selection
The Quality Assurance (QA) Regulation requires the College to randomly select RDs to participate in the PPA. The College selects between 2 - 5% annually based on resources needed to conduct the PPA.
All RDs in Ontario are eligible for random selection except for:
- RDs who are not practising in Ontario;
- Those whose Certificate of Registration is under suspension;
- RDs with a Temporary Certificate of Registration;
- New RDs who passed the Canadian Dietetic Registration Examination (CDRE) for a period of three years; and,
- RDs who completed the PPA or any form of Practice Assessment for randomly selected members within the previous five years.
2. Referred by the Quality Assurance Committee
The QA Committee may require an RD to participate in the PPA if he/she has not complied with other submission requirements of the QA Program such as the Self-Directed Learning (SDL) Tool or the Jurisprudence Knowledge and Assessment Tool (JKAT). This includes:
- RDs who are not practising in Ontario;
- New RDs who passed the (CDRE); and,
- RDs who completed the PPA or any form of Practice Assessment for randomly selected members within the previous five years.
Notification
RDs required to participate in the PPA are notified in March and assigned an assessor. The assessor’s role is to conduct the interview and file a report with the Quality Assurance Committee. Members must work with the assessor to determine the most suitable time for the assessment. The assessment must take place between April 1 to June 30.
The Assessment
Once a suitable time is arranged, the Assessor meets the RD at their work place to conduct the PPA. It is expected that the assessment should take about two to three hours of the RD’s time.
The PPA uses behavioural-based questions to assess the RD’s practice performance with respect to the
Essential Competencies for Dietitians in Canada. These questions form a semi-structured interview conducted by a Registered Dietitian Peer Assessor. The interview is tailored to the RD based on their practice.
Assessment Questions
All interviews include 1) general questions that assess competencies common to all RDs and 2) questions that assess competencies specific to an RDs area of practice.
1) Questions common to all RDs will assess the following essential competencies:
- Responsibility and accountability — Assumes responsibility and accountability in the provision of competent, safe, ethical, professional practice:
- Communication – Communicates and interacts effectively with individuals and groups in the provision of professional services: and
- Competence – Maintains competence in dietetic practice and the provision of professional services
2. Questions specific to RD practice will assess essential competencies in the following areas of dietetic practice:
- Client Care – Providing professional services to achieve the nutrition care goals of clients
- Community and Population Health – Providing professional services to promote health and prevent disease in communities and populations
- Management of Organizations – Applying organization management principles in the provision of professional service
- Management of Food Service Systems – Applying principles of foodservice systems management in the provision of safe, nutritious foods
Information RDs provide to the College on their renewal form will help determine which questions would optimally assess an RD’s competence in their area of practice. Participating RDs are asked to complete a pre-assessment questionnaire which is designed to complement and/or confirm information already on file with the College.
The Assessment Report
After the assessment, the assessor completes a report that summarizes how the RD scored (yes and no options) at demonstrating the competencies and performance behaviours assessed. A copy of the report is sent to both the RD and the Quality Assurance (QA) Committee.
Upon review of the assessor’s report, the Registered Dietitian can make a submission to the QA Committee if they feel that there are other facts they want the Committee to be aware of when they make their decision.
The QA Committee Makes a Decision
The QA Committee makes a decision based on the assessor’s report. In their review of the report (and possibly a submission from the Registered Dietitian) the QA Committee may take the following action:
- do nothing, which means that the process in complete;
- require the RD to participate in specified continuing education or practice enhancement program if there are areas in the RD’s knowledge, skill and judgment that have been assessed and found to be unsatisfactory; or
- in very extreme circumstances, direct the Registrar to impose terms, conditions or limitations for a specified period to be determined by the QA Committee on the certificate of registration of the RD.
Reconsideration of the QA Committee’s decision:
RDs have the right to have the QA Committee reconsider their decision. This is in addition to making a submission prior to the QA Committee making their decision which is described above. If the RD wants the QA Committee to reconsider their decision then they must request this in writing and should include:
- Their name and registration number.
- The reason for the requested reconsideration.
- Any documentation that may be pertinent and supportive of the reconsideration and would assist the QA Committee in making its decision.
The QA Committee, or a panel thereof, may choose between the options listed below when conducting a reconsideration of their decision:
- Do nothing and continue with the PPA process as per the QA Regulation and policies;
- Require the RD to undergo a new PPA with the same or a different Assessor. The Committee may require the member to pay for the cost of a new assessment depending on the circumstances;
- Reconsider any earlier QA Committee decision if one was made and issue a new decision; or
- Any other remedy within the authority of the QA Committee.
Members can request that a Peer & Practice Assessment (PPA) be delayed for extenuating circumstances. The Quality Assurance (QA) Committee will consider requests in a fair, equitable and an objective manner based on the RD’s circumstances.
Requests should be made in writing (email and fax are accepted) by June 1st at the latest. However, the College acknowledges that in some cases it may be necessary to file a request after June 1st.
The written request should include the following:
- RD’s name and registration number clearly identified;
- The request for the extension or deferral in completing the PPA;
- An indication of the amount of time being requested;
- Medical certificates, notes or letters to support a medical reason for the request
- An indication of the RD’s current work status;
- Any information/reasons that is pertinent and supportive of the request and would assist the College in making its decision; and
- Supporting documentation from other sources/persons if available.
A member who has a disability (defined according to the Human Rights Code) and requires special accommodation to complete the Peer & Practice Assessment, may request that the College make those provisions. The College will work with the member to accommodate their needs ensuring that self-worth, individuality, privacy, confidentiality comfort and autonomy is maintained. The College will assume any costs incurred as a result of accommodating a member’s special need.
