Community Nutrition Competency Evaluation with associated learning activities
Please evaluate the intern on the competencies listed below.  
Scores of 1 require remediation for successful completion of the rotation.
Rotations of no longer that 3 weeks do not require a midpoint evaluation; however the preceptor may mid-point evaluate as he or she sees fit.
Competencies not accomplished due to practice site limitations should not completed  and noted in the comment section.
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Date of this evaluation *
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Student Name *
Intern Email (Required for intern to receive evaluation)
Practice Site *
Preceptor Name and Title/Credentials *
This evaluation is being completed by *
I testify that ______hours were completed for this rotation. *
CRDN 1.4: Conduct projects using appropriate research or quality improvement methods, ethical procedures and data analysis utilizing current and/or new technologies.  (Learning activity: targeted community nutrition investigation)
Does not meet expectations
Exceeds expectations
Clear selection
  CRDN 1.5: Incorporate critical-thinking skills in overall practice.   (Learning activity: targeted community nutrition proposal based on investigation) 
Does not meet expectations
Exceeds expectations
Clear selection
CRDN 2.11: Show cultural humility in interactions with colleagues, staff, clients, patients and the public. (Learning activity: demonstrate knowledge of and respect for cultural diversity during nutrition assessment and counseling)
Does not meet expectations
Exceeds expectations
Clear selection
CRDN 2.12: Implement culturally sensitive strategies to address cultural biases and differences.  (Learning activity: engage in practices that respect cultural diversity during nutrition assessment and counseling)
Does not meet expectations
Exceeds expectations
Clear selection
CRDN 2.13: Advocate for local, state or national legislative and regulatory issues or policies impacting the nutrition and dietetics profession.  (Learning activity:  participate in advocacy and public policy activities)
Does not meet expectations
Exceeds expectations
Clear selection
CRDN 3.4: Design, implement and evaluate presentations to a target audience (Learning activity: present targeted community nutrition wellness program developed based on community investigation)
Does not meet expectations
Exceeds expectations
Clear selection
CRDN 3.5:  Develop nutrition education materials that are culturally and age appropriate and designed for the educational level of the audience (Learning activity: develop materials for community wellness program created based on community investigation)
Does not meet expectations
Exceeds expectations
Clear selection
CRDN 3.7: Develop and deliver products, programs or services that promote consumer health, wellness and lifestyle management (Learning activity: develop and present community wellness program based on community investigation)
Does not meet expectations
Exceeds expectations
Clear selection
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