Peer & Practice Assessment (PPA)

The Regulated Health Professions Act requires the Quality Assurance (QA) Program of the College to conduct practice assessments of dietitians to ensure continuing competence for public protection.  The PPA:

  • Evaluates whether the knowledge, skills and judgment of Registered Dietitians (RD) meet the standards established in the Integrated Competencies for Dietetic Education and Practice (ICDEP).
  • Assures the public and other stakeholders that Registered Dietitians in Ontario practice safely, competently and ethically.
  • Helps Registered Dietitians improve their competence if an improvement is required.

Random Selection in Spring

Each year 10% of RDs are randomly selected for a Peer and Practice Assessment.  Additionally, RDs who have not complied with other quality assurance obligations, such as completing their Self-Directed Learning Tool or the Jurisprudence Knowledge and Assessment Tool, may also be required to participate in a practice assessment.

Request a deferral

A registrant may request a deferral from participating in the PPA in a given year because of: Major illness, Self/family crisis, Leave of Absence or Not currently practicing.

Registrants must submit the request for deferral form by the deadline communicated by the College.

Request for Deferral Form

The Peer and Practice Assessment is a 2-Step Process

STEP 1 involves a multi-source feedback method (often called 360 º feedback) to gather input from peers, colleagues and patients (if applicable).  Registrants will move onto Step 2 of the PPA based on several criteria including the Z Score (norm reference score), overall performance on STEP 1 and random selection of registrants who scored above the cut score.

Step 1 Handbook-Peer Practice Assessment (PPA)

Patient Cover Letters-Other Languages


Multi Source Feedback Patient Survey-Other Languages

STEP 2 involves a behaviour-based interview conducted by a peer assessor who is an experienced dietitian. A chart review is included if the dietitian provides direct patient care.

Who moves on to Step 2

The QA Committee sets a threshold score (Z Score) and other specific criteria to determine which dietitians require further assessment of their practice. Falling below a specified Z score remains the main criteria for moving onto Step 2; However, the QA Committee will have some discretion based on z-scores such that if a dietitian does not have any low scores (but rather has most scores closer to 6), they may not be asked to proceed to Step 2. Regardless of the Z score, any RD who receives an average score of 4 or less from a single patient or colleague will move onto to Step 2.

To ensure that the process is identifying the right RDs, 2-3 RDs whose Z scores are above the established criteria will be randomly chosen to move onto Step 2

Step 2 Handbook-Peer Practice Assessment (PPA)

The Quality Assurance Committee may require an RD to undertake continuing education or a practice enhancement program when Step 2 survey results identify practice concerns or learning needs. In extreme circumstances, the Committee may impose terms, conditions or limitations on an RD’s certificate of registration until the registant meets the ICDEP standards of practice.

Selected RDs Required to Participate by Law

When selected, RDs must participate in the Peer & Practice Assessment and cooperate fully with the Quality Assurance Committee and/or the College Assessor, which means they:

  • Permit the assessor to inspect their records of the patient care; 
  • Permit the assessor to enter and inspect the premises where they practice;
  • Give the QA Committee or the assessor information requested with respect to the care of patients or with respect to their records of the patient care in the form the Committee or assessor specifies; 
  • Confer with the QA Committee or the assessor if requested to do so. 

If an RD does not fulfill the terms of the Peer and Practice Assessment, the QA Committee may refer the matter to the College’s Inquiries, Complaints and Reports Committee for consideration of professional misconduct.