Reflections on Perceived Preparedness of Dietetic Internship Graduates Following Entry into Practice

Changes to Canadian Dietetic Education Models 1993-2021

Purpose: There have been many changes to both academic and practical aspects of dietetic education in Canada since 1993. This study sought to document and explore major changes. Methods: Key informants (n = 22) identified through purposeful sampling completed semi-structured interviews, using a draft timeline based on a literature review. Recordings were transcribed, coded, and analyzed thematically using a social ecologic framework. Results: Five main themes emerged: (i) challenges with the traditional dietetic education model; (ii) emergence of champions for change; (iii) barriers and facilitators for change; (iv) shift towards integration; and (v) increasing access for diverse populations. The interviews supported that changes had been driven by a need to increase access to dietitians and to improve the capacity and sustainability of dietetic education. Conclusions: The past thirty years have been marked by changes in the organization and delivery of dietetic education in Canada, mainly through collaborations of university programs with health system and community partners. Overall, dietetic education programs have increased their capacity and sustainability. By doing so, they have improved access and better positioned the profession to meet the needs of diverse populations. These findings provide context for dietitians, educators, and students to prepare for future development of the profession.

Evaluation of a Media Training Workshop for Nutrition Students and Trainees in Nova Scotia

Gaps in communication training have been identified in Canadian and international academic and practicum dietetics programs. A workshop was developed to pilot supplementary media training to nutrition students/trainees studying in Nova Scotia. Students, interns, and faculty from two universities participated in the workshop. Data on perceived learning, media knowledge/skill use, and workshop feedback were collected immediately post-workshop using a mixed-form questionnaire. A modified questionnaire was administered eight months post-workshop to obtain information on utility of the perceived acquired knowledge/skills. Closed-ended responses underwent descriptive analysis, while open-ended responses underwent thematic analysis. Twenty-eight participants completed the questionnaire post-workshop, and six completed it at follow-up. All participants rated the workshop positively (7-point Likert scale) and reported learning something new (perceived). Perceived learning emphasized general media knowledge/skills and communication skills. Follow-up data suggested participants had applied perceived media knowledge/skills in message development and media and job interviews. These data suggest that nutrition students/trainees may benefit from supplementary communications and media training and provide a stimulus for ongoing curriculum review and discussion.

Preparedness for advancing future health: a national qualitative exploration of dietetics graduates' experiences

Effective health workforce preparation is critical to the health of those who stand to benefit from its services. Emerging dietitians can provide important insights on an evolving workforce that is well-placed to advance future global health. This study aimed to explore a national sample of dietetics graduates' experiences of, and challenges faced in, dietetics workforce preparation and preparedness in Australia. An interpretive description methodology guided this study whereby researchers interpreted the meanings that participants attributed to their experiences. Twenty dietitians (graduated within the last 2 years) were purposively sampled from across Australia and detailed insights were obtained through semi-structured interviews. A multi-analyst approach employing thematic and template analysis, enabled five themes to be identified across the data set. These included: (1) being held back; (2) chasing the prize; (3) valuing real learning; (4) easing the transition; and (5) encountering influencers. While graduates appreciated their preparation, they were not empowered or equipped to embrace opportunities in diverse and emerging areas of dietetics practice. Graduates were challenged by the competitive landscape of securing obvious job opportunities and by a lack of support in transitioning into the workforce. Practice exposures and encounters with influential dietitians were highly valued. Research on role-emerging dietetics placements along with enhanced support mechanisms for novice dietitians is urgently required to ensure appropriate alignment between future dietetics preparation and practice. Obtaining insights into health professional graduates' experiences of their education can be used to ensure that emerging health workforces are relevant and responsive to future market needs.

Participating in Faculty-Supervised Extracurricular Experiential Learning Activities Contributes to Dietetic Competency Development

Purpose: To examine the relationship between Food and Nutrition graduates' involvement in faculty-supervised extracurricular experiential learning activities (FEEs) and the development of dietetic competencies. Methods: An original web-based survey, assessing involvement in FEEs and self-perceived level of Canadian dietetic competencies, was administered to Brescia University College Food and Nutrition graduates for graduation years 2011-2017. Competency scores were calculated for each respondent in 4 practice areas (Professional Practice, Communication and Collaboration, Population and Public Health, and Management), and summed for a Total Competency Score. Multiple linear regressions were used to assess predictors of competency scores. Results: The final sample consisted of 233 respondents who participated in 1.9 ± 1.1 FEEs. The highest average competency score (out of 100) was Communication and Collaboration (59.7 ± 31.7); the lowest was Management (40.3 ± 30.9). Total hours spent and breadth of experiences in FEEs were significant predictors of all scores (P < 0.05). Depth of experiences was a significant predictor of all competency scores (P < 0.05) except for Management (P = 0.27). Conclusions: Participation in FEEs contributes to Food and Nutrition students' development of entry-level dietetic competencies; therefore, counting some FEEs as curricular credits may be warranted. Given the prominence of competency-based learning assessments, these results also have implications for faculty resources, budgets, and collective agreements.

Dietetics students' experiences of dietetics workforce preparation and preparedness: a systematic review and qualitative synthesis

BACKGROUND

Dietetics students are a widely researched group. As emerging dietitians, they can provide valuable insights to inform how dietetics education programmes may be enhanced to meet contemporary healthcare needs. This review aimed to systematically synthesise dietetics students' experiences of dietetics workforce preparation.

METHODS

MEDLINE, CINAHL, Embase, PsycINFO, ERIC, Informit and ProQuest Dissertations and Theses Global were searched to identify research published until June 2017. Studies investigating dietetics students' experiences of dietetics workforce preparation, and employing qualitative data collection and analysis methods were included. Data analysis was guided by thematic synthesis, where themes were constructed through an iterative and inductive process. Study quality was appraised using the RATS Qualitative Research Review Guidelines.

RESULTS

From the 3301 records identified, five studies met the inclusion criteria and the views of 120 dietetics students from two countries over a 9-year period were synthesised. The overarching theme of 'navigating through the ups and downs' was underpinned by four main themes: enduring hurdles; reconciling expectations; transforming self; and making and breaking connections. Quality appraisal results rated selection bias as being inadequate/inappropriate across all studies.

CONCLUSIONS

Dietetics students undertake a transformational journey through dietetics education. They are inspired by seeing what is possible through meaningful encounters with practitioners in diverse settings. However, they are challenged by competitive environments and perceived ideals that are embedded in the profession. Strategies that focus on exposing dietetics students to inspirational practitioners, increasing and celebrating diversity in academic/placement settings, and incentivising collaboration across dietetics education, could act as catalysts to enhance the experience of future dietetics students and the nutrition-related health of those they will serve.

Is it possible to enhance the confidence of student dietitians prior to professional placements? A design-based research model

BACKGROUND

Student confidence is an important contributor to a successful professional placement experience. The present study aimed to evaluate a placement preparation program for student dietitians and to assess the impact on self-rated confidence with respect to commencing placements.

METHODS

The present study is part of a design-based research approach that involves students in a cyclic enquiry to evaluate and improve curricula. Nutrition and Dietetics students at an Australian university participated in a 1-week mandatory workshop - Pre-Placement week (PrePW), N = 98 students: in 2015 (n = 54) and 2016 (n = 44). An online survey was conducted before and after PrePW using a five-point Likert scale (1 = not confident; 5 = very confident) to assess self-rated confidence to commence placements. Mean (SD) scores were calculated. Paired and independent t-tests evaluated within- and between-group differences, respectively.

RESULTS

Before PrePW, the mean (SD) for student confidence to commence placements overall (in all areas of practise) was 'somewhat confident' [2.9 (0.6) in 2015 and 3.0 (0.7) in 2016]. Students were least confident to commence Clinical Practice [2015: 2.5 (0.6); 2016: 2.8 (0.6)] compared to Food Service Management (FSM) [2015: 3.2 (0.9); 2016: 3.1 (0.9)] and Community and Public Health Nutrition (CPHN) [2015: 3.3 (0.9); 2016: 3.2 (0.8)]. Student feedback from PrePW 2015 was used to change the curriculum and PrePW program. The 2016 students reported significantly greater confidence within all areas of practice: Clinical Practice [3.4 (0.6)], FSM [3.7 (0.6)] and CPHN [3.8 (0.6)], including confidence to commence placements overall [3.6 (0.6)] (P < 0.05).

CONCLUSIONS

Design-based research provides a useful framework for improvement to curricula and, in this case, was successful in enhancing student confidence in preparation for professional placement.