Dietitian professional competence development: an integrative review on traineeships literature in undergraduate education
Article Sidebar
Published:
Jun 30, 2021
Keywords:
Learning from the field, Undergraduate education, dietitian, standards, traineeship
Main Article Content
Abstract
Introduction
Integrating theory and learning from the field is considered essential in Dietitians undergraduate education. The evolution of healthcare professional practice and the evolving needs of workplaces lead to the urge for continuous improvement of learning experiences, in order to ensure that students achieve the required standards of competence. In Italy, general guidelines are currently given with the healthcare professions traineeships, but they do not specifically concern future Dietitians; agreed and specific standards for the Dietitians undergraduate internships are lacking.
Aims
Our goal was to search standards and guidelines for the Dietitians traineeship in national and international literature, to identify expected competencies and best practices to improve the traineeship in an Italian context.
Materials and methods
An integrative literature review on the Dietitian internship (combining scientific and grey literature) was conducted by using PubMed, CINAHL, Embase, Eric databases, and the Google Scholar search engine. Furthermore, we consulted institutional national websites and documents of the Italian Permanent Conference of the Healthcare Professions Undergraduate Programs, in addition to the most representative Dietitian Associations websites. The search keywords were: "Nutritionist", "Dietitian", "Dietician", "Dietetics student", "Nutritional Sciences", "Dietetics", "Dietetics education", "Traineeship," Apprenticeship "," Internship "," Learning in the field”, “On-the-job training”, combined with the boolean operators AND and OR. The selected papers were analyzed and charted; finally, a thematic analysis of the charted data was conducted by the researchers.
Results
Fifty-two papers from scientific (n=36) and grey (n=16) literature were eligible. From da-ta analysis, the following recommendations for the Dieticians internship emerged:
- To develop adequate students theoretical background before practice.
- To define traineeship learning objectives, starting from national/international standards.
- To use multiple, innovative, and student-centered learning approaches and training strategies.
- To involve adequately trained tutors and staff at a clinical/specialist and educational level;
- To guarantee variability and diversification of experiences and settings of students, still considering the logic of internship rotations.
- To develop stimulating, inclusive and collaborative learning environments.
- To encourage regular use of constructive and reciprocal feedback.
- To guarantee clear and effective communication between all the stakeholders.
- To increase mutual commitment and collaboration between university and internship partners.
Conclusions
Regardless of the diversified organizational peculiarities of various national and international contexts, the need to implement innovative and sustainable approaches for the undergraduate traineeship of Dietitians is commonly acknowledged. To promote continuous improvement, constantly analyzing and monitoring the quality of the internships is considered pivotal.
Downloads
Download data is not yet available.
Article Details
How to Cite
Matelloni, I. A., & Zannini, L. (2021). Dietitian professional competence development: an integrative review on traineeships literature in undergraduate education. Journal of Biomedical Practitioners, 5(1). https://doi.org/10.13135/2532-7925/5939
Issue
Section
Articles
The authors agree to transfer the right of their publication to the Journal, simultaneously licensed under a Creative Commons License - Attribution that allows others to share the work indicating intellectual authorship and the first publication in this magazine.
References
[1] Conferenza permanente dei Corsi di Laurea delle professioni sanitarie. Principi e Standard Del Tirocinio Pro-fessionale Nei Corsi Di Laurea Delle Professioni Sanitarie.; 2010.
[2] EFAD, DIETS. European Practice Placement Standards for Dietetics.; 2010.
[3] Brissette C, Leung E, Darling PB, Keith M. Reflections on perceived preparedness of dietetic internship grad-uates following entry into practice. Can J Diet Pract Res. 2014;75(4):202-205. doi:10.3148/cjdpr-2014-010
[4] Palermo C, Dart J, Begley A, et al. Dietetics students’ construction of competence through assessment and placement experiences. Nutr Diet. 2018;75:307-315. doi:10.1111/1747-0080.12359
[5] Ghirotto L. La Systematic Review Nella Ricerca Qualitativa. (Carocci, ed.). Roma; 2020.
[6] Pautasso M. Ten Simple Rules for Writing a Literature Review. PLoS Comput Biol. 2013;9(7):1-4. doi:10.1371/journal.pcbi.1003149
[7] Turner RE, Evers WD, Bennet Wood O, Lehman JD, Peck LW. Computer-based simulation enhance clinical experience of dietetics interns. J Am Diet Assoc. 2000;100:183-190.
[8] Martin RL. Continuous improvement in dietetics education with a regional advisory board: A model that works. J Am Diet Assoc. 2003;103(8):1026-1028. doi:10.1016/S0002-8223(03)00475-9
[9] Ortman D, Mann L, Arsenault JF. Perceived roles, benefits, and supports: For dietetic internship preceptors. Can J Diet Pract Res. 2010;71(1):33-38. doi:10.3148/71.1.2010.33
[10] Shows AR, Killough JE, Jackson S, Lui J. Instilling Success in an Internship Program: A Dietetic Case Study. J Fam Consum Sci. 2015;107(3):50-54.
[11] Gibson S, Dart J, Bone C, Palermo C. Dietetic Student Preparedness and Performance on Clinical Place-ments. Perspectives of Clinical Educators. J Allied Health. 2015;44(2):101-108.
[12] Gord C. Preparing students for experiential learning in a clinical setting - Abstracts from Dietetic Research Event – June 04–06, 2015. Can J Diet Pract Res. 2015;76(3):7-8. doi:10.3148/cjdpr-2015-026
[13] Maher J, Pelly F, Swanepoel E, Sutakowsky L, Hughes R. The contribution of clinical placement to nutrition and dietetics competency development: A student-centred approach. Nutr Diet. 2015;72(2):156-162. doi:10.1111/1747-0080.12163
[14] Kapica C, O’ Sullivan Maillet J. A business rotation for dietitians - An imperative in the new millennium. J Am Diet Assoc. 2002;102(9):1220.
[15] Markaki A, Spyridaki A, Chatzi V, Joossens S, de Looy A. Exploring the quality of European dietetic practice placements. Nutr Food Sci. 2015;45(3):377-387. doi:10.1108/NFS-10-2014-0094
[16] Reidlinger DP, Lawrence J, Thomas JE, Whelan K. Peer-assisted learning and small-group teaching to im-prove practice placement quality and capacity in dietetics. Nutr Diet. 2017;74:349-356. doi:10.1111/1747-0080.12293
[17] Wright L. Comparison of Student Outcomes in Distance. Top Clin Nutr. 2009;24(3):243-251.
[18] Lordly D, Taper J. Assumptions lead to the devaluation of dietitian roles in long-term care practice envi-ronments. J Allied Health. 2008;37(2):78-81.
[19] Kruzich LA, Anderson J, Litchfield RE, Wohlsdorf-Arendt S, Oakland MJ. A preceptor focus group approach to evaluation of a dietetic internship. J Am Diet Assoc. 2003;103(7):884-886. doi:10.1053/jada.2003.50165
[20] Barr AB, Walters MA, Hagan DW. The value of experiential education in dietetics. J Am Diet Assoc. 2002;102:1458-1460.
[21] Pender FT, de Looy AE. The testing of clinical skills in dietetic students prior to entering clinical placement. J Hum Nutr Diet. 2004;17(1):17-24. doi:10.1046/j.1365-277X.2003.00474.x
[22] Pender FT, de Looy AE. Monitoring the development of clinical skills during training in a clinical placement. J Hum Nutr Diet. 2004;17(1):25-34. doi:10.1046/j.1365-277X.2003.00473.x
[23] Rose M, Mcalpine L, Strychar I. Learning opportunity and preparedness for practice: Perceptions from die-tetics programs in Canada. Can J Diet Pract Res. 2005;66(4):221-228. doi:10.3148/66.4.2005.221
[24] Raeder Schumacher J. Critical-Thinking Dispositions Among Dietetic Interns at the Completion of their In-ternship. J Fam Consum Sci. 2014;106(2):55-57.
[25] Knoblock-Hahn AL, Scharff DP, Elliott M. Cultural competence in dietetics education: Where are we now and where do we need to go? Top Clin Nutr. 2010;25(4):323-334. doi:10.1097/TIN.0b013e3181faba17
[26] Gates G, Sandoval W. Teaching multiskilling in dietetics education. J Am Diet Assoc. 1998;98:278-284.
[27] McWhorter JW, Raber M, Sharma S V., Moore LS, Hoelscher DM. The Nourish Program: An Innovative Mod-el for Cooking, Gardening, and Clinical Care Skill Enhancement for Dietetics Students. J Acad Nutr Diet. 2019;119(2):199-203. doi:10.1016/j.jand.2017.12.004
[28] Kicklighter JR, Dorner B, Hunter AM, et al. Visioning Report 2017: A Preferred Path Forward for the Nutri-tion and Dietetics Profession. J Acad Nutr Diet. 2017;117(1):110-127. doi:10.1016/j.jand.2016.09.027
[29] McIntosh C. Dietitian students empowered for change - Abstracts from Dietetic Research Event – June 04–06, 2015. Can J Diet Pract Res. 2015;65(3):10.
[30] Henry BW, Duellman MC, Smith TJ. Nutrition-based standardized patient sessions increased counseling awareness and confidence among dietetic interns. Top Clin Nutr. 2009;24(1):25-34. doi:10.1097/TIN.0b013e3181978050
[31] Henry BW, Smith TJ. Evaluation of the FOCUS (Feedback on Counseling Using Simulation) Instrument for As-sessment of Client-centered Nutrition Counseling Behaviors. J Nutr Educ Behav. 2010;42(1):57-62. doi:10.1016/j.jneb.2008.12.005
[32] Cividin T. Journal Writing in a Dietetic Internship Program. Can J Diet Pract Res. 2004;65(3):B8.
[33] Fontenot Molaison E, Taylor KA, Erickson D, Lawson Connell C. The use and perceptions of concept mapping as a learning tool by dietetic internship students and preceptors. J Allied Health. 2009;38(3):97-103.
[34] Morley C. Integrating the Organizational Framework for Exploring Nutrition Narratives (OFFENN) and the Nutrition Community Mentors Project (NCMP) to prepare students for their roles in client-centred nutrition counselling - Abstracts from Dietetic Research Event – . Can J Diet Pract Res. 2015;65(3):9-10.
[35] Penumetcha M, McCarroll C, Smith SC. Use of a food frequency questionnaire to fulfill the research compe-tency requirement for dietetics students. J Allied Health. 2012;41(1).
[36] Jean-Jacques Gilbert. Guida Pedagogica per Il Personale Sanitario. Edizione Italiana a Cura Di G. Palascia-no e A. Lotti. (Edizioni dal Sud, ed.). Bari; 2001.
[37] Lordly D, MacLellan D. Dietetic students’ identity and professional socialization: In preparation for prac-tice. Can J Diet Pract Res. 2012;73(1):7-13. doi:10.3148/73.1.2012.7
[38] Hinrichs RJ. Dietetic interns’ perceptions and use of evidence-based practice: an exploratory study. J Med Libr Assoc. 2018;106(1). doi:10.5195/jmla.2018.308
[39] Lordly D. Dietetic prior learning assessment: Student and faculty experiences. Can J Diet Pract Res. 2007;68(4):207-212. doi:10.3148/68.4.2007.207
[40] PDEP. Accreditation Standards for Dietetic Education Programs in Canada - 2014.; 2014.
[41] ACEND. ACEND Accreditation Standards for Nutrition and Dietetics Coordinated Programs (CP).; 2017. www.eatright.org/ACEND.
[42] BDA. A Curriculum Framework for the Pre-Registration Education and Training of Dietitians.; 2013.
[43] DIETS2. Guide to Lifelong Learning for Dietitians in Europe - How to Develop Your Professional Compe-tence.; 2013.
[44] EFAD and DIETS. Pedagogic Standards for Dietetic Placement Teachers.; 2013.
[45] BDA. A Guide to Innovative Practice Education Placements.; 2015.
[46] ICDA. International Standards for Dietitians-Nutritionists. http://www.internationaldietetics.org/Downloads/International-Definition-of-Dietitian.aspx. Published 2014. Accessed November 24, 2019.
[47] ICDA. Dietitians-Nutritionists around the World. Their Education and Their Work.; 2016. https://www.internationaldietetics.org/Downloads/2016-ICDA-Education---Work-report.aspx.
[48] DAA. Accreditation Standards for Dietetics Education Programs - Version 2.0.; 2017.
[49] Adami G, Borgarelli C, Capezzali D, et al. Il Core Competence Del Dietista - Linee Di Indirizzo per La For-mazione Universitaria. (Genova) C di ME (Università degli S di, ANDID, eds.).; 2013.
[50] EFAD. Dietitians in Europe. Definition, Profession and Education.; 2016.
[51] Dietitians Improving Education and Training Standards. Report 2: Learning About Practice Placement Educa-tion From Each Other.; 2009.
[52] Proudfoot A, Lordly D, Anderson B, Gillis D. Enhanced dietetics education through collaboration: A study to identify opportunities. Can J Diet Pract Res. 2014;75(2):101-104. doi:10.3148/75.2.2014.101
[53] EFAD. EFAD Academic Standards – 2018 Revision.; 2018.
[2] EFAD, DIETS. European Practice Placement Standards for Dietetics.; 2010.
[3] Brissette C, Leung E, Darling PB, Keith M. Reflections on perceived preparedness of dietetic internship grad-uates following entry into practice. Can J Diet Pract Res. 2014;75(4):202-205. doi:10.3148/cjdpr-2014-010
[4] Palermo C, Dart J, Begley A, et al. Dietetics students’ construction of competence through assessment and placement experiences. Nutr Diet. 2018;75:307-315. doi:10.1111/1747-0080.12359
[5] Ghirotto L. La Systematic Review Nella Ricerca Qualitativa. (Carocci, ed.). Roma; 2020.
[6] Pautasso M. Ten Simple Rules for Writing a Literature Review. PLoS Comput Biol. 2013;9(7):1-4. doi:10.1371/journal.pcbi.1003149
[7] Turner RE, Evers WD, Bennet Wood O, Lehman JD, Peck LW. Computer-based simulation enhance clinical experience of dietetics interns. J Am Diet Assoc. 2000;100:183-190.
[8] Martin RL. Continuous improvement in dietetics education with a regional advisory board: A model that works. J Am Diet Assoc. 2003;103(8):1026-1028. doi:10.1016/S0002-8223(03)00475-9
[9] Ortman D, Mann L, Arsenault JF. Perceived roles, benefits, and supports: For dietetic internship preceptors. Can J Diet Pract Res. 2010;71(1):33-38. doi:10.3148/71.1.2010.33
[10] Shows AR, Killough JE, Jackson S, Lui J. Instilling Success in an Internship Program: A Dietetic Case Study. J Fam Consum Sci. 2015;107(3):50-54.
[11] Gibson S, Dart J, Bone C, Palermo C. Dietetic Student Preparedness and Performance on Clinical Place-ments. Perspectives of Clinical Educators. J Allied Health. 2015;44(2):101-108.
[12] Gord C. Preparing students for experiential learning in a clinical setting - Abstracts from Dietetic Research Event – June 04–06, 2015. Can J Diet Pract Res. 2015;76(3):7-8. doi:10.3148/cjdpr-2015-026
[13] Maher J, Pelly F, Swanepoel E, Sutakowsky L, Hughes R. The contribution of clinical placement to nutrition and dietetics competency development: A student-centred approach. Nutr Diet. 2015;72(2):156-162. doi:10.1111/1747-0080.12163
[14] Kapica C, O’ Sullivan Maillet J. A business rotation for dietitians - An imperative in the new millennium. J Am Diet Assoc. 2002;102(9):1220.
[15] Markaki A, Spyridaki A, Chatzi V, Joossens S, de Looy A. Exploring the quality of European dietetic practice placements. Nutr Food Sci. 2015;45(3):377-387. doi:10.1108/NFS-10-2014-0094
[16] Reidlinger DP, Lawrence J, Thomas JE, Whelan K. Peer-assisted learning and small-group teaching to im-prove practice placement quality and capacity in dietetics. Nutr Diet. 2017;74:349-356. doi:10.1111/1747-0080.12293
[17] Wright L. Comparison of Student Outcomes in Distance. Top Clin Nutr. 2009;24(3):243-251.
[18] Lordly D, Taper J. Assumptions lead to the devaluation of dietitian roles in long-term care practice envi-ronments. J Allied Health. 2008;37(2):78-81.
[19] Kruzich LA, Anderson J, Litchfield RE, Wohlsdorf-Arendt S, Oakland MJ. A preceptor focus group approach to evaluation of a dietetic internship. J Am Diet Assoc. 2003;103(7):884-886. doi:10.1053/jada.2003.50165
[20] Barr AB, Walters MA, Hagan DW. The value of experiential education in dietetics. J Am Diet Assoc. 2002;102:1458-1460.
[21] Pender FT, de Looy AE. The testing of clinical skills in dietetic students prior to entering clinical placement. J Hum Nutr Diet. 2004;17(1):17-24. doi:10.1046/j.1365-277X.2003.00474.x
[22] Pender FT, de Looy AE. Monitoring the development of clinical skills during training in a clinical placement. J Hum Nutr Diet. 2004;17(1):25-34. doi:10.1046/j.1365-277X.2003.00473.x
[23] Rose M, Mcalpine L, Strychar I. Learning opportunity and preparedness for practice: Perceptions from die-tetics programs in Canada. Can J Diet Pract Res. 2005;66(4):221-228. doi:10.3148/66.4.2005.221
[24] Raeder Schumacher J. Critical-Thinking Dispositions Among Dietetic Interns at the Completion of their In-ternship. J Fam Consum Sci. 2014;106(2):55-57.
[25] Knoblock-Hahn AL, Scharff DP, Elliott M. Cultural competence in dietetics education: Where are we now and where do we need to go? Top Clin Nutr. 2010;25(4):323-334. doi:10.1097/TIN.0b013e3181faba17
[26] Gates G, Sandoval W. Teaching multiskilling in dietetics education. J Am Diet Assoc. 1998;98:278-284.
[27] McWhorter JW, Raber M, Sharma S V., Moore LS, Hoelscher DM. The Nourish Program: An Innovative Mod-el for Cooking, Gardening, and Clinical Care Skill Enhancement for Dietetics Students. J Acad Nutr Diet. 2019;119(2):199-203. doi:10.1016/j.jand.2017.12.004
[28] Kicklighter JR, Dorner B, Hunter AM, et al. Visioning Report 2017: A Preferred Path Forward for the Nutri-tion and Dietetics Profession. J Acad Nutr Diet. 2017;117(1):110-127. doi:10.1016/j.jand.2016.09.027
[29] McIntosh C. Dietitian students empowered for change - Abstracts from Dietetic Research Event – June 04–06, 2015. Can J Diet Pract Res. 2015;65(3):10.
[30] Henry BW, Duellman MC, Smith TJ. Nutrition-based standardized patient sessions increased counseling awareness and confidence among dietetic interns. Top Clin Nutr. 2009;24(1):25-34. doi:10.1097/TIN.0b013e3181978050
[31] Henry BW, Smith TJ. Evaluation of the FOCUS (Feedback on Counseling Using Simulation) Instrument for As-sessment of Client-centered Nutrition Counseling Behaviors. J Nutr Educ Behav. 2010;42(1):57-62. doi:10.1016/j.jneb.2008.12.005
[32] Cividin T. Journal Writing in a Dietetic Internship Program. Can J Diet Pract Res. 2004;65(3):B8.
[33] Fontenot Molaison E, Taylor KA, Erickson D, Lawson Connell C. The use and perceptions of concept mapping as a learning tool by dietetic internship students and preceptors. J Allied Health. 2009;38(3):97-103.
[34] Morley C. Integrating the Organizational Framework for Exploring Nutrition Narratives (OFFENN) and the Nutrition Community Mentors Project (NCMP) to prepare students for their roles in client-centred nutrition counselling - Abstracts from Dietetic Research Event – . Can J Diet Pract Res. 2015;65(3):9-10.
[35] Penumetcha M, McCarroll C, Smith SC. Use of a food frequency questionnaire to fulfill the research compe-tency requirement for dietetics students. J Allied Health. 2012;41(1).
[36] Jean-Jacques Gilbert. Guida Pedagogica per Il Personale Sanitario. Edizione Italiana a Cura Di G. Palascia-no e A. Lotti. (Edizioni dal Sud, ed.). Bari; 2001.
[37] Lordly D, MacLellan D. Dietetic students’ identity and professional socialization: In preparation for prac-tice. Can J Diet Pract Res. 2012;73(1):7-13. doi:10.3148/73.1.2012.7
[38] Hinrichs RJ. Dietetic interns’ perceptions and use of evidence-based practice: an exploratory study. J Med Libr Assoc. 2018;106(1). doi:10.5195/jmla.2018.308
[39] Lordly D. Dietetic prior learning assessment: Student and faculty experiences. Can J Diet Pract Res. 2007;68(4):207-212. doi:10.3148/68.4.2007.207
[40] PDEP. Accreditation Standards for Dietetic Education Programs in Canada - 2014.; 2014.
[41] ACEND. ACEND Accreditation Standards for Nutrition and Dietetics Coordinated Programs (CP).; 2017. www.eatright.org/ACEND.
[42] BDA. A Curriculum Framework for the Pre-Registration Education and Training of Dietitians.; 2013.
[43] DIETS2. Guide to Lifelong Learning for Dietitians in Europe - How to Develop Your Professional Compe-tence.; 2013.
[44] EFAD and DIETS. Pedagogic Standards for Dietetic Placement Teachers.; 2013.
[45] BDA. A Guide to Innovative Practice Education Placements.; 2015.
[46] ICDA. International Standards for Dietitians-Nutritionists. http://www.internationaldietetics.org/Downloads/International-Definition-of-Dietitian.aspx. Published 2014. Accessed November 24, 2019.
[47] ICDA. Dietitians-Nutritionists around the World. Their Education and Their Work.; 2016. https://www.internationaldietetics.org/Downloads/2016-ICDA-Education---Work-report.aspx.
[48] DAA. Accreditation Standards for Dietetics Education Programs - Version 2.0.; 2017.
[49] Adami G, Borgarelli C, Capezzali D, et al. Il Core Competence Del Dietista - Linee Di Indirizzo per La For-mazione Universitaria. (Genova) C di ME (Università degli S di, ANDID, eds.).; 2013.
[50] EFAD. Dietitians in Europe. Definition, Profession and Education.; 2016.
[51] Dietitians Improving Education and Training Standards. Report 2: Learning About Practice Placement Educa-tion From Each Other.; 2009.
[52] Proudfoot A, Lordly D, Anderson B, Gillis D. Enhanced dietetics education through collaboration: A study to identify opportunities. Can J Diet Pract Res. 2014;75(2):101-104. doi:10.3148/75.2.2014.101
[53] EFAD. EFAD Academic Standards – 2018 Revision.; 2018.