Development of advanced practice competency standards for dietetics in Australia

Aim: This study aimed to explore the work roles, major tasks and core activities of advanced practice dietitians in Australia to define the Competency Standards for advanced practice. Methods: A qualitative approach was used to review advanced dietetic practice in Australia involving experienced professionals, mostly dietitians. Four focus groups were conducted with a total of 17 participants and an average of 20 years experience: 15 dietitian practitioners plus 2 employers (1 dietitian and 1 non-dietitian). The focus groups explored the key purpose, roles and outcomes of these practitioners. Data from the focus groups were confirmed with in-depth interviews about their core activities with a purposive sample of 10 individuals recently recognised as Advanced Accredited Practising Dietitians. Data from both focus groups and interviews were analysed adductively to identify key themes. Results: The key theme that emerged to define advanced dietetics practice was leadership, with four subthemes that described in more detail the major work roles and outcomes of advanced practice. These subthemes identified that advanced practitioners were (i) outcome-focused, having impact; (ii) influence others and advocate; (iii) innovate and embrace change; and (iv) inspire others and are recognised for their practice. These outcomes were conceptualised within a broad generalist framework to generate revised Competency Standards. Conclusions: This study confirmed that leadership rather than specialist practice skills is the key determinant of advanced practice

Dietetics students’ construction of competence through assessment and placement experiences

Aim Competency standards are widely adopted as a framework to describe standards of performance required in the workplace. Little is known, however, about how students construct competence. This qualitative study aimed to explore how dietetics students ready to graduate construct the concept of competence and the role of assessment in developing professional competence. Methods A qualitative description was used to gather data from a convenience sample of students ready to graduate from universities with accredited dietetics programs across Australia (10 out of 15 at the time of the study). A total of 11 focus groups were conducted to explore perspectives of competence and experiences of ‘competency-based’ assessment. Data were audio-recorded, transcribed and analysed using a thematic analysis approach. Results A total of 81 (n = 81) participants across 10 universities representing 22% of total students participated in the focus groups. Themes revealed that: (i) there is no shared understanding of competence; (ii) current work placement experiences may not reflect current standards or workforce needs; (iii) assessment approaches may not fully support the development of competence; and (iv) the competent performance of supervising dietitians/clinical educators in the workplace influences the construction of competence. Conclusions There is a need to work towards a shared understanding of dietetic entry-level competence in the profession. ‘Work-based’ learning experiences may need to be modified to ensure students meet current competency standards. Practitioners involved in student supervision need to acknowledge the influential role they have in the development of the future workforce

Methodology for developing competency standards for dietitians in Australia

Competency standards document the knowledge, skills, and attitudes required for competent performance. This study develops competency standards for dietitians in order to substantiate an approach to competency standard development. Focus groups explored the current and emerging purpose, role, and function of the profession, which were used to draft competency standards. Consensus was then sought using two rounds of a Delphi survey. Seven focus groups were conducted with 28 participants (15 employers/practitioners, 5 academics, 8 new graduates). Eighty-two of 110 invited experts participated in round one and 67 experts completed round two. Four major functions of dietitians were identified: being a professional, influencing the health of individuals, groups, communities, and populations through evidence-based nutrition practice, and working collaboratively in teams. Overall there was a high level of consensus on the standards: 93% achieved agreement by participants in round one and all revised standards achieved consensus on round 2. The methodology provides a framework for other professions wishing to embark on competency standard review or development

Hidden Jedi: A critical qualitative exploration of the Fellow credential and advanced expertise

Aim: The present study aimed to describe the characteristics of a Fellow and critically review factors relevant to recognition and promotion of excellence within the profession of dietetics in Australia. Methods: Through the development of revised Competency Standards for the Fellow credential, a critical qualitative approach drawing on action research was used whereby members of the profession were given a voice in the research process. Six focus groups with a total of 30 participants explored descriptions of expertise and perceptions of Fellow by the profession and determinants of uptake. Focus groups were conducted during February and March 2018. Data were examined using a thematic analysis approach, with additional meaning explored through cultural historical activity theory. Participants/setting - A purposive sample of Australian dietitians. Results: Fellows embodied leadership, impact, influence, innovation and inspiration, internal and external to the profession and this was reflected in the revised Competency Standards. Potential Fellows perceived they were not capable of achieving the standard required. A lack of recognition of the credential both from within the community of dietetics, and externally, was identified. The role of the social system in which these credentials operate including the role of the professional association in awarding the credential are relevant. Conclusions: Changes to the standards, and the system, may improve perceptions and uptake of the credential. This example provides highly relevant insights for the profession internationally

Methodology for developing competency standards for dietitians in Australia

Competency standards document the knowledge, skills, and attitudes required for competent performance. This study develops competency standards for dietitians in order to substantiate an approach to competency standard development. Focus groups explored the current and emerging purpose, role, and function of the profession, which were used to draft competency standards. Consensus was then sought using two rounds of a Delphi survey. Seven focus groups were conducted with 28 participants (15 employers/practitioners, 5 academics, 8 new graduates). Eighty-two of 110 invited experts participated in round one and 67 experts completed round two. Four major functions of dietitians were identified: being a professional, influencing the health of individuals, groups, communities, and populations through evidence-based nutrition practice, and working collaboratively in teams. Overall there was a high level of consensus on the standards: 93% achieved agreement by participants in round one and all revised standards achieved consensus on round 2. The methodology provides a framework for other professions wishing to embark on competency standard review or development

Toward a global definition of professionalism for nutrition and dietetics education: A systematic review of the literature

Background: Professionalism of health care practitioners is central to safe and ethical health care, and forms part of the trust that the public places in health care practitioners. Lapses in professionalism in health care present considerable challenges and can have serious consequences and outcomes. Teaching, learning, and assessing professionalism is an important component of nutrition and dietetics education. There is scant peer-reviewed published research related to professionalism in nutrition and dietetics. Providing a definition of professionalism will support progress in curriculum planning and design, teaching, learning and assessment of students, and ongoing professional development of educators and practitioners. Objective: The aim of this study was to conceptualize and define professionalism for the purpose of teaching nutrition and dietetics. Design: This study included a critical systematic literature review of original research and a targeted and systematic search of national and international dietetics competency standards, exploring the concept and definitions of professionalism in nutrition and dietetics. Competency standards were chosen as an additional focus in the systematic literature search, as they are the key framework documents that guide curriculum development and education standards internationally. Thematic analysis was used to synthesize extracted data and an inductive, interpretivist approach was then applied in conceptualizing a definition of professionalism. Results: Seven studies and six national and international sets of competency standards were included in the literature review. Four major themes conceptualizing a definition of professionalism for nutrition and dietetics were identified from the integration of the original research and targeted gray literature reviews: 1) personal attributes; 2) interpersonal communication; 3) approach to practice; and 4) commitment to lifelong learning. Conclusions: Defining professionalism for nutrition and dietetics supports progress toward shared understandings, building trust, and assisting in dietetics education and practice. It can be used to support and extend teaching, learning, and assessment of professionalism.</p

Hidden Jedi: A critical qualitative exploration of the Fellow credential and advanced expertise

Aim: The present study aimed to describe the characteristics of a Fellow and critically review factors relevant to recognition and promotion of excellence within the profession of dietetics in Australia. Methods: Through the development of revised Competency Standards for the Fellow credential, a critical qualitative approach drawing on action research was used whereby members of the profession were given a voice in the research process. Six focus groups with a total of 30 participants explored descriptions of expertise and perceptions of Fellow by the profession and determinants of uptake. Focus groups were conducted during February and March 2018. Data were examined using a thematic analysis approach, with additional meaning explored through cultural historical activity theory. Participants/setting – A purposive sample of Australian dietitians. Results: Fellows embodied leadership, impact, influence, innovation and inspiration, internal and external to the profession and this was reflected in the revised Competency Standards. Potential Fellows perceived they were not capable of achieving the standard required. A lack of recognition of the credential both from within the community of dietetics, and externally, was identified. The role of the social system in which these credentials operate including the role of the professional association in awarding the credential are relevant. Conclusions: Changes to the standards, and the system, may improve perceptions and uptake of the credential. This example provides highly relevant insights for the profession internationally.</p

Development of advanced practice competency standards for dietetics in Australia

Aim: This study aimed to explore the work roles, major tasks and core activities of advanced practice dietitians in Australia to define the Competency Standards for advanced practice

Promoting evidence based nutrition education across the world in a competitive space: delivering a massive open online course

The internet is the fastest growing source of nutrition information for consumers. Massive Open Online Courses (MOOCs) provide and avenue for nutrition professionals’ urgent need to respond to consumer demand for low-cost, accessible and engaging information. This research aimed to evaluate learner participation and perceptions in an evidence-based nutrition MOOC and provide recommendations for engaging international online lay audiences. Learners completed pre and post course surveys including quantitative and open-ended questions. Pre-course surveys collected demographic data, prior nutrition knowledge and motivations for doing the course. Post-course surveys evaluated their preferred learning modes and learners’ opinions of the course. Quantitative were analyzed using descriptive statistics. Conventional content analysis was conducted on learners’ responses to open-ended survey questions using an inductive approach. Learners represented 158 countries from a range of educational backgrounds. There were 3799 qualitative comments related to learners’ learning and course content preferences. Qualitative analysis identified key themes related to (1) online interaction, the (2) value of the evidence presented by nutrition experts and (3) the course structure and practical aspects. Divergent opinions were expressed within these themes. Satisfying the needs of large international audiences with diverse backgrounds is challenging in promoting sound evidence-based nutrition messages. MOOCs provide a means for delivering evidence based global nutrition education in the online space crowded with food advertising and nutrition conjecture. Recommendations are made as to how to construct and engage diverse on-line audiences