The Profession – Training & Education

HNU 185

Dr. L. Wadsworth

Professions

Founded on ethical considerations instead of techniques or tools used fulfill society’s needs

The Dietetics Profession

1. Clearly defined field of expertise Unique body of knowledge

2. Period of prescribed education or training precedes entry into membership Undergraduate degree and competency

attainment

The Dietetics Profession 3. Selective process of entry into the profession

Training requirements, documentation of competence, and registration exam

4. Procedure for testing and licensing Registration exam and annual renewal of license

5. Dedication of profession to social service Foundation in sense of social responsibility –

rooted in issues of hunger and food insecurity

The Dietetics Profession

6. Service as primary motivation instead of income/wealth Provision of service to a client

7. Provision of adequate services for all Focus on vulnerable populations

8. Differential fees for service based on ability to pay Not generally fee based

The Dietetics Profession

9. Set of self governing rules Professional standards including code of ethics

and service at high levels of competence

10. Means of self-surveillance Professional standards and regulatory

association; penalties for misbehavior or negligence of members

Education of Nutrition Professionals

Combination of classroom & experiential learning needed for eligibility

Degree course began in 1902

Stages in Professional Growth

Chambers, D.W., Gilmore, C.J., O’Sullivan Maillet, J., Mitchell, B.E. (1996)

Education Preparing leaders on issues related to

food and nutritional needs Leaders in promoting health Have diverse, rewarding and novel roles Food and nutrition education is accessible,

flexible, inclusive, & innovative Adapted from Vision 2020, 2008

Educational Standards

CDA/DC established common standards in essential courses

Core courses physical & biological sciences applied sciences social sciences others

DC Education & Training, 1993

Educational Standards

University accreditation by DC Continuing Education

planned, organized learning that builds on present knowledge

lifelong learning workshops, conferences, articles, journal

clubs, study guides

Educational Programs

Undergraduate programs at 16 Universities in Canada

Dietetic Education & Training Programs

Program Type

32%

50%

7%

11%University Program

Internship Program

Masters PracticumProgram

MSc withInternship/Practicum

Post-degree Training Dietetic Internships

1-year experience integrated internships

Graduate degree + competencies Dietetic Residency

Graduate Education Master’s nutrition degree 9 universities

in Canada Other master’s degrees accepted by DC

Competencies Statements of performance expected of

beginning practitioners Specific to environments where

practitioners perform independently – not in educational setting

Integrate understanding, performance, and values

Competencies

Professional Practice

Assessment Planning Implementation Evaluation Communication

http://www.dietitians.ca/pdf/Competencies_for_Entry-level_Dietitian.pdf

Renewing Competencies Foundational knowledge

Integrate a unique body of knowledge in all practice activities Professional practice

Demonstrate professional integrity in all aspects of practice

Communication and collaboration Communicate effectively and practice collaboratively

Nutrition care Provide services to meet the nutrition-care needs of individual

Health promotion Lead and collaborate to promote the nutritional health of

individuals, groups, communities, and populations Management

Manage food and nutrition services and programs

Registration & Licensure Provincial dietetics

association requirements Education needs Experience needs Nationally established

exam Annual license renewal

Payment of fees Documented continuing

education

Ethics and Standards Code of Ethics

“proclaims ideals of the profession” Aspirational code

Code of Conduct/Standards of Practice “supplements code of ethics” List behaviours to follow to avoid

misconduct ICDA, 2007

Change to Course Outline Change to University Policy Requires that 40% of grade for 100 and

200 level courses come from the December exam

Final Exam will be – 40% Midterm Exam will be – 15%

DC Code of Ethics http://www.dietitians.ca/public/content/

career_in_nutrition/code_of_ethics.asp NSDA Code of Ethics https://www.nsdassoc.ca/images/documents/

documents/C%20of%20E%202007.pdf DC Standards of Practice http://www.dietitians.ca/public/content/

career_in_nutrition/standards_of_practice.asp

Ethics The part of philosophy that deals with

morals, duty and judgment” The World Book Dictionary, 1986

Further reading on ethics http://en.wikipedia.org/wiki/Ethics

Ethics “. . . Ethics is concerned about what is

right, fair, just or good, about what we ought to do, not just about what is the case or what is most acceptable or expedient.”

Preston (1996). Understanding Ethics. Sydney, Australia: The Federation Press.

Context dependent

Principles underlying ethics Autonomy

Independent actions and choices of individuals and communities not to be constrained by others

Non-Maleficence Duty not to inflict evil, harm or risk of

harm on others

Principles underlying ethics Beneficence

Duty to help others by doing what is best for them

Confidentiality Information given by another will not be

revealed to any other person without permission

Principles underlying ethics Distributive Justice

Resources, especially scarce resources, ought to be allocated fairly

Integrity Honesty and that information provided is

accurate

Code of Ethics The Code of Ethics was developed by

Dietitians of Canada and officially adopted by the provincial dietetic associations and regulatory bodies http://www.dietitians.ca/public/content/

career_in_nutrition/code_of_ethics.asp

Proposed International Code of Ethics for Dietetics Being competent, objective & honest in

our actions Respecting all people & their needs Collaborating with others Ensuring positive nutrition outcomes for

people Adhering to the standards of good

practice in nutrition & dietetics

Code of Conduct or Standards of Practice “Attempt to set minimum national or

international standards for practice” “Place boundaries on the way that

professions undertake their work” Type of quality assurance

Outlining expected standard of care across the profession

ICDA, 2007

Code of Conduct or Standards of Practice Differs from Code of Ethics:

More detailed information about how required to act in particular situations

Usually includes disciplinary proceedings or sanctions for failure to follow standards

Professional Standards

http://www.dietitians.ca/public/content/career_in_nutrition/standards_of_practice.asp Accreditation Competencies Professional Standards for Dietitians -- factsheet

http://www.dietitians.ca/public/content/career_in_nutrition/prof_standards_factsheet.asp

Practice supporting role papers

Six Professional Standards

Provision of service to a client Unique body of knowledge Competent application of knowledge Continued competence Ethics Professional responsibility and

accountabilityhttp://www.dietitians.ca/career/i5.htm

NomenclatureDietitian

Protected title Registered dietitian,

professional dietitian, and dietitian

provincial regulatory bodies can use one of the following designations -- RD, RDt or PDt (or the French equivalent Dt.P.).

Nutritionist Not always a

protected title May often be

used when working in the community

Emerging Trends & Innovations in Practice More dietitians in PHC Industry dietitians Entrepreneurs – spa, school, life coach,

camps, media (TV, radio, paper print, web based)

Others

Where do nutrition professionals work?

Employment survey 1 year from internship Average 2 months to find employment 90% employed in 1 year

95% jobs in related field

51% full-time + 20% full-time from multiple jobs

Where do nutrition professionals work? (1997/98)

Principal employer 43% general or acute

care hospitals 17% non-acute care 14% business or

industry 11% in community,

public health, home care 15% other (i.e. self

employed, schools, non-profit)

Sector 54% clinical dietetics 16% administrative 14% community,

public health and home care

15% other (education, sales, etc)

Nutrition professionals as entrepreneurs…

Respond to environmental and consumer changes

1994 – 14% vs. 1997/98 - 28% employed in business, industry, private practice

Relationships with entrepreneurship: Self-efficacy Entrepreneurial experiences Dietetic internship Belief in importance of business skills

Required Reading Anderson. (1998). Reflection on practice:

Dietitian as partner or expert?