The Profession – Training & Education

1. The Profession – Training & Education HNU 185 Dr. L. Wadsworth

2. Professions • Founded on ethical considerations instead of techniques or tools used • fulfill society’s needs

3. 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

4. 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

5. 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

6. 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

7. Education of Nutrition Professionals • Combination of classroom & experiential learning needed for eligibility • Degree course began in 1902

8. Stages in Professional Growth Chambers, D.W., Gilmore, C.J., O’Sullivan Maillet, J., Mitchell, B.E. (1996)

9. 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

10. Educational Standards • CDA/DC established common standards in essential courses • Core courses • physical & biological sciences • applied sciences • social sciences • others

11. DC Education & Training, 1993

12. 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

13. Educational Programs • Undergraduate programs at 16 Universities in Canada

14. Dietetic Education & Training Programs

15. Post-degree Training • Dietetic Internships • 1-year experience • integrated internships • Graduate degree + competencies • Dietetic Residency

16. Graduate Education • Master’s nutrition degree 9 universities in Canada • Other master’s degrees accepted by DC

17. Competencies • Statements of performance expected of beginning practitioners • Specific to environments where practitioners perform independently – not in educational setting • Integrate understanding, performance, and values

18. Competencies • Professional Practice • Assessment • Planning • Implementation • Evaluation • Communication http://www.dietitians.ca/pdf/Competencies_for_Entry-level_Dietitian.pdf

19. 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

20. Registration & Licensure • Provincial dietetics association requirements • Education needs • Experience needs • Nationally established exam • Annual license renewal • Payment of fees • Documented continuing education

21. 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

22. 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%

23. 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

24. 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

25. 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

26. 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

27. 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

28. Principles underlying ethics • Distributive Justice • Resources, especially scarce resources, ought to be allocated fairly • Integrity • Honesty and that information provided is accurate

29. 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

30. Proposed International Code of Ethics for Dietetics • Being competent, objective & honest in our actions • Respectingall people & their needs • Collaborating with others • Ensuring positive nutrition outcomes for people • Adhering to the standards of good practice in nutrition & dietetics

31. 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

32. 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

33. 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

34. Six Professional Standards • Provision of service to a client • Unique body of knowledge • Competent application of knowledge • Continued competence • Ethics • Professional responsibility and accountability http://www.dietitians.ca/career/i5.htm

35. Dietitian 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 Nomenclature

36. 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

37. 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

38. 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) Where do nutrition professionals work? (1997/98)

39. 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

40. Required Reading • Anderson. (1998). Reflection on practice: Dietitian as partner or expert?