How is the client‐dietitian relationship embedded in the professional education of dietitians? An analysis of curriculum documentation and program coordinators' perspectives in Australia

Abstract

Aim How dietitians are trained to develop relationships with clients is not clearly articulated despite its importance being well‐documented. This study aimed to describe how this relationship is expressed and addressed in curriculum documents of Australian dietetics education programs, and to explore program coordinators' perspectives of this description and how relationship development is actually taught. Methods Data extracted from subject outlines included subject descriptions, learning outcomes, assessments, readings and the mode of delivery (eg, lectures). Guided by a pre‐existing coding framework, deductive thematic analysis was utilised to explore qualitative themes from subject outline data. Semi‐structured telephone interviews were conducted with 10 program coordinators and analysed using inductive thematic analysis. Results Subject outlines for 122 subjects across all 21 accredited Australian programs were analysed. The over‐arching theme was the wide “variability” in the ways that the client‐dietitian relationship was expressed across subject outlines. Program coordinators perceived that findings from the analysis of subject outlines made sense, however, acknowledged limitations of analysing data from curriculum documents. The relationship appeared ambiguously defined amongst programs and was described as occurring mostly in communication, counselling and medical nutrition therapy subjects and through theoretical and practical learning. Conclusion The client‐dietitian relationship appears inconsistently embedded in the curriculum of Australian dietetics education programs despite widespread acceptance of its importance to practice. Further research is needed to investigate if training programs should embed more consistent language around therapeutic relationships, and how this might be achieved to reflect current competency standards.

Teaching and assessment of communication skills in dietetics: a scoping review

“…A further study describing how behaviour change is embedded in pre‐registration dietetic programmes in Australia and New Zealand reported that communication skills were a component of all programmes but the content varied 9 . Similar findings were reported in an analysis of how the client‐dietitian relationship is embedded in dietetic programmes 10 . In addition, dietitians have expressed some dissatisfaction with their training in communication skills 11–13 underlining the need for more consistent educational approaches.…”

“…Seven studies described the inclusion of communication skills in pre‐registration education of dietitians. Communication skills teaching was found to be consistently included in dietetic education programmes in two Australian analyses of curriculum documentation and dietetic educator perspectives 9,10 . How this was delivered and embedded in the wider context of behaviour change science and building effective dietitian‐patient therapeutic relationships was highly variable 9,10 .…”

“…Communication skills teaching was found to be consistently included in dietetic education programmes in two Australian analyses of curriculum documentation and dietetic educator perspectives. 9,10 How this was delivered and embedded in the wider context of behaviour change science and building effective dietitian-patient therapeutic relationships was highly variable. 9,10 The teaching that dietitians received in communication skills as part of their pre-registration education was explored in five studies.…”

“…9,10 How this was delivered and embedded in the wider context of behaviour change science and building effective dietitian-patient therapeutic relationships was highly variable. 9,10 The teaching that dietitians received in communication skills as part of their pre-registration education was explored in five studies. In a survey of multidisciplinary diabetes teams in the UK including 50 dietitians, 88% of dietitians reported pre-registration teaching in communication skills.…”

“…9 Similar findings were reported in an analysis of how the clientdietitian relationship is embedded in dietetic programmes. 10 In addition, dietitians have expressed some dissatisfaction with their training in communication skills [11][12][13] underlining the need for more consistent educational approaches. The evidence for the topic, content, delivery method and effectiveness of the teaching and assessment of communication skills in dietetic programmes has not been synthesised, potentially meaning dietetic educators may be unsure of optimal teaching strategies that could be integrated into curricula.…”