Background: The nutrition and diet-related programs should be organized at the community and society level to improve the health of the people. It is only possible to encourage preceptors and interns to acquire skills and practices to meet the demand for professional practice. It is also recommended that interns and preceptors should acquire and progress in the field of food and nutrition to contribute their significant role in the anticipation and prevention of the disease. Dietetic preceptors can play a significant role in educating interns on clinical, community, and foodservice departments. No research has been available to date to evaluate the currently available dietetic preceptor training programs. Purpose: The purpose of the study is to identify topics, skills, and attributes that dietetic preceptors believe to be of greatest importance when it approaches to appropriately preparing the dietetic interns for dietetic registration. Also, the findings of the study would be helpful in the preparation of the upcoming dietetic preceptor training programs held at the University of Florida. Methods: Local dietetic preceptors from different regions of the country were asked to participate in 10-25 minutes of individual and focus group interviews. The interview questions were open-ended eight questions. Qualtrics survey having 15 closed-ended questions was prepared conducted in the form of individual interviews and focus group interviews. Results: Number of participants n= 197 out of which interview participants rated themselves lower as compared to the survey participants. Online preceptor training programs were preferred by the majority of the participants and resulted in 67%. Survey responses resulted in 80% of the individuals stated to attend the training programs annually. Out of which, less than 40% of responses indicated that the training was effective and fruitful and enhanced their learning dietetic preceptor abilities. Conclusions: The results of the study have revealed that more preceptor training and preparations are desired and necessary to meet the needs of the current dietetic preceptors. The findings of this study have the potential to be utilized in a future dietetic preceptor training module. The results overall represented that most of the preceptors feel that they need to improve and develop themselves. The majority of the participants established that additional dietetic preceptor training would be beneficial for the registration of ACEND and clinical practice.
Keywords: Dietetic Preceptors, Preceptors training, Dietetics and nutrition, Registered Dietitian
Dietetic Preceptor Training Informational Study
Registered Dietitian Nutritionists (RDNs) possesses a significant part in averting as well as handling various chronic illnesses in the United States. It has been forecast that there would be only 75% of dietetics practitioners who can meet the demand for dietitians in the year 2020. To upsurge the integer of RDNs to bump into this requirement, it is essential to upsurge in the integer of interns acknowledged into credited programs. This is essential for the interns to complete 1200 hours of the supervised practice to get enrolled in the registration examination. There are capable candidates, but the internship shortage exists. Rendering to the Accreditation Council for Education in Nutrition and Dietetics, the limiting factor is the availability of the volunteer preceptors ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"a1v26avv2ir","properties":{"formattedCitation":"(Andersen et al., 2018)","plainCitation":"(Andersen et al., 2018)"},"citationItems":[{"id":383,"uris":["http://zotero.org/users/local/p8kwKNoG/items/74VTPPTL"],"uri":["http://zotero.org/users/local/p8kwKNoG/items/74VTPPTL"],"itemData":{"id":383,"type":"article-journal","title":"Academy of Nutrition and Dietetics: Revised 2017 scope of practice for the registered dietitian nutritionist","container-title":"Journal of the Academy of Nutrition and Dietetics","page":"141-165","volume":"118","issue":"1","author":[{"family":"Andersen","given":"Denise"},{"family":"Baird","given":"Shari"},{"family":"Bates","given":"Tracey"},{"family":"Chapel","given":"Denise L."},{"family":"Cline","given":"Alana D."},{"family":"Ganesh","given":"Shyamala N."},{"family":"Garner","given":"Margaret"},{"family":"Grant","given":"Barbara L."},{"family":"Hamilton","given":"Kathryn K."},{"family":"Jablonski","given":"Krista"}],"issued":{"date-parts":[["2018"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Andersen et al., 2018). It is highly important to understand the factors that are influencing the ratio of volunteer preceptors.
The food and diet specialists who provide services related to the improvement in the diet and nutrition and solutions for a healthy lifestyle are called Registered Dietitian Nutritionists (RDN). These registered dietitians and nutritionists help individuals to adopt positive lifestyle changes and behaviors; the RDNs work in the hospitals, care centers, schools, and food departments ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"afnbvdp657","properties":{"formattedCitation":"(Nasser, Morley, Cook, Coleman, & Berenbaum, 2014)","plainCitation":"(Nasser, Morley, Cook, Coleman, & Berenbaum, 2014)"},"citationItems":[{"id":372,"uris":["http://zotero.org/users/local/p8kwKNoG/items/ZEU38FEL"],"uri":["http://zotero.org/users/local/p8kwKNoG/items/ZEU38FEL"],"itemData":{"id":372,"type":"article-journal","title":"Dietitians’ perceptions of precepting: knowledge, skills, attitudes, barriers, and training","container-title":"Canadian Journal of Dietetic Practice and Research","page":"7-14","volume":"75","issue":"1","author":[{"family":"Nasser","given":"Roseann"},{"family":"Morley","given":"Catherine"},{"family":"Cook","given":"Stephanie"},{"family":"Coleman","given":"Jean"},{"family":"Berenbaum","given":"Shawna"}],"issued":{"date-parts":[["2014"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Nasser, Morley, Cook, Coleman, & Berenbaum, 2014). Their role in the academics and the institutions working on training interns and new practitioners is very critical. Their role in nursing homes, nutrition management centers, and public health hospitals are significant in the prevention of avoidable and preventable diseases such as cardiovascular disorders. The role of the RDNs in the research and sports is also important in managing the sports activities related to athletics diet and nutrition plans to improve their health.
According to the Commission on Dietetic Registration (CDR), there are around 89,300 registered dietitians overall in the United States. Out of these, only 10000 are actively participating in precepting dietetic interns (CDR, 2013). Dietetic preceptors play an imperative role in educating dietetic interns. The Dietetic interns deliver training related to clinical, community, and aspects of nutrition in practice. However, it has been observed that there are no sufficient researches available to identify and declared how much training a preceptor receives. Moreover, there has been limited prospects available for dietetic preceptors to acquire the learning necessities of interns. Consequently, various preceptors do not obtain any training before taking on interns. They have limited knowledge of teaching and education to work on interns. Therefore, most dietitian preceptors depend on their own experiences and preferences when it comes to teaching and evaluating.
The American Dietetic Association has declared the three-branched method for teaching dietetic specialists: Didactic knowledge supervised practice and examination. The requirement for supervised practice knowledge in the training of dietetic specialists is acknowledged. The interns need to get trained under supervised training. Supervised practice cannot be substituted by didactic training ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"a2fjblebbqq","properties":{"formattedCitation":"(Nasser et al., 2014)","plainCitation":"(Nasser et al., 2014)"},"citationItems":[{"id":372,"uris":["http://zotero.org/users/local/p8kwKNoG/items/ZEU38FEL"],"uri":["http://zotero.org/users/local/p8kwKNoG/items/ZEU38FEL"],"itemData":{"id":372,"type":"article-journal","title":"Dietitians’ perceptions of precepting: knowledge, skills, attitudes, barriers, and training","container-title":"Canadian Journal of Dietetic Practice and Research","page":"7-14","volume":"75","issue":"1","author":[{"family":"Nasser","given":"Roseann"},{"family":"Morley","given":"Catherine"},{"family":"Cook","given":"Stephanie"},{"family":"Coleman","given":"Jean"},{"family":"Berenbaum","given":"Shawna"}],"issued":{"date-parts":[["2014"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Nasser et al., 2014). It cannot be tested by the present examination system ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"a11ci41k5ti","properties":{"formattedCitation":"(Andersen et al., 2018)","plainCitation":"(Andersen et al., 2018)"},"citationItems":[{"id":383,"uris":["http://zotero.org/users/local/p8kwKNoG/items/74VTPPTL"],"uri":["http://zotero.org/users/local/p8kwKNoG/items/74VTPPTL"],"itemData":{"id":383,"type":"article-journal","title":"Academy of Nutrition and Dietetics: Revised 2017 scope of practice for the registered dietitian nutritionist","container-title":"Journal of the Academy of Nutrition and Dietetics","page":"141-165","volume":"118","issue":"1","author":[{"family":"Andersen","given":"Denise"},{"family":"Baird","given":"Shari"},{"family":"Bates","given":"Tracey"},{"family":"Chapel","given":"Denise L."},{"family":"Cline","given":"Alana D."},{"family":"Ganesh","given":"Shyamala N."},{"family":"Garner","given":"Margaret"},{"family":"Grant","given":"Barbara L."},{"family":"Hamilton","given":"Kathryn K."},{"family":"Jablonski","given":"Krista"}],"issued":{"date-parts":[["2018"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Andersen et al., 2018). Effective preceptors most often tend to serve as a resource person for dietetic interns. Preceptors with higher scores from interns can communicate the reasoning behind their decisions or actions, which helps the student learn to think and perform as professionals ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"a17tvcn37lo","properties":{"formattedCitation":"(Nasser et al., 2014)","plainCitation":"(Nasser et al., 2014)"},"citationItems":[{"id":372,"uris":["http://zotero.org/users/local/p8kwKNoG/items/ZEU38FEL"],"uri":["http://zotero.org/users/local/p8kwKNoG/items/ZEU38FEL"],"itemData":{"id":372,"type":"article-journal","title":"Dietitians’ perceptions of precepting: knowledge, skills, attitudes, barriers, and training","container-title":"Canadian Journal of Dietetic Practice and Research","page":"7-14","volume":"75","issue":"1","author":[{"family":"Nasser","given":"Roseann"},{"family":"Morley","given":"Catherine"},{"family":"Cook","given":"Stephanie"},{"family":"Coleman","given":"Jean"},{"family":"Berenbaum","given":"Shawna"}],"issued":{"date-parts":[["2014"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Nasser et al., 2014). However, when a preceptor and intern do not have similar communication and learning styles, learning and teaching ability may be strained. Unlike many other educators, preceptors do not need to have any preliminary teaching or effective communication training before accepting interns.
Significance
The preceptors are assumed to be prepared to deliver their knowledge to the students to prepare them for future practice. Many preceptors were educated and trained enough that they can work as nutrition and health care professionals ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"a137lf5chlf","properties":{"formattedCitation":"(Nasser et al., 2014)","plainCitation":"(Nasser et al., 2014)"},"citationItems":[{"id":372,"uris":["http://zotero.org/users/local/p8kwKNoG/items/ZEU38FEL"],"uri":["http://zotero.org/users/local/p8kwKNoG/items/ZEU38FEL"],"itemData":{"id":372,"type":"article-journal","title":"Dietitians’ perceptions of precepting: knowledge, skills, attitudes, barriers, and training","container-title":"Canadian Journal of Dietetic Practice and Research","page":"7-14","volume":"75","issue":"1","author":[{"family":"Nasser","given":"Roseann"},{"family":"Morley","given":"Catherine"},{"family":"Cook","given":"Stephanie"},{"family":"Coleman","given":"Jean"},{"family":"Berenbaum","given":"Shawna"}],"issued":{"date-parts":[["2014"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Nasser et al., 2014). The skills to practice according to the requirement of the patients is not delivered to the students during course curriculums. Consequently, the preceptors need to deliver knowledge to the scholars during an internship with appropriate skills, and preceptors also need suitable tools and conditions to deliver information effectively. Those having a background experience of health promotion, personnel experience are more operative and competent preceptors. The need for these preceptors with the background experience of public health is required in the United States ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"akh9mtto0s","properties":{"formattedCitation":"(AbuSabha et al., 2018)","plainCitation":"(AbuSabha et al., 2018)"},"citationItems":[{"id":373,"uris":["http://zotero.org/users/local/p8kwKNoG/items/KEY79JRN"],"uri":["http://zotero.org/users/local/p8kwKNoG/items/KEY79JRN"],"itemData":{"id":373,"type":"article-journal","title":"Benefits, Barriers, and Motivators to Training Dietetic Interns in Clinical Settings: A Comparison between Preceptors and Nonpreceptors","container-title":"Journal of the Academy of Nutrition and Dietetics","page":"471-480","volume":"118","issue":"3","author":[{"family":"AbuSabha","given":"Rayane"},{"family":"Muller","given":"Colette"},{"family":"MacLasco","given":"Jacqueline"},{"family":"George","given":"Mary"},{"family":"Houghton","given":"Erica"},{"family":"Helm","given":"Alison"}],"issued":{"date-parts":[["2018"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (AbuSabha et al., 2018). There is a significant need for preceptor training as it narrates to enlightening interns in the dietetic community. To progress in these training it is important to understand the current status of dietetic preceptors ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"amicmt7ou8","properties":{"formattedCitation":"(Weber, Carter, Jenkins, & Jamieson, 2019)","plainCitation":"(Weber, Carter, Jenkins, & Jamieson, 2019)"},"citationItems":[{"id":379,"uris":["http://zotero.org/users/local/p8kwKNoG/items/DF8RYQDP"],"uri":["http://zotero.org/users/local/p8kwKNoG/items/DF8RYQDP"],"itemData":{"id":379,"type":"article-journal","title":"A dietetic clinical educator enhances the experience and assessment of clinical placement","container-title":"Nutrition & Dietetics","page":"486-492","volume":"76","issue":"4","author":[{"family":"Weber","given":"Katrina"},{"family":"Carter","given":"Brie"},{"family":"Jenkins","given":"Gemma"},{"family":"Jamieson","given":"Janica"}],"issued":{"date-parts":[["2019"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Weber, Carter, Jenkins, & Jamieson, 2019). This would help in identifying the research gaps present and will help in future planning and development for preceptor training. Furthermore, the researcher's aim should be to evaluate the current training available for preceptors. Also, the topics of concern for preceptor training will be assessed and evaluated. The supervised practice knowledge is significant in concocting scholars and in providing them the expertise they require to be entry-level practitioners. The role of the preceptors is significant in preparing students to work as a dietitian. Various supervised practice courses (dietetic internships) depend greatly on preceptors to educate and assess scholars in medical, administration, and public health nutrition services.
Purpose
The purpose of the study is to identify topics, skills and attributes that dietetic preceptors believe to be of greatest importance when it approaches to appropriately preparing the dietetic interns for dietetic registration. The aims and objectives of the study were to comprehend the aptitudes and capabilities of the preceptors. Moreover, the feedback received from the research and the requirements identified would be fruitful for future preceptor training held at the University of Florida Dietetic Preceptor Trainings.
Review of Literature
A study was conducted in the year 2014 by Nasser and the colleagues to evaluate the dietitians’ perceptions regarding precepting: understanding, skills, approaches, barriers, and training. The study was a survey base and had 98 sections were developed that were circulated to the dietitians electronically. 95% of the participants approved that preceptors must have an understanding of endorsing knowledge and skills attainment, and of student evaluation and assessment ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"af28j2vn8t","properties":{"formattedCitation":"(Nasser et al., 2014)","plainCitation":"(Nasser et al., 2014)"},"citationItems":[{"id":372,"uris":["http://zotero.org/users/local/p8kwKNoG/items/ZEU38FEL"],"uri":["http://zotero.org/users/local/p8kwKNoG/items/ZEU38FEL"],"itemData":{"id":372,"type":"article-journal","title":"Dietitians’ perceptions of precepting: knowledge, skills, attitudes, barriers, and training","container-title":"Canadian Journal of Dietetic Practice and Research","page":"7-14","volume":"75","issue":"1","author":[{"family":"Nasser","given":"Roseann"},{"family":"Morley","given":"Catherine"},{"family":"Cook","given":"Stephanie"},{"family":"Coleman","given":"Jean"},{"family":"Berenbaum","given":"Shawna"}],"issued":{"date-parts":[["2014"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Nasser et al., 2014). 90% of the participants agreed that preceptors should know about coaching, research, teaching, and evaluation (Nasser et al., 2014). The study successfully identified the needs and the requirements of the preceptors and suggested that the training should be considered as an evaluation and assessment tool for the preceptors (Nasser et al., 2014). The respondents suggested that practice-based research should be conducted, and preceptors should engage themselves in it (Nasser et al., 2014). The findings have articulated that the significant barriers are the availability of the preceptors, insufficient time, and work environment ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"akgfjdelgt","properties":{"formattedCitation":"(Nasser et al., 2014)","plainCitation":"(Nasser et al., 2014)"},"citationItems":[{"id":372,"uris":["http://zotero.org/users/local/p8kwKNoG/items/ZEU38FEL"],"uri":["http://zotero.org/users/local/p8kwKNoG/items/ZEU38FEL"],"itemData":{"id":372,"type":"article-journal","title":"Dietitians’ perceptions of precepting: knowledge, skills, attitudes, barriers, and training","container-title":"Canadian Journal of Dietetic Practice and Research","page":"7-14","volume":"75","issue":"1","author":[{"family":"Nasser","given":"Roseann"},{"family":"Morley","given":"Catherine"},{"family":"Cook","given":"Stephanie"},{"family":"Coleman","given":"Jean"},{"family":"Berenbaum","given":"Shawna"}],"issued":{"date-parts":[["2014"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Nasser et al., 2014). It has been identified that particular time availability for the preceptors to conduct training; also, the working environment should be encouraged to develop a noteworthy outcome.
To recognize clinical dietitians' professed benefits and challenges of teaching dietetic interns and to conclude significant motivators that would induce non-preceptors to offer themselves for the role, a study was conducted by AbuSabha and the colleagues in the year 2018. A semi-structured interview was constructed for the registered dietitians practicing in clinical settings, long-term care facilities, and outpatient clinics ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"a2aljga2snb","properties":{"formattedCitation":"(AbuSabha et al., 2018)","plainCitation":"(AbuSabha et al., 2018)"},"citationItems":[{"id":373,"uris":["http://zotero.org/users/local/p8kwKNoG/items/KEY79JRN"],"uri":["http://zotero.org/users/local/p8kwKNoG/items/KEY79JRN"],"itemData":{"id":373,"type":"article-journal","title":"Benefits, Barriers, and Motivators to Training Dietetic Interns in Clinical Settings: A Comparison between Preceptors and Nonpreceptors","container-title":"Journal of the Academy of Nutrition and Dietetics","page":"471-480","volume":"118","issue":"3","author":[{"family":"AbuSabha","given":"Rayane"},{"family":"Muller","given":"Colette"},{"family":"MacLasco","given":"Jacqueline"},{"family":"George","given":"Mary"},{"family":"Houghton","given":"Erica"},{"family":"Helm","given":"Alison"}],"issued":{"date-parts":[["2018"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (AbuSabha et al., 2018). There were 54 preceptors, and 46 non-preceptors and statistical analysis of qualitative research methodology were incorporated (AbuSabha et al., 2018). The results were interpreted from the t-test applied among the preceptors and the non-preceptors (AbuSabha et al., 2018). The preceptor respondents demonstrated that to train interns was supportive of them in staying informed regarding new researches and gaining knowledge for clinical practice. The significant barrier reported in the research was insufficient time ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"a1ucrg5aecf","properties":{"formattedCitation":"(AbuSabha et al., 2018)","plainCitation":"(AbuSabha et al., 2018)"},"citationItems":[{"id":373,"uris":["http://zotero.org/users/local/p8kwKNoG/items/KEY79JRN"],"uri":["http://zotero.org/users/local/p8kwKNoG/items/KEY79JRN"],"itemData":{"id":373,"type":"article-journal","title":"Benefits, Barriers, and Motivators to Training Dietetic Interns in Clinical Settings: A Comparison between Preceptors and Nonpreceptors","container-title":"Journal of the Academy of Nutrition and Dietetics","page":"471-480","volume":"118","issue":"3","author":[{"family":"AbuSabha","given":"Rayane"},{"family":"Muller","given":"Colette"},{"family":"MacLasco","given":"Jacqueline"},{"family":"George","given":"Mary"},{"family":"Houghton","given":"Erica"},{"family":"Helm","given":"Alison"}],"issued":{"date-parts":[["2018"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (AbuSabha et al., 2018). The incentives and encouragement programs should be established to induce non-preceptors to proceed with interns (AbuSabha et al., 2018). The programs should contain widespread teaching on the role of the preceptors. The training should include the options concerning how to improve the problem of obstruction of time consumed for supervising interns.
A study was conducted by Weber and his colleagues in the year 2019 to assess the influence of a Clinical Educator model on knowledge skill and setting for scholars, preceptors, and managers. At Edith Cowan University, a 10-week dietetic clinical practice setting was established, and the clinical educators were accountable for the assessment and supervision of the interns and students ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"a2g6mlnbbui","properties":{"formattedCitation":"(Weber et al., 2019)","plainCitation":"(Weber et al., 2019)"},"citationItems":[{"id":379,"uris":["http://zotero.org/users/local/p8kwKNoG/items/DF8RYQDP"],"uri":["http://zotero.org/users/local/p8kwKNoG/items/DF8RYQDP"],"itemData":{"id":379,"type":"article-journal","title":"A dietetic clinical educator enhances the experience and assessment of clinical placement","container-title":"Nutrition & Dietetics","page":"486-492","volume":"76","issue":"4","author":[{"family":"Weber","given":"Katrina"},{"family":"Carter","given":"Brie"},{"family":"Jenkins","given":"Gemma"},{"family":"Jamieson","given":"Janica"}],"issued":{"date-parts":[["2019"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Weber et al., 2019). A qualitative study was performed using a focus group methodology tool (Weber et al., 2019). It was observed that clinical educators declined the burden of the scholar placements and progressed time efficiency. It was found that it evaluated the students and enhanced their confidence and capacity building (Weber et al., 2019). It was also helpful in improving failing and underperforming students (Weber et al., 2019). It supported and strengthened the stakeholders and clinical educator relationships along with that it facilitate the educator to manage underperforming students effectively utilizing the time ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"a2k3gpmreg5","properties":{"formattedCitation":"(Weber et al., 2019)","plainCitation":"(Weber et al., 2019)"},"citationItems":[{"id":379,"uris":["http://zotero.org/users/local/p8kwKNoG/items/DF8RYQDP"],"uri":["http://zotero.org/users/local/p8kwKNoG/items/DF8RYQDP"],"itemData":{"id":379,"type":"article-journal","title":"A dietetic clinical educator enhances the experience and assessment of clinical placement","container-title":"Nutrition & Dietetics","page":"486-492","volume":"76","issue":"4","author":[{"family":"Weber","given":"Katrina"},{"family":"Carter","given":"Brie"},{"family":"Jenkins","given":"Gemma"},{"family":"Jamieson","given":"Janica"}],"issued":{"date-parts":[["2019"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Weber et al., 2019). This study highlighted the significance of the clinical placement to facilitate and improve the student learning environment.
Despite a scarcity of Registered Dietitians, merely half of the candidates presently meet the criteria set by the dietetic internship ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"a12i9d9k0tu","properties":{"formattedCitation":"(Butler, 2019)","plainCitation":"(Butler, 2019)"},"citationItems":[{"id":374,"uris":["http://zotero.org/users/local/p8kwKNoG/items/CYSEWS2V"],"uri":["http://zotero.org/users/local/p8kwKNoG/items/CYSEWS2V"],"itemData":{"id":374,"type":"thesis","title":"Factors Associated With Commitment of Registered Dietitian Nutritionists to the Dietetic Internship Preceptor Role","publisher":"Teachers College, Columbia University","author":[{"family":"Butler","given":"Summer"}],"issued":{"date-parts":[["2019"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Butler, 2019). A cross-sectional study was conducted to assess the RDNs views and opinions of the preceptor role (Butler, 2019). This study was carried out by Butler and colleagues in the year 2019. A survey was conducted online and was sent to a randomly selected sample of 10% of RDNs. 1170 RDNs completed the survey, and five different provisions were measured that is, benefits, supports, commitment, barriers, and satisfaction. Participants were divided into three groups (Butler, 2019). Current (37.1%), former (33.6%), and never preceptors (29.3%) were analyzed using regression analysis to assess the factors linked with the preceptor's role. 37% of respondents were active preceptors, whereas 69% received no preceptor training. The most common barriers observed were stress associated with having interns, insufficient time, and amplified workload. It was observed that continuing professional education units for preceptors was the utmost common incentive (Butler, 2019). The study extensively assessed the provisions such as supports, barriers, commitment, and satisfaction associated with the preceptor training. The research has identified that the introduction of most common incentives and motivation, for example, continuing professional education units can encourage the non-preceptors to become preceptors.
Materials and Methods
Researchers developed a mixed-methods approach for this study. The participants were divided into two groups: local dietetic preceptors and national dietetic preceptors. Participants accomplished interviews and surveys out of their own free will; no incentives were provided for the study.
Population & Sampling
The participants were divided into two groups. The participants of both groups were dietetic preceptors working in clinical, community, food service, private practices, and business of dietetics. Male and female participants of any age were included in the study. Local Alachua County dietitians were interviewed utilizing a semi-structured questionnaire. Local dietetics were communicated utilizing the emails from the University of Florida's dietetic preceptors. Preceptors from the country completed the survey online. The preceptors were contacted with the help of Dietetics Internship program Directors to complete the survey online, and researchers emailed the link. The participants were not awarded with any incentives.
Ethical Considerations
The research and intervention pose no-known risk and harm to the study population. Participants were aware of the fact to participate in the research with their will and can refuse to participate. The participants were informed about the survey and the research and possible risk related to the study. In-person interviewers were asked to fill the consent form, and participants contacting via electronic means were asked consent through calls and emails. The study was approved and accepted by the University of Florida Institutional Review Board (IRB).
Interview group
Local dietetic preceptors from different regions of the country were asked to participate in 10-25 minutes of individual and focus group interviews. The interview questions were open-ended eight questions. Subsequent questions were added to some questions. The interview questions were related to dietetic practice and dietetic preceptor. A few questions were related to the characteristics and the qualities of the preceptors. Questions related to attributes of the preceptors and precepting abilities were also incorporated in the research. The opinions of the participants were asked via questions concerning training that enhance preceptor training, and knowledge building were also added in the interviews. Focus groups and individual interviews were recorded, transcribed, and coded for common qualitative themes. Local dietetic preceptors were contacted to participate through email coordination with the University of Florida’s dietetic program. The responses of the participants were kept unidentified and anonymous (See table 1 in Appendices for the complete questionnaire, See table 3 in Appendices for participant consent form).
Survey Group
With the help of Dietetic Internship directors, the Qualtrics survey was published online for dietetic preceptors to participate in various areas of the country. The survey comprises of 17 close-ended questions with several means of responding. The survey questions were prepared on a five-point Likert scale. The researchers contacted every dietetic internship program director in the United States to request them to become part of the research and allow their preceptors to become part of the research. It was unknown how many preceptors were forwarded to the survey; however, 337 dietetic program directors were contacted across the United States. The preceptors were delivered with an anonymous link to complete the survey, and no identifying information was shared. Participants were provided with a clickable response in which the consent was mentioned to continue the survey after clicking that option. Survey questions that were related to the confidence, self-efficacy, and preceptor ability self-rankings were adapted from Desired Skills and Attributes for Dietitian Preceptors (2014).
Demographics
Currently practicing and previously working dietetic preceptors participated in the study. The areas included were limited to the clinical dietetics, inpatient, outpatient, renal care, community dietetics, business, private practice, and foodservice management. The information related to demography was location, registered dietitian status, years spent in practice, and years spent in precepting.
Method Justification
The methodology utilizing surveys is employed in academic researches because it is the best way to collect detailed information regarding problems of a targeted population. Surveys are useful in providing feedback related to characteristics, opinions, and attitudes or a specific group ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"a1uhd00chuu","properties":{"formattedCitation":"(Nasser et al., 2014)","plainCitation":"(Nasser et al., 2014)"},"citationItems":[{"id":372,"uris":["http://zotero.org/users/local/p8kwKNoG/items/ZEU38FEL"],"uri":["http://zotero.org/users/local/p8kwKNoG/items/ZEU38FEL"],"itemData":{"id":372,"type":"article-journal","title":"Dietitians’ perceptions of precepting: knowledge, skills, attitudes, barriers, and training","container-title":"Canadian Journal of Dietetic Practice and Research","page":"7-14","volume":"75","issue":"1","author":[{"family":"Nasser","given":"Roseann"},{"family":"Morley","given":"Catherine"},{"family":"Cook","given":"Stephanie"},{"family":"Coleman","given":"Jean"},{"family":"Berenbaum","given":"Shawna"}],"issued":{"date-parts":[["2014"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Nasser et al., 2014). Surveys and interviews help researchers to study design without manipulating variables or constructs. It allows maximum confidentiality to the participants, for example, interviews and surveys are designed by keeping anonymity in mind intended to give respondents the freedom to answer with confidence and without fear of retribution or (Brewer, Torrisi-Steele, & Wang, 2018). The study was intended to improve the future perspectives of the preceptors training held at the University of Florida. The local dietitian preceptors were included specifically for this purpose; however, the interview groups and the participation was completely kept confidential. This methodology and the research was well suited because gleaning feedback from both the sample populations of dietetic preceptors can inaugurate valuable insight for ascertaining an entry point for training improvement and development.
Analysis
Qualitative Analysis (Interview Groups)
The 15 in-person and phone interviews were audio-recorded, then transcribed verbatim. Transcriptions were read multiple times by graduate researcher and undergraduate research aid separately, and a frame for analysis was developed. Answers were scrutinized using a phenological process with both systematic text condensation and by using direct quotes of terms. Terms of attributes rescored based on the frequency and then grouped into common themes. Direct quotes were utilized for inputs and suggestions on preceptor training.
Quantitative Analysis (Survey Group)
The frequencies and the percentages of the preceptor survey were analyzed using descriptive analysis by the researchers of the preceptor survey. The methodology of descriptive statistics was selected to reach a wider scale of dietetic preceptors through easy distribution and to be able to quantify the results generally.
Results
The participants who participated in the online Qualtrics survey were 188, whereas 6 surveys were disqualified due to lacking the consent form. Some participants did not complete the survey or left some questions unanswered. The interviews of two focus groups were completed, each having 10 participants. Five individual interviews were conducted through the phone. The sum of the interviews conducted were n= 15. The study participants, n= 197 were dietetic preceptors. The time for the survey was 5-10 minutes, and the average time of focus groups and the individual interviews was 5-25 minutes. 94% were registered dietitians, and 83% had been a dietetic preceptor for a minimum of 3 years. Over 50% of the participants were involved in preceptors training for more than ten years. The majority of the participants were currently working in clinical nutrition, inpatient, and outpatient settings. The responses to attributes, skills, emotional intelligence, personal characteristics, teaching skills, and efficacy, and job skills were coded with a definite theme. The emerging themes representing were communication skills, emotional intelligence, personal characteristics, teaching skills, job skills, and efficacy and evaluation skills.
The most common responses received for rating preceptors by themselves were 3 and 4 on the Likert Scale. It characterizes that they consider themselves to improve in the preceptor training. Survey participants were also asked to rate themselves, and responses received were 4 and 5 on the Likert scale. The results overall represented that most of the preceptors feel that they need to improve and develop themselves.
Table 3: Qualtrics survey results for knowledge skills, and attitudes indicators
13% of the participants completed the preceptor training programs before accepting interns. However, 93% of the interviewees completed a preceptor training program presented by the Commission on Dietetic Registration. The results received for the efficacy and the effectiveness of the training program were low (0-3). The responses showed that there was a deficiency in the learning outcomes and a lack of memory in the preceptor training programs. The survey question regarding participation in the training program before becoming dietetic preceptors was 44% had completed the online CDR module. 22% of the participants received a specific university dietetic internship. 28% responded that they had not completed specific preceptor training. Out of which, less than 40% of responses indicated that the training was effective and fruitful and enhanced their learning dietetic preceptor abilities.
Table 4: Qualtrics survey results for preceptor training
Interview responses related to whether there is a need to develop more tailored, continuous, and vigorous preceptor training for the enhancement of the precepting abilities and learning opportunities for interns, only one answer received as no. The rest of the respondents entailed that they would join those training to improve their skills, job skills, communication skills, and clinical preceptor abilities. The results stated that respondents are willing to attend preceptor training sessions if available according to their routine schedule, onsite, and online annual training. Every individual participant responded that the training would be beneficial for their attributes, skills, and knowledge. Participants' responses to how often they would join the preceptor training sessions were annually 51%. 28% of responses were to attend this training every 2 to 3 years. Online preceptor training programs were preferred by the majority of the participants and resulted in 67%. Survey responses resulted in 80% of the individuals stated to attend the training programs annually. The topics and attributes to be presented in the training programs were resulted in enhancing skills as a preceptor, evaluation of the interns, precepting ACEND requirements, corresponding workload during preceptor training, and constructive feedback.
Table 5: Qualtrics survey results for preceptor training topics
Limitations
Dietetic preceptors voluntarily joined this study, which may result in self-selection bias. Self-selection bias often affected the results; however, the results from the responses were prepared anonymously. Response bias may occur because the respondents have reported their self-perceived preceptor abilities, which may have affected the results. The research was completed without any incentive; therefore, the response rate was low relative to the number of dietetic preceptors present in the United States ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"aak7fctupu","properties":{"formattedCitation":"(AbuSabha et al., 2018)","plainCitation":"(AbuSabha et al., 2018)"},"citationItems":[{"id":373,"uris":["http://zotero.org/users/local/p8kwKNoG/items/KEY79JRN"],"uri":["http://zotero.org/users/local/p8kwKNoG/items/KEY79JRN"],"itemData":{"id":373,"type":"article-journal","title":"Benefits, Barriers, and Motivators to Training Dietetic Interns in Clinical Settings: A Comparison between Preceptors and Nonpreceptors","container-title":"Journal of the Academy of Nutrition and Dietetics","page":"471-480","volume":"118","issue":"3","author":[{"family":"AbuSabha","given":"Rayane"},{"family":"Muller","given":"Colette"},{"family":"MacLasco","given":"Jacqueline"},{"family":"George","given":"Mary"},{"family":"Houghton","given":"Erica"},{"family":"Helm","given":"Alison"}],"issued":{"date-parts":[["2018"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (AbuSabha et al., 2018). The results generated from the small sample size would limit the study to generalize it on the overall population. The short duration of the research also limits the study for the participants to schedule their interviews or join the online survey and analyze it in a relatively short period.
Discussion
Improvement in diet and nutrition is the initial level of collaboration from the persons, families, and societies to improve the health status of the country. The role of dietitians and nutritionists includes discrete care with health promotion of diet and nutrition guide, the role of diet in the acquisition of illness, and community progresses in acquiring the disorders that are directly linked with nutrition ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"a2a8p2frqtf","properties":{"formattedCitation":"(Nottingham & Kasamatsu, 2018)","plainCitation":"(Nottingham & Kasamatsu, 2018)"},"citationItems":[{"id":377,"uris":["http://zotero.org/users/local/p8kwKNoG/items/79NMMG6C"],"uri":["http://zotero.org/users/local/p8kwKNoG/items/79NMMG6C"],"itemData":{"id":377,"type":"article-journal","title":"Paired Athletic Training Preceptors' and Students' Perceptions of Effective Preceptor Characteristics","container-title":"Journal of allied health","page":"1E-7E","volume":"47","issue":"1","author":[{"family":"Nottingham","given":"Sara L."},{"family":"Kasamatsu","given":"Tricia M."}],"issued":{"date-parts":[["2018"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Nottingham & Kasamatsu, 2018). Like nutritionists and dietitians working in diverse locations, interns also have specialized, authorized, and moral duties to promote healthy lifestyles among communities and societies. Beached in the occasion of practice, these professionals supply publicly suitable, commonly obtainable, and systematically comprehensive initial level care regarding food choices and lifestyle ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"a16ou0glqig","properties":{"formattedCitation":"(Nottingham & Kasamatsu, 2018)","plainCitation":"(Nottingham & Kasamatsu, 2018)"},"citationItems":[{"id":377,"uris":["http://zotero.org/users/local/p8kwKNoG/items/79NMMG6C"],"uri":["http://zotero.org/users/local/p8kwKNoG/items/79NMMG6C"],"itemData":{"id":377,"type":"article-journal","title":"Paired Athletic Training Preceptors' and Students' Perceptions of Effective Preceptor Characteristics","container-title":"Journal of allied health","page":"1E-7E","volume":"47","issue":"1","author":[{"family":"Nottingham","given":"Sara L."},{"family":"Kasamatsu","given":"Tricia M."}],"issued":{"date-parts":[["2018"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Nottingham & Kasamatsu, 2018). They practice separately and interdependently in clusters to deliver significance to those in greatest need and address health inequalities.
The dietetic professionals and the interns should ensure the contribution and association of public and private governments to endorse healthy behaviors, particularly nutrition and diet guide, which is impossible to achieve without dietetic preceptor training ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"a1j7hllt903","properties":{"formattedCitation":"(Winham, n.d.)","plainCitation":"(Winham, n.d.)"},"citationItems":[{"id":387,"uris":["http://zotero.org/users/local/p8kwKNoG/items/SB28DABL"],"uri":["http://zotero.org/users/local/p8kwKNoG/items/SB28DABL"],"itemData":{"id":387,"type":"article-journal","title":"Attitudes and Perceptions of the Dietetic Internship Preceptor Role by Nutrition Professionals","source":"www.academia.edu","abstract":"Attitudes and perceptions on the role of preceptors in dietetic internships were assessed by an online survey among 552 registered dietitians and other nutrition professionals. Significant differences were observed in the scores concerning the value","URL":"https://www.academia.edu/30936703/Attitudes_and_Perceptions_of_the_Dietetic_Internship_Preceptor_Role_by_Nutrition_Professionals","language":"en","author":[{"family":"Winham","given":"Donna M."}]}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Winham, n.d.). The results of the study are revealing that additional preceptor training is required and necessary to meet the needs of current dietetic preceptors. As dietetic preceptors offer dietetic interns their only practical experience before entering the workforce, preceptors must receive adequate and effective preceptor training. Furthermore, the results indicate that preceptors request supplementary and continuing preceptor training to enhance their abilities and meet their needs to increase self-efficacy related to precepting. Though greater importance is for professional responsibility by the Academy of Nutrition and Dietetics, dietetic educators and preceptors may be necessary.
The study design and the outcomes have the potential to be applied in an upcoming dietetic preceptor training module ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"a3jipaql3a","properties":{"formattedCitation":"(Nottingham & Kasamatsu, 2018)","plainCitation":"(Nottingham & Kasamatsu, 2018)"},"citationItems":[{"id":377,"uris":["http://zotero.org/users/local/p8kwKNoG/items/79NMMG6C"],"uri":["http://zotero.org/users/local/p8kwKNoG/items/79NMMG6C"],"itemData":{"id":377,"type":"article-journal","title":"Paired Athletic Training Preceptors' and Students' Perceptions of Effective Preceptor Characteristics","container-title":"Journal of allied health","page":"1E-7E","volume":"47","issue":"1","author":[{"family":"Nottingham","given":"Sara L."},{"family":"Kasamatsu","given":"Tricia M."}],"issued":{"date-parts":[["2018"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Nottingham & Kasamatsu, 2018). Dietetic educators, training organizations, and universities should utilize the study findings to develop a program that will prepare and support dietetic preceptors in precepting ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"a1604qi17t1","properties":{"formattedCitation":"(Border, Endrizal, & Cecil, 2019)","plainCitation":"(Border, Endrizal, & Cecil, 2019)"},"citationItems":[{"id":376,"uris":["http://zotero.org/users/local/p8kwKNoG/items/3GEL48WD"],"uri":["http://zotero.org/users/local/p8kwKNoG/items/3GEL48WD"],"itemData":{"id":376,"type":"article-journal","title":"Academy of Nutrition and Dietetics: Revised 2018 Standards of Professional Performance for Registered Dietitian Nutritionists (Competent, Proficient, and Expert) in Education of Nutrition and Dietetics Practitioners","container-title":"Journal of the Academy of Nutrition and Dietetics","page":"124-136. e29","volume":"119","issue":"1","author":[{"family":"Border","given":"Kathleen"},{"family":"Endrizal","given":"Cynthia"},{"family":"Cecil","given":"Malinda"}],"issued":{"date-parts":[["2019"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Border, Endrizal, & Cecil, 2019). By doing so, dietetic internships may be able to accept more nutrition competent graduates into the programs, and as a result, people may appreciate more dietetic professionals entering the workforce in the future.
The fortes of the study acknowledge it as one of its supreme kind in the United States as no study has been conducted to evaluate the efficacy and effectiveness of the dietetic preceptor training. The methodological tool adapted was unfailing and established significant results with reliability. The interviews and the survey effectively identified and recognized the research gaps. The interviews provided a comprehensive and detailed insight by delivering open-ended questions and coded responses ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"a2lpphqlrlv","properties":{"formattedCitation":"(Weber et al., 2019)","plainCitation":"(Weber et al., 2019)"},"citationItems":[{"id":379,"uris":["http://zotero.org/users/local/p8kwKNoG/items/DF8RYQDP"],"uri":["http://zotero.org/users/local/p8kwKNoG/items/DF8RYQDP"],"itemData":{"id":379,"type":"article-journal","title":"A dietetic clinical educator enhances the experience and assessment of clinical placement","container-title":"Nutrition & Dietetics","page":"486-492","volume":"76","issue":"4","author":[{"family":"Weber","given":"Katrina"},{"family":"Carter","given":"Brie"},{"family":"Jenkins","given":"Gemma"},{"family":"Jamieson","given":"Janica"}],"issued":{"date-parts":[["2019"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Weber et al., 2019). Moreover, the short time of the study was helpful in this regard that the interviews were accessible and easily available for the participants. However, the study may not be able to generalize the results on the overall population of dietetic preceptors (less than 2%) in the United States.
The nutrition and diet-related disease burden is preventable and can be significantly declined by availing and improving the preceptor's training, and through the intern's collaborations, the health status of the country can be improved ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"a1ncaghisni","properties":{"formattedCitation":"(Hinrichs, 2018)","plainCitation":"(Hinrichs, 2018)"},"citationItems":[{"id":389,"uris":["http://zotero.org/users/local/p8kwKNoG/items/PGIIPYF5"],"uri":["http://zotero.org/users/local/p8kwKNoG/items/PGIIPYF5"],"itemData":{"id":389,"type":"article-journal","title":"Dietetic interns’ perceptions and use of evidence-based practice: an exploratory study","container-title":"Journal of the Medical Library Association: JMLA","page":"65","volume":"106","issue":"1","author":[{"family":"Hinrichs","given":"Rachel J."}],"issued":{"date-parts":[["2018"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Hinrichs, 2018). The nutrition and diet-related programs should be organized at the community and society level to improve the health of the people. It is only possible to encourage preceptors and interns to acquire skills and practices to meet the demand for professional practice. It is also recommended that interns and preceptors should acquire and progress in the field of food and nutrition to contribute their significant role in the anticipation and prevention of the disease. This also requires the involvement of the governments and administrations to endorse and provide opportunities to the preceptors to deliver their services.
A nutritious diet, and achieving and sustaining an energetic weight are the greatest requirements to cope with disorders timely; the dietetic preceptor professional training is the only solution to combat the burden ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"a2jgtr909gu","properties":{"formattedCitation":"(Border, Endrizal, & Cecil, 2019)","plainCitation":"(Border, Endrizal, & Cecil, 2019)"},"citationItems":[{"id":376,"uris":["http://zotero.org/users/local/p8kwKNoG/items/3GEL48WD"],"uri":["http://zotero.org/users/local/p8kwKNoG/items/3GEL48WD"],"itemData":{"id":376,"type":"article-journal","title":"Academy of Nutrition and Dietetics: Revised 2018 Standards of Professional Performance for Registered Dietitian Nutritionists (Competent, Proficient, and Expert) in Education of Nutrition and Dietetics Practitioners","container-title":"Journal of the Academy of Nutrition and Dietetics","page":"124-136. e29","volume":"119","issue":"1","author":[{"family":"Border","given":"Kathleen"},{"family":"Endrizal","given":"Cynthia"},{"family":"Cecil","given":"Malinda"}],"issued":{"date-parts":[["2019"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Border, Endrizal, & Cecil, 2019). Obesity, in particular, is the consideration of various public health scientists in the United States. New strategies have been smeared by the US sectors of food, nutrition, and other related departments. Frequent policies are also in progress to be applied by centers for disease control and prevention ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"a20uhq1gfs0","properties":{"formattedCitation":"(Gardner, 2014)","plainCitation":"(Gardner, 2014)"},"citationItems":[{"id":127,"uris":["http://zotero.org/users/local/p8kwKNoG/items/C7EU3JQB"],"uri":["http://zotero.org/users/local/p8kwKNoG/items/C7EU3JQB"],"itemData":{"id":127,"type":"article-journal","title":"Eat Smart, Move More North Carolina An Obesity Prevention Movement","container-title":"North Carolina medical journal","page":"407-412","volume":"75","issue":"6","author":[{"family":"Gardner","given":"David"}],"issued":{"date-parts":[["2014"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Gardner, 2014). However, the incidence of obesity in the United States is unexpected, recognizing around one-third of grownups, and 17% of teenagers are overweight. It appears to have trampled off between 2003-2004 and 2009-2010. A balanced diet and dynamic bodyweight are crucial measures of a person's overall health and well-being. By introducing these all in one's life can help in decreasing a person's risk of developing severe health illnesses, for instance, hypertension, and a rise in cholesterol, diabetes, cardiovascular disorders, and stroke.
When the RDs are not sufficient in the region having rigorous training and knowledge and meeting the criteria set for the restarted dietitian and nutritionists, the burden of the non-communicable diseases will keep on rising in the states. The registered practitioners, such as a dietitian and nutritionists know the dissemination of the disease. The root cause of the non-communicable disease is linked with nutrition ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"a2lppt616pa","properties":{"formattedCitation":"(Notaras, Mak, & Wilson, 2018)","plainCitation":"(Notaras, Mak, & Wilson, 2018)"},"citationItems":[{"id":386,"uris":["http://zotero.org/users/local/p8kwKNoG/items/LAD7N4MV"],"uri":["http://zotero.org/users/local/p8kwKNoG/items/LAD7N4MV"],"itemData":{"id":386,"type":"article-journal","title":"Advancing practice in dietitians’ communication and nutrition counselling skills: a workplace education program","container-title":"Journal of human nutrition and dietetics","page":"725-733","volume":"31","issue":"6","author":[{"family":"Notaras","given":"S."},{"family":"Mak","given":"M."},{"family":"Wilson","given":"N."}],"issued":{"date-parts":[["2018"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Notaras, Mak, & Wilson, 2018). These registered practitioners are limited in the states and, therefore, need to have more interns to be skilled and trained to practice in the communities. The effective teaching of the interns is necessary to meet the employment demand.
The interns are required to complete credit hours and accreditation process of the state to work as a professional. It has been observed that in the year 2013, only 52% of the applicants meet the exact criteria of the internship as per the accreditation. Also, the number of graduates is in a large number, whereas only 52% were able to qualify the criteria ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"a2g9r8athke","properties":{"formattedCitation":"(Winham, n.d.)","plainCitation":"(Winham, n.d.)"},"citationItems":[{"id":387,"uris":["http://zotero.org/users/local/p8kwKNoG/items/SB28DABL"],"uri":["http://zotero.org/users/local/p8kwKNoG/items/SB28DABL"],"itemData":{"id":387,"type":"article-journal","title":"Attitudes and Perceptions of the Dietetic Internship Preceptor Role by Nutrition Professionals","source":"www.academia.edu","abstract":"Attitudes and perceptions on the role of preceptors in dietetic internships were assessed by an online survey among 552 registered dietitians and other nutrition professionals. Significant differences were observed in the scores concerning the value","URL":"https://www.academia.edu/30936703/Attitudes_and_Perceptions_of_the_Dietetic_Internship_Preceptor_Role_by_Nutrition_Professionals","language":"en","author":[{"family":"Winham","given":"Donna M."}]}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Winham, n.d.). The number states that the country is lacking registered dietitians and nutritionists as preceptors to train new scholars. However, there is a chance that the available registered nutritionist and the dietitians may lack the ability to deliver the knowledge to the scholars, or they are unaware of the professional teaching and training methods. This represents that the preceptors are also prerequisites to be trained according to professional teaching.
The preceptors usually do not have teaching sessions and training programs to improve their skills and abilities to train interns. Although there are studies available that have shown that the preceptors are usually ignored in terms of incentives and the reward to train the interns, these benefits are in the form of training and knowledge and to gain personal satisfaction to deliver services effectively. The preceptors should be stimulated and encouraged to train the interns by providing them the opportunities of knowledge building and enhanced professional training. The purpose of this study was to identify skills, knowledge, and attitudes preceptors deemed necessary, as well as identifying areas for training for dietetic preceptors. This study was successful in identifying the needs and wants of preceptors, as well as gathering information on preceptor training; however, more research is needed in this area.
Potential refusals are also related to the working of a preceptor. Earlier researches have specified an important barrier to being a preceptor. These studies have identified that preceptors need additional time to train the interns. It is difficult for the preceptors to train the interns according to the set criteria of the accreditation academies with their practice. Other factors such as additional responsibilities, paper works, inadequate communication skills, lack of organizational support and the resources to carry out the training.
Implications
The implications of this research are significant in identifying the needs and the requirements of the dietetic preceptors in regards to training, as well as perceiving self-efficacy to become an effective dietetic preceptor. The research suggests further evaluation of the dietetic preceptor training and the concerns, attributes, and complications in conducting this training. For higher completion rates of the survey, it could be sent out as part of a final package of dietetic internships. In this way, the dietetic preceptors would have a chance to reflect on the recent experiences and practices. This may provide more accurate feedback and significantly reduce recall bias. This research has implications for the discipline of public health as a dietitian can play an important role in improving the health status of the country. Preparing good and professional nutritionists and dietitians, the leading cause of the disorders and death can be significantly reduced in the United States. Efficient and skilled dietetic preceptors would ultimately outcome in better health of the country as well as a prepared generation of nutrition professionals.
It was expected that in the year 2020, the field of nutrition would merely be capable of encountering 75% of the requirement for nutritionists and dietetics. It was also projected that there might be an unexpected upsurge in the given percentage ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"a2kiqiiitmq","properties":{"formattedCitation":"(Border et al., 2019)","plainCitation":"(Border et al., 2019)"},"citationItems":[{"id":376,"uris":["http://zotero.org/users/local/p8kwKNoG/items/3GEL48WD"],"uri":["http://zotero.org/users/local/p8kwKNoG/items/3GEL48WD"],"itemData":{"id":376,"type":"article-journal","title":"Academy of Nutrition and Dietetics: Revised 2018 Standards of Professional Performance for Registered Dietitian Nutritionists (Competent, Proficient, and Expert) in Education of Nutrition and Dietetics Practitioners","container-title":"Journal of the Academy of Nutrition and Dietetics","page":"124-136. e29","volume":"119","issue":"1","author":[{"family":"Border","given":"Kathleen"},{"family":"Endrizal","given":"Cynthia"},{"family":"Cecil","given":"Malinda"}],"issued":{"date-parts":[["2019"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Border et al., 2019). If the United States fails to accomplish the demand, the incompetent and less skilled professionals may occupy the space. This would be ultimately outcome in the upsurge of non-communicable disease burden in the country, which is the leading cause of death. According to the demand and need for employment, it is estimated that there is an expected increase of 16% in the coming ten years. This increase in employment is higher as compared to the other professions in the country.
Personal implications
Learning, preparing, and conducting the research was very helpful for my personal experience. I learned the skills to conduct research, analysis of the data collected, identified the research gaps present in the dietetic preceptor training. I would prefer the new generation to join the field of public health, particularly dietetics because every disease and illness is effectively preventable if there are skilled professionals available. Completion of my project helped me:
To understand and apply the principles of community participation in public health research and interventions.
To demonstrate the knowledge and skills necessary to research the discipline of social and behavioral science.
To demonstrate effective communication skills, a key to public health workforce participation and advocacy.
Exclusively, I was capable only to complete the research and analysis of the study under the leadership and supervision of my preceptor. The research is important not only to the University of Florida to develop a more effective preceptor training program but also to the field of nutrition and dietetics in general. Dietetic precepts can significantly play an important role in training future nutrition and dietetic professionals ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"ah1egpltvv","properties":{"formattedCitation":"(Hinrichs, 2018)","plainCitation":"(Hinrichs, 2018)"},"citationItems":[{"id":389,"uris":["http://zotero.org/users/local/p8kwKNoG/items/PGIIPYF5"],"uri":["http://zotero.org/users/local/p8kwKNoG/items/PGIIPYF5"],"itemData":{"id":389,"type":"article-journal","title":"Dietetic interns’ perceptions and use of evidence-based practice: an exploratory study","container-title":"Journal of the Medical Library Association: JMLA","page":"65","volume":"106","issue":"1","author":[{"family":"Hinrichs","given":"Rachel J."}],"issued":{"date-parts":[["2018"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Hinrichs, 2018). Understanding their needs and requirements as well as the efficacy of the training programs on a national level is the first step to develop a new and highly demanded training program. Furthermore, I pioneered the qualitative survey, which was sent at the national level; this survey is the first research of its kind in the United States. Overall this research will be the first in the field of evolving and emerging dietetic research preceptors. Evidence and information composed will be castoff by future students to organize new dietetic preceptor training programs.
Conclusion
The leading cause of death continues to be upsurging in the United States; non-communicable disease such as diabetes and cardiovascular disorders are significantly increasing in the country. The alarming facts of the nutrition-linked diseases have opened new research fields that demand more public health professionals, particularly nutritionists and dietitians ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"a10d425i2tu","properties":{"formattedCitation":"(Border et al., 2019)","plainCitation":"(Border et al., 2019)"},"citationItems":[{"id":376,"uris":["http://zotero.org/users/local/p8kwKNoG/items/3GEL48WD"],"uri":["http://zotero.org/users/local/p8kwKNoG/items/3GEL48WD"],"itemData":{"id":376,"type":"article-journal","title":"Academy of Nutrition and Dietetics: Revised 2018 Standards of Professional Performance for Registered Dietitian Nutritionists (Competent, Proficient, and Expert) in Education of Nutrition and Dietetics Practitioners","container-title":"Journal of the Academy of Nutrition and Dietetics","page":"124-136. e29","volume":"119","issue":"1","author":[{"family":"Border","given":"Kathleen"},{"family":"Endrizal","given":"Cynthia"},{"family":"Cecil","given":"Malinda"}],"issued":{"date-parts":[["2019"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Border et al., 2019). The results of the study have suggested that more and effective preceptor training and preparations are required to meet the demand of the dietetic preceptor training. The rigorous interventions, training, and interferences are sought to promote dietetic preceptors and to control the epidemic of diet-related disorders, including obesity and hypertension. The involvement of the non-preceptors to engage themselves in perception is highly recommended by introducing any kind of incentive or motivation. The operative and effective dietetic preceptor training would be beneficial for the registration of the dietetic students in ACEDN. The community-based programs such as involvement of the community in the food and healthy lifestyle and improved food quality should be encouraged to change the behaviors of the societies and the communities.
Tables and Charts (Appendices)
Interview questions (Table 1)
Table 1: Developed preceptor interview questions (IRB approved)
Preceptor Questions
How many years have you been a practicing dietitian?
How long have you been a preceptor?
What area of dietetics have you been a preceptor for? (Clinical, community, outpatient, etc.)
In general, what are the attributes of a preceptor (specific skills, knowledge, attitudes)?
Based on X attribute (do each one separately based on what they listed), on a scale of 1 (poor) to 5 (excellent), how do you rate yourself?
Please explain why you gave yourself that number (need to do this for each attribute they listed)
Prior to becoming a preceptor, what types of training did you have to help prepare you for this role?
As a preceptor, how often do you participate in preceptor-specific training?
Which organization(s) provided this training?
Was the training live- in-person; live- webinar; or recorded or another format?
On a scale from 1 (poor) to 5 (excellent), indicate if the training environment was conducive to learning. Explain why you gave that number.
What information was provided during this training?
On a scale from 1 (poor) to 5 (excellent), indicate how well you incorporated the training information as you precepted. Explain why you gave that number.
Rate on a scale of 1 (not at all) to 5 (drastically improved), if this training helped improve your precepting abilities. Explain why you gave that number.
Do you feel that receiving training, on an on-going basis that was tailored to your needs, would enhance your precepting abilities? Why or why not?
How often would you prefer to receive preceptor training?
What formats would you prefer to receive this training? (If they ask – live, hands-on workshops, webinars, articles).
Do you believe preceptor training would help your intern learn more from you? Why or why not?
The MS/DI program at UF is developing an annual preceptor workshop, what type of information would you like to see in these workshops?
Would you attend this workshop? Why or why not?
Survey questions (table 2)
Q2 1. Based on the following knowledge, skills, and attitude statements, indicate your level of agreement from a scale of strongly disagree to strongly agree As a preceptor, I know how to....
Strongly disagree (50)
Somewhat disagree (51)
Neither agree nor disagree (52)
Somewhat agree (53)
Strongly agree (54)
Teach my interns the skills needed to be a successful entry-level dietitian (1)
Evaluate my interns effectively (2)
Q19 2. Based on the following knowledge, skills, and attitude statements, indicate your level of agreement from a scale of strongly disagree to strongly agree As a preceptor, I understand…
Strongly disagree (13)
Somewhat disagree (14)
Neither agree nor disagree (15)
Somewhat agree (16)
Strongly agree (17)
the requirements of an ACEND accredited internship program (1)
My role as a preceptor (2)
The importance of the dietetic internship (3)
Q18 3. Based on the following knowledge, skills, and attitude statements, indicate your level of agreement from a scale of strongly disagree to strongly agree As a preceptor, I am confident in my ability to…
Strongly disagree (13)
Somewhat disagree (14)
Neither agree nor disagree (15)
Somewhat agree (16)
Strongly agree (17)
Identify the different learning styles of my interns (1)
Adapt my precepting approach to the different learning styles of my interns (2)
Identify learning opportunities for interns (3)
Challenge my interns (4)
Communicate effectively with my interns (5)
Actively listen to interns’ comments and concerns (6)
Identify interns’ performance issues (7)
Provide constructive feedback to my interns (8)
Establish an environment that encourages interns to ask questions (9)
Help interns feel comfortable in the working environment (10)
Allow interns to make mistakes (11)
Recognize external factors that can influence an intern’s performance (12)
Not overwhelm interns (13)
Q20 4. Based on the following knowledge, skills, and attitude statements, indicate your level of agreement from a scale of strongly disagree to strongly agreeAs a preceptor......
Strongly disagree (13)
Somewhat disagree (14)
Neither agree nor disagree (15)
Somewhat agree (16)
Strongly agree (17)
I empower interns to take control of their own learning (1)
I build up interns’ confidence (2)
I commit to interns’ development (3)
I respect interns’ opinions (4)
I enjoy my role as a preceptor (5)
I have been able to enhance my own clinical, community and/or foodservice skills (6)
I am able to lead my interns (7)
Q3 5. What preceptor training(s) have you participated in? (select all that apply)
CDR & Eat Right Pro preceptor training module/ preceptor resources (1)
Specific Internship or University training (if so please list organization/School) (2)
Other (Please list) (4)
I have not participated in preceptor training programs (3)
Q4 6. How often do you participate in preceptor-specific training?
Once, when starting as a preceptor (1)
More than once per year (2)
Annually (3)
Every 2-3 years (4)
Q5 7. How was this training delivered? (Select all that apply)
In person (1)
Online training program (on demand) (2)
Webinar (3)
Other (please list)
Q6 8. What topic(s) were discussed in the training? (Select all that apply)
ACEND requirements for precepting (1)
Background of internship (2)
Balancing workload with precepting (3)
Discipling an intern (4)
Enhancing skills as a preceptor (5)
Enhancing teaching methods (6)
Evaluating an intern (7)
Facilitating intern learning (8)
Handling a difficult intern (9)
Providing constructive feedback to interns (10)
Role as a preceptor (11)
Other (please list)
Q7 9. Based on the following knowledge, skills, and attitude statements, indicate your level of agreement from a scale of strongly disagree to strongly agree
Strongly disagree (13)
Somewhat disagree (14)
Neither agree nor disagree (15)
Somewhat agree (16)
Strongly agree (17)
The training environment was conducive to my learning (2)
When precepting, I use the training information (1)
My precepting skills were enhanced due to the training (3)
I am a better preceptor because of the training (4)
Q8 10. How often would you prefer to receive preceptor training?
Once before beginning to precept (1)
More than once per year (2)
Annually (3)
Every 2-3 years (4)
Never (5)
Q9 11. What formats would you prefer to receive this training? (Select all that apply)
In person (1)
Online training program (on demand) (2)
Webinar (3)
Newsletter format (4)
Other (please list) (5)
Q10 12. What topics should be included in a preceptor training? (select all that apply)
ACEND requirements for precepting (1)
Balancing workload with precepting (2)
Cultural competency (3)
Discipling an intern (4)
Education on how to promote learning and skill development in others (5)
Consent Form for Interview about Preceptor Training
IRB: 201901692
Investigator: Dr. Jeanette Andrade
Description. You are invited to participate in an interview about preceptor training and potential preceptor training offered through the University of Florida. The goal of this interview is to gather your thoughts about the possibility of a preceptor training workshop and the content. The following paragraphs provide important information to consider before deciding.
Activity. A moderator will ask you 8 questions regarding your time as a preceptor, the necessary skills and abilities of a preceptor, preceptor training that you may have taken advantages of – the strengths and weaknesses of these training, and if the University of Florida was to offer a preceptor training workshop if you would attend and the ideal content to include. Another moderator will record all responses on paper; thus, no audio or voice recordings will occur. The interview will take no more than 30-45 minutes.
Voluntariness. Consenting to participate in this interview is entirely voluntary. Providing information will NOT affect your current or future status as a preceptor. You are free to stop the interview at any time, for any reason, without consequences. Additionally, you can decline to answer the interview questions.
Privacy and Confidentiality. If we use quotes or paraphrase information in our reports, we’ll strive to avoid including information that could identify you or other participants, but we cannot guarantee complete success. Any publications or presentations from this focus group will include information as a whole and will not identify participants.
Risks. The risk is negligible since your responses will be de-identified and securely stored in a locked file cabinet that is only accessible by the main investigator. The University does not provide compensation for any injury sustained as a result of participation in a study, except as required by law.
Benefits. Overall, the results from this interview will inform the content for a potential preceptor training workshop hosted through the MS/DI program at the University of Florida.
Dissemination. Results from this interview will be included in academic presentations, journal articles, and possibly subsequent research in this area. No identifying information will be included in any dissemination of the results.
Contact. You are encouraged to ask questions about this interview before, during, or after your participation. Questions can be addressed to Dr. Jeanette Andrade at 352-294-3975 or jandrade1@ufl.edu. You may also contact the IRB office at (irb2@ufl.edu), for any questions about your rights as a human subject in research.
If you are interested in participating in this interview, please complete the following fields below. If you do not want to participate in the interview, we will exit the room.
I have read and understood the above consent form and voluntarily agree to participate in this interview, and I am 18 years of age or older.
___ Yes
___ No
If you agree to participate in this interview, sign your name and write the date.
Name: _________________________________
Date: ___________________________________
A copy of this consent form will be provided to you.
Table 4 (Survey Consent form)
Preceptor Survey
Q1 University of Florida Food Science and Human Nutrition Department Consent Form for Preceptor Survey IRB: 201901692 Investigators: Somir Shreim and Dr. Jeanette Andrade Description. You are invited to participate in an online survey that is conducted by Somir Shreim under the advisement of Dr. Jeanette Andrade in the Food Science and Human Nutrition Department at University of Florida survey about your knowledge, skills, and attitudes towards precepting and preceptor training. The survey should take no longer than 10 minutes. Participation. Your participation in this survey is voluntary. You may refuse to take part in the survey or exit the survey at any time without penalty. You may skip any question you do not wish to answer for any reason. Privacy and Confidentiality. Your survey answers will be stored initially within Qualtrics in a password protected electronic format. Data will later be downloaded and stored on a password protected computer. Your responses will be coded and will not be associated with your name, as there will be no means to identify your name on the web survey. Any publications or presentations of the results of this research will include information on group performances (e.g., means and standard deviations) and will not identify participants. Risks. There is a minimal risk that security of any online data may be breached, but our survey host (QUALTRICS) Uses strong encryption and other data security methods to protect your information. Only the researchers will have access to your information on the Qualtrics server. No identifying information will be collected or connected with your responses, which will be anonymous. Benefits. Overall, the results of this survey will identify areas for training preceptors. Dissemination. Results from this interview will be included in academic presentations, journal articles, and possibly subsequent research in this area. No identifying information will be included in any dissemination of the results. Contact. You are encouraged to ask questions about this interview before, during, or after your participation. Questions can be addressed to Dr. Jeanette Andrade at 352-294-3975 or jandrade1@ufl.edu. You may also contact the IRB office at (irb2@ufl.edu), for any questions about your rights as a human subject in research. If you are interested, please complete the following fields below. If you don’t want to continue with this study, you can close this browser at any time. I have read the above consent form and voluntarily agree to participate in this study. I am 18 years or older. NOTE. Please maintain this form for future reference or print it for your personal records.
Yes (1)
No (2)
References
ADDIN ZOTERO_BIBL {"custom":[]} CSL_BIBLIOGRAPHY AbuSabha, R., Muller, C., MacLasco, J., George, M., Houghton, E., & Helm, A. (2018). Benefits, Barriers, and Motivators to Training Dietetic Interns in Clinical Settings: A Comparison between Preceptors and Nonpreceptors. Journal of the Academy of Nutrition and Dietetics, 118(3), 471–480.
Andersen, D., Baird, S., Bates, T., Chapel, D. L., Cline, A. D., Ganesh, S. N., … Jablonski, K. (2018). Academy of Nutrition and Dietetics: Revised 2017 scope of practice for the registered dietitian nutritionist. Journal of the Academy of Nutrition and Dietetics, 118(1), 141–165.
Border, K., Endrizal, C., & Cecil, M. (2019). Academy of Nutrition and Dietetics: Revised 2018 Standards of Professional Performance for Registered Dietitian Nutritionists (Competent, Proficient, and Expert) in Education of Nutrition and Dietetics Practitioners. Journal of the Academy of Nutrition and Dietetics, 119(1), 124–136. e29.
Butler, S. (2019). Factors Associated With Commitment of Registered Dietitian Nutritionists to the Dietetic Internship Preceptor Role. Teachers College, Columbia University.
Gardner, D. (2014). Eat Smart, Move More North Carolina An Obesity Prevention Movement. North Carolina Medical Journal, 75(6), 407–412.
Hinrichs, R. J. (2018). Dietetic interns’ perceptions and use of evidence-based practice: an exploratory study. Journal of the Medical Library Association: JMLA, 106(1), 65.
Nasser, R., Morley, C., Cook, S., Coleman, J., & Berenbaum, S. (2014). Dietitians’ perceptions of precepting: knowledge, skills, attitudes, barriers, and training. Canadian Journal of Dietetic Practice and Research, 75(1), 7–14.
Notaras, S., Mak, M., & Wilson, N. (2018). Advancing practice in dietitians’ communication and nutrition counselling skills: a workplace education program. Journal of Human Nutrition and Dietetics, 31(6), 725–733.
Nottingham, S. L., & Kasamatsu, T. M. (2018). Paired Athletic Training Preceptors’ and Students’ Perceptions of Effective Preceptor Characteristics. Journal of Allied Health, 47(1), 1E–7E.
Weber, K., Carter, B., Jenkins, G., & Jamieson, J. (2019). A dietetic clinical educator enhances the experience and assessment of clinical placement. Nutrition & Dietetics, 76(4), 486–492.
Winham, D. M. (n.d.). Attitudes and Perceptions of the Dietetic Internship Preceptor Role by Nutrition Professionals. Retrieved from https://www.academia.edu/30936703/Attitudes_and_Perceptions_of_the_Dietetic_Internship_Preceptor_Role_by_Nutrition_Professionals
