Assumptions lead to the devaluation of dietitian roles in long-term care practice environments

Changing demographics in aging place new demands on dieticians related to education and subsequent employment. This study presents data from a survey illuminating dietitians' perceptions concerning the acquisition of entry-level clinical competence within a single practice setting. A purposive sample consisting of recent, employed internship graduates (n = 8) and internship supervisors (n = 6) from both long-term and active care settings completed a survey and was interviewed. While initial analysis suggested there were perceived risks and benefits associated with receiving clinical training exclusively in either of the environments, a more disturbing finding was a pervasive attitude indicating long-term care dietitian roles and training were devaluated. Thematic analysis indicated that issues related to career commitment, skill development, and philosophy of care were barriers to viewing training or working in long-term care as comparable to training or working in active care environments. Attitudes expressed were based on assumptions that could be clarified through increased education and communication, leading to a greater understanding of dietitian roles. Individual and professional efforts must be directed at creating a professional culture that fosters the valuing of all practice areas and the recognition of unique, rather than inferior, skills, knowledge, attitudes, and behaviors that support those environments.