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Identifying components of advanced-level clinical nutrition practice: a Delphi study
Rebecca A Brody1, Laura Byham-Gray, Riva Touger-Decker
1Graduate Programs in Clinical Nutrition, Department of Nutritional Sciences, School of Health Related Professions, University of Medicine and Dentistry of New Jersey, 65 Bergen St, Room 157, Newark, NJ 07101-1709, USA. brodyra@umdnj.edu
Journal of the Academy of Nutrition and Dietetics
|June 20, 2012
Summary
Defining advanced practice for registered dietitians (RDs) is crucial. Expert consensus established key attributes and activities for advanced practice RDs in clinical nutrition, emphasizing knowledge, skills, and patient-centered care.
Area of Science:
- Dietetics and Clinical Nutrition
- Professional Practice Standards
- Health Professions Education
Background:
- The dietetics profession requires a clear definition of advanced-level practice.
- Existing definitions lack comprehensiveness, hindering professional development and recognition.
- Advanced practice registered dietitians (RDs) play a vital role in clinical nutrition.
Purpose of the Study:
- To achieve expert consensus on the dimensions defining advanced-level practice for RDs in clinical nutrition.
- To develop a comprehensive model for advanced practice in dietetics.
- To identify essential knowledge, skills, behaviors, and roles for advanced practice RDs.
Main Methods:
- A three-round Delphi study utilizing mailed surveys with 117 identified advanced practice RDs.
- Experts rated the essentiality of practice statements on a 7-point scale.
- Consensus was defined by an interquartile range of ≤2.0.
Main Results:
- Consensus was achieved on 233 statements, with 211 (90.6%) deemed essential for advanced practice RD clinical practice.
- Essential qualifications include a master's degree, advanced residency/coursework, 8 years of experience, specialization, and research/technology/communication skills.
- Key practice attributes include systematic yet adaptable approaches, critical thinking, professional growth, patient-centered care, and leadership.
Conclusions:
- A consensus-based model for advanced-level practice in clinical nutrition was proposed.
- The model outlines essential attributes and activities across four dimensions: knowledge, abilities/skills, approaches, and roles/relationships.
- This definition provides a framework for advanced practice RD professional development and recognition.
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