Educational empowerment of the clinical dietitian: a proposed practice doctorate curriculum

Practice doctorate (NutritionD) programs that emphasize use of discipline-specific diagnostic assessments have been proposed for clinical dietitians. A preliminary survey of dietitians was conducted to ascertain perceived barriers to use of dietetics-specific diagnostic assessments; interest in earning a practice doctorate, and course topics of perceived importance to selected subspecialties and a practice doctorate curriculum. A questionnaire was developed and administered to a nonrandom sample of 120 dietitians attending a clinical nutrition conference. Response rate was 83%, yielding 100 usable responses. Of the respondents, 60 perceived education to be one of the most limiting barriers to use of diagnostic assessments; 55 expressed interest in earning a practice doctorate. Respondents ranked 22 course topics for perceived importance in each of 14 dietetics subspecialties; 5 topics were categorized as core, 12 as supporting, and 5 as elective. Course topics perceived to be of highest importance in 11 or more of 14 subspecialties were nutritional diagnosis; clinical nutrition examination procedures; advanced diet therapies/nutriotherapeutics; drug-nutrient interactions; and the care process/diagnostic charting. Dietetics-specific diagnosis, which often complements medical diagnosis, is in the process of becoming a standard of practice for many dietitians. Therefore, as seasoned dietitians we are challenged to overcome any possible educational barriers to realization of this new practice. One approach to achieving this educational empowerment would be to direct national study efforts toward components of the proposed curriculum and to develop a practice doctorate option for clinical dietitians.