Specialty practice in dietetics: empirical models and results

This article, which is the second of a two-part series, presents results for the second and third objectives of The American Dietetic Association (ADA) 1991 Dietetic Practice Study: to distinguish the task activities among registered dietitians practicing in renal nutrition, pediatric nutrition, and metabolic nutrition care; and to investigate the relationship between advanced-level practice and specialty practice. A nationwide mail survey of advanced-level practice was conducted on a stratified random sample of 8,012 beyond-entry-level (registered before April 1988) registered dietitians who were members of ADA and of dietetic practice groups (DPGs). The sample was supplemented with two randomly selected control groups of 1,000 entry-level and 1,000 beyond-entry-level registered dietitians. The operational definition for specialty practice was met by 1,925 sample members who were also included in the survey on practice in the three specialty areas. The overall response rate was 63.1%, and the total number of usable returns was 5,852. The results from a discriminant analysis of 121 specialty job tasks, administered in common to practitioners in each specialty, found that 84 tasks could be used to construct a generic model of specialty practice from which specific task lists were derived that defined practice in renal nutrition, pediatric nutrition, and metabolic nutrition care. Validation analyses found the generic model to be a reliable means of distinguishing the job activities in renal nutrition and in pediatric nutrition; it was somewhat less reliable for metabolic nutrition care. A weak relationship was found between advanced-level practice and practice in the three specialty areas.(ABSTRACT TRUNCATED AT 250 WORDS)