Perceptions, adequacy, and acquisition of clinical advanced practice training and skills in the dietetic profession

Abstract

Purpose: This study aimed to investigate RDN use of nutrition-related lab testing as a potential advanced clinical skill, and to describe RDN perceptions of the adequacy of training for nutrition-related lab testing and advanced clinical skills. Methods: A 40-item survey was sent electronically by email to 4951 randomly selected RDNs who have maintained dietetic registration with the Commission on Dietetic Registration ≥ three years. Reminders were sent weekly for the first three weeks, and the survey was open for five weeks. Answers to 10 questions on professional training and practice were used to assign participants into beyond-entry-level (BEL) or advanced-practice-eligible (AP) groups, according to Academy of Nutrition and Dietetics (AND) and Commission on Dietetic Registration (CDR) definitions. Descriptive statistics and differences (Mann Whitney U or Chi-square) between BEL and AP groups were analyzed, and significance was defined as p<.05. Results: Out of 805 participants, 64% of whom were categorized as BEL, 649 surveys were completed. A majority (85%) reported use of laboratory testing where a comprehensive metabolic panel was the most frequently used test and genetic testing the most infrequently used test. There were no differences between BEL or AP groups for use of laboratory testing except in the case of nutrient status testing, where the AP group reported significantly more frequent use (p=.02). The BEL group rated their professional training as more adequate for their current level of practice (p=.03). AP RDNs more often identified the most useful training method as self-teaching (34% vs 21%, p<.001). Conclusions: There is a need for improved clinical training to support dietetic AP and nutrition-related lab testing represents one potential gap in training for advanced level clinical practice.