Abstract
Effective health workforce preparation is critical to the health of those who stand to benefit from its services. Emerging dietitians can provide important insights on an evolving workforce that is well-placed to advance future global health. This study aimed to explore a national sample of dietetics graduates’ experiences of, and challenges faced in, dietetics workforce preparation and preparedness in Australia. An interpretive description methodology guided this study whereby researchers interpreted the meanings that participants attributed to their experiences. Twenty dietitians (graduated within the last 2 years) were purposively sampled from across Australia and detailed insights were obtained through semi-structured interviews. A multi-analyst approach employing thematic and template analysis, enabled five themes to be identified across the data set. These included: (1) being held back; (2) chasing the prize; (3) valuing real learning; (4) easing the transition; and (5) encountering influencers. While graduates appreciated their preparation, they were not empowered or equipped to embrace opportunities in diverse and emerging areas of dietetics practice. Graduates were challenged by the competitive landscape of securing obvious job opportunities and by a lack of support in transitioning into the workforce. Practice exposures and encounters with influential dietitians were highly valued. Research on role-emerging dietetics placements along with enhanced support mechanisms for novice dietitians is urgently required to ensure appropriate alignment between future dietetics preparation and practice. Obtaining insights into health professional graduates’ experiences of their education can be used to ensure that emerging health workforces are relevant and responsive to future market needs.
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References
Atkinson, R., & McElroy, T. (2016). Preparedness for physiotherapy in private practice: Novices identify key factors in an interpretive description study. Manual Therapy,22, 116–121.
Australian Health Practitioner Regulation Agency. (2018). Data access and research. Retrieved 5 September, 2018, from https://www.ahpra.gov.au/About-AHPRA/What-We-Do/Data-access-and-research.aspx.
Barr, J., Ogden, K., Rooney, K., & Robertson, I. (2017). Preparedness for practice: The perceptions of graduates of a regional clinical school. Medical Journal of Australia,206(10), 447–452.
Barradell, S., Peseta, T., & Barrie, S. (2018). ‘There’s so much to it’: The ways physiotherapy students and recent graduates experience practice. Advances in Health Sciences Education,23(2), 387–406.
Brady, J., Lordly, D., MacLellan, D., & Gingras, J. (2012). New dietetic practitioners’ perspectives: On their education and training. Canadian Journal of Dietetic Practice and Research,73(3), 117–121.
Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology,3(2), 77–101.
Brissette, C., Leung, E., Darling, P. B., & Keith, M. (2014). Reflections on perceived preparedness of dietetic internship graduates following entry into practice. Canadian Journal of Dietetic Practice and Research,75(4), 202–205.
Brooks, J., McCluskey, S., King, N., & Turley, E. (2015). The utility of template analysis in qualitative psychology research. Qualitative Research in Psychology,12(2), 202–222.
Brown, L., Capra, S., & Williams, L. (2006). Profile of the Australian dietetic workforce: 1991–2005. Nutrition & Dietetics,63(3), 166–178.
Bunce, L., Baird, A., & Jones, S. E. (2017). The student-as-consumer approach in higher education and its effects on academic performance. Studies in Higher Education,42(11), 1958–1978.
Clarke, C., de Visser, R., Martin, M., & Sadlo, G. (2014). Role-emerging placements: A useful model for occupational therapy practice education? A review of the literature. International Journal of Practice-based Learning in Health and Social Care,2(2), 14–26.
Creswell, J. W. (2013). Qualitative inquiry and research design: Choosing among five approaches. Thousand Oaks, CA: SAGE Publications.
Creswell, J. W., & Poth, C. N. (2018). Qualitative inquiry and research design: Choosing among five approaches. Los Angeles: SAGE.
Crotty, M. (1998). The foundations of social research: Meaning and perspective in the research process. St. Leonards, NSW: Allen & Unwin.
Dancza, K., Warren, A., Copley, J., Rodger, S., Moran, M., McKay, E., et al. (2013). Learning experiences on role-emerging placements: An exploration from the students’ perspective. Australian Occupational Therapy Journal,60(6), 427–435.
Darnton-Hill, I., Nishida, C., & James, W. P. T. (2004). A life course approach to diet, nutrition and the prevention of chronic diseases. Public Health Nutrition,7(1a), 101–121.
Department of Health. (2013). Statewide interprofessional allied health graduate program manual. Melbourne: Victorian Government.
Dey, I. (1999). Grounding grounded theory: Guidelines for grounded theory inquiry. San Diego: Academic Press.
Dietitians Association of Australia. (2012). Dietitians Association of Australia skilled occupations list 2012 submission. Dietitians Association of Australia. Deakin, ACT. Retrieved 21 February 2014, from http://www.awpa.gov.au/our-work/labour-market-information/skilled-occupation-list/Documents/DietitiansAssociationofAustralia.pdf.
Dietitians Association of Australia. (2015). Emerging dietitians terms of reference. Retrieved 5 September, 2018, from https://daa.asn.au/wp-content/uploads/2016/11/Emerging-Dietitians-TOR.pdf.
Dietitians Association of Australia. (2017). Accreditation Standards for Dietetics Education Programs Version 2.0. Dietitians Association of Australia. Canberra, ACT.
Dietitians Association of Australia. (2018a). Accredited dietetics education programs. Retrieved 7 September, 2018, from https://daa.asn.au/becoming-a-dietitian-in-australia/currently-accredited-dietetic-programs/.
Dietitians Association of Australia. (2018b). Accredited practising dietitian program. Retrieved 7 September, 2018, from https://daa.asn.au/apd-program/.
Dietitians Association of Australia. (2018c). Dietitian scope of practice. Retrieved 3 September, 2018, from https://daa.asn.au/maintaining-professional-standards/dietitian-scope-of-practice/.
Dietitians Association of Australia. (2018d). Provisonal APD program. Retrieved 4 September, 2018, from https://daa.asn.au/apd-program/apd-program-handbook/provisonal-apd-program/.
Dietitian Connection. (2018a). Coaching to get that job! Retrieved 5 September, 2018, from https://dietitianconnection.com/uncategorised/recruitment-coaching-to-get-that-job/.
Dietitian Connection. (2018b). How to get that job webinar series. Retrieved 5 September, 2018, from https://dietitianconnection.com/product/how-to-get-that-job-webinar-series/.
Duchscher, J. B., & Windey, M. (2018). Stages of transition and transition shock. Journal for Nurses in Professional Development,34(4), 228–232.
Gray, M., Clark, M., Penman, M., Smith, J., Bell, J., Thomas, Y., et al. (2012). New graduate occupational therapists feelings of preparedness for practice in Australia and Aotearoa/New Zealand. Australian Occupational Therapy Journal,59(6), 445–455.
Halcomb, E. J., Salamonson, Y., Raymond, D., & Knox, N. (2012). Graduating nursing students’ perceived preparedness for working in critical care areas. Journal of Advanced Nursing,68(10), 2229–2236.
Hatzenbuhler, N. J. & Klein, J. E. (2018). Educational preparation for clinical practice: Reflections of newly graduated RNs. Nurse Educator, Publish Ahead of Print.
Health Workforce Australia. (2014). Australia’s health workforce series—Dietitians in focus. Health Workforce Australia. Adelaide. Retrieved 21 March 2014, from http://www.health.gov.au/internet/main/publishing.nsf/Content/hwa-archived-publications.
Hickson, M., Child, J., & Collinson, A. (2017). Future Dietitian 2025: Informing the development of a workforce strategy for dietetics. Journal of Human Nutrition & Dietetics,31, 23–32.
Hodgetts, S., Hollis, V., Triska, O., Dennis, S., Madill, H., & Taylor, E. (2007). Occupational therapy students’ and graduates’ satisfaction with professional education and preparedness for practice. Canadian Journal of Occupational Therapy,74(3), 148–160.
Hommes, J., Rienties, B., de Grave, W., Bos, G., Schuwirth, L., & Scherpbier, A. (2012). Visualising the invisible: A network approach to reveal the informal social side of student learning. Advances in Health Sciences Education,17(5), 743–757.
Hudson, J., Weston, K., & Farmer, E. (2017). Changes in medical education to help physicians meet future health care needs. The Medical Journal of Australia,206(9), 378–379.
Hunt, M. R. (2009). Strengths and challenges in the use of interpretive description: Reflections arising from a study of the moral experience of health professionals in humanitarian work. Qualitative Health Research,19(9), 1284–1292.
Institute of Medicine. (2003). Health professions education: A bridge to quality. Washington, DC: The National Academies Press.
International Confederation of Dietetic Associations. (2016). Dietitians-nutritionists around the World—Their education and their work (2016). ICDA. Toronto. http://www.internationaldietetics.org/Downloads/2016-ICDA-Education—Work-report.aspx.
Jones, M., McIntyre, J., & Naylor, S. (2010). Are physiotherapy students adequately prepared to successfully gain employment? Physiotherapy,96(2), 169–175.
Kairuz, T., Noble, C., & Shaw, J. (2010). Preceptors, interns, and newly registered pharmacists’ perceptions of New Zealand pharmacy graduates’ preparedness to practice. American Journal of Pharmaceutical Education,74(6), 1–6.
Kellett, J., Papageorgiou, A., Cavenagh, P., Salter, C., Miles, S., & Leinster, S. J. (2015). The preparedness of newly qualified doctors—Views of Foundation doctors and supervisors. Medical Teacher,37(10), 949–954.
Kicklighter, J. R., Dorner, B., Hunter, A. M., Kyle, M., Pflugh Prescott, M., Roberts, S., et al. (2017). Visioning report 2017: A preferred path forward for the nutrition and dietetics profession. Journal of the Academy of Nutrition and Dietetics,117(1), 110–127.
Liamputtong, P. (2013). Qualitative research methods. South Melbourne, VIC: Oxford University Press.
Liamputtong, P., Beeson, M., & Hameiri, S. (2017). Research methods in health: Foundations for evidence-based practice. South Melbourne, VIC: Oxford University Press.
Mackenzie, M., & Newman, E. (2017). Preparing the dietetic workforce of the future: Developing innovative placements in social care settings. International Journal of Practice-based Learning in Health and Social Care,5(1), 65–76.
Maher, J., Pelly, F., Swanepoel, E., Sutakowsky, L., & Hughes, R. (2015). The contribution of clinical placement to nutrition and dietetics competency development: A student-centred approach. Nutrition & Dietetics,72(2), 156–162.
Morgan, K., Campbell, K. L., & Reidlinger, D. P. (2019a). Dietetics students’ experiences of dietetics workforce preparation and preparedness: A systematic review and qualitative synthesis. Journal of Human Nutrition & Dietetics,32(2), 226–246.
Morgan, K., Campbell, K. L., Sargeant, S., & Reidlinger, D. P. (2019b). Preparing our future workforce: A qualitative exploration of dietetics practice educators’ experiences. Journal of Human Nutrition & Dietetics,32(2), 247–258.
Morgan, K., Kelly, J. T., Campbell, K. L., Hughes, R., & Reidlinger, D. P. (2019c). Dietetics workforce preparation and preparedness in Australia: A systematic mapping review to inform future dietetics education research. Nutrition & Dietetics,76(1), 47–56.
Morgan, K., Reidlinger, D. P., Sargeant, S., Crane, L. & Campbell, K. L. (2018). Challenges in preparing the dietetics workforce of the future: An exploration of dietetics educators’ experiences. Nutrition & Dietetics (In press) https://doi.org/10.1111/1747-0080.12438 (Epub ahead of print).
Morrow, G., Johnson, N., Burford, B., Rothwell, C., Spencer, J., Peile, E., et al. (2012). Preparedness for practice: The perceptions of medical graduates and clinical teams. Medical Teacher,34(2), 123–135.
Noble, C., O’Brien, M., Coombes, I., Shaw, P. N., Nissen, L., & Clavarino, A. (2014). Becoming a pharmacist: Students’ perceptions of their curricular experience and professional identity formation. Currents in Pharmacy Teaching and Learning,6(3), 327–339.
Nyland, N., & Lafferty, L. (2012). Implications of the dietetics workforce demand study. Journal of the Academy of Nutrition and Dietetics,112(3), S92–S94.
Obeso, V. T., Phillipi, C. A., Degnon, C. A., Carter, T. J., Aiyer, M., Baron, B., et al. (2018). A systems-based approach to curriculum development and assessment of core entrustable professional activities in undergraduate medical education. Medical Science Educator,28(2), 407–416.
O’Brien, B. C., Harris, I. B., Beckman, T. J., Reed, D. A., & Cook, D. A. (2014). Standards for reporting qualitative research: A synthesis of recommendations. Academic Medicine: Journal of the Association of American Medical Colleges,89(9), 1245.
Palermo, C., Chung, A., Beck, E. J., Ash, S., Capra, S., Truby, H., et al. (2015). Evaluation of assessment in the context of work-based learning: Qualitative perspectives of new graduates. Nutrition & Dietetics,72(2), 143–149.
Palermo, C., Gibson, S. J., Dart, J., Whelan, K., & Hay, M. (2017). Programmatic assessment of competence in dietetics: A new frontier. Journal of the Academy of Nutrition and Dietetics,117(2), 175–179.
Palermo, C., Hughes, R., & McCall, L. (2011). A qualitative evaluation of an Australian public health nutrition workforce development intervention involving mentoring circles. Public Health Nutrition,14(08), 1458–1465.
Patton, M. Q. (2015). Qualitative research and evaluation methods: Integrating theory and practice. Thousand Oaks, CA: SAGE Publications.
Rhea, M., & Bettles, C. (2012a). Four futures for dietetics workforce supply and demand: 2012–2022 Scenarios. Journal of the Academy of Nutrition and Dietetics,112(3), S25–S34.
Rhea, M., & Bettles, C. (2012b). Future changes driving dietetics workforce supply and demand: Future scan 2012–2022. Journal of the Academy of Nutrition and Dietetics,112(3), S10–S24.
Rodger, S., Thomas, Y., Dickson, D., McBryde, C., Broadbridge, J., Hawkins, R., et al. (2007). Putting students to work: Valuing fieldwork placements as a mechanism for recruitment and shaping the future occupational therapy workforce. Australian Occupational Therapy Journal,54(s1), S94–S97.
Rose, M., McAlpine, L., & Strychar, I. (2005). Learning opportunity and preparedness for practice: Perceptions from dietetics programs in Canada. Canadian Journal of Dietetic Practice and Research,66(4), 221–228.
Ruel, G., Shi, Z., Zhen, S., Zuo, H., Kroger, E., Sirois, C., et al. (2014). Association between nutrition and the evolution of multimorbidity: The importance of fruits and vegetables and whole grain products. Clinical Nutrition,33(3), 513–520.
Ruhl, J. M., & Lordly, D. (2017). The nature of competition in dietetics education: A narrative review. Canadian Journal of Dietetic Practice and Research,78(3), 129–136.
Ryan, R. M., & Deci, E. L. (2000). Self-determination theory and the facilitation of intrinsic motivation, social development, and well-being. American Psychologist,55(1), 68–78.
Sandelowski, M. (2000). Whatever happened to qualitative description? Research in Nursing & Health,23(4), 334–340.
Schuwirth, L., & Ash, J. (2013). Assessing tomorrow’s learners: In competency-based education only a radically different holistic method of assessment will work. Six things we could forget. Medical Teacher,35(7), 555–559.
Scott, J. (1991). A survey of recent graduate dietitians: Career choices, plans and aspirations and satisfaction with academic preparation. Australian Journal of Nutrition and Dietetics,48(4), 132–138.
Ten Cate, T. J., Kusurkar, R. A., & Williams, G. C. (2011). How self-determination theory can assist our understanding of the teaching and learning processes in medical education. AMEE guide No. 59. Medical Teacher,33(12), 961–973.
Thorne, S. E. (2016). Interpretive description: Qualitative research for applied practice. London, UK: Routledge.
Tomlinson, M. (2016). The impact of market-driven higher education on student-university relations: Investing. Consuming and Competing. Higher Education Policy,29(2), 149–166.
Varpio, L., Ajjawi, R., Monrouxe, L. V., O’Brien, B. C., & Rees, C. E. (2017). Shedding the cobra effect: Problematising thematic emergence, triangulation, saturation and member checking. Medical Education,51(1), 40–50.
Willig, C. (2013). Introducing qualitative research in psychology. Buckingham: McGraw-Hill Education.
World Health Organization. (2006). The world health report 2006: Working together for health. Geneva: World Health Organization.
Acknowledgements
The authors wish to thank the twenty dietetics graduates who participated in this study and shared their experiences of dietetics workforce preparation and preparedness.
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This research was supported in part, by an Australian Government Research Training Program Scholarship. The funding body had no involvement in this study.
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Morgan, K., Campbell, K.L., Sargeant, S. et al. Preparedness for advancing future health: a national qualitative exploration of dietetics graduates’ experiences. Adv in Health Sci Educ 25, 31–53 (2020). https://doi.org/10.1007/s10459-019-09904-6
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DOI: https://doi.org/10.1007/s10459-019-09904-6