Training interns in nutrition and dietetics: a cross-sectional study of the barriers and motivators to being a Registered Dietitian Nutritionist preceptor

Abstract

Background As is common across the health professions, training of Registered Dietitian Nutritionists (RDNs) requires experiential learning for interns/students to gain skills and demonstrate entry-level competency. Preceptors are essential to the experiential learning component of health care professional training, providing supervision and mentoring as students and interns gain the skills required for entry-level practice competency. Over the past 27 years, 47–73% of applicants to dietetic internships have received a placement. Practitioners willing to volunteer as preceptors are needed to generate more internship or experiential learning opportunities for the profession to continue to meet workforce demands. Methods The objective of this national-level online cross-sectional survey was to identify perceptions and attitudes associated with the preceptor role and incentives that might encourage precepting by current RDNs. A random sample of RDN and Nutrition and Dietetic Technicians, Registered (NDTR) professionals from the Commission on Dietetic Registration credentialed practitioner database were eligible to participate in the online survey. The main outcome measures included perceptions, attitudes, and preferred incentives to precept compared by preceptor experience categories (current, former, never precepted). Comparisons of perceptions, attitudes, and preferred incentives were made between preceptor experience categories using Chi-square and ANOVA. Results Of 2464 invitations, 308 participants had complete variables for analysis. Top incentives were the opportunity to earn continuing education units (65.9%) and having expenses paid to attend a national conference (49.5%). Significantly more (P < 0.001) “former” and “never” preceptors reported the ability to choose when to take an intern, training on how to teach and communicate with interns, and access to an “on-call” specialist as incentives compared to “current” preceptors. Significantly more (P < 0.01) “never” preceptors reported training on internship expectations and the ability to provide input on intern selection process as incentives compared to “current” or “former” preceptors. Conclusions Incentives to serve as a preceptor differ based on “current”, “former”, or “never” precepted status. Promoting and strategizing solutions to the current imbalance between the greater number of dietetic internship applicants compared to preceptors should be targeted based on preceptor status to retain current preceptors, encourage former preceptors to return and recruit professionals who have never served.

A Nationwide Survey of Clinical Dietitians' Perceptions of Precepting

“…Additional opportunities for recognition or appreciation were noted by Hutchins et al21 They found that only 35% of current preceptors indicated that there were adequate opportunities to share information with other preceptors 21. This may be another opportunity for preceptors to learn best practices for precepting while also recognizing those individuals with extensive experience.…”

“…Only 5% of respondents indicated that they receive extra pay for precepting, while just over half indicated receiving insufficient compensation. Canadian and US dietitians similarly reported low frequencies for pay and compensation increases as well as workload decreases 17,21. Among current preceptors completing a national survey, only 6% indicated that precepting increases their chances of promotion and advancement 21.…”

“…Among nutrition professionals in Arizona, approximately 66% reported supportive supervisors 20. Similarly, among current preceptors throughout the United States, 68% reported adequate availability of the dietetic internship (DI) director/clinical coordinator to help the individual in their role as a preceptor 21. The idea that precepting is difficult or stressful was reported by 66% of Canadian dietitians17 and mentioned 16 times by clinical dietitians 25…”

“…Perceptions of interns were evaluated by professionals in Arizona with similarly high levels of regard for the interns 20. Preceptors nationwide also indicated that interns conduct projects that are useful to the department and interns bring new ideas 21. However, among clinical dietitians, intern challenges were mentioned as a barrier 46 times in the interviews 25.…”

“…The lack of qualified professionals to precept, or supervise, students limits the number of students who can complete supervised practice or internships each year 14,15. Explanations for why nutrition professionals in all areas of dietetics either choose not to precept or not to precept more students include the amount of time required, additional responsibility, inadequate resources and/or staff, and insufficient communication 14,16–22. Major reported benefits to precepting include receiving continuing education units (CEUs) from the program or having expenses paid toward national conferences 20,21…”