School of Medicine, University of Wollongong, Wollongong, New South Wales, Australia.
School of Health & Society, University of Wollongong, Wollongong, New South Wales, Australia.
Nutr Diet. 2021 Apr;78(2):218-231. doi: 10.1111/1747-0080.12657. Epub 2021 Jan 22.
How dietitians are trained to develop relationships with clients is not clearly articulated despite its importance being well-documented. This study aimed to describe how this relationship is expressed and addressed in curriculum documents of Australian dietetics education programs, and to explore program coordinators' perspectives of this description and how relationship development is actually taught.
Data extracted from subject outlines included subject descriptions, learning outcomes, assessments, readings and the mode of delivery (eg, lectures). Guided by a pre-existing coding framework, deductive thematic analysis was utilised to explore qualitative themes from subject outline data. Semi-structured telephone interviews were conducted with 10 program coordinators and analysed using inductive thematic analysis.
Subject outlines for 122 subjects across all 21 accredited Australian programs were analysed. The over-arching theme was the wide "variability" in the ways that the client-dietitian relationship was expressed across subject outlines. Program coordinators perceived that findings from the analysis of subject outlines made sense, however, acknowledged limitations of analysing data from curriculum documents. The relationship appeared ambiguously defined amongst programs and was described as occurring mostly in communication, counselling and medical nutrition therapy subjects and through theoretical and practical learning.
The client-dietitian relationship appears inconsistently embedded in the curriculum of Australian dietetics education programs despite widespread acceptance of its importance to practice. Further research is needed to investigate if training programs should embed more consistent language around therapeutic relationships, and how this might be achieved to reflect current competency standards.
尽管有大量文献证明与客户建立关系对营养师的重要性，但营养师如何接受培训以建立这种关系却没有明确说明。本研究旨在描述澳大利亚营养学教育课程大纲文件中如何表达和解决这种关系，并探讨课程协调员对这种描述的看法以及关系发展是如何实际教授的。
从课程大纲中提取的数据包括课程描述、学习成果、评估、阅读材料和教学模式（例如讲座）。在预先存在的编码框架的指导下，采用演绎主题分析方法从课程大纲数据中探索定性主题。对 21 个认可的澳大利亚项目中的 10 个项目协调员进行了半结构化电话访谈，并采用归纳主题分析进行分析。
分析了所有 21 个认可的澳大利亚项目中的 122 个课程的课程大纲。总体主题是客户-营养师关系在课程大纲中的表达方式存在广泛的“可变性”。课程协调员认为分析课程大纲得出的结果有意义，但也承认分析课程文件数据的局限性。该关系在各个项目中似乎定义不明确，被描述为主要发生在沟通、咨询和医学营养治疗课程中，以及通过理论和实践学习。
尽管普遍接受其对实践的重要性，但客户-营养师关系似乎在澳大利亚营养学教育课程的课程中不一致地嵌入。需要进一步研究以调查培训计划是否应该围绕治疗性关系嵌入更一致的语言，以及如何实现这一点以反映当前的能力标准。
