Dietetic interns’ perceptions and use of evidence-based practice: an exploratory study
Keywords:Evidence-Based Practice, Attitude of Health Personnel, Dietetics, Internships, Nonmedical
Objective: This study explored dietetic interns’ perceptions and knowledge of evidence-based practice (EBP), their use and observation of EBP principles during their clinical rotations, and their intentions to use EBP in their careers.
Methods: A mixed methods design combining a survey and focus group was employed. Dietetic interns (n=16) from a large Midwestern university were recruited in person and via email to participate in the survey, focus group, or both. Perceptions and experiences of EBP were analyzed through the focus group (qualitative), and EBP knowledge and clinical practice behaviors were analyzed through the survey (quantitative). The focus group discussion was recorded, transcribed, and analyzed using thematic analysis.
Results: Four major themes emerged from the focus group data: (1) observations of EBP in clinical practice, (2) use of EBP during clinical rotations, (3) barriers to EBP, and (4) perceived use of EBP as future registered dietitians. Interns considered EBP important for their profession and future careers. They struggled, however, with the discrepancies between current research and practice, and highlighted differences that they observed and barriers that they experienced across different clinical settings.Conclusions: This exploratory study is the first to examine dietetic interns’ perceptions of and experiences with EBP in the clinical setting. Future research is needed to identify how dietetics educators, librarians, and preceptors can address the barriers that interns perceive in applying EBP in their internships.
Diekman CB. Evidence-based practice: key to success. J Am Diet Assoc. 2007 Jul;107(7):1088.
Academy of Nutrition and Dietetics. Definition of terms list 2017 [Internet]. The Academy [rev. Jun 2017; cited 7 Aug 2017]. <http://www.eatrightpro.org/~/media/eatrightpro%20files/practice/scope%20standards%20of%20practice/academydefinitionoftermslist.ashx>.
Laramee SH. Evidence-based practice: a core competency for dietetics. J Am Diet Assoc. 2005 Mar;105(3):333.
Papoutsakis C, Moloney L, Sinley RC, Acosta A, Handu D, Steiber AL. Academy of Nutrition and Dietetics Methodology for developing evidence-based nutrition practice guidelines. J Acad Nutr Diet. 2017 May;117(5):794–804.
Myers EF. ADA evidence analysis library. J Am Diet Assoc. 2005 May;105(supp):S79–S.
Sabo R. Evidence-based practice: what is it, and why is it important to registered dietitians? Today’s Dietician [Internet]. 7 Jan 2013 [cited 7 Aug 2017]. <https://ce.todaysdietitian.com/node/4063#group-tabs-node-course-default1>.
Byham-Gray LD, Gilbride JA, Dixon LB, Stage FK. Evidence-based practice: what are dietitians’ perceptions, attitudes, and knowledge? J Am Diet Assoc. 2005 Oct;105(10):1574–81.
Hall-McMahon EJ, Campbell KL. Have renal dietitians successfully implemented evidence-based guidelines into practice? a survey of dietitians across Australia and New Zealand. J Ren Nutr. 2012 Nov;22(6):584–91.
Hand RK, Abram JK. Sense of competence impedes uptake of new academy evidence-based practice guidelines: results of a survey. J Acad Nutr Diet. 2016 Apr;116(4):695–705.
Vogt EAM, Byham-Gray LD, Touger-Decker R. Perceptions, attitudes, knowledge, and clinical use of evidence-based practice among US registered dietitians. Top Clin Nutr. 2013 Jul/Sep;28(3):283–94.
Chiu YW, Weng YH, Wahlqvist ML, Yang CY, Kuo KN. Do registered dietitians search for evidence-based information? a nationwide survey of regional hospitals in Taiwan. Asia Pac J Clin Nutr. 2012;21(4):630–7.
Academy of Nutrition and Dietetics. 5 steps to become a registered dietitian nutritionist [Internet]. The Academy [cited 7 Aug 2017]. <http://www.eatrightpro.org/resource/about-us/become-an-rdn-or-dtr/high-school-students/5-steps-to-become-a-registered-dietitian-nutritionist>.
Accreditation Council for Education in Nutrition and Dietetics. ACEND accreditation standards for nutrition and dietetics internship programs [Internet]. Chicago, IL: Academy of Nutrition and Dietetics [rev. 29 Jul 2016; cited 7 Aug 2017]. <http://www.eatrightpro.org/~/media/eatrightpro%20files/acend/about%20program%20accreditation/accreditation%20standards/2017standardsfordiprograms.ashx>.
Charny A, DeMage A, Banta C, Buonincontri C. Evaluation of interns’ research experience and ability before and after the dietetic internship. J Acad Nutr Diet. 2015 Sep;115(supp):A53–A.
Steiber A, Barkoukis H. Individualized research experiences in a dietetic internship program. Top Clin Nutr. 2006 Jul/Sep;21(3):176–81.
Whelan K, Thomas JE, Madden AM. Undertaking a research project improves student dietitians’ confidence in their research skills. J Hum Nutr Diet. 2006 Dec;19(6):474–5.
Horsman AR. Evidence based nutrition and the integrated librarian. J Can Health Libr Assoc/Journal de l’Association des bibliothèques de la santé du Canada. 2015;36(3).
Olfert MD, Arnold SJ. Beyond Google: helping nutrition students achieve information literacy. J Acad Nutr Diet. 2012 Sep;112(sup):A18–A.
Smith SC, Penumetcha M. Librarian involvement in a nutrition undergraduate research course: preparing nutrition students for evidence-based practice. J Allied Health. 2010 Summer;39(2):e69–e76.
Fidel R. Are we there yet?: mixed methods research in library and information science. Libr Inf Sci Res. 2008 Dec;30(4):265–72.
Vogt EAM, Byham-Gray LD, Denmark R, Touger-Decker R. Impact of an evidence-based practice intervention on knowledge and clinical practice behaviors among registered dietitians. Top Clin Nutr. 2016 Apr/Jun;31(2):111–24.
Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol. 2006;3(2):77–101.
Bozzolan M, Simoni G, Balboni M, Fiorini F, Bombardi S, Bertin N, Da Roit M. Undergraduate physiotherapy students’ competencies, attitudes and perceptions after integrated educational pathways in evidence-based practice: a mixed methods study. Physiother Theory Pract. 2014 Nov;30(8):557–71.
Ilic D, Forbes K. Undergraduate medical student perceptions and use of evidence based medicine: a qualitative study. BMC Med Educ. 2010 Aug 19;10:58.
Straub-Morarend CL, Wankiiri-Hale CR, Blanchette DR, Lanning SK, Bekhuis T, Smith BM, Brodie AJ, Oliveira DC, Handysides RA, Dawson DV, Spallek H. Evidence-based practice knowledge, perceptions, and behavior: a multi-institutional, cross-sectional study of a population of U.S. dental students. J Dent Educ. 2016 Apr;80(4):430–8.
Brooke J, Hvalic-Touzery S, Skela-Savic B. Student nurse perceptions on evidence-based practice and research: an exploratory research study involving students from the University of Greenwich, England and the faculty of Health Care Jesenice, Slovenia. Nurse Educ Today. 2015 Jul;35(7):e6–e11.
Krantz A, Cotugna N, Manning CK. Dietetic interns can serve as a valuable resource for diffusing the nutrition care process into clinical practice. Top Clin Nutr. 2011 Oct/Dec;26(4):293–9.