Effect of Simulated Patient Practice on the Self-Efficacy of Japanese Undergraduate Dietitians in Nutrition Care Process Skills

Abstract

ObjectiveTo examine the effect of an adapted simulated patient (SP) intervention on self-efficacy in nutrition care process skills. DesignA repeated-measures design using a 25-item survey divided into 7 nutrition professional practice competencies (PPCs) employing a 5-point self-efficacy scale (1 = lowest to 5 = highest) administered immediately before and after the intervention. SettingA private Japanese university. ParticipantsNinety Japanese third-year dietetics undergraduates aged 20–38 years. InterventionAn adapted SP activity practicing nutrition care process skills for the infirm elderly population. Main Outcome MeasuresPre- to postintervention self-efficacy response scores and feedback. AnalysisMean preintervention survey scores were used to divide participants into statistical quartiles (Q1 indicated lowest mean scores and Q3, highest mean scores). Wilcoxon signed-rank tests compared each PPC's pre- and postintervention means. Kruskal-Wallis tests examined changes in quartiles' scores within each PPC. ResultsSelf-efficacy improved significantly in PPCs relating to application of appropriate medical ethics and interpersonal skills (P = .02), appropriate nutrition assessment (P = .04), and creation of a nutrition management plan and nutrition intervention (P = .03). Self-efficacy of Q1 and Q2 rose significantly in most PPCs, although not for acting as a dietitian within a medical care team, whereas that of Q3 decreased for all PPCs. Conclusions and ImplicationsAmong initially low self-efficacy dietetics undergraduates, the SP intervention enhanced self-efficacy in 3 of the 6 PPCs practiced directly and may facilitate more realistic self-views among initially high self-efficacy students. However, further research in the design, implementation, and efficacy of this type of training is recommended to gauge its effects on the quality of related professional practice.