How is the client-dietitian relationship embedded in the professional education of dietitians? An analysis of curriculum documentation and program coordinators' perspectives in Australia.

Abstract

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.