Influences on the development of dietitian clinical decision making expertise: A qualitative study

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The clinical decision making (CDM) expertise of dietitians facilitates identifying and addressing nutritional issues in patients. The aim of this doctoral research was to uncover the nature of clinical decision making of dietitians in the acute setting. A qualitative design within the interpretative paradigm was used, specifically philosophical hermeneutics. Philosophical hermeneutics is concerned with the human experience but more specifically, the interpreted meaning of this experience. This study involved two in-depth semi-structured interviews with ten experienced acute care dietitians that were recorded, transcribed and interpreted using the principles of hermeneutics. A reference group session was then used to provide rigour and further interpretation of the findings. Participants revealed dietitian CDM expertise development is facilitated through a cycle of reflection on experience. Dietitians with a high degree of intrinsic motivation maintain a tension within their skill capacity, seeking or accepting challenges that generate further learning from the experience-reflection cycle. Professional confidence was both an input and output of experience and core to the process of developing CDM expertise. Increasing confidence facilitated an increased sense of power to positively influence patient care via effective care planning as well as influential interprofessional interactions. Adequate mentoring, guidance and feedback characterised supportive workplace environments that fostered development. Developing CDM expertise included increasing knowledge, refining of clinical reasoning and judgement skills and commonly lead to specialisation of clinical practice. A deeper understanding of how decision making expertise develops was gained and therefore can contribute to education, professional development and research activities which can subsequently optimise patient care.
Original languageEnglish
Pages (from-to)42-43
Number of pages1
JournalNutrition and Dietetics
Issue numberS1
Publication statusPublished - 10 Aug 2019
EventDietitians Association of Australia Annual 36th National Conference - Gold Coast, Australia
Duration: 12 Aug 201914 Aug 2019


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