Commission on Dietetic Registration (CDR) Report

Fall 2008
Proposed New DTR Registration Eligibility Pathways
CDR has proposed the establishment of a new pathway for dietetic technician registration which would allow graduates of DPD programs and students currently enrolled in a CADE-accredited Didactic Program in Dietetics (DPD) or an accredited Coordinated Program in Dietetics (CP) eligibility to take the registration examination for dietetic technicians. The rationale for this proposal is based on the often cited fact that DTRs are not available throughout the country. This uneven geographic distribution poses a significant challenge when promoting and marketing the DTR and credential to employers. With a larger pool of DTRs more evenly disbursed throughout the country employers would have less difficulty in finding and hiring DTRs. This proposal provides a career option/career ladder for DPD graduates who do not complete a dietetic internship. This DTR pathway can provide valuable work experience, enhance internship and other related applications, and provides a valuable credential in the dietetics and nutrition workforce.

During 2007-2008, CDR completed surveys of students enrolled in either a DPD or CP and a survey of DPD Program graduates to solicit their perspectives on the value of the DTR credential; obtain data on the likelihood they would pursue the new credential should the proposed new pathway to DT registration eligibility be established; and to describe what it would take for them to go from their 4-year degree to the DTR (such as cost, length of time, practice component, etc.).

CDR recognizes that the registration examination cannot assess all aspects of entry-level practice and that successful completion of the three prongs of academic, supervised practice and examination requirements are necessary to ensure entry-level competence. In order to achieve its public protection mission CDR must rely on dietetics education programs to document that specific dietetic technician education and practice skills and competencies are met by applicants for these new registration eligibility pathways. Since the success of these proposed new registration eligibility pathways is dependent on the support of dietetics education program directors, CDR plans to conduct a survey of both DPD and CP educators to determine their perceptions and level of support for the proposed new DTR registration eligibility pathways for existing CP and DPD students and graduates of DPD programs. CDR will evaluate the results of this survey data and make a determination regarding the establishment of the new pathways in late 2008.

Professional Development Portfolio Update
For the five-year recertification period ending May 31, 2008, 96% of RDs scheduled to recertify in 2008 successfully completed the PDP process. For the same period, 87% of DTRs successfully recertified. This is consistent with past recertification rates.

As of July 2008, 84% of all RDs in all recertification cycles and 72% of DTRs have submitted learning plans. This is an increase over previous years, and suggests that practitioners are becoming more familiar with the PDP process. Another positive increase was noted with 84% of RDs utilizing online submission of the PDP logs.

Assess and Learn Module Update
In March 2008 CDR implemented a new Assess and Learn online module entitled Sports Dietetics: Nutrition for Athletic Performance. Five continuing professional units are awarded for completion of the module. The Assess and Learn modules are available at the CDR Education Director Website: cdrnet.educationdirector.com. The cost per module is $45.99 for RDs/DTRs and/or ADA members.

The Assess and Learn modules are designed to assess knowledge and skills RDs/DTRs currently have in a particular area, utilizing the context of a case scenario.

In addition to self-assessment tools, learning is facilitated through the following:

  • Each multiple choice question is followed by feedback that provides an explanation for why each response option is correct or incorrect, current references and web links for additional information.
  • Evidence-based nutrition information, current research literature, and existing government disease-specific consensus guidelines and recommendations are used to support various courses of action and care.

The Assess and Learn modules provide feedback on practitioner performance to assist in determining current and future learning needs. After completion, practitioners will be able to use assessment results to complete the learning needs assessment and establish a learning action plan for CDR's Professional Development Portfolio. An Assess an Learn module addressing Gerontological Nutrition is currently being pilot- tested and will be released in the fall. This module uses a simulated gerontological case designed to allow the user (clinician) to apply medical nutrition therapy skills necessary to manage the unique needs of older adults. The case follows the suggested steps outlined in ADA’s Nutrition Care Process and integrates the step of nutrition diagnosis.

Future modules currently in the initial stages of development include: Pediatric Nutrition, Celiac Disease, Critical Care in Cardiovascular Disease, and Management.

Specialty Certification
There are currently 1,118 Board Certified Specialists; 419 in Pediatric Nutrition, 380 in Renal Nutrition, 151 in Gerontological Nutrition, 74 in Oncology Nutrition and 194 in Sports Dietetics. CDR has had initial discussions with several DPG representatives regarding the development of new specialty certifications in such areas as weight management, informatics, complementary and alternative Medicine and developmental and psychiatric disorders. The specialty certification petition guidelines, which include market analysis as a first step, have been shared with these DPGs.

Levels of Practice Study
CDR is currently in the process of reviewing input received in response to the 2006-2008 Levels of Practice Study. CDR has identified possible options/next steps:

  • Next study should be focused on a specific practice segment(s)/areas.
  • Current practice segments/areas, (clinical, community, management, education/research, business), need to be reviewed and evaluated for their relevance to advanced level practice.
  • Future research efforts may need to employ additional or alternative methods for identifying advanced practitioners for study, as the nomination process employed in this research appears to have identified individuals based on, at least in part, characteristics/attributes other than those of dietetics practice.
  • A standardized advanced level dietetics practice role, educational program, and vocabulary should be established, disseminated, and widely accepted.
  • Different study methodologies could be considered to better assess critical thinking skills.
  • An article reporting the results of this study should be published in the Journal of the American Dietetic Association.

The results of the Levels of Practice Study will be presented at the CDR Forum at FNCE 2008. This session is scheduled for Sunday, October 26, 2008, 3:30 to 5:00 pm.

Non-RD Employer Exploratory Study
In reviewing the results of the employer focus groups conducted in conjunction with the 2005-2006 Dietetics Practice Audit, CDR expressed concern regarding the small number of non-RD employers participating in the focus groups. During Spring/Summer 2008, CDR conducted a survey of a stratified sample of 2,400 Registered Dietitians to better understand the structure and dynamics of the employment market for Registered Dietitians (RDs) and to learn the extent to which non-RDs influence decisions to hire, promote, and compensate RDs. CDR will review the results of this survey in August 2008. If the proportion of dietetics-related positions affected by non-RD employers is substantial, CDR will consider further research specifically targeting non-RD employers and influencers. If this proportion turns out to be minimal — that is, most RD employment is primarily affected and influenced by other RDs — then a modification in research priorities would be indicated.

Manpower Demand Study
CDR is currently exploring an option to conduct a Manpower Demand Study for Registered Dietitians/Dietetic Technicians, Registered. The last Dietetic Manpower Demand Study was completed in 1981 and published in the Journal of the American Dietetic Association in 1983. In this report P. Fitz et. al. related that ADA has long had interest in manpower issues. One of the primary focuses of an organization or profession related to manpower is development of a work force population to assure an adequate supply of trained practitioners.

A Manpower Demand Study would provide quantified estimates of the marketplace demand for dietetic practitioners; identify environmental, demographic, economic, regulatory and other factors which could affect supply and demand; and assess future practice and employment opportunities. CDR plans to further discuss these issues and render a decision regarding a Manpower Demand Study at its October 2008 meeting.

Submitted by: Robyn Wong, MPH, RD, CSP, Chair

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