J. Chang¹, O. Fournier¹, H. Zhang¹, M.Wyatt², L. Dietrich³, P. Brauer¹, J. Randall Simpson¹

¹Department of Family Relations and Applied Nutrition, College of Social and Applied Human Sciences, University of Guelph, Guelph, ON, ²London, ON, ³Haliburton, ON

Since 1993, there has been a lack of current documentation of the major systemic changes that have occurred within clinical dietetics in the past 30 years. Systemic changes are changes in the structure of professional practice including regulation, compensation, peer support, etc.

To develop a timeline documenting the major structural changes and to document dietitians’ perspectives.

The draft timeline was developed by synthesizing the data from a literature review of peer review and grey literature. Of key informants identified through target and convenience sampling, one-hour semi-structured interviews, based on the draft timeline, were conducted virtually with each informant, and recorded. Interviews were then transcribed and coded using qualitative content thematic analysis amongst four other researchers, to capture reflections on the impact to clinical dietetics practice and to produce a final timeline of major structural changes.

Qualitative thematic analysis of the interviews revealed six themes including: 1) increased use of technology in practice, e.g., Practice-based Evidence in Nutrition (PEN), Electronic Medical Records (EMR); 2) increasing regulation of practice, e.g., Personal Health Information Protection Act (PHIPA); 3) expansion of responsibilities, e.g., behavioural and motivational counselling; 4) role recognition, e.g., publishing position papers alongside physicians; 5) growth of peer support, e.g., Dietitians of Canada (DC) network groups; and 6) changing reporting structures, e.g., matrix reporting, program management reporting. Key challenges for the future included recruitment challenges due to the aging of the workforce, and uncertain or lack of funding for the programs and services dietitians provide.

Over the last 30 years, many systemic changes have occurred due to the advancements in technology, recognition from other health professions, and growing participation in international collaborations.

Documenting these changes will provide dietitians with an accurate historical account of the major systemic changes that have occurred within clinical dietetics.

In kind support from University of Guelph