Wednesday, December 30, 2009

Intern Research: Surveys Aren’t Easy



As a part of our internship, we experienced the thrill, exhaustion and excitement involved in conducting research. As a three-member team, we completed a research project on the knowledge and comfort level of Registered Dietitians (RDs) in recommending vitamin and mineral supplements.

The first and most difficult task in completing research was hammering out the research question. It was amazing that one question could lead to so many others. For example, our group spent hours discussing what the word comfort meant to each of us. Defining the research question was an important process to go through, and as an added benefit, we learned a lot about fellow group members.

The literature review revealed little research on the topic of our research question. At first, this made us nervous. However, with time, we realized that it was exciting to be the first to help explore a question key to dietetic practice. The next step was to go through the process of getting ethical approval from Fraser Health and from UBC. In other words, “read the fine print”. This was the part where three ‘big-picture’ people ran into trouble and where detail-oriented people (not on our team) would have thrived.


The concept of using a survey to gather information seemed simple, but we learned that it was not. Developing survey questions that asked for the specific information we wanted was very challenging. We discovered that it was extremely valuable to test questions with a focus group as much as possible. We were told (more then once) to avoid double negatives. So, of course, during data analysis we noticed we had still created a question for which the resulting data was a very confusing double negative. Specifically, the result to one of the questions was that ‘RDs are not feeling it was their role to make vitamin and mineral supplement recommendations’. Confused yet?

In our overzealous excitement and eagerness, we ended up asking too many questions that were interesting of course, but did not actually help us answer the research question we had set out to answer or to address our research objectives. For example, our research question
was registered dietitians’ practices in recommending vitamin and mineral supplements. We asked questions about the barriers that prevent RDs from making vitamin/mineral recommendations and what sorts of things would help them improve their comfort level. Although it was very hard to leave some questions out of our results and discussion, having to do so suggested that there are many unanswered questions around this topic.

In general, the research process for our group involved the following things: approximately 10,000 emails, several 1:00 a.m. conference calls, about 100 to-do lists, a couple dinner parties, and a pretty satisfying end-result.


Overall, we found the research component of internship very challenging and interesting. We gained an appreciation for people who contribute to furthering the dietetic profession by completing research, and learned the basics of how to complete a research project from
beginning to end. That being said, the most important things that we learned were how to be effective group members and how not to do surveys.

ACKNOWLEDGMENTS

Karol Traviss, RD for helping us through the process of survey development. Dr. Cathy Morley, RD for helping us find our way out of that huge mess of data. Liz Da Silva, RD and Sian-Hoe Cheong,
RD for being there every step of the way.


Contact

Jaclyn Smith, RD(t)
New Westminster, BC
T: (778) 397-2087
E: Jaclyn.Smith@fraserhealth.ca


Co-researchers:
Damaris Campbell, RD(t) and
Jill Wallace, RD(t)

Thursday, December 3, 2009

Beyond Nutritionism – An Invitation to Critical Dietetics Dialogue

In spring of 2009 a research workshop entitled "Beyond Nutritionism: Rescuing Dietetics through Critical Dialogue" was held at Ryerson University and funded by the Social Sciences and Humanities Research Council. Appropriately, for a springtime gathering, it marked the establishment of a new movement - Critical Dietetics.

At the workshop, leading international theorists, researchers, practitioners, students, and advisors had long-awaited conversations regarding gender, race, class, ability, size, dietetic epistemology, post-structural orientations to dietetic education, art, and poetry in the context of dietetics. The result was an animated, groundbreaking commitment to redefine the profession through Critical Dietetics.

What counts as “knowing” in dietetic practice? How do we, as nutrition professionals, come to know what we don’t know? How does the evidenced-based culture of dietetics give voice? Where does dietetic culture render silence? What is it that we have already accomplished as a profession? In what ways do we continue to evolve? How can we further build upon the rich roots of our profession? What do we envision for the future of our profession? These are but a few of the difficult, essential questions that Critical Dietetics seeks to explore.

Critical Dietetics takes courage as we depart from familiar ways of doing and knowing. Indeed as Simmons (2009) challenged us in an earlier edition of Practice, it is time to “expand” (p.3) our dietetic identities to become more “pluralistic” (p.3), as we move beyond mere nutritionism (Pollan, 2008) in our work.

Critical Dietetics requires conviction for change, comfort with the uncertainty of not knowing, acceptance of the blurry divide between art and science, and a desire for our allies’ knowledge in social sciences, humanities and natural sciences with whom we have much to integrate. We can grapple with the limits of science alongside the imperative to use it, and venture into the vulnerability evoked by the merging of personal and professional ways of knowing.

We are authors of our own experience and supportive witnesses to one another’s growth in the midst of this new terrain.

Critical Dietetics: A Declaration stands as testament to the commitment the initial group has forged. It is extended as an invitation to our colleagues to become companion dietetic explorers in this exciting new movement. Together we can expand the body of knowledge in dietetics and shape the future of our profession.

REFERENCES
Pollan M. (2008). In defense of food: An eater’s manifesto. New York: The Penguin Press.
Simmons D. (2009). Questioning my Dietitian identity. Practice, 46, 3.



Critical Dietetics - A Declaration – June 2009

Dietetics is a diverse profession with a commitment to, and tradition of, enhancing health, broadly defined, through diet and food. We recognize the commitment and hard work undertaken by dietetic professionals of the past and present who continue to innovatively shape and reshape the profession from its roots in home economics to the incorporation of contemporary perspectives on health. While recognizing the multiple meanings of food and its power to nourish and heal, we acknowledge that food is more than the mere sum of its constituent nutrients. We recognize that human bodies in health and illness are complex and contextual. Moreover, we recognize that the knowledge that enables us to understand health is socially, culturally, historically, and environmentally constructed.

Building on the past century of dietetics and the “Beyond Nutritionism”workshop held at Ryerson University June 12-14, 2009, we extend an invitation to individuals in all areas of dietetics education, practice, and research to collaborate on the Critical Dietetics initiative.

Critical Dietetics is informed by transdisciplinary scholarship from the natural sciences, social sciences, and the humanities. By contributing to scholarship, practice, and education, it strives to make visible our assumptions, give voice to the unspoken, embrace reflexivity, reveal and explore power relations, encourage public engagement and diverse forms of expression, and acknowledge that there are no value-free positions. Through these principles, Critical Dietetics will engage with the ever-changing health, social, and environmental issues facing humanity.

Assuming a critical stance means remaining inquisitive and willing to ask and hear challenging questions. Critical approaches grant us permission to imagine new ideas and explore new ways of approaching our practice. Critical Dietetics creates space for an emancipatory (i.e., liberating and socially just) scholarship by drawing upon many perspectives, philosophies, orientations, ways of asking questions, and ways of knowing.

Critical Dietetics derives its strength from supportive relationships, recognizing that it takes courage to step beyond familiar ways of knowing. It invites constructive dialogue and challenges us to discuss, debate, and rethink what we know and how we know it. It is a generative and collective effort which understands that strength comes from diversity and debate. This declaration is therefore a bold invitation that welcomes different ways of thinking and practicing within our own profession and in collaboration with allied fields. We anticipate collectively expanding the body of knowledge in dietetics and continuing the inclusive, scholarly, collective, and pluralistic development of the profession. If you want to contribute to this dialogue and become a signatory of Critical Dietetics, please email your expression of interest to jgingras@ryerson.ca by January 7, 2010.

Sincerely,

Lucy Aphramor (UK) BSc, RD
Yuka Asada MHSc, RD
Jennifer Atkins MHSc, RD
Shawna Berenbaum PhD, RD, FDC
Jenna Brady BA, BASc, MHSc
Shauna Clarke (UK) BA, MA
John Coveney (Australia) MPHEd, PhD
Marjorie DeVault (USA) PhD
Lisa Forster-Coull MA, RD
Ann Fox MHSc, PhD, RD
Jacqui Gingras PhD, RD
Charna Gord MEd, RD
Mustafa Koc PhD
Esther Ignagni MSc
Daphne Lordly RD
Debbie MacLellan PhD, RD, FDC
Elizabeth Manafo MHSc, RD
Catherine Morley MA, PhD, RD, FDC
Dean Simmons MSc(c), RD
Karen Trainoff BASc, RD
Roula Tzianetas MSc, RD
Jennifer Welsh MSc
Kristen Yarker-Edgar MSc, RD