Year

1995

Degree Name

Doctor of Philosophy

Department

Department of Public Health and Nutrition

Abstract

The dietetic interview is defined as the interaction between dietitians and clients who seek professional nutrition counselling. Like the medical interview it has certain characteristics which are constructed and reproduced by organisational constraints and the actions of interview participants. In the teaching clinic these constraints are even more defined by the presence of the supervising dietitian, and the task of assessment.This study argues that dietetic education would benefit from an understanding of the social organisation of the professional interview in the context of the teaching clinic. The gains of this added dimension would lie in better prepared students and the development of quality public dietetic services in teaching clinics. These claims are bracketed in a critical social epistemology, which recognises the social construction of 'what counts' as effective practice and in turn, how this is construed in the pedagogical environment.

The study was conducted in three stages. During 1992-93, thirty two case studies of audio recorded interactions between student dietitians and clients were analysed using methods of conversation analysis. The findings were then developed as teaching concepts which would inform students of the social organisation of talk in the teaching clinic. During 1994 a teaching intervention was introduced whereby communication techniques derived from the study were discussed in class and reviewed by students on listening to audio recordings of their own performances. At the end of 1994 another 30 interactions were audio recorded and analysed to examine the effects of the teaching intervention.

The results indicated the production of well directed and organised interviews from relatively inexperienced practitioners. This was seen as the effect of vicarious experience which preempted that usually gained by constructing numerous interviews and establishing a 'feel' for attending to the social constraints which the interview works through. From an educational perspective, this was clearly a productivity gain. The form ofinterview produced, however, raised a number of questions on the nature of the dietetic interview in this context, and the relative problems which the current combination of performance indicators hold for practice. Challenges for dietetic educators include a re-definition of the entry level dietetic interview and questions concerning the effects of observing performance. Finally, it is recognised that all of these features represent the current political and social climate of dietetics in Australia, determining in the end 'what counts' as dietetic practice.

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