Advice over empathy: a national cross-sectional examination of communication in United States dietetic education

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Pubblicato in:BMC Medical Education vol. 25 (2025), p. 1
Autore principale: Braun, Ashlea
Altri autori: Corcoran, Sarah, Wollenberg, Gena, McClanahan, Kristen, Liebe, Rachel, Businelle, Michael, Joyce, Jillian
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Springer Nature B.V.
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022 |a 1472-6920 
024 7 |a 10.1186/s12909-025-07254-z  |2 doi 
035 |a 3216559285 
045 2 |b d20250101  |b d20251231 
084 |a 58506  |2 nlm 
100 1 |a Braun, Ashlea 
245 1 |a Advice over empathy: a national cross-sectional examination of communication in United States dietetic education 
260 |b Springer Nature B.V.  |c 2025 
513 |a Journal Article 
520 3 |a BackgroundEmpathy is an important element of patient communication and is well operationalized in established approaches to one-on-one communication, such as motivational interviewing (MI). The accurate demonstration of empathy is especially important when seeking to facilitate a change in behavior, such as in lifestyle or diet, given these issues often involve psychological barriers versus knowledge deficits. Registered dietitians are a key licensed healthcare provider tasked with facilitating changes in diet, but the extent to which current educational standards in the United States (US) contribute to cultivation of empathy as a professional skill has not been systematically evaluated. The objective of this study was to characterize therapeutic empathy and communication among US dietetics students.MethodsA cross-sectional survey-based study was conducted among US-based dietetics students, recruited via forwarded e-mail messages from directors of accredited programs. Personal characteristics and responses to the Helpful Responses Questionnaire (HRQ)– a validated measure of therapeutic empathy– were collected. All HRQ responses (6/participant) were reviewed and scored from 1 to 5 based on the use of reflections and communication roadblocks (1 = least empathetic, 5 = most empathetic) per established methods. One mean total HRQ score was computed per participant and precise roadblocks used were tabulated. Given the distribution of the final data set, a binary variable was created to capture whether participants had a total HRQ score of 1 or > 1. Logistic regression and chi-square tests were used to identify participant attributes associated with achieving scores > 1.ResultsParticipants (n = 506) were mostly white females (95.06% female, 79.05% white). The mean total HRQ score was 1.21 (SD: 0.47), with n = 175 participants (34.6%) achieving a mean total HRQ score > 1. Age, being married, having a previous non-nutrition-related career, or enrollment in a standalone internship were associated with HRQ score > 1 (P ≤ 0.001). The most common roadblock used was advising followed by using logic.ConclusionUS-based dietetics students may not be consistently using empathetic communication, instead prioritizing problem-solving-oriented strategies (e.g., giving advice). Exploring optimal strategies to training that facilitate improved empathy, and the relative importance of empathy versus problem-solving strategies in facilitating behavior change, are important next steps. Further, the HRQ was successfully implemented, and its use should be replicated in other regions and populations. 
651 4 |a United States--US 
653 |a Behavior 
653 |a Students 
653 |a Communication 
653 |a Nutrition research 
653 |a Questionnaires 
653 |a Diet 
653 |a Confidence 
653 |a Counseling 
653 |a Academic standards 
653 |a Patients 
653 |a Trauma 
653 |a Dietitians 
653 |a Electronic mail systems 
653 |a Empathy 
653 |a Education 
653 |a Medical education 
653 |a Dietetics 
653 |a Patient education 
653 |a Stimuli 
653 |a Behavior Modification 
653 |a Nutrition Instruction 
653 |a Outcomes of Treatment 
653 |a Interrater Reliability 
653 |a Communication (Thought Transfer) 
653 |a Interviews 
653 |a Meta Analysis 
653 |a Feedback (Response) 
653 |a Student Surveys 
653 |a Student Participation 
653 |a Health Behavior 
653 |a Nutrition 
653 |a Behavior Change 
653 |a Recruitment 
653 |a Individual Characteristics 
700 1 |a Corcoran, Sarah 
700 1 |a Wollenberg, Gena 
700 1 |a McClanahan, Kristen 
700 1 |a Liebe, Rachel 
700 1 |a Businelle, Michael 
700 1 |a Joyce, Jillian 
773 0 |t BMC Medical Education  |g vol. 25 (2025), p. 1 
786 0 |d ProQuest  |t Healthcare Administration Database 
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