Recognizing the dietetics profession

Recognizing the dietetics profession – For your Information

Jane White

Nine out of 10 consumers recognize the registered dietitian as a reliable source of food and nutrition information (1). In 2002, the Commission on Dietetic Registration (CDR) recognized the competence of over 75,000 individuals and granted them the right to be called registered dietitians or dietetic technicians, registered (CDR 2002 registered member list, unpublished). Another 600 dietitians are recognized for specialty competence with renal or pediatric certifications (CDR 2002 board certification specialty statistics, unpublished). It is also important in any profession to recognize outstanding members in the field; there are several ways the dietetics profession recognizes exceptional service. Every year the ADA, the American Dietetic Association Foundation (ADAF), and numerous affiliate, state, and dietetic practice groups (DPGs) recognize their peers and colleagues with a variety of awards and honors, as well as through election to office (2).

There are diverse expectations about the benefits and responsibilities that accompany these recognition opportunities. A unified philosophy on member recognition programs and their purpose is important in advancing the dietetics profession. A review of current member recognition opportunities provides a background for further discussion and offers an opportunity for the development of additional/alternative recognition pathways.

MEMBER PERCEPTIONS AND EXPECTATIONS

Members’ multifaceted expectations and perceptions of the value of professional recognition programs surfaced during the recent evaluation of the Fellow of the American Dietetic Association program (3). As part of CDR’s planned review of this program, it became apparent that members’ desires and expectations for recognition, such as awards, honors, credentials, and advanced-level practice, are diverse and complex. In addition, the Association has yet to articulate a general philosophy on the purpose of honors, awards and recognition programs.

QUESTIONS ABOUT RECOGNITION

* What is a reasonable function of awards within the Association? How much time and resources should be devoted to their development and pursuit?

* Are current routes to recognition adequate to meet member needs?

* Should a higher percentage of ADA honors and awards evolve into tangible benefits (eg, dues funding, salary, leave time, flexible work hours) that are transferable beyond the realm of “professional recognition”? Is tangible benefit a realistic expected outcome of professional recognition? If so, can it be accomplished by the Association? What is the responsibility of the individual member in securing tangible rewards?

* What is the responsibility of the Association and the individual member in their understanding and pursuit of an award? How should Association recognition be valued?

WHAT IS KNOWN ABOUT THIS ISSUE?

Recognition implies special benefits and conveys unique responsibilities. Some responsibilities belong to the Association, while others fall upon the individual. Obvious benefits include such rewards as a client’s smile, a plaque, a membership card, or a monetary award. Responsibilities such as advocacy, stewardship (promotion), and mentorship are subtler aspects of recognition for both the Association and the member.

A review of the various Association and dietetics profession recognition programs available provides background for further discussion while exposing opportunities to better recognize and promote excellence within the dietetics profession. Conversations on this topic will help the Association and its members develop a reasoned and realistic philosophy regarding member recognition.

ADA/FOUNDATION HONORS AND AWARDS

The American Dietetic Association

The Marjorie Hulsizer Copher Award is the ADA’s most prestigious award. Established in 1945, this signature award recognizes excellence in the practice of dietetics (4). Each year one member of the ADA is recognized for exceptional competence, leadership, and contributions to the advancement of dietetics. The list of recipients is a litany of dietetic visionaries (Figure 1).

The ADA has established additional member recognition programs since the inception of the Hulsizer Copher Award.

Members’ contributions are also recognized through a variety of programs within the DPGs and affiliate/state dietetic associations. These programs recognize members in a range of ages and with a variety of experiences, as well as within distinct practice specialties. National recognition programs provide an opportunity for members to acknowledge the contributions of their professional colleagues and identify excellence on a broad scale. The review process for these programs is lengthy and requires documented examples of professional practice, service, innovation, creativity, and leadership. In addition, the awards are designed to encourage continued participation in ADA affairs.

National awards are most often presented at the Association’s annual Food & Nutrition Conference & Expo (FNCE). Recipients are formally recognized in some manner, including plaques, ribbons, special breakfasts and/or presentations. Some awards also include monetary stipends that the recipient may use for discretionary or specific purposes.

The ADAF developed numerous awards and honor and scholarship programs. Recipients of these awards are determined through an objective, systematic review of candidates against established criteria.

PRACTICE CERTIFICATION PROGRAMS

Individuals who meet certain academic eligibility requirements and pass a national certification examination administered by CDR are recognized by the title “registered dietitian” and the initials “RD.” A 1972 study of the dietetics profession indicated that dietitians wanted additional recognition of professional achievement beyond registration and entry-level practice (5).

The ADA House of Delegates (HOD) proposed a voluntary but formal certification process to designate dietetic specialties and advanced-level subspecialties (6). This resulted in the development of two certification programs: one that recognized practice specialists and another that recognized RDs with the characteristics of advanced-level practice (7-9).

The 1993 ADA HOD approved the establishment of the Fellow of the American Dietetic Association and directed that it be an advanced-level certification program rather than a recognition program. The program was to be “an objective, valid, and reliable measure of the characteristics of advanced level practice rather than an honor conferred on members” (10). To further distinguish the certification aspect of the program, CDR would develop and administer it.

In a somewhat similar fashion, CDR developed and administered a program to recognize specialists in distinct practice disciplines. To be certified as a “specialist practitioner,” individuals applying for this designation must meet certain eligibility criteria and successfully complete either an examination or a portfolio assessment. Individuals who successfully complete a certification process are permitted to call themselves Certified Specialist in Renal Nutrition, Certified Specialist in Pediatric Nutrition, or Fellow of the American Dietetic Association (11). Also permitted is the use of identifying initials after their name.

ELECTION TO OFFICE

A more traditional, yet frequently unacknowledged, way in which members are recognized is through election to office. There is no higher honor, and no greater vote of confidence, at the district, state, dietetic practice group, or national level than to be chosen by one’s peers to represent their views to the larger dietetics, food, and nutrition communities.

At the district and state level, the opportunity for member service is initially presented in the form of participation in meetings, then service on committees or task forces, and ultimately on the executive board. Service at the local level provides networking, mentoring, leadership development, cultivation of local/regional legislative contacts, increased familiarity with regulatory processes that govern practice, and the opportunity to hone communications skills utilizing multiple forms of media to reach local public and professional audiences.

Membership and involvement in DPGs affords opportunities for mentoring, networking, and recognition in highly specialized areas of dietetic practice by established leaders in the field and newcomers “on the cutting edge.” DPG involvement via elected office offers specialized legislative and regulatory involvement at the national level. The opportunity for recognition through DPG and peer-reviewed publications and as a thought leader is considerable.

Service to members in the HOD and on the ADA/F Boards of Directors and the CDR offers recognition not only through ADA channels, but at national and international levels as well. Opportunities to direct the future of the profession and the Association through the strategic planning, position paper, and policy statement development processes abound. Service at the national level offers recognition of the individual beyond of that typically afforded via other venues, for example:

* national and international consensus conferences;

* private/public corporations and foundations;

* multicultural/multinational coalitions of individuals and groups with dietetics, food, and/or nutrition as their primary interest;

* advocacy for nutritional health and well-being on the national and global level;

* broad coalitions of health, social services, agricultural, food and/or nutrition professionals;

* congressional hearings; and

* regulatory agencies and national standards-setting coalitions.

Election to office at any level, while providing significant recognition, mandates an unselfish commitment of time, energy, and talent. It necessitates a commitment to function as a team player and “servant member” whose primary interest is advancement of all membership segments with the expected outcome of improved public health and vitality.

SHOULD A STANDARD DEFINITION OF RECOGNITION BE DEVELOPED?

Members can be recognized in countless ways. One benefit of recognition is the receipt of an award, honor, office, or certification. The definitions of recognition vary. For Association members, award criteria or office eligibility requirements reflect the manner by which the desired recognition is attained.

The responsibilities that accompany the various types of recognition also vary. The registered dietitian, dietetic technician, registered, and registered and practice specialist must maintain continuing education hours to recertify every five years.

The recipients of the ADA or ADAF awards or honors and those who are elected to office are recognized as leaders and models of excellence. The hallmarks of these individuals are their continued commitment to the profession and/or the Association. Once recognized, these members incur a lifelong responsibility to encourage the profession and its members.

WHY MEMBERS PURSUE RECOGNITION

The desire for recognition varies widely among members. Factors such as the number of years as a member, perceived importance or need for a specific type of recognition, registration status, level of involvement in the ADA, employment situation, and personal goals determine how the need for recognition is perceived.

For a newly certified registered dietitian or dietetic technician, registered, the right to use the designated credential after one’s name is prized. This type of recognition represents achievement of an educational goal and career objective. The RD or DTR brings with it significant employment opportunities.

For an experienced practitioner, the ability to further document practice competence through the use of specialty practice credentials enhances self-esteem and external professional recognition. For some members, this type of recognition provides additional salary and/or benefits. However, not all employers recognize and reward added professional training. This could reflect a lack of adequate promotion of the award outside the dietetics profession; it could also mean a lack of promotion to the administrative and professional community with whom the dietetics professional interacts daily. The specific benefits such recognition confers upon the institution/employer/public whom the dietetics professional serves are best marketed at the local level.

In the case of the FADA program, the top reasons Fellows gave for pursuing FADA certification included pride and personal satisfaction (93%), test of competence (73%), peer recognition (71%), employer recognition (60%), and increased credibility among peers (58%) (12). Yet during the time that the opportunity to pursue the Fellow credential existed, it was rarely sought.

Specialists reported that their experiences met their expectations in four of the top five results reported by Fellows: pride and personal satisfaction (95%), test of competence (84%), increased credibility by dietetics peers (68%), and increased credibility among other professionals (68%) (13). While fewer than 50% of the specialists surveyed expected recognition by peers, over 80% experienced some form of peer recognition through achievement of specialty certification. Specialists also reported an increase in monetary compensation (63%). Specialty certifications are associated with an increased minimum salary (14).

Members who are recognized through any of the ADA or ADAF recognition routes have not been formally surveyed to determine what benefits they have experienced since receipt of the award. It would seem that monetary gain is not the driving force behind most of the individuals who have received these awards. Subjectively, it appears that members who have been awarded some of the Association’s highest honors are truly being recognized for their lifelong contributions and commitment to the profession.

CURRENT CONTROVERSIES

The lines between professional competence and professional recognition have blurred, particularly with regard to the FADA certification program. A comparison of familiar recognition programs available to members is found in Figure 2. These programs exist for various purposes, but most serve to promote the profession. Only some carry any monetary benefit.

In 2002, on the basis of extensive evaluation and analysis, CDR determined that it would no longer administer the FADA advanced-level certification program (15). In order to meet member needs, CDR recommended that ADA investigate the development of a recognition program in its place; the new program should be part of the Association’s current recognition programs to honor individuals who demonstrate exceptional professional characteristics. Additional member dialogue overwhelmingly suggested that the Association has adequate award programs; however, these have not been sufficiently leveraged by the profession and its members (16).

It appears that each year literally hundreds of opportunities exist to recognize our members for distinguished service.

The ADA needs to more assertively share information regarding recognized members with our nondietetics colleagues. The ADA must adequately communicate to employers, the media, and federal, state, and local agencies the difference that dietetics professionals make to the health and vitality of the American public. ADA must also convey to public and private educational institutions and regulatory agencies the role that dietetics professionals play in nutrition and lifestyle education at all stages of professional and personal development. However, irrespective of Association efforts, widespread recognition of the value of an awards program cannot permeate the dietetics landscape without significant and virtually universal member effort.

CONCLUSION

The Association uses awards and certifications to recognize professional contributions and performance. Opportunities to serve the membership through elected or appointed office also provide recognition. However, unlike registration, certification, or elected office, an award recognizes the individual’s approach to the profession and is often not deliberately pursued.

This article is designed to help all members become more familiar with current routes to professional recognition, including awards and certification programs, and the differences between them. We hope that pursuit of recognition in the form of member service via elected or appointed leadership routes will increase. Our aim is to make ADA recognition more attractive and accessible to members. Take steps now to get involved with your Association and increase member recognition, as well as your own (Figure 3).

Figure 3. Member call to action: Things you can do to promote member recognition.

1. Get involved at the local level.

2. Run for elected office.

3. Nominate a peer or colleague for an award, honor, or office.

4. Pursue additional CDR certifications and/or certificate programs.

5. Promote the profession to your institution and professional colleagues.

6. Talk to your district, state, HOD, and ADA leaders about ways to promote member recognition.

Figure 1. Marjorie Hulsizer Copher Award recipients.

Year Recipient

1945 Lt. Ruby Motley Armbrust

1946 Mary P. Huddleson

1947 Lulu G. Graves

1948 Grace Bulman

1949 Fairfax T. Proudfit

1950 Mary de Garmo Bryan

1951 Lenna F. Cooper

1952 Lydia J. Roberts

1953 Mable MacLachlan

1954 Lillian S. Coover

1955 S. Margaret Gillam

1956 Mary I. Barbar

1957 Anna Boller Beach

1958 Helen A. Hunscher

1959 Dorothea F. Turner

1960 Bessie Brooks West

1961 Mary W. Northrup

1962 E. Neige Todhunter

1963 M. Lute Troutt

1964 Beula Becker Marble

1965 Fern W. Gleiser

1966 Margaret A. Ohlson

1967 Doris Johnson

1968 Martha Nelson Lewis

1969 Levelle Wood

1970 Miriam E. Lowenberg

1971 Edith A. Jones

1972 Charlotte M. Young

1973 Gertrude E. Miller

1974 Margaret L. Ross

1975 Katherine E. Manchester

1976 Louise Hatch

1977 Ruth M. Yakel

1978 Corinne H. Robinson

1979 Frances E. Fischer

1980 Grace S. Shugart

1981 Ruby W. Linn

1982 Marjorie M. Donnelly

1983 Beatrice Donaldson David

1984 Mary C. Egan

1985 Isabelle A. Hallahan

1986 Aimee Moore

1987 Arlene M. Wilson

1988 Annie L. Galbraith

1989 Marian Spears

1990 Edna Page Langholz

1991 Anita L. Owen

1992 Kathleen Zolber

1993 Esther Winterfeldt

1994 Janice Neville

1995 Jack Bellick

1996 Sara C. Parks

1997 Audrey C. Wright

1998 Susan Finn

1999 Mary Lou South

2000 Kenneth W. Wear

2001 Ann Gallagher

2002 Margaret L. Bogle

2003 Ruby P. Puckett

Figure 2. Comparison of ADA recognition programs.

Recognition Program Sponsor Purpose

Marjorie Hulsizer Copher ADA Recognize contribution to the

Award Association and profession

through long, active

participation

Medallion Award ADA Recognize leadership, ability

and service to the profession

Lena Frances Cooper Lecture ADAF Valuable insights into specific

area of dietetics practice

Presidents’ Lecture (a) ADA/ADAF Named to honor ADA presidents,

brings cutting-edge

concepts/technology to members

from thought leaders, internal

and external, to traditional

dietetics practice.

Mary P. Huddleson Award ADAF Contribution to the profession

through research excellence

published in the Journal of

the American Dietetic

Association

Excellence in Practice ADAF Innovation, creativity and

Awards leadership in specific

practice areas.

Anita Owen Recognition Award ADAF Innovation in nutrition

education

Judy Ford Stokes Award ADAF Innovation in administrative

dietetics of food service

facility design

Ross Award in Women’s Health ADAF Contributions in understanding

the importance of nutrition in

women’s health

Mary Abbot Hess Award ADAF Innovation in incorporation of

food and culinary concepts

into dietetics practice

Leadership Development Award ADAF Emerging leaders in

accredited/approved

CADE programs

DPG/Affiliate/State Programs

Variable (b) 29 DPGs

Recognized Young Dietitian State Competence and participation of

of the Year (RYDY) dietitians 35 years or younger

Recognized Dietetic State Professional contributions of

Technician of the Year dietetic technicians

(RDTY)

Emerging Dietetic Leader State Competence and distinctive

Award (EDL) contributions early in

dietetics careers

Outstanding Dietetics State Teaching, mentoring and

Educator Award leadership activities of

faculty in

CADE-accredited/approved

programs

Outstanding Dietetics State Emerging leadership and

Student Award achievement of students in

CADE-accredited/approved

programs

Outstanding Dietitian Award State Distinguished contributions to

advancing the profession

CDR Board Certification

Programs

Renal Nutrition CDR Recognizes documented practice

experience and successful

completion of examination.

Pediatric Nutrition CDR Recognizes documented practice

experience and successful

completion of examination.

Fellow of the American CDR Recognizes characteristics of

Dietetic Association advanced level practice

through successful completion

of portfolio

Recognition Program Process

Marjorie Hulsizer Copher National peer-review process

Award

Medallion Award National peer-review process.

Eight members recognized in

2002

Lena Frances Cooper Lecture National peer-review process

Presidents’ Lecture (a) ADA Board review/approval

process

Mary P. Huddleson Award Peer review process; Lead

author in Journal article

Excellence in Practice National peer-review process;

Awards 1 per practice area

Anita Owen Recognition Award

Judy Ford Stokes Award

Ross Award in Women’s Health

Mary Abbot Hess Award

Leadership Development Award CADE review needed

DPG/Affiliate/State Programs

Variable (b)

Recognized Young Dietitian 76 dietitians recognized in

of the Year (RYDY) 2002

Recognized Dietetic 15 dietetic technicians

Technician of the Year recognized in 2002

(RDTY)

Emerging Dietetic Leader 25 EDL recognized in 2002

Award (EDL)

Outstanding Dietetics 17 dietitians recognized in

Educator Award 2002

Outstanding Dietetics 85 dietetics students

Student Award recognized in 2002

Outstanding Dietitian Award 42 dietitians recognized in

2002

CDR Board Certification

Programs

Renal Nutrition

Pediatric Nutrition

Fellow of the American Blind peer-review

Dietetic Association

Recognition Program Tangible Benefit

Marjorie Hulsizer Copher Recognition at FNCE,

Award Journal

Medallion Award Recognition at FNCE,

Journal

Lena Frances Cooper Lecture Recognition at FNCE,

Journal

Presidents’ Lecture (a) Recognition at FNCE,

Journal

Mary P. Huddleson Award Recognition at FNCE;

Journal; $1000

Excellence in Practice Recognition at FNCE,

Awards Journal

Anita Owen Recognition Award

Judy Ford Stokes Award

Ross Award in Women’s Health Recognition at FNCE;

Journal; $1,000

Mary Abbot Hess Award Recognition at FNCE;

Journal; $1,000

Leadership Development Award

DPG/Affiliate/State Programs

Variable (b)

Recognized Young Dietitian

of the Year (RYDY)

Recognized Dietetic

Technician of the Year

(RDTY)

Emerging Dietetic Leader Recognition at FNCE,

Award (EDL) Journal

Outstanding Dietetics

Educator Award

Outstanding Dietetics

Student Award

Outstanding Dietitian Award

CDR Board Certification

Programs

Renal Nutrition 75 members met

standard in 2002;

use of CSR

Pediatric Nutrition 82 members met

standard in 2002;

use of CSP

Fellow of the American No longer offered

Dietetic Association

(a) Supported by ADAF with ADA Board responsible for topic selection.

(b) Established by ADA with DPG’s/affiliates/states responsible for

selection.

Additional information on these programs is available at

www.eatright.org or through ADA (phone: 312/899-4750), ADAF (phone:

312/899-4825), or CDR (phone: 312/899-0040, ext 5500).

References

(1.) Wirthlin Worldwide. American Dietetic Association: Nutrition & You: Trends 2002. Chicago, IL: American Dietetic Association; 2002.

(2.) The American Dietetic Association Awards and Honors. Available at: http://www.eatright.org/Member/ProfessionalDevelopment/76_8143.crm. Accessed June 23, 2003.

(3.) American Dietetic Association Recognition Program Task Force. House of Delegates Background Paper: ADA member recognition program. January 2003.

(4.) Cassell JA. Carry the Flame: The History of The American Dietetic Association. Chicago, IL: American Dietetic Association; 1990.

(5.) The Profession of Dietetics: The Report of the Study Commission on Dietetics. Chicago, IL: American Dietetic Association; 1972.

(6.) A New Look at the Profession of Dietetics: The Report of the 1984 Study Commission on Dietetics. Chicago, IL: American Dietetic Association; 1984.

(7.) Bradley RT, Ebbs P, Martin J, Young WY. Role Delineations for Advanced-Level and Specialty Practice in Dietetics: Results of an Empirical Study. Vol. I: Narrative Presentation of the Findings. Vol. II: Tables and Frequency Distributions. Vol. III: Appendices. Chicago, IL: American Dietetic Association; 1992.

(8.) Bradley RT, Ebbs P, Young WY, Martin J. Specialty practice in dietetics: Empirical models and results. J Am Diet Assoc. 1993;93:203-210.

(9.) Bradley RT, Ebbs P, Young WY, Martin J. Characteristics of advanced-level practice: A model and empirical results. J Am Diet Assoc. 1993;93:196-202.

(10.) Fellow of the American Dietetic Association: Project Milestones. Chicago, IL: American Dietetic Association; 2001.

(11.) Commission on Dietetic Registration. Eligibility Requirements. Available at: http://www.cdrnet.org. Accessed June 23, 2003.

(12.) Rops MS. Fellow of the American Dietetic Association Certification: Evaluation 2000. Chicago, IL: American Dietetic Association; 2000.

(13.) Rops MS. Board Certification as a Specialist in Dietetics: Evaluation 2000. Chicago, IL: American Dietetic Association; 2000.

(14.) Rogers D. Report on the ADA 2002 dietetics compensation and benefits survey. J Am Diet Assoc. 2003;103:243-255.

(15.) Commission on Dietetic Registration. Fellow Program Report to the Board of Directors, Executive Summary. May 2002. Chicago, IL: American Dietetic Association; 2002.

(16.) Recognition/Certification Task Force. Report to the ADA Board of Directors, March 2003: summary of House of Delegates dialogue. Available at: http://www.eatright.com/images/leadership/comments0203.pdf. Accessed June 2, 2003.

RELATED ARTICLE

This report was written on behalf of the ADA Member Recognition Task Force. In addition to the authors, its members are: Mary Jo Feeney, MS, RD, FADA (Chair), Nutrition Consultant to the food and health care industries, Los Altos, CA; Paul Cotton, PhD, RD, Beltsville Human Nutrition Research Center, Agricultural Research Service, US Department of Agriculture; Judith Gilbride, PhD, RD, FADA, Professor, Department of Nutrition and Food Studies, New York University; Doris Fredericks, MEd, RD, FADA, Executive Director, Choices for Children, San Jose, CA; and Karen A. Lechowich, MBA, RD, ADA staff partner.

This article was written by Jane White, PhD, RD, FADA, professor, Department of Family Medicine, Graduate School of Medicine, University of Tennessee, Knoxville, and past president ADA; and Barbara J. Ivens, MS, RD, CSP, FADA, nutrition fellow with PepsiCo Foods and Beverages.

doi: 10.1016/j.jada.2003.11.005

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