Addressing the Need for Advanced Practice Doctoral RDNs
The field of dietetics is currently experiencing a shortage of registered dietitian nutritionists (RDNs) who hold a terminal degree. This issue has been exacerbated by recent changes requiring an entry-level RDN to possess a graduate degree, alongside a wave of retirements among the baby boomer generation. The demand for doctoral-prepared RDNs is becoming increasingly apparent, and Advanced Practice Doctoral (APD) programs offer a promising solution to bridge this gap.
To address this need, the Accreditation Council for Education in Nutrition and Dietetics Board established an Expanded Standards Committee tasked with developing academic accreditation standards for APD programs. This initiative aimed to create and validate doctoral-level competencies specific to dietetics practice. The process began with an extensive literature review, incorporating advanced practice standards from non-dietetic, health-related professional programs, as well as existing professional-doctorate accreditation guidelines. Additionally, focus groups were conducted to evaluate perceptions of and the necessity for APD programs.
A structured and iterative Delphi research process was employed to refine the academic standards, competencies, and performance indicators. Ultimately, this rigorous approach resulted in the development of eight validated standards, encompassing 14 competencies and 34 performance indicators that define the APD academic accreditation standards. These standards establish a curriculum that is distinct from traditional entry-level graduate clinical nutrition programs and research-focused PhD programs. The APD framework integrates advanced didactic coursework, a structured practice residency, and applied practice-based research to cultivate specific professional competencies.
By implementing academic accreditation at the doctoral level, APD programs ensure that RDNs attain a high level of proficiency in advanced-practice roles. This not only enhances professional practice but also contributes to the expansion of research supporting clinical application, education, and leadership within the field of dietetics.
Commentary by SuppBase Columnist Alice Winters
The shortage of doctoral-prepared RDNs highlights a critical gap in the dietetics profession, one that is further complicated by evolving educational requirements and workforce attrition. While the introduction of APD programs appears to be a proactive step in addressing this issue, it raises several important considerations.
First, the distinction between APD programs and traditional PhDs in clinical nutrition must be clearly articulated to prevent confusion among aspiring professionals. Unlike PhDs, which emphasize theoretical research and academic contributions, APD programs are designed to produce high-level practitioners with applied, practice-based expertise. However, there is a potential risk of these programs being undervalued compared to PhDs in academic and research settings. Ensuring that APD graduates receive the recognition they deserve will be crucial to the program’s success.
Another key concern is accessibility. Graduate education in nutrition and dietetics is already a costly and time-intensive endeavor. If APD programs become the gold standard for advanced practice, will they be financially viable for mid-career professionals looking to further their expertise? Additionally, are there sufficient incentives for RDNs to pursue these programs, given the existing career trajectories available with a master’s degree? Addressing financial barriers and providing clear career advancement pathways will be essential to encouraging enrollment.
Furthermore, the emphasis on performance-based competencies in APD programs is a step in the right direction. However, the profession must ensure that these competencies translate effectively into real-world clinical settings. There is a risk that the rigidity of accreditation standards may hinder the flexibility needed for professionals to adapt to emerging trends in dietetics, such as personalized nutrition, integrative medicine, and digital health applications.
The future success of APD programs will depend on strategic efforts to raise awareness of their value, ensure accessibility, and integrate them seamlessly into the existing professional landscape. If done correctly, these programs have the potential to elevate the field of dietetics, strengthen clinical practice, and expand research in ways that benefit both professionals and the populations they serve.
