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- Seabrook, Jamie A PhD10
- Dwyer, John J M PhD8
- Lordly, Daphne MA PDt7
- Brauer, Paula M PhD RD6
- He, Meizi PhD6
- Brauer, Paula PhD RD5
- Buchholz, Andrea C PhD RD5
- Dietrich, Linda MEd RD5
- Hammond, David PhD5
- Hanning, Rhona M PhD RD FDC5
- MacLellan, Debbie PhD RD5
- Mann, Linda PDt MBA5
- Duncan, Alison M PhD RD4
- Farmer, Anna PhD RD4
- Haines, Jess PhD RD4
- Hanning, Rhona M PhD RD4
- Irwin, Jennifer D PhD4
- Marquis, Marie Dt P Ph D4
- McCargar, Linda J PhD RD4
- Nasser, Roseann MSc RD CNSD4
- Rossiter, Melissa D RD PhD4
- Royall, Dawna MSc RD4
- Shatenstein, Bryna PhD PDt4
- Vanderlee, Lana PhD4
- Willows, Noreen D PhD4
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- Amanda Raffoul PhD,
- Lesley Andrade MHSc, RD,
- Rachel B. Acton PhD,
- Kirsten M. Lee PhD,
- Kathleen E. Burns PhD,
- Katelyn M. Godin PhD, and
- Rhona M. Hanning PhD, RD, FDC
Weight bias and discrimination are highly pervasive and harmful to Canadians with higher weights. Researchers and practitioners who deliver, evaluate, and advise on dietary and weight-related interventions may inadvertently perpetuate weight bias through their work; however, trainees in these fields rarely have access to weight bias education within their applied health programs. This study evaluated the acceptability of an online educational weight bias module developed for undergraduate students enrolled in health courses. The intervention included a pre-recorded 20-minute online module with prompts for reflection or discussion, a self-assessment quiz, as well as a separate module and range of resources for instructors. Overall, 211 students from applied health courses and 4 instructors completed an online survey querying the module’s delivery, impact, and relevance. Students agreed that the module provided useful information (82%), was easy to understand (97%), and was the right length (75%), but reported wanting more interactivity and engagement with the content. Instructors found the module engaging and useful and expressed interest in additional resources and support for weight bias education. Future research should explore the impact of weight bias education on students’ weight-related attitudes and perceptions as well as feasibility and relevance of online features such as multimedia tools.- Purpose: When admitted to the hospital, individuals with celiac disease rely on food handlers for provision of safe, uncontaminated gluten-free meals. We aimed to assess the knowledge of gluten-free diet (GFD) amongst individuals involved in meal preparation for patients.Methods: A questionnaire with 10 demographic and 35 test items to assess knowledge of GFD, including workplace scenarios encountered in meal preparation, was administered to food handlers including cooks, utility workers, dietary technicians, and supervisors in 2 tertiary care, university-affiliated hospitals. A score of ≥28 of 35 (≥80%) was considered a “pass”.Results: A total of 72 individuals completed the study, mean age 40.3 ± 1.6 years, 75% female. Only 42 (56.8%) scored ≥80% and achieved a pass. The average score was 75.9% ± 13.4%, range 25.7%–100%. The supervisors had significantly higher scores (87.9% ± 11.4%) than utility workers (73.0% ± 11.4%; P = 0.01) and cooks (71.7% ± 14.5%; P = 0.01). Cooks had the lowest scores with 80% scoring <80%. Females scored higher than males (77.8% vs. 68.8%; P = 0.02).Conclusions: There are significant differences in GFD knowledge amongst various groups involved in food preparation in hospitals. The gaps identified in knowledge can potentially compromise the safety of patients with celiac disease. Targeted interventions to educate hospital food handlers about GFD are warranted. Registered Dietitians can play an important role in providing this education.
- OPEN ACCESS
- Daiva E. Nielsen PhD,
- Irem Karamanoglu RD, MScA,
- Hannah Yang Han MSc,
- Katherine Labonté PhD, and
- Catherine Paquet PhD
Purpose: This investigation evaluated food values, food purchasing, and other food and eating-related outcomes during the COVID-19 pandemic in Quebec, Canada. The role of stress in eating outcomes was also examined.Methods: An online household survey was conducted among Quebec adults aged ≥18 years (n = 658). Changes in outcomes during, as compared to before, the pandemic were evaluated using descriptive statistics and thematic analysis of free text responses. Eating outcomes by daily stress level (low, some, high) were assessed using Cochran–Armitage test for trend.Results: Most respondents reported increased importance and purchasing of local food products (77% and 68%, respectively) and 60% reported increased grocery spending (mean ± standard deviation: 28% ± 23%). Respondents with a higher daily stress level had a higher frequency of reporting eating more than usual compared to before the pandemic (low stress 21%, some stress 34%, high stress 39%, p-trend <0.0001). Free text responses described more time spent at home as a reason for eating more than usual.Conclusions: To support healthy eating during and post-pandemic, dietitians should consider patients’ mental/emotional well-being and time spent at home. Moreover, support of local food products may provide opportunities to promote healthy eating, sustainability, and post-pandemic resiliency of food systems. - Dragana Misita BSc, RD,
- Sharan Aulakh BSc,
- Venu Jain MD, PhD,
- Maira Quintanilha PhD, RD,
- Maria B. Ospina PhD, and
- Rhonda C. Bell PhD
Introduction: Optimizing women’s diets in pregnancy improves maternal and child health outcomes; however, the best format for supporting women’s nutrition goals in pregnancy is not clear, and access to dietetic services is not standard in prenatal care in Alberta. This study explored women’s perceptions about access to Registered Dietitians (RDs) throughout pregnancy and RDs experiences providing prenatal nutrition counselling.Methods: Two studies were conducted. Study A: Pregnant women completed a short survey while attending a prenatal appointment in a large prenatal clinic. The survey assessed women’s perspectives about accessing dietetic services during pregnancy. Survey data were analyzed using descriptive statistics. Study B: RDs participated in either a semi-structured phone interview or a focus group and described their experiences working with pregnant women. Data were analyzed using thematic analysis.Results: One hundred pregnant women completed the survey. Ninety percent indicated that they had not seen a RD at this time in pregnancy, and 48% reported that they would like to access a RD in pregnancy, if available. Dietitians discussed the diversity of women’s concerns and the challenges to providing prenatal nutrition support.Conclusions: Women have nutrition-related questions during pregnancy. Dietitians experience challenges providing services in the current care systems.- Purpose: Our purpose was to explore the experiences of self-identifying Two-Spirit, lesbian, gay, bisexual, transgender, and questioning (2SLGBTQ+) Canadians in treatments for their eating disorders (EDs). By knowing more about their experiences, we hoped to better understand how dietitians and ED service providers can better support 2SLGBTQ+ clients.Methods: Ten self-identifying 2SLGBTQ+ individuals reporting concerns regarding body image or eating patterns, as well as accessing support services or treatments, within Canada were recruited through social media platforms. Participants took part in semi-structured interviews. Data were recorded, transcribed, and analyzed using thematic analysis.Results: Four themes are presented: (i) feelings of judgement and otherness, (ii) experiencing shame in EDs and 2SLGBTQ+ identity, (iii) perceiving a lack of understanding and knowledge, and (iv) sharing lived experiences with the care team.Conclusions: Increased focus on trauma-informed approaches to ED treatment in 2SLGBTQ+ populations are indicated so that 2SLGBTQ+ clients feel comfortable to share. Increased education in 2SLGBTQ+ terminology and gender expression is recommended for dietetic professionals. We also recommend increased recruitment efforts for more diverse care teams.
- While conducting nutrition/health research into weight changes during incarceration and related determinants, it became apparent that the correctional setting in Canada was unique and required study design modifications to ensure study success. Consequently, we made many methodological adjustments during recruitment and data collection because of unforeseen challenges in the correctional context. This paper provides an illustrative example and shares insights on the challenges faced when conducting nutrition/health research in Canadian correctional facilities. Guidance on how to adapt research methods to make them more conducive to this unique environment is provided. This paper also highlights the importance of conducting nutrition/health research in this setting, especially given the lack of this type of research and the need for more evidence-based data to guide health promotion and nutritional interventions in Canadian correctional facilities.
- Natalie D. Riediger PhD,
- Maria Kisselgoff HBSc,
- Maureen Cooper BSc,
- Kelsey Mann MSc,
- Hannah Derksen BA,
- Maria Gaddi BSc, and
- Patti Glazer BSc RD
Purpose: Barriers in research for women and dietitians have been documented. We sought to describe tri-council funding awarded within the nutrition discipline according to institution type, academic rank, gender, dietitian status, and primary research methods used.Methods: Using an online search methodology, faculty members with research appointments were identified from nutrition departments offering accredited dietetic programs and/or at Canada’s collective of research-intensive universities known as U15. All data regarding faculty members, their institutions, and funding were collected through publicly available websites and Scopus. Tri-council funding associated with the nominated principal investigator, from a 5-year period, 2013–2014 to 2017–2018, was extracted. Binary logistic regression was used to test for predictors of receiving any tri-council operating funds within the 5-year period.Results: Faculty members (n = 237) from 21 institutions were identified for inclusion. Those from U15 institutions, at the full professor rank, nondietitians, men, and those who engaged in primarily quantitative research methods (vs. qualitative or mixed-methods) were significantly more likely to hold any tri-council funding during the eligible period. Dietitians (n = 76) were significantly less likely to hold tri-council funding, independent of institution, rank, gender, and primary research methods utilized.Conclusions: The apparent under-funding of academic dietitians from federal tri-council sources requires exploration.- Purpose: This study examines body satisfaction, weight attitudes, dieting behaviours, and aging concerns of baby boomer women (BBW; born 1946–1965) from rural and urban Manitoba.Methods: Primary data collection occurred November 2015, and 1083 participants completed the Body Image and Food Choice Survey. Four strata of BBW were represented to examine differences between older and younger BBW and location of residence. Multinomial logistic regression models were fit to determine predictors of weight and appearance satisfaction. Odds ratios and 95% confidence intervals were considered significant at p ≤ 0.05.Results: Fifty-three percent of participants were satisfied with their appearance, whereas only 34% were satisfied with their weight. Ninety-one percent desired to lose weight (29.9 ± 29.3 lbs). Aging anxiety was evident for 46% of participants and associated with appearance satisfaction (χ2 = 27.46, df = 4, p < 0.001). Body work and dieting behaviours were used to mitigate body dissatisfaction, and media influence was associated with both appearance (χ2 = 76.17, df = 6, p < 0.001) and weight satisfaction (χ2 = 67.90, df = 6, p < 0.001). Desired weight change, appearance stress, appearance importance, and self-rated health predicted both weight and appearance satisfaction.Conclusions: There is a need for greater awareness of aging women’s body image concerns and the need for age-appropriate tools/resources to help dietitians support women achieve a healthy body image.
- Leland Guillemin BSc, RD,
- Jessica Hofstede BSc, RD,
- Teigan Anderson BSc, RD,
- Hailey Walkeden BSc, RD,
- Kerri Schellenberg MD, MMedEd, FRCPC, CSCN (EMG),
- Ester Kang MSc, RD,
- Dayna Berry BSc, RD,
- Stephanie Lefebvre BSc, RD, and
- Jessica RL Lieffers PhD, RD
Nutrition concerns are prevalent in individuals with Amyotrophic Lateral Sclerosis (ALS). Despite the prevalence of nutrition concerns, few data are available on perceptions and experiences of nutrition interventions in individuals with ALS and their caregivers; this study aimed to collect this information. An online survey was developed and hosted on Survey Monkey®. Individuals with ALS and their caregivers from Saskatchewan, Canada, were invited to complete the survey through email to attendees of the ALS Clinic (Saskatoon, Canada), and via the ALS Society of Saskatchewan Facebook page in February–March, 2021. Quantitative data were analyzed using descriptive statistics. Twelve eligible respondents completed the survey (n = 10 individuals with ALS; n = 2 caregivers). The present study found nutrition was important to respondents and there was interest in trying diets and supplements for ALS management; of note, many respondents were interested in exploring the ketogenic diet. Six (50%) respondents had weight loss concerns. All respondents would recommend consulting with a dietitian upon being diagnosed with ALS. Many respondents reported a predefined negative perception of tube feeding. The results of this study suggest that increasing the accessibility of dietitians could positively impact ALS-related care. The findings also provide guidance for dietitians to enhance nutrition care for individuals with ALS.- The home environment and parental influence are strong predictors of eating behaviours in young children and can influence healthy development. The objective of this study was to describe the feeding practices of a sample of families on Prince Edward Island. Eleven parent participants were recruited, one-on-one interviews were held, and a thematic analysis was conducted. Conversations with parents revealed that the family feeding environment is influenced by a multitude of factors that change daily and need to be navigated based on the age of the child. Parents saw family meals as time together and an opportunity to model healthy eating behaviours; however, they faced several challenges at mealtimes, including perceived picky eating. Parents recognized their children’s hunger and satiety cues, although they respected satiety signals more often if children ate what they perceived as a lot of food. Many parents used food as a reward to encourage their children to eat more but recognized that it could lead to the development of undesirable habits. Despite the complex factors that influence feeding, dietitians can work with families to foster a responsive feeding environment by encouraging family meals, recognizing and respecting hunger and satiety cues, and understanding typical changes in eating behaviours as children age.
- Osman Mohamed Elfadil MBBS,
- Saketh R. Velapati MBBS,
- Lisa D. Miller RDN,
- Michael F. Huiras RDN,
- Evan A. Stoecker RDN,
- Morgan Warner RDN,
- Laura Vanderveer RDN,
- Ashley Adkins RDN,
- Christopher Chargo RDN,
- Katherine Kueny RDN,
- Molly S. Bailey RDN,
- Ryan T. Hurt MD, PhD, and
- Manpreet S. Mundi MD
Hospitalized patients are at an increased risk of malnutrition due to multiple factors including, but not limited to, acute and chronic diseases especially those affecting gastrointestinal tract, surgery, appetite, and frequent nil per os while undergoing diagnostic workup. Because of this, guidelines suggest the use of oral nutritional supplements (ONS) in hospitalized patients to reduce the risk of malnutrition and its complications. The current report aims to highlights key findings from a cross-sectional survey of 99 hospitalized patients who were at risk for or diagnosed with malnutrition and prescribed ONS. Data regarding ONS prescriber information as well as number ordered and consumed were collected. Of the 2.4 ± 1.5 supplements ordered per person each day, only 1.3 ± 1.1 were consumed, and there was 48% wastage of prescribed ONS. However, dietitian involvement was associated with significant reduction in wastage. Given the need and benefit, it is imperative for the nutrition community to further explore best practices to improve ONS consumption.- Purpose: The values, beliefs and practices between the family home and child care environment can play a role in shaping a responsive food environment for young children, but few studies have explored the differences across these settings. The purpose of this study was to compare responsive feeding practices in child care and home environments through the framework of the 2019 Canada Food Guide healthy eating recommendations.Methods: Nova Scotia families and child care providers completed an online survey on responsive feeding. Independent-samples t-tests explored the differences between family and child care respondents on variables related to the 2019 Canada’s Food Guide, including: food variety, mindfulness, eating with others, cooking more often, and enjoyment of food. A directed content analysis was used to code the open-ended qualitative questions.Results: Family respondents (n = 603) were more likely to report offering a variety of foods, repeated exposures to new foods, and asking children about fullness. Child care respondents (n = 253) were more likely to sit with children during meals and less likely to encourage children to finish their food.Conclusions: The results identify potential points of intervention, including the importance of increasing communication to ensure mutually supportive messages and environments for healthy eating.
- Purpose: Canada’s Food Guide (CFG) contains recommendations for healthy eating for Canadians. The objective was to examine the awareness of and learning about CFG by Canadian youth.Methods: Cross-sectional online surveys were conducted with 3,674 youth aged 10–17 years in Canada in November/December 2019. Logistic binary regression models examined awareness of CFG, learning about CFG in school, and learning about healthy eating in schools in the past 12 months.Results: Most participants reported hearing of CFG (84.5%), learning about CFG in school (86.6%), and learning about healthy eating in school (65.4%) in the past 12 months. Awareness of CFG was higher among females (OR: 1.61; 95% CI: 1.32–1.96), older youth (1.70; 1.39–2.07), and those in Atlantic Canada (OR: 1.77; 95% CI: 1.10, 2.84). Significantly fewer East/Southeast Asian, South Asian, Latino, and Middle Eastern participants reported hearing of CFG compared to white participants (p < 0.05 for all). Unstated/missing BMI (0.56; 0.45–0.71) and living in BC (OR: 0.61; 95% CI: 0.45, 0.82) were negatively associated with hearing about CFG. Similar results were observed in the models on learning about CFG and healthy eating in school.Conclusions: This study indicates discrepancies in awareness of CFG among youth by sex, ethnicity, region, and BMI which may suggest differences in use of CFG and healthy eating behaviours.
- Purpose: COVID-19 has disrupted the daily routines of many Canadian families. In Ontario, provincially mandated public health measures have resulted in significant changes to school policies, including those related to food. The impact of COVID-19 related school food policies on parental lunch packing habits is unknown; therefore, this study investigated how school-related COVID-19 policies have impacted parental school lunch packing habits.Methods: Parents (N = 287) of school-aged children were recruited from parent-specific Facebook groups across Ontario, Canada, to complete an online survey regarding lunch packing habits. This survey was developed based on findings from a previously conducted scoping review. Open-ended survey responses were inductively analyzed.Results: Three over-arching themes were constructed: (1) Food Programs and COVID-19; (2) Schedule Changes; and (3) School Policy Changes. Parents explained that the cancellation or modification of food programs at schools, changes to the length of time children are given to eat at school, and removal of access to microwaves, garbage cans, and teacher assistance during lunch have forced parents to change their lunch packing habits.Conclusion: Findings from this study demonstrate a need for better support to help ease the burden parents experience when packing their child’s school lunch, during an already extremely stressful time.
- Erin K. Smith BSc,
- Rebecca Lewis MSc, RD,
- Andrea C. Buchholz PhD, RD,
- Jess Haines PhD, RD,
- David W. L. Ma PhD, and
- Alison M. Duncan PhD, RD
Purpose: To investigate the breakfast quality of preschool-aged children through a comparison of their energy and nutrient intakes at breakfast to published benchmarks for a balanced breakfast.Methods: Dietary data were collected for 163 children aged 3–5 years enrolled in the Guelph Family Health Study using one parent-reported online 24-hour recall and analyzed for energy and nutrient intakes. Breakfast quality was assessed by tallying the frequency of participants whose nutrient and energy intakes at their breakfast meal met the recommendations for a balanced breakfast established by the International Breakfast Research Initiative (IRBI).Results: Almost all participants (98%) consumed breakfast, and most participants (82.5%) met the energy IRBI recommendation. However, the majority of participants did not meet the IRBI recommendations for breakfast intakes of most macronutrients and micronutrients. In particular, fewer than 25% of participants met the IRBI recommendations for breakfast intakes of dietary fibre, niacin, folate, vitamin C, calcium, potassium and zinc.Conclusions: Almost all preschool-aged children in this study consumed breakfast, but the nutritional quality of their breakfast did not meet recommendations for most nutrients. These results can inform nutrition education and intervention programs for children that aim to improve the nutritional quality of breakfast.- Kelsey Van MSC,
- David M. Beauchamp MSC,
- Hiba Rachid MAN, RD,
- Marina Mansour MAN, RD,
- Brooklyne Buckley MAN, RD,
- Debora Choi MAN, RD,
- Alexia Prescod RD, and
- Jennifer M. Monk PhD
Purpose: A pilot study to investigate the impact of the COVID-19 pandemic and shift to online learning and practicum training on dietetics students’ perceptions of Partnership for Dietetic Education and Practice (PDEP) competency acquisition and mental health.Methods: Dietetics students (n = 19) at the University of Guelph (2020–2021) were invited to complete an anonymous online survey to assess self-reported online dietetics practicum training experiences including (i) benefits and challenges, (ii) PDEP competency acquisition, and (iii) impact on mental health.Results: The benefits of online dietetics training included schedule flexibility (42.1%), reduced commute time (31.6%), and acquiring virtual counselling experience (21.1%). Reported challenges were insufficient communication with preceptors (36.8%), increased project workload (57.9%), and technology (15.8%). In online practicum placements, 52.6% of dietetics students reported adequately acquiring all PDEP competencies, with Nutrition Care identified as the most challenging to obtain (63.2%). A negative impact on mental health and increased levels of stress/anxiety were reported in 94.7% of trainees. Notably, 63.2% of students favoured continuation of online dietetics training through a hybrid or entirely online format.Conclusion: Online dietetics training has the potential to complement the traditional in-person model; however, further adaptation is required to optimize PDEP competency acquisition and students’ mental health.- Rhea D’Costa MD,
- Sandra Fucile PhD, OT (reg),
- Brittany Dickson RD,
- Alessia Gallipoli MD, and
- Kimberly E Dow MD, FRCPC
Purpose: To compare nutrition and health outcomes before and after implementing a standardized enteral feeding protocol on nutrition and health outcomes in very low birth weight preterm infants.Methods: A retrospective chart review was performed evaluating preterm infants, born less than 34 weeks gestation and weighing less than 1500 g, before and after the implementation of a standardized enteral feeding protocol. Outcomes included weaning of parenteral nutrition, initiation and advancement of enteral feeds, initiation of human-milk fortifier (HMF), change in weight z-score and neonatal morbidities.Results: Fifty-six infants (30 in pre-group, 26 in post-group) met the inclusion criteria. Infants in the standardized enteral feeding protocol group started enteral feeds earlier (p = 0.039) and received full HMF fortification at lower weights (p = 0.033) than those in the pre-group. Fewer days on continuous positive airway pressure (p = 0.021) and lower rates of bronchopulmonary dysplasia (p = 0.018) were also observed in the post-group. Weaning of parenteral nutrition and weight z-score were not significantly different between groups. There were no differences in other morbidities.Conclusion: Study results suggest that adopting a standardized enteral feeding protocol may promote early initiation of enteral feeds and fortification.- The purpose of this study was to evaluate nutrition knowledge and diet quality in collegiate athletes to determine if referral to a sports registered dietitian (RD) is warranted. This cross-sectional study analyzed four sections of the Nutrition for Sport Knowledge Questionnaire and the Rapid Eating Assessment for Patients Questionnaire, both validated in athletic populations. The relationship between nutrition knowledge and diet quality was evaluated. Significance was set at P ≤ 0.05. One hundred and twenty athletes reported a median nutrition score of 52 (45–61), and a dietary quality score of 53 (46–58), with a weak, positive association between both (r = 0.28 (95% CI: 0.11–0.44), P < 0.01). Fifty-four percent were categorized as needing a referral to a sports RD. Diet quality scores differed between dietitian referral group with 49 (43–54) versus 58 (52–62) for the nonreferral group, respectively (P < 0.01, V = 0.71), with no difference in nutrition knowledge observed, P = 0.73. Overall, nutrition knowledge and diet quality in our sample of collegiate athletes was poor. College athletic departments with limited access to sports RD should use these questionnaires to evaluate knowledge and the need of dietitian referral separately.
- Purpose: Our aim was to explore Canadian dietitians’ knowledge, beliefs, and values relating to the nutritional care of Two-Spirit, lesbian, gay, bisexual, trans, and other queer groups (2SLGBTQ+).Methods: The research was qualitative and used a poststructural theoretical lens. Interviews were conducted with 16 Canadian dietitians. Data were analyzed using thematic analysis.Results: Three themes were noted: (i) moving away from the binary; (ii) systemic discrimination and 2SLGBTQ+ experiences; and (iii) professional organizations and advocacy. The participants discussed structural, professional, and cultural barriers that affect the nutrition and health experiences of sexual and gender diverse groups.Conclusion: Dietetic institutions and regulatory bodies must provide sexual and gender diversity resources and engage in activities that acknowledge the lives and nutritional concerns of sexual and gender diverse people. Such advocacy is a means to provide more inclusive and equitable care. Key recommendations for structural changes within the profession include using an intersectional lens and a critical dietetic approach to nutritional care.
- In nursing and medicine, taking part in simulation activities has been shown to be beneficial for students’ learning; however, little has been documented in dietetics. This study aimed to document the perceived effect of 4 simulations on development of professional competencies by dietetic students. A mixed-method convergent approach was used with pre- and post-questionnaires, interviews, and a focus group discussion to look at dietetic students’ perceptions of learning as part of a Nutrition Assessment course. Nonparametric tests for questionnaires and theme analysis for transcripts were used to examine data. After analysis, data were compared and merged for interpretation. Results showed that participants perceived a significant increase in comprehension of various competencies with simulations. In interviews and a focus group, a participant subgroup (n = 7) perceived an enriched understanding of some dietetic competencies compared with pre-simulations. Simulations seemed to have transformed classroom concepts to a more practical understanding of dietetic practice. More studies are needed to identify if these results could be replicated in different settings. Simulations had a positive effect on students’ perception of competencies development and may be an andragogical tool of choice to support preparing future dietitians for entry to practice.