Validation of an evidence-based dietetic practice instrument and the association between level of education and use of evidence-based dietetic practices among registered dietitian nutritionists
Bibliographic record
Abstract
Evidence-based practice (EBP) is associated with improved and consistent patient care and reduced healthcare costs. While dietetic didactic and practice requirements emphasize EBP, there is a lack of a valid and reliable instrument that measures both objective and subjective knowledge of EBP among registered dietitian nutritionists (RDNs). Content validity was conducted with 11 experts and resulted in a 38-item survey that included ten items assessing objective knowledge of EBP. Items were deemed clear and appropriate for the survey goals and intended audience based on a face validity review among 16 RDNs with varying backgrounds. A pilot evaluation (n = 12) pre- and post-research methods course found responsiveness to the objective knowledge subscale; however, this was only statistically significant with the pre-validation instrument (p = .05, r = .57). Internal consistency reliability (n = 482) was acceptable for the survey (Cronbach’s alpha = .91) and its subscales. However, the objective knowledge subscale was low (Cronbach’s alpha = .41), likely due to too few items and variation in EBP exposure and training among participants. Test-retest (n = 335) found a good degree of reliability within the objective knowledge subscale at both timepoints (ICC = .71). Secondarily, this instrument was used to assess associations between level of education (i.e., bachelor’s, master’s, doctoral) and objective knowledge of EBP (n = 482). This research suggests that each increasing degree type further supports the knowledge of EBP concepts (all comparisons p < .001). Other predictors of EBP include recency of degree completion, peer-reviewed publications, and specialty certifications. Moderate positive associations (r = .41, p < .001) were found between subjective and objective knowledge measures, suggesting RDNs may be relatively accurate in their self-assessed knowledge of EBP. Future research should evaluate the efficacy of EBP training, particularly among practitioners further from degree completion.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.035 | 0.065 |
| Meta-epidemiology (narrow) | 0.000 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".