Academic Journal
Integrating Systems and Critical Thinking, Clinical Reasoning, Decision-Making, and Judgement in Dietetic Education: Development of a Conceptual Pilot Model.
| Τίτλος: | Integrating Systems and Critical Thinking, Clinical Reasoning, Decision-Making, and Judgement in Dietetic Education: Development of a Conceptual Pilot Model. |
|---|---|
| Συγγραφείς: | Schönberg S; Department of Health Professions, Bern University of Applied Sciences, Bern, Switzerland., Bertozzi E; Department of Health Professions, Bern University of Applied Sciences, Bern, Switzerland., Stalder J; Department of Health Professions, Bern University of Applied Sciences, Bern, Switzerland., Bucher A; Department of Health Professions, Bern University of Applied Sciences, Bern, Switzerland., Haddad J; Department of Health Professions, Bern University of Applied Sciences, Bern, Switzerland., Rufener A; Department of Health Professions, Bern University of Applied Sciences, Bern, Switzerland., Jent S; Department of Health Professions, Bern University of Applied Sciences, Bern, Switzerland. |
| Πηγή: | Journal of human nutrition and dietetics : the official journal of the British Dietetic Association [J Hum Nutr Diet] 2026 Oct; Vol. 39 (5), pp. e70343. |
| Τύπος έκδοσης: | Journal Article |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: Wiley on behalf of The British Dietetic Association Ltd., [c1988- Country of Publication: England NLM ID: 8904840 Publication Model: Print Cited Medium: Internet ISSN: 1365-277X (Electronic) Linking ISSN: 09523871 NLM ISO Abbreviation: J Hum Nutr Diet Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: [Oxford] : Wiley on behalf of The British Dietetic Association Ltd., [c1988- |
| Ιατρικοί όροι (MeSH): | Dietetics*/education , Clinical Reasoning* , Clinical Decision-Making* , Models, Educational*, Humans ; Pilot Projects ; Thinking ; Judgment ; Switzerland ; Qualitative Research ; Decision Making |
| Περίληψη: | Introduction: Dietetic practice is increasingly characterised by complexity arising from chronic disease, food and nutrition insecurity, demographic shifts, and environmental sustainability concerns. Addressing this complexity requires the effective and interprofessionally aligned use of central cognitive strategies. However, despite frequent reference to systems thinking, critical thinking, clinical reasoning, clinical decision-making, and clinical judgement in health professional education, inconsistent use, and limited shared understanding across professions hinder coherent educational approaches - particularly in dietetic education, where these strategies underpin the Nutrition Care Process (NCP). This article presents an initiative at a Swiss University of Applied Sciences to develop a conceptual pilot model bringing together these five cognitive strategies for Bachelor-level nutrition and dietetics education, aiming to clarify their relationships, support their use in teaching the NCP and contribute to reflection on a shared interprofessional language. Methods: A qualitative case study design with an iterative-inductive reflexive interpretive approach was used to explore shared and profession-specific understandings of central cognitive strategies within Bachelor-level nursing, midwifery, physiotherapy, and nutrition and dietetics education. Data were generated through a targeted narrative literature review, consultations with five expert educators across the four professions, and a feedback session with 16 members of the Nutrition and Dietetics Bachelor's educational team. These inputs informed the development of a conceptual pilot model. Results: The analysis revealed variation in how the five cognitive strategies are defined, emphasised, and applied across dietetics and other health professions. In response, the Five Cognitive Strategies in Dietetics Education Pilot Model offers an initial shared vocabulary and positions the strategies in relation to the NCP. Conclusions: This article introduces a conceptual pilot model addressing fragmented understandings of key cognitive strategies in Bachelor-level dietetic education. By linking five commonly cited strategies to the NCP, it offers a preliminary framework to support reflection, dialogue, and engagement with complexity in practice. While not intended as a comprehensive or definitive framework, making these strategies explicit may foster a more analytically grounded understanding of professional decision-making. Further piloting and refinement are needed to assess the model's relevance and educational value. (© 2026 The Author(s). Journal of Human Nutrition and Dietetics published by John Wiley & Sons Ltd on behalf of British Dietetic Association.) |
| References: | J Hum Nutr Diet. 2011 Jun;24(3):209-14. (PMID: 21091921) Br J Nurs. 2021 May 13;30(9):526-532. (PMID: 33983801) Nurs Clin North Am. 2020 Mar;55(1):29-37. (PMID: 32005363) J Eval Clin Pract. 2018 Jun;24(3):638-645. (PMID: 29237237) Acad Med. 2017 Jan;92(1):123-131. (PMID: 27049541) J Public Health Manag Pract. 2025 Jan-Feb 01;31(1):E20-E25. (PMID: 39110893) J Eval Clin Pract. 2011 Aug;17(4):621-7. (PMID: 20973873) J Eval Clin Pract. 2021 Oct;27(5):1175-1181. (PMID: 33592677) J Clin Nurs. 2023 Jul;32(13-14):3328-3340. (PMID: 35880251) PeerJ. 2024 Mar 6;12:e17042. (PMID: 38464754) J Med Educ Curric Dev. 2023 Oct 25;10:23821205231209093. (PMID: 37900617) Health Promot Int. 2024 Aug 1;39(4):. (PMID: 39136157) Aust Fam Physician. 2012 Jan-Feb;41(1-2):18-20. (PMID: 22276278) J Eval Clin Pract. 2021 Apr;27(2):438-450. (PMID: 32573080) J Acad Nutr Diet. 2017 Dec;117(12):2003-2014. (PMID: 28988837) J Gen Intern Med. 2020 Aug;35(8):2314-2320. (PMID: 32342481) Nurse Educ Today. 2024 Feb;133:106047. (PMID: 38039885) J Acad Nutr Diet. 2025 Jan;125(1):42-53. (PMID: 38964713) J Acad Nutr Diet. 2026 Jan;126(1):156195. (PMID: 40865636) J Hum Nutr Diet. 2021 Feb;34(1):124-133. (PMID: 33009683) Int J Environ Res Public Health. 2021 Oct 25;18(21):. (PMID: 34769721) Biomed Instrum Technol. 2014 Fall;Suppl:31-4, 36. (PMID: 25244335) Acad Med. 2020 Sep;95(9):1362-1372. (PMID: 32287080) Semin Nucl Med. 2010 Sep;40(5):319-26. (PMID: 20674590) Int J Qual Health Care. 2007 Dec;19(6):349-57. (PMID: 17872937) J Hum Nutr Diet. 2010 Dec;23(6):559-66. (PMID: 21029212) J Hum Nutr Diet. 2022 Apr;35(2):376-387. (PMID: 34997658) Int J Nurs Educ Scholarsh. 2018 Nov 7;15(1):. (PMID: 30403653) J Hum Nutr Diet. 2025 Apr;38(2):e70036. (PMID: 40065542) BMC Med Educ. 2020 Apr 7;20(1):107. (PMID: 32264895) Med Teach. 2021 Feb;43(2):152-159. (PMID: 33205693) Med Teach. 2023 Jul;45(7):701-707. (PMID: 37027517) J Eval Clin Pract. 2020 Aug;26(4):1114-1123. (PMID: 32069376) J Hum Nutr Diet. 2020 Oct;33(5):614-623. (PMID: 32281212) J Acad Nutr Diet. 2019 Feb;119(2):225-241. (PMID: 30553587) Nurs Forum. 2017 Oct;52(4):323-330. (PMID: 28000925) J Acad Nutr Diet. 2022 Jan;122(1):15-24. (PMID: 33715975) J Am Dent Assoc. 2018 Sep;149(9):745-747. (PMID: 30165967) |
| Contributed Indexing: | Keywords: Nutrition Care Process (NCP); clinical decision making; clinical judgement; clinical reasoning; cognitive strategies; critical thinking; dietetic education; systems thinking |
| Entry Date(s): | Date Created: 20260923 Date Completed: 20260923 Latest Revision: 20260925 |
| Update Code: | 20260925 |
| PubMed Central ID: | PMC13598357 |
| DOI: | 10.1111/jhn.70343 |
| PMID: | 42773604 |
| Βάση Δεδομένων: | MEDLINE |
| FullText | Text: Availability: 0 CustomLinks: – Url: https://resolver.ebsco.com/c/fiv2js/result?sid=EBSCO:cmedm&genre=article&issn=1365277X&ISBN=&volume=39&issue=5&date=20261001&spage=e70343&pages=e70343&title=Journal of human nutrition and dietetics : the official journal of the British Dietetic Association&atitle=Integrating%20Systems%20and%20Critical%20Thinking%2C%20Clinical%20Reasoning%2C%20Decision-Making%2C%20and%20Judgement%20in%20Dietetic%20Education%3A%20Development%20of%20a%20Conceptual%20Pilot%20Model.&aulast=Sch%C3%B6nberg%20S&id=DOI:10.1111/jhn.70343 Name: Full Text Finder (for New FTF UI) (ns324271) Category: fullText Text: Full Text Finder MouseOverText: Full Text Finder |
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| Items | – Name: Title Label: Title Group: Ti Data: Integrating Systems and Critical Thinking, Clinical Reasoning, Decision-Making, and Judgement in Dietetic Education: Development of a Conceptual Pilot Model. – Name: Author Label: Authors Group: Au Data: <searchLink fieldCode="AU" term="%22Schönberg+S%22">Schönberg S</searchLink>; Department of Health Professions, Bern University of Applied Sciences, Bern, Switzerland.<br /><searchLink fieldCode="AU" term="%22Bertozzi+E%22">Bertozzi E</searchLink>; Department of Health Professions, Bern University of Applied Sciences, Bern, Switzerland.<br /><searchLink fieldCode="AU" term="%22Stalder+J%22">Stalder J</searchLink>; Department of Health Professions, Bern University of Applied Sciences, Bern, Switzerland.<br /><searchLink fieldCode="AU" term="%22Bucher+A%22">Bucher A</searchLink>; Department of Health Professions, Bern University of Applied Sciences, Bern, Switzerland.<br /><searchLink fieldCode="AU" term="%22Haddad+J%22">Haddad J</searchLink>; Department of Health Professions, Bern University of Applied Sciences, Bern, Switzerland.<br /><searchLink fieldCode="AU" term="%22Rufener+A%22">Rufener A</searchLink>; Department of Health Professions, Bern University of Applied Sciences, Bern, Switzerland.<br /><searchLink fieldCode="AU" term="%22Jent+S%22">Jent S</searchLink>; Department of Health Professions, Bern University of Applied Sciences, Bern, Switzerland. – Name: TitleSource Label: Source Group: Src Data: <searchLink fieldCode="JN" term="%228904840%22">Journal of human nutrition and dietetics : the official journal of the British Dietetic Association</searchLink> [J Hum Nutr Diet] 2026 Oct; Vol. 39 (5), pp. e70343. – Name: TypePub Label: Publication Type Group: TypPub Data: Journal Article – Name: Language Label: Language Group: Lang Data: English – Name: TitleSource Label: Journal Info Group: Src Data: <i>Publisher: </i><searchLink fieldCode="PB" term="%22Wiley+on+behalf+of+The+British+Dietetic+Association+Ltd%2E%2C+[c1988-%22">Wiley on behalf of The British Dietetic Association Ltd., [c1988- </searchLink><i>Country of Publication: </i>England <i>NLM ID: </i>8904840 <i>Publication Model: </i>Print <i>Cited Medium: </i>Internet <i>ISSN: </i>1365-277X (Electronic) <i>Linking ISSN: </i><searchLink fieldCode="IS" term="%2209523871%22">09523871 </searchLink><i>NLM ISO Abbreviation: </i>J Hum Nutr Diet <i>Subsets: </i>MEDLINE – Name: PublisherInfo Label: Imprint Name(s) Group: PubInfo Data: <i>Original Publication</i>: [Oxford] : Wiley on behalf of The British Dietetic Association Ltd., [c1988- – Name: SubjectMESH Label: MeSH Terms Group: Su Data: <searchLink fieldCode="MM" term="%22Dietetics%22">Dietetics*</searchLink>/<searchLink fieldCode="MM" term="%22Dietetics+education%22">education</searchLink> <br /><searchLink fieldCode="MM" term="%22Clinical+Reasoning%22">Clinical Reasoning*</searchLink> <br /><searchLink fieldCode="MM" term="%22Clinical+Decision-Making%22">Clinical Decision-Making*</searchLink> <br /><searchLink fieldCode="MM" term="%22Models%2C+Educational%22">Models, Educational*</searchLink><br /><searchLink fieldCode="MH" term="%22Humans%22">Humans</searchLink> ; <searchLink fieldCode="MH" term="%22Pilot+Projects%22">Pilot Projects</searchLink> ; <searchLink fieldCode="MH" term="%22Thinking%22">Thinking</searchLink> ; <searchLink fieldCode="MH" term="%22Judgment%22">Judgment</searchLink> ; <searchLink fieldCode="MH" term="%22Switzerland%22">Switzerland</searchLink> ; <searchLink fieldCode="MH" term="%22Qualitative+Research%22">Qualitative Research</searchLink> ; <searchLink fieldCode="MH" term="%22Decision+Making%22">Decision Making</searchLink> – Name: Abstract Label: Abstract Group: Ab Data: Introduction: Dietetic practice is increasingly characterised by complexity arising from chronic disease, food and nutrition insecurity, demographic shifts, and environmental sustainability concerns. Addressing this complexity requires the effective and interprofessionally aligned use of central cognitive strategies. However, despite frequent reference to systems thinking, critical thinking, clinical reasoning, clinical decision-making, and clinical judgement in health professional education, inconsistent use, and limited shared understanding across professions hinder coherent educational approaches - particularly in dietetic education, where these strategies underpin the Nutrition Care Process (NCP). This article presents an initiative at a Swiss University of Applied Sciences to develop a conceptual pilot model bringing together these five cognitive strategies for Bachelor-level nutrition and dietetics education, aiming to clarify their relationships, support their use in teaching the NCP and contribute to reflection on a shared interprofessional language.<br />Methods: A qualitative case study design with an iterative-inductive reflexive interpretive approach was used to explore shared and profession-specific understandings of central cognitive strategies within Bachelor-level nursing, midwifery, physiotherapy, and nutrition and dietetics education. Data were generated through a targeted narrative literature review, consultations with five expert educators across the four professions, and a feedback session with 16 members of the Nutrition and Dietetics Bachelor's educational team. These inputs informed the development of a conceptual pilot model.<br />Results: The analysis revealed variation in how the five cognitive strategies are defined, emphasised, and applied across dietetics and other health professions. In response, the Five Cognitive Strategies in Dietetics Education Pilot Model offers an initial shared vocabulary and positions the strategies in relation to the NCP.<br />Conclusions: This article introduces a conceptual pilot model addressing fragmented understandings of key cognitive strategies in Bachelor-level dietetic education. By linking five commonly cited strategies to the NCP, it offers a preliminary framework to support reflection, dialogue, and engagement with complexity in practice. While not intended as a comprehensive or definitive framework, making these strategies explicit may foster a more analytically grounded understanding of professional decision-making. Further piloting and refinement are needed to assess the model's relevance and educational value.<br /> (© 2026 The Author(s). Journal of Human Nutrition and Dietetics published by John Wiley & Sons Ltd on behalf of British Dietetic Association.) – Name: Ref Label: References Group: RefInfo Data: J Hum Nutr Diet. 2011 Jun;24(3):209-14. (PMID: <searchLink fieldCode="PM" term="%2221091921%22">21091921)</searchLink><br />Br J Nurs. 2021 May 13;30(9):526-532. (PMID: <searchLink fieldCode="PM" term="%2233983801%22">33983801)</searchLink><br />Nurs Clin North Am. 2020 Mar;55(1):29-37. (PMID: <searchLink fieldCode="PM" term="%2232005363%22">32005363)</searchLink><br />J Eval Clin Pract. 2018 Jun;24(3):638-645. (PMID: <searchLink fieldCode="PM" term="%2229237237%22">29237237)</searchLink><br />Acad Med. 2017 Jan;92(1):123-131. (PMID: <searchLink fieldCode="PM" term="%2227049541%22">27049541)</searchLink><br />J Public Health Manag Pract. 2025 Jan-Feb 01;31(1):E20-E25. (PMID: <searchLink fieldCode="PM" term="%2239110893%22">39110893)</searchLink><br />J Eval Clin Pract. 2011 Aug;17(4):621-7. (PMID: <searchLink fieldCode="PM" term="%2220973873%22">20973873)</searchLink><br />J Eval Clin Pract. 2021 Oct;27(5):1175-1181. (PMID: <searchLink fieldCode="PM" term="%2233592677%22">33592677)</searchLink><br />J Clin Nurs. 2023 Jul;32(13-14):3328-3340. (PMID: <searchLink fieldCode="PM" term="%2235880251%22">35880251)</searchLink><br />PeerJ. 2024 Mar 6;12:e17042. (PMID: <searchLink fieldCode="PM" term="%2238464754%22">38464754)</searchLink><br />J Med Educ Curric Dev. 2023 Oct 25;10:23821205231209093. (PMID: <searchLink fieldCode="PM" term="%2237900617%22">37900617)</searchLink><br />Health Promot Int. 2024 Aug 1;39(4):. (PMID: <searchLink fieldCode="PM" term="%2239136157%22">39136157)</searchLink><br />Aust Fam Physician. 2012 Jan-Feb;41(1-2):18-20. (PMID: <searchLink fieldCode="PM" term="%2222276278%22">22276278)</searchLink><br />J Eval Clin Pract. 2021 Apr;27(2):438-450. (PMID: <searchLink fieldCode="PM" term="%2232573080%22">32573080)</searchLink><br />J Acad Nutr Diet. 2017 Dec;117(12):2003-2014. (PMID: <searchLink fieldCode="PM" term="%2228988837%22">28988837)</searchLink><br />J Gen Intern Med. 2020 Aug;35(8):2314-2320. (PMID: <searchLink fieldCode="PM" term="%2232342481%22">32342481)</searchLink><br />Nurse Educ Today. 2024 Feb;133:106047. (PMID: <searchLink fieldCode="PM" term="%2238039885%22">38039885)</searchLink><br />J Acad Nutr Diet. 2025 Jan;125(1):42-53. (PMID: <searchLink fieldCode="PM" term="%2238964713%22">38964713)</searchLink><br />J Acad Nutr Diet. 2026 Jan;126(1):156195. (PMID: <searchLink fieldCode="PM" term="%2240865636%22">40865636)</searchLink><br />J Hum Nutr Diet. 2021 Feb;34(1):124-133. (PMID: <searchLink fieldCode="PM" term="%2233009683%22">33009683)</searchLink><br />Int J Environ Res Public Health. 2021 Oct 25;18(21):. (PMID: <searchLink fieldCode="PM" term="%2234769721%22">34769721)</searchLink><br />Biomed Instrum Technol. 2014 Fall;Suppl:31-4, 36. (PMID: <searchLink fieldCode="PM" term="%2225244335%22">25244335)</searchLink><br />Acad Med. 2020 Sep;95(9):1362-1372. (PMID: <searchLink fieldCode="PM" term="%2232287080%22">32287080)</searchLink><br />Semin Nucl Med. 2010 Sep;40(5):319-26. (PMID: <searchLink fieldCode="PM" term="%2220674590%22">20674590)</searchLink><br />Int J Qual Health Care. 2007 Dec;19(6):349-57. (PMID: <searchLink fieldCode="PM" term="%2217872937%22">17872937)</searchLink><br />J Hum Nutr Diet. 2010 Dec;23(6):559-66. (PMID: <searchLink fieldCode="PM" term="%2221029212%22">21029212)</searchLink><br />J Hum Nutr Diet. 2022 Apr;35(2):376-387. (PMID: <searchLink fieldCode="PM" term="%2234997658%22">34997658)</searchLink><br />Int J Nurs Educ Scholarsh. 2018 Nov 7;15(1):. (PMID: <searchLink fieldCode="PM" term="%2230403653%22">30403653)</searchLink><br />J Hum Nutr Diet. 2025 Apr;38(2):e70036. (PMID: <searchLink fieldCode="PM" term="%2240065542%22">40065542)</searchLink><br />BMC Med Educ. 2020 Apr 7;20(1):107. (PMID: <searchLink fieldCode="PM" term="%2232264895%22">32264895)</searchLink><br />Med Teach. 2021 Feb;43(2):152-159. (PMID: <searchLink fieldCode="PM" term="%2233205693%22">33205693)</searchLink><br />Med Teach. 2023 Jul;45(7):701-707. (PMID: <searchLink fieldCode="PM" term="%2237027517%22">37027517)</searchLink><br />J Eval Clin Pract. 2020 Aug;26(4):1114-1123. (PMID: <searchLink fieldCode="PM" term="%2232069376%22">32069376)</searchLink><br />J Hum Nutr Diet. 2020 Oct;33(5):614-623. (PMID: <searchLink fieldCode="PM" term="%2232281212%22">32281212)</searchLink><br />J Acad Nutr Diet. 2019 Feb;119(2):225-241. (PMID: <searchLink fieldCode="PM" term="%2230553587%22">30553587)</searchLink><br />Nurs Forum. 2017 Oct;52(4):323-330. (PMID: <searchLink fieldCode="PM" term="%2228000925%22">28000925)</searchLink><br />J Acad Nutr Diet. 2022 Jan;122(1):15-24. (PMID: <searchLink fieldCode="PM" term="%2233715975%22">33715975)</searchLink><br />J Am Dent Assoc. 2018 Sep;149(9):745-747. (PMID: <searchLink fieldCode="PM" term="%2230165967%22">30165967)</searchLink> – Name: SubjectMinor Label: Contributed Indexing Group: Data: <i>Keywords: </i>Nutrition Care Process (NCP); clinical decision making; clinical judgement; clinical reasoning; cognitive strategies; critical thinking; dietetic education; systems thinking – Name: DateEntry Label: Entry Date(s) Group: Date Data: <i>Date Created: </i>20260923 <i>Date Completed: </i>20260923 <i>Latest Revision: </i>20260925 – Name: DateUpdate Label: Update Code Group: Date Data: 20260925 – Name: PubmedCentralID Label: PubMed Central ID Group: ID Data: PMC13598357 – Name: DOI Label: DOI Group: ID Data: 10.1111/jhn.70343 – Name: AN Label: PMID Group: ID Data: 42773604 |
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