Date of Award

Fall 10-2018

Document Type


Degree Name

Doctor of Education (EdD)



First Advisor

Dr. Rhonda Bishop

Second Advisor

Dr. Sherry DeVore

Third Advisor

Dr. Jo Branstetter-Hall


Dietitian nutritionists are challenged with processing information and making clinical decisions as part of the nutrition diagnostic process, hence it is important to understand how dietitian nutritionists think and make clinical judgments (Goodman et al., 2018; Trostler & Meyers, 2008). Two major processes underlie decision-making: experiential (intuitive) and rational (conscious) thinking (Croskerry et al., 2017). The reflection process is a metacognitive skill thought to influence thinking (Croskerry, 2017). This mixed methods study was designed to investigate the difference in thinking styles, selfreflection, and insight between graduates of a Dietetic Internship and a combined Master of Science/Dietetic Internship, as well as the relationship between thinking styles, selfreflection, and insight. The Rational-Experiential Inventory (REI-40) was used to examine thinking styles and the Self-Reflection and Insight Scale (SRIS) was used to examine self-reflection and insight. Participant perceptions regarding individual thinking styles and abilities to diagnose nutrition problems were investigated using two focus groups of participants with similar didactic and clinical practice experiences. There were no statistically significant differences in the mean REI-40 or SRIS scores between the groups. Because the study was underpowered, the relationship between the SRIS and REI-40 scores was unanswered (Polit, 2010). Three core themes emerged from the focus groups interviews: confidence, competence, and coaching. Information from this study adds to current knowledge on critical thinking and decision-making by dietitian nutritionists. The study is potentially important for developing dietetics and nutrition program curricula, as well as continuing education and clinical support tools for practitioners.


Copyright 2018