A Peer Reviewed Publication of the College of Allied Health & Nursing at Nova Southeastern University

Correspondence:

Terra L. Smith, PhD, RD
Department of Health and Sport Sciences
Elma Roane Fieldhouse Room 161B
The University of Memphis
Memphis, TN 38152-3490

tsmith3@memphis.edu

Citation:
Smith, T.. It's a question of scholarship. The Internet Journal of Allied Health Sciences and Practice. April 2005. Volume 3 Number 2.

"Scholarship is . . . a way of life. Advancement of the [dietetics] profession requires that every
 member has a personal commitment to scholarship."¹

Introduction
The Commission on Dietetic Registration (CDR) recently clarified its decision to discontinue continuing professional educational units (CPEU) for authoring manuscripts and conducting presentations by retroactively implementing a new CPEU category, Research (www.cdrnet.org). On June 1, 2001, the Commission on Dietetic Registration (CDR) announced that professional CPEUs for conducting presentations, both oral and poster, as well as authoring publications (i.e., manuscripts) are no longer available to registered dietitians (RDs). The comments section of the CDR publication "Continuing Professional Education Guidelines," concerning presentations and publications states that "Speakers [and Authors] may receive CPEUs for certain preparation activities within other CPEU categories, e.g., Professional Reading (limit 15 CPEUs/five-year cycle)."²    These changes articulated the perspective that much of the learning that takes place in connection with presentations and publications occurs when conducting research needed to prepare the materials, which typically involves reading articles from journals or conducting studies or research. 

The new category CPE, research, represents a significant shift in the nature of required activity documentation for while the only other CPE activity that requires the production of a written document is the sponsored independent learning contract, the research category requires the production of a technical report that is submitted to a funding agency or a peer reviewed abstract or manuscript. Thus, to reward the RD who successfully meets this new challenge, participation in research activities may award up to 60 CPEU per 5 year registration cycle.

In addition to research, a type of discovery scholarship, there are a number of other types of scholarship that are articulated for the dietetics profession by former American Dietetic Association (ADA) President Sara Parks and others.¹  These are the scholarships of synthesis,  application, and teaching. Though the CDR announcement provides generously for research scholarship, the profession lacks stated positions on these other types of scholarship; thus, possibly risking oversight. For example, this manuscript has components of multiple types of scholarship, especially application and synthesis, but under the new guidelines the author will be awarded 1-2 CPEs. Articles written focusing on the scholarships of teaching, application, and synthesis have similar outcomes.^3-6  Therefore, the goal of this article is to continue the dialogue on dietetics scholarship, in particular, and allied health scholarship, in general, that promotes "lifelong learning."⁷  A dialogue, eventually supported by un-biased scientific research on such topics as the nature of allied health scholarship, would provide the background needed to help gain the insights that can lead to reflections and judgments concerning best practices. This article includes a discussion of selected professional organizations and scholarship, learning and scholarship, academic and practitioner scholarship, and application of scholarship, while concluding with a summary of the major points.

Dietetics Scholarship
"Scholarship," as described by Parks and others is . .. ."the use of discipline inquiry and critical thought to create or acquire new knowledge.”¹  Dietitians' responses to the June 1, 2001 announcement indicate that RDs value scholarship. Their responses ranged from acceptance to disbelief, surprise, agitation, a feeling of unfair treatment, or admission that they do not request CPEUs for presentations or manuscripts. Others are concerned that this decision will discourage dietitians from submitting peer-reviewed manuscripts and presentations. One professional observed that seeking certification may be more highly valued than conducting discipline-based research, and another questioned why CPEUs for presentations and manuscripts were being eliminated rather than reduced. Some consider presentations and manuscripts as evidence of significant learning experiences. Even those attending a presentation or reading an article may believe that the speakers and writers have learned through the process of generating possible project ideas, considering project opportunities, determining methodologies and conducting a project, and organizing, clarifying, reflecting on, and articulating their findings. For graduate dietetic students who have enjoyed the professional appreciation for academic course work, the discipline's position on non-research scholarship may represent a lack of appreciation for some of the scholarly products that their academic work has prepared them to produce.
 

Professional Organizations and Scholarship
Though scholarship is valued by both allied health and family and consumer sciences professionals, other allied health professional organizations vary in the placement and comprehensive nature of scholarship statements. For example, the standards of clinical certification for speech pathology, audiology, and occupational therapy all include credit for scholarly works as a component of continuing education activities.^8-10  Concerning scholarship for physical therapies, a nationally applicable statement is located among the position papers for program accreditation adopted by the Commission on Accreditation in Physical Therapy Education [CAPTE].¹¹  Listed among the approved programs by CDR is the American Association of Family and Consumer Sciences’s (AAFCS) certification in family and consumer sciences (CFCS). Continuing certification for CFCS incorporates scholarly activities.¹²  In addition, the AAFCS participated in the national project “Institutional Priorities and Faculty Rewards” for disciplines to develop statements on faculty work and scholarship.¹³  In terms of ADA, the strategic plan includes the following statement concerning research: “Impact the research agenda and facilitate research supporting the dietetics profession.”¹⁴  In addition, the statement “Influence key food, nutrition and health initiatives” implies scholarly activities. Though student research educational activities are required for accreditation, these seem to be the primary references available among the mission and value statements and undergraduate program accreditation standards of ADA concerning professional scholarship.^{14, 15}

Learning and Scholarship
Allied health scholarship represents advanced learning and learning-in-action. Preparing non-research presentations and manuscripts for peer-review journals affords allied health professionals the opportunity to interact with scholarly professionals in a discipline-valued learning context. In the case of peer-reviewed abstracts, the learner receives, in many cases, a passive lesson, acceptance or rejection of the submission. However, in the case of manuscripts, the learner receives written comments from editors and reviewers. An invaluable educational resource for prospective authors, these targeted evaluations can emphasize the importance of justifying content, style, form, relevance of topic, methods, and literature view, etc. So, this begs the question stated by a co-presenter at a professional development seminar, 'When does the learning occur?'  It occurs in the process of generating and assimilating new ideas, constructing concepts, developing methodology and systems to collect data, digesting data into information, organizing information into knowledge, integrating knowledge into the practical applications documenting these experiences through presentations and manuscripts, and synthesizing the criticisms of peer-reviewers. The following section considers the nature of the scholarship-supporting activity, discipline-valued relationships.

As stated above, CPEUs include several activities integral to scholarship; however, some activities may limit the potential of professional relationships, discourage challenging cognitive activities, and circumvent the needs of adult learners. In an article entitled "The philosophy of nutrition therapy," the author, while placing aspects of Dewey's educational philosophy in a therapeutic setting, asserts that learning between a client and a registered dietitian (RD) is promoted through a reciprocal relationship but discouraged by an autocratic relationship.^17,18  "Education is . . .a rather mutual experience in which both persons in the relationship give and receive, act and undergo, teach and learn.”¹⁷  However, when two dietitians, a learner and a mentor, enter a sponsored independent learning activity to explore, for example, how to write a manuscript or grant application, only the "learner" can earn CPEUs.²  This can be interpreted as imposing an autocratic relationship with the assumption that the learning experiences are one-way. Thus, the profession may be overlooking an opportunity to engage two professionals in an educational activity that promotes partnerships, a discipline-valued relationship.¹⁹  In addition, constructing CPEU activities that model core values of the profession may help to transfer behaviors from learning activities to practice settings, thus promoting adult education practices.

Adult Education
Educational opportunities related to scholarship fall short of valuing learner experiences and encouraging the reflective process as articulated in adult education philosophy. Brookfield concludes that "Common to the contrasting and sometimes contradicting radical and humanistic impulses that one finds in the field, adult education's unique purpose is to help people understand and learn from their life experience.”²⁰  He goes on to explain that Eduard Linderman's (What is Adult Education, unpublished manuscript Butler Library Linderman Archive, Columbia University, 1925 as cited by Brookfield), considered the parent of adult education in the United States, definition for adult education is ". . . a cooperative venture in non-authoritarian, informal learning the chief purpose of which is to discover the meaning of experience; a quest of the mind which digs down to the roots of the preconceptions which formulate our conduct. . .begin[ning ] not with subject matter but with the situations and experiences which mold adult life." When CPEUs are granted only for the learner assimilating the experiences of the mentor, the learning experiences associated with being a mentor are devalued. Brookfield continues with "What turns [recognizing, honoring, and celebrating experience] into adult education is subjecting experience to a critical analysis.”²⁰ Preparing manuscripts and presentations support critical analysis and reflection on professional experiences, both important for the adult learning process as well as cognitive activities.

Review of Professional Writing as a Cognitive Activity
Evaluation based on Bloom's Taxonomy: The professional reading cited as a preparatory activity for scholarship stops short of encompassing hierarchical educational objectives. In the "Taxonomy of Educational Objectives," Bloom and others categorize comprehension and synthesis as the second and fifth hierarchical levels of the 6 educational objectives,  respectively.²¹ That is, earning CPEUs for comprehending 30 articles is a lower level cognitive function linked to the higher cognitive function of synthesizing 30 articles into a non-research manuscript or presentation. Comprehension is explained as ". . .when [professionals] are confronted with a communication, they are expected to know what is being communicated and to be able to make some use of the material or ideas contained in it.”²¹ On the other hand, synthesis is described as

. . .a process of working with elements, parts, etc., and combining them in such a way as to constitute a pattern or structure not clearly there before. Generally this would involve a recombination of parts of previous experience with new material, reconstructed into a new and more or less well-integrated whole. This is the category in the cognitive domain which most clearly provides for creative behavior on the part of the learner.²¹  

By promoting lower level cognitive functions while devaluing related higher level cognitive functions, the profession risks sending mixed messages about the intellectual sophistication needed to address current and future dietetics-related challenges.

Evaluation based on the cognitive theory of writing:  In addition, consider the nature of reading and writing. Adler and Van Doren have identified 4 levels of reading: elementary, inspection, analytical, and syntopical.²²  The skills required for syntopical reading (chapt. 20: selecting relevant passages; identifying terms of texts; clarifying questions and issues; and organizing the discussion) are closely related to the skills required for writing peer-reviewed manuscripts. Yet the nature of the cognitive process of writing a manuscript is considerably different from reading the same manuscript. Flower and Hayes's cognitive process theory of writing identifies audience and teaching considerations in terms of the rhetorical problem as a requirement for successful writing.²³  Though Adler and Van Doren suggest that communication of ideas to others is a by-product of syntopical reading, attention to audience is central to the task of preparing manuscripts of professional peer-reviewed journals. Thus, addressing the needs of the audience appears to be an opportunity for advanced learning in the form of professional service and teaching. Unlike reading, central to the cognitive process of writing is revising, a sub-process of reviewing.²³  Revising a manuscript is driven by the identification of problems and goal setting generated during the writing process, which writers must learn to become successful. Flower and Hayes identified another key difference between reading and writing, the process of translating "ideas into visible language."²³ Though Adler and Van Doren conclude that reading is supported by tasks such as summarizing and note taking, translating is central to the cognitive process of writing. Flowers and Hayes write that a "writer's task is to translate a meaning, which may be embodied in key words. . .and organized in a complex network of relationships into a linear piece of written English."²³  Thus, subcomponents of the rhetorical problem (audience and teaching), revising, and translating are key components of the cognitive writing process that are substantially different from the highest level of reading, the syntopical reading process, and must be learned in order to produce successful peer-reviewed manuscripts.

Academic and Practitioner Scholarship
Academic Scholarship
While learning activities seek to maintain or advance the knowledge-base of the individual RD, dietetics scholarship addresses additional questions. For the RD community, in general, and profession, specifically, college and university faculty create products that serve as the standards for scholarship. The following section discusses the paradigm shift in academic scholarship. For many years, academic scholarship has emphasized research; however, the works of the late E. L. Boyer, E. Rice and others expand the concept of academic scholarship to include four main types of scholarship: discovery, teaching, application/ profession service, and integration (synthesis).^24-26

Since Parks and others have outlined for the profession these 4 types of scholarship, the following is a brief description of each.¹  Simply stated in terms of a how these forms of scholarship interact with knowledge: discovery, which includes research, is the creation of knowledge; teaching is the dissemination of knowledge; application or professional service is the distribution of knowledge; and integration is the multidisciplinary approach to knowledge. Many works combine two or more types of scholarship. For example, Kiy's paper, cited previously, incorporates integrative and application scholarships.¹⁶  Educators acknowledge the shifting academic scholarship paradigm in institutional tenure and promotion guidelines, in professional journals and texts, and at conferences.^{27, 28}  Hopefully, the new scholarship paradigm encourages a fuller appreciation of dietetics scholarship in academic settings.

Practitioner Scholarship
Academic scholarship, though a good reference point, differs from practitioner scholarship. Schön, in his seminal work entitled, The Reflective Practitioner: How Professionals Think in Action, argues that "... the distinctive structure of reflection-in-action [of professionals] . . . is susceptible to a kind of rigor that is both like and unlike the rigor of scholarly research and controlled experiment.”²⁹  This quote indicates that practitioner scholarship is similar to academic scholarship yet with unique components. The latter point is highlighted by the following incident. During the summer of 2001, a group of RDs met with the faculty of a university to discuss the fate of the dietetic internship's thesis requirement. The program director wanted to know if the thesis component should be mandatory or optional. A majority of those present agreed that the master's thesis should be optional. This scene brings forth two questions: Do the practitioners favor advanced learning activities over scholarship?  Alternatively, do the practitioners value scholarship, but not necessarily academic scholarship? So, what are the activities of the dietetics-practitioner scholar?  Parks and others have provided a reference point from which to dialogue that notes the scholarships of : discovery (research), synthesis (integration), application (service), and teaching.¹ 

Criteria of Scholarship
For academicians, what demarcates best practices and scholarship is the willingness to produce based on scholarly criteria, according to Diamond, products that are “discipline-related; innovative; replicated or elaborated; documented; peer-reviewed; and impacts the community or discipline”; and according to Johnson and Wamser, "clarity and relevance of goals; mastery of existing knowledge; appropriate use of methodology and resources; effectiveness of communication; significance of results; and consistently ethical behavior."^{7, 30}  In order to encourage practitioner scholarship, a relevant set of criteria needs to be outlined. Encouraging scholarship among practitioners is vital because scholarly practitioners have opportunities to reach beyond current statements of best practices to help ensure that the dietetics profession is vibrant, relevant, responsive, and dynamic. In addition to delineating key components of practitioner scholarship, the profession needs to continue to articulate that these activities are discipline-valued, and to continue to value both academic scholarship and practitioner scholarship in meaningful ways.
 

Application of Scholarships
Scholarship has been a vital component of the American fabric for over a century. In addition to presenting a new paradigm for academic scholarship, in Scholarship Reconsidered, Boyer outlines the history of American scholarship. Diamond, Adams, and others took on the difficult task of engaging educational institutions and professional organizations in dialogues to promote a broader, discipline-valued definition of scholarship.¹³  The position paper for academic scholarship of CAPTE is clearly linked to this shifting paradigm, stating a value for all 4 of types of scholarship.¹¹  Now is the time for the American Dietetic Association's academicians and practitioners to develop statements on the value of scholarship and for each member to reflect on the scholarship agenda of the profession as outlined by former President Parks and others.

For some [dietitians],  this ["personal commitment to scholarship"] will take the form of scientific investigation. For others, scholarship might entail using the scientific approach to practice, formulating meaningful problems for quality improvement, developing new protocols or standards of care based on research findings, inserting scientific curiosity into daily practice, evaluating research findings for applicability in practice, regularly reading scientific literature in the field, giving presentations that draw on current research, or engaging in original research studies.¹

Research is needed to help the profession with the question of scholarship. Therefore, one of the first objectives of a dialogue on scholarship is determining which questions need to be studied in order to better understand the nature of dietetics scholarship. Possible questions should come from the community of dietitians participating in a dialogue in which each participant who desires to contribute articulates, in the words of former ADA President Parker and others, "a personal commitment to scholarship."¹

Summary of Major Points
The purpose of this article is to spark an interest among dietetic professionals in continuing the dialogue on dietetics scholarship initiated by former American Dietetic Association President Parks and others. Though in mid-2001, the CDR implemented new certification guidelines that eliminated CPEUs for conducting presentations and authoring publications, the CDR recently announced a retroactive category of CPE activity typed called "Research."  Research is included in as a component of discovery in the new scholarship paradigm that also includes the scholarships of teaching, application/service, and integration (synthesis). A broader definition of dietetics scholarship, including its application and assessment criteria, will be beneficial to the profession. Therefore, because the nature of scholarship is at the heart of the discipline, an unbiased scientific, data-driven approach to exploring the subject of dietetics scholarship is needed to inform the members of the profession.

References

1. Parks S, Schiller R, Bryk J. President's Page: Investment in our future--The role of science and scholarship in developing knowledge for dietetics practice. J Am Diet Assoc. 1994;94(10):1159-1161.

2. Commission on Dietetic Registration. Continuing Professional Education Guidelines: Registered Dietitians, Dietetic Technicians, Registered. Chicago, IL; American Dietetic Association; 2001: 25.

3. Smith TL. Research across the curriculum (RAC): Integration of research into 3 undergraduate foods courses. J Am Diet Assoc. 2001;101(12):1470-1472

4. Smith TL. The Application of RE-CIPE pedagogical values: A practitioner's reflective guide. In: BL Stewart, RS Purnell, RP Lovingood, eds. Research Applications in Family and Consumer Sciences. Alexandria ,VA: American Association of Family and Consumer Sciences. 2003:68-81.

5. Smith TL. The scholarship of service: Student project aids local food bank. Journal of Family and Consumer Sciences. 2002;94(3):60-62.

6. Smith TL, Janna JS. Reflections on scholarship of integration as a model for problem-based learning in undergraduate engineering education. International Journal of Engineering Education. 2003:19(5): 730-733.

7. Johnson RN, Wamser CC. Respecting diverse scholarly work: The key to advancing the multiple missions of the urban university. Metropolitan Universities. 1997;7(4), 43-59.

8. American Speech-Language-Hearing Association. New Audiology Standards: Standard VI Maintenance of certification (effective January 1, 2003). Available at: http://www.asha.org/about/membership-certification/certification/aud_standards_new.htm. Accessed March 4, 2004.

9. American Speech-Language-Hearing Association. Certification Maintenance Guidelines for Meeting the Requirements of Standard VII: Maintaining Certification in Speech-Language Pathology. Available at: http://www.asha.org/about/membership-certification/certification/ standard7-SLP-guide.htm. Accessed March 4, 2004.

10. NBCOT 2004 Certification Renewal Handbook.: Acceptable professional development activities, pp. 9-13. Available at: http://www.nbcot.org/WebArticles/articlefiles/66-2004_cert_renewal_handbook.pdf. Accessed March 4, 2004.

11. Commission on Accreditation in Physical Therapy Education. CAPTE Accreditation Handbook, pp. E4-E8.  Other Information, Position papers adopted by CAPE, Scholarly Activity Expectations of Physical Therapy Faculty. (October 1999; revised November 2000; February 2003). Available at: http://www.apta.org/pdfs/accreditation/AppendixE-POSITION-PAPERS- ADOPTED-BY- CAPTE.pdf Accessed March 4, 2004.

12. American Association of Family and Consumer Sciences. Office of Certification. Available at: http://www.aafcs.org/certification/pdu.html. Accessed March 4, 2004.

13. Diamond RM, Adam BE. The Disciplines Speak: Rewarding the Scholarly, Professional, and Creative Work of Faculty. Washington, DC: American Association for Higher Education; 1995.

14. American Dietetic Association. ADA Strategic Plan. Available at:
    http://www.eatright.org/Member/Governance/85_9457.cfm. Accessed March 4, 2004.

15. American Dietetic Association. Commission on Accreditation Dietetics Education 2002 Eligibility Requirements and Accreditation Standards, Approved December 2001, Released February 2002, Implementation March 1, 2003. http://www.eatright.org/Member/Files/2002_ERAS-Web.pdf. Accessed March 4, 2004.

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17. Kiy AM. The philosophy of nutrition therapy. Top Clin Nutr. 1998;13(2):51-62.

18. Dewey J. Moral Principles in Education. Riverside Educational Monographs, Suzzallo H, ed. Boston: Houghton Mifflin; 1975. In  Kiy AM. The philosophy of nutrition therapy. Top Clin Nutr. 1998;13(2):51-62.

19. Borra ST. President's Page: Effects of partnerships: 1 + 1 = much more than 2. J Am Diet Assoc. 2001;101(11):1304.

20. Brookfield SD. Becoming a Critically Reflective Teacher. San Francisco, CA: Jossey-Bass; 1995: 222-223.

21. Bloom BS, ed. Taxonomy of Educational Objectives: The Classification of Educational Goals: Handbook 1: Cognitive Domain. New York: David McKay; 1956: 89, 162,  

22. Adler M, Van Doren C. How to read a book. New York: MJF Books; 1972.

23. Flower L, Hayes JR. A cognitive process theory of writing. College Composition and Communication. 1981;32(4):365-387.

24. Boyer EL. Scholarship reconsidered: Priorities for the Professoriate. Princeton, N.J.: Carnegie Foundation for the Advancement of Teaching; 1990.

25. Rice RE. The new American scholar: Scholarship and the purposes of the university. Metropolitan Universities Journal. 1991;1(4):7-18.

26. Paulsen MB, Feldman KA. Toward a reconceptualization of scholarship: A human action system with functional imperatives. Journal of Higher Education. 1995;66(6):615-640.

27. Diamond RM. Serving on Promotion and Tenure Committees: A Faculty Guide. Bolton, MA: Anker Pub. Co.; 1994: 24-39.

28. Glassick CE, Huber MT, Maeroff GI. Scholarship Assessed: Evaluation of the Professoriate. San Francisco, CA: Jossey-Bass; 1997

29. Schön DA. The Reflective practitioner: How Professionals Think in Action. New York, NY: Basic Books;1983: ix.

30. Diamond RM. Changing priorities and the faculty reward system. New Directions in Higher Education. 1993;81:5-12.

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