A self-determination theory analysis of reflective debrief themes about dietetic student placement experiences in hospital: implications for education

Abstract

Background. Healthcare placements in dietetics education contribute significantly to student learning. Exploring students’ self-conceptualisation of placement experiences may provide insights to better support learning. Self-determination theory (SDT) has been used to seek insight into clinical and educational settings but has not yet been applied to dietetic placement learning. This study investigated dietetics students’ reflections of key influences on placement learning experiences and their alignment with an SDT framework.

Methodology. A post-placement two-stage critical incident debrief was conducted with seven successive cohorts (168 students) of dietetic undergraduate students on final placement. In debriefs, students’ anonymous themes were collected and discussed, inductively analysed, and then mapped against an SDT framework of psychological and motivational constructs.

Results. Nine key themes were identified that impacted upon placement experiences. Four themes related to framework constructs: 1. Supervisor (and peer) autonomy support: 2. Perceived competence; 3. Relatedness; and, 4. Autonomy and intrinsic motivation. Non-SDT themes were also present including: 5. Learning environment and experience; and, themes about professional behaviours and identity: 6. Teamwork and interactions, 7. Managing emotions and self-care, 8. Dietetic professional communications and behaviours and, 9. Developing a professional identity.

Conclusions. Embedding a structured debrief in the curriculum and using a psychological motivational SDT framework to analyse themes arising can provide valuable information about the learning needs of students on placement with potential for wider application in dietetic learning and teaching and workforce employability. The current findings may have application in university curricula before and after professional placement.