Exploring the current working profiles of nutritional therapists to inform curriculum and professional development

Transitioning to practice: a qualitative investigation of Australian graduate naturopath's experiences of being in practice

BACKGROUND

The transition from student to practitioner can be challenging, resulting in stress, burnout and attrition. While there has been ample research examining graduate medical and allied health practitioner experiences of transitioning to practice, there is a paucity of research exploring such experiences in newly qualified naturopathic medicine practitioners. In light of this knowledge gap, the objective of this study was to ascertain the experiences of practicing as a naturopath in Australia within the first 5 years post-graduation.

METHODS

Using a qualitative descriptive approach, recent graduates of an Australian Bachelor of Naturopathy (or equivalent) program were invited to participate in a semi-structured telephone interview to address the study objective. Data were analysed utilising a framework approach.

RESULTS

A total of 19 new graduates (94.7% female; 57.9% aged 40-59 years) undertook an interview. Five inter-related themes emerged from the data: practitioner, practice, proprietorship, professions, and perceptions. Connected with these themes were contrasting feelings, multiplicity of duties, small business challenges, professional collaboration, and professional identity, respectively.

CONCLUSIONS

Participants were generally content with their decision to become a naturopath. However, most were confronted by a range of challenges as they transitioned from graduate to practitioner, for which many felt ill-prepared. In light of the complexity of the issue, and the potential impact on the sustainability of the profession, it is evident that a multi-pronged, multi-stakeholder approach would be needed to better support graduate naturopath transition to practice.

Transforming personalized nutrition practice

The strengths and limitations of current approaches to clinical nutrition practice and their underpinning research are explored in this article. It describes how a personalized nutrition practice approach supported by evidence-based pathophysiological reasoning could direct additional research, which could then transform practice and support food industry developments. Current use of the term "personalized nutrition" is reviewed and a definition is provided. Also explored are current approaches to personalized nutrition practice and evidence-based practice in clinical nutrition. Patient-centered practice, which involves individuals in their healthcare decisions, is currently being provided under the name "personalized." An evidence-based personalized practice approach should include the use of robust, standardized, and validated tools that gather a patient's signs and symptoms, health history, family history, genetics, environment, lifestyle, social life, diet, behavior and other factors that have an impact on physiological processes. It should also gather anthropometric measures as well as functional, diagnostic, and prognostic biomarkers for pathophysiological mechanisms. Such tools would pool n = 1 data into a case-by-case evidence base that uses computational network modelling to predict the efficacy of personalized nutrition interventions. Prediction of the efficacy of interventions should also be validated using, when possible, blinded, randomized, controlled, stratified intervention studies. This model would provide practitioners with data that support evidence-based pathophysiological reasoning. It would enable clinicians to prioritize interventions on the basis of the mechanisms of action of interventions and to ameliorate the mechanisms of pathophysiology, which are a priority for the individual. Interventions then may be applied using a patient-centered practice approach. This would transform evidence-based nutrition practice into a P4 medicine approach that is personalized, preventive, predictive, and participatory. Developing pathophysiological mechanistic understanding also provides new opportunities for stakeholders, including the food industry, researchers, healthcare practitioners, and consumers.