Integrating Systems and Critical Thinking, Clinical Reasoning, Decision‐Making, and Judgement in Dietetic Education: Development of a Conceptual Pilot Model

ABSTRACT

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.

​Journal of Human Nutrition and Dietetics, Volume 39, Issue 5, October 2026. Read More