UBC Theses and Dissertations

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UBC Theses and Dissertations

A survey of the relationship of dietitians’ future intentions to participate and their past continuing… Zibrik, Deborah A. 1983

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A Survey of the R e l a t i o n s h i p of D i e t i t i a n s ' Future I n t e n t i o n s to P a r t i c i p a t e and T h e i r Past C o n t i n u i n g Education A c t i v i t y by Deborah A. Z i b r i k B.H.E., U n i v e r s i t y of B r i t i s h Columbia, 1974 A THESIS SUBMITTED IN PARTIAL FULFILMENT OF THE REQUIREMENTS FOR THE DEGREE OF MASTER OF ARTS i n THE FACULTY OF GRADUATE STUDIES (Department of A d m i n i s t r a t i v e , A d u l t and Higher Education) We accept t h i s t h e s i s as conforming to the r e q u i r e d standard THE UNIVERSITY OF BRITISH January 1983 © Deborah A. Z i b r i k , COLUMBIA 1983 In p r e s e n t i n g t h i s t h e s i s i n p a r t i a l f u l f i l m e n t o f the requirements f o r an advanced degree a t the U n i v e r s i t y of B r i t i s h Columbia, I agree t h a t the L i b r a r y s h a l l make i t f r e e l y a v a i l a b l e f o r r e f e r e n c e and study. I f u r t h e r agree t h a t p e r m i s s i o n f o r e x t e n s i v e copying o f t h i s t h e s i s f o r s c h o l a r l y purposes may be granted by the head o f my department or by h i s o r her r e p r e s e n t a t i v e s . I t i s understood t h a t copying or p u b l i c a t i o n o f t h i s t h e s i s f o r f i n a n c i a l gain s h a l l not be allowed without my w r i t t e n p e r m i s s i o n . Department o f Administrative, Adult and Higher Education The U n i v e r s i t y o f B r i t i s h Columbia 1956 Main Mall Vancouver, Canada V6T 1Y3 E-6 (3/81) i i A SURVEY OF THE RELATIONSHIP OF DIETITIANS'  FUTURE INTENTIONS TO PARTICIPATE  AND THEIR PAST CONTINUING EDUCATION ACTIVITY ABSTRACT The d i e t e t i c s p r o f e s s i o n has been among the l e a d e r s i n the p r o f e s s i o n s i n i t s commitment to the concept of l i f e - l o n g l e a r n i n g . T h i s r e s e a r c h was designed to i n v e s t i g a t e the i n t e n t i o n s of d i e t i t i a n s to p a r t i c i p a t e i n c o n t i n u i n g e d u c a t i o n . During the Spring of 1981 a q u e s t i o n n a i r e designed to i n v e s t i g a t e a t t i t u d e s and e x p e c t a t i o n s toward p a r t i c i p a t i o n i n c o n t i n u i n g education was mailed to a l l members of the B r i t i s h Columbia D i e t i t i a n s ' and N u t r i t i o n i s t s ' A s s o c i a t i o n (BCDNA). From the completed q u e s t i o n n a i r e s three determinants of i n t e n t i o n s to p a r t i c i p a t e ( i . e . a t t i t u d e s (Ag), s u b j e c t i v e s o c i a l normative (SSN) b e l i e f s , and s u b j e c t i v e p e r s o n a l normative (SPN.) b e l i e f s ) and t h e i r r e l a t i o n s h i p s to past p a r t i c i p a t i o n i n c o n t i n u i n g education were c h a r a c t e r i z e d . The s u b j e c t i v e s o c i a l normative (SSN) b e l i e f f a c t o r was the s i n g l e best i n d i c a t o r of past p a r t i c i p a t i o n i n c o n t i n u i n g e d u c a t i o n . E s s e n t i a l l y t h i s f i n d i n g suggests that a s t a t e d commitment to c o n t i n u i n g one's education was the s i n g l e best i n d i c a t o r of past p a r t i c i p a t i o n by t h i s group of h e a l t h p r o f e s s i o n a l s . When the two normative b e l i e f f a c t o r s and the a t t i t u d i n a l v a r i a b l e were combined with s e l e c t e d socioeconomic v a r i a b l e s i n r e g r e s s i o n with past p a r t i c i p a t i o n , a t o t a l of 7% of the v a r i a n c e i n past p a r t i c i p a t i o n c o u l d be accounted f o r . T h i s represented a d o u b l i n g of the amount of v a r i a t i o n i n past p a r t i c i p a t i o n accounted f o r when the ten socioeconomic v a r i a b l e s as a group, or the determinants of i n t e n t i o n s as a group were analyzed by m u l t i p l e r e g r e s s i o n . T h i s r e s e a r c h i n d i c a t e s that l e a d e r s of the p r o f e s s i o n a l a s s o c i a t i o n are i n f l u e n t i a l i n shaping the i n t e n t i o n s of d i e t i t i a n s to engage i n c o n t i n u i n g e d u c a t i o n . The m a j o r i t y of respondents valued the o p i n i o n s of others r e g a r d i n g p a r t i c i p a t i o n i n c o n t i n u i n g e d u c a t i o n . Very few of the socioeconomic c h a r a c t e r i s t i c s were r e l a t e d to past p a r t i c i p a t i o n , and the a t t i t u d i n a l and normative b e l i e f f a c t o r s o f f e r e d a g r e a t e r account f o r the v a r i a n c e i n past p a r t i c i p a t i o n than the socioeconomic v a r i a b l e s . These f i n d i n g s are of i n t e r e s t to r e s e a r c h e r s i n v e s t i g a t i n g p a r t i c i p a t i o n phenomena. i v TABLE OF CONTENTS ABSTRACT i i LIST OF TABLES v i i LIST OF FIGURES i x ACKNOWLEDGEMENT x CHAPTER I:INTRODUCTION 1 The Problem 2 Purposes 8 Hypotheses : 9 D e f i n i t i o n s And Assumptions 13 Design 16 O r g a n i z a t i o n Of The Study 18 CHAPTER I I : LITERATURE REVIEW 19 A t t i t u d e s 20 Development Of The I n t e n t i o n a l Model 23 A t t i t u d e s And I n t e n t i o n s 29 P a r t i c i p a t i o n And A t t i t u d e Research In Adult Education . 34 P a r t i c i p a t i o n And A t t i t u d e Research Among Health P r o f e s s i o n a l s 39 CHAPTER I I I : METHODOLOGY 46 P o p u l a t i o n 46 Data C o l l e c t i o n Instrument 53 Consequence Item Pool 54 E x p e c t a t i o n Scale 57 B e l i e f s About P a r t i c i p a t i o n In Continuing Education . 59 V . P a r t i c i p a t i o n — P a s t And Future 62 Demographic Information 63 P r e - t e s t Of The Instrument 64 Data C o l l e c t i o n 64 Data A n a l y s i s 65 C h a r a c t e r i s t i c s Of The Sample 65 T e s t i n g The Hypotheses 67 Summary 68 CHAPTER IV: RESULTS AND DISCUSSION 69 D e s c r i p t i o n Of Respondents 69 Education 71 Employment C h a r a c t e r i s t i c s 73 Job R e s p o n s i b i l i t y 76 Geographic Region And C o n t i n u i n g E d u c a t i o n 77 Membership In The P r o f e s s i o n a l A s s o c i a t i o n And C o n t i n u i n g Education 80 D i s c u s s i o n 84 B e l i e f s About P a r t i c i p a t i o n In Co n t i n u i n g Education .... 85 The Consequences Of P a r t i c i p a t i n g In C o n t i n u i n g Education 88 S u b j e c t i v e Normative B e l i e f s Regarding P a r t i c i p a t i o n ... 92 D i s c u s s i o n 94 I n t e n t i o n To P a r t i c i p a t e 97 M u l t i p l e Regression: Past P a r t i c i p a t i o n , I n t e n t i o n To P a r t i c i p a t e Score And Socioeconomic V a r i a b l e s ....100 P a r t i a l C o r r e l a t i o n 106 D i s c u s s i o n . . . 109 v i Summary 113 CHAPTER V: SUMMARY AND IMPLICATIONS 1-14 Summary 115 Methodology 1 1 5 . F i n d i n g s 117 L i m i t a t i o n s 122 I m p l i c a t i o n s 123 REFERENCES 127 APPENDIX A: Co n t i n u i n g Education G u i d e l i n e s 134 APPENDIX B: Correspondence 147 APPENDIX C: The Test Instrument . .. 153 v i i LIST OF TABLES 1: C l a s s i f i c a t i o n Of Concepts R e l a t e d To A t t i t u d e Research 27 2: Score Determination For The Consequence Scale 56 3: Score Determination For The E x p e c t a t i o n Scale 59 4: Score Determination For B e l i e f s About P a r t i c i p a t i o n .... 61 5: Summary Of Socioeconomic C h a r a c t e r i s t i c s Of Respondents ( I n t e r v a l Data) 70 6: D i s t r i b u t i o n Of Respondents By Age In Years 71 7: Education C h a r a c t e r i s t i c s Of Respondents 72 8: Employment C h a r a c t e r i s t i c s Of Respondents 74 9: D i s t r i b u t i o n Of Respondents By Percentage Of Time Devoted To V a r i o u s Job Duties 76 10: Response Rates And P a r t i c i p a t i o n Of D i e t i t i a n s In C o n t i n u i n g Education By Geographic Region 78 11: Most Recent And P r e f e r r e d Methods Of Study Used By D i e t i t i a n s To Obtain Continuing Education 79 12: S u b j e c t i v e Personal Normative B e l i e f s (SPN) Of D i e t i t i a n s Regarding Continuing Education 87 13: Statements Concerning The Consequences Of P a r t i c i p a t i n g In Order Of S a l i e n t C o n t r i b u t i o n To The A t t i t u d e Score (A &) 90 14: S o c i a l S u b j e c t i v e Normative (SSN) Scores Regarding The E x p e c t a t i o n s Of S i g n i f i c a n t Referents And The v i i i P a r t i c i p a t i o n Of D i e t i t i a n s In Co n t i n u i n g Education .... 93 15: D i s t r i b u t i o n Of Respondents By I n t e n t i o n Score 98 16: P a r t i t i o n i n g Of I n t e n t i o n Score With The Mean Values Of Various Socioeconomic V a r i a b l e s And Past P a r t i c i p a t i o n . 99 17: Summary For M u l t i p l e R e g r e s s i o n : Past P a r t i c i p a t i o n With A t t i t u d e (Ag), S u b j e c t i v e S p e c i a l Norm (SSN), And S u b j e c t i v e Personal Norm (SPN) 101 18: Summary Of M u l t i p l e R egression: Past P a r t i c i p a t i o n With S e l e c t e d Socioeconomic V a r i a b l e s 103 19: Summary Of M u l t i p l e R e g r e s s i o n : Past P a r t i c i p a t i o n With S e l e c t e d Socioeconomic V a r i a b l e s And The Determinants Of I n t e n t i o n s 105 20: C o r r e l a t i o n s Between Past P a r t i c i p a t i o n , Determinants Of I n t e n t i o n And Socioeconomic V a r i a b l e s 107 ix LIST OF FIGURES 1: Schematic P r e s e n t a t i o n Of Conceptual Framework For The P r e d i c t i o n Of S p e c i f i c I n t e n t i o n s And Behaviours 7 2: F i s h b e i n And Ajzen Conceptual Framework 15 3: Framework For Understanding The Formation Of I n t e n t i o n s 25 ACKNOWLEDGEMENT The support and d i r e c t i o n p r o v i d e d by the members of my t h e s i s committee served as the m o t i v a t i o n t o complete t h i s r e s e a r c h . I g r a t e f u l l y acknowledge the wisdom and encouragement of Dr. W. S. G r i f f i t h and Dr. N. E. Schwartz. In a d d i t i o n I extend thanks t o Dr. J . G. D i c k i n s o n f o r h i s i n i t i a l guidance i n g e t t i n g the study underway. I would l i k e a l s o to thank Joan Benedict, D i r e c t o r of Food S e r v i c e at the Vancouver General H o s p i t a l f o r a l l o w i n g me to review the q u e s t i o n n a i r e with the h e l p of the h o s p i t a l ' s d i e t e t i c i n t e r n s . Throughout the l a s t three years many of my f e l l o w students i n a d u l t education provided encouragement, advi c e and h e l p . To each of them I extend thanks and a p p r e c i a t i o n . T h i s r e s e a r c h would not have been p o s s i b l e without the q u e s t i o n n a i r e obtained from the U n i v e r s i t y of I l l i n o i s . I am indebted to Arden Grotelueschen f o r g r a n t i n g me permiss i o n t o use h i s q u e s t i o n n a i r e . To Mar D e l l P a r r i s h I owe s p e c i a l thanks f o r h i s energy i n the i n i t i a l word p r o c e s s i n g of these pages. F i n a l l y I would l i k e t o express my s i n c e r e thanks to Ray and K e l l y who s a c r i f i c e d so much f o r t h i s p r o j e c t completion. To Mary-Ann, Ruth and Li n d a , three very s p e c i a l f r i e n d s , thanks f o r your moral support and encouragement. 1 CHAPTER I INTRODUCTION Over the past few years vast gains i n re s e a r c h and development have been made in both the p u b l i c and the p r i v a t e s e c t o r s of s o c i e t y . As a r e s u l t of these changes, i t has been estimated that a c t i v e bodies of knowledge double every ten yea r s . According to Wendell (1974), knowledge has become an i n c r e a s i n g l y p e r i s h a b l e commodity due to the r a p i d i t y of t e c h n o l o g i c a l and s o c i a l change. Hesberg, M i l l e r and Wharton (1975), i n t h e i r book Pa t t e r n s f o r L i f e - L o n g L e a r n i n g , s t a t e t h a t : The changing nature of our s o c i e t y r e q u i r e s v i r t u a l l y a l l c i t i z e n s to gain new s k i l l s and i n t e l l e c t u a l o r i e n t a t i o n s throughout a l l t h e i r l i v e s . Formal education of youth and young a d u l t s , once thought of as the vac c i n e that would prevent ignorance i n l a t e r l i f e , i s now recognized as inadequate by i t s e l f to giv e people a l l the e d u c a t i o n a l guidance they w i l l need to l a s t a l i f e t i m e . (p. 3) The need f o r h e a l t h p r o f e s s i o n a l s to develop and renew t h e i r knowledge and s k i l l s has been f r e q u e n t l y c i t e d by educators and planners of higher education ( L a u f f e r , 1 9 7 7 ) . So too, p r a c t i s i n g p r o f e s s i o n a l s have requested l e a r n i n g experiences that w i l l h e l p them i n c o r p o r a t e t e c h n o l o g i c a l advances i n t o t h e i r p r o f e s s i o n a l r o l e s , thus safeguarding the 2 r i g h t of the general p u b l i c to r e c e i v e s e r v i c e s from competent p r o f e s s i o n a l s (Beamer, 1972). C o n t i n u i n g education has gained prominence as the p r i n c i p a l means f o r such knowledge d i s s e m i n a t i o n and has g e n e r a l l y been accepted as a necessary component of l i f e l o n g l e a r n i n g f o r h e a l t h p r o f e s s i o n a l s . Although i t i s g e n e r a l l y accepted t h a t c o n t i n u i n g education does not guarantee competency i n p r o f e s s i o n a l p r a c t i c e , Houle (1967) a p p r o p r i a t e l y noted t h a t : "while c o n t i n u i n g education w i l l not cure a l l the problems of the p r o f e s s i o n s , without i t no cure i s p o s s i b l e " (p. 17). The l a s t decade i n p a r t i c u l a r , has seen a r a p i d p r o l i f e r a t i o n of p u b l i c a t i o n s o u t l i n i n g program o b j e c t i v e s and g u i d e l i n e s f o r the development of c o n t i n u i n g education programs fo r a wide range of h e a l t h p r o f e s s i o n a l s (Barlow & Chesny,l977; Boissoneau,1977; Broski & Upp,l979; G r i f f i n , 1 9 6 7 ; Lemburger & McCormick,1976; Moxley,l969; Nakamoto,1972; Stensland,1977). The d i e t e t i c s p r o f e s s i o n has not been an exce p t i o n with res p e c t to implementing c o n t i n u i n g e d u c a t i o n , and i n some r e s p e c t s , has been among the le a d e r s of North American h e a l t h p r o f e s s i o n a l groups i n committing i t s e l f to the concept of l i f e l o n g l e a r n i n g as a means of a v o i d i n g p r o f e s s i o n a l obsolescence (American D i e t e t i c A s s o c i a t i o n {ADA}, 1969; B r i t i s h Columbia D i e t e t i c A s s o c i a t i o n {BCDA}, 1975; Canadian D i e t e t i c A s s o c i a t i o n {CDA}, 1974 & 1975). The Problem A review of the a v a i l a b l e l i t e r a t u r e from 1960 to 1981, re v e a l e d that l i t t l e r e s e a r c h has been conducted i n r e l a t i o n to 3 c o n t i n u i n g education f o r p r o f e s s i o n a l d i e t i t i a n s . What s t u d i e s are a v a i l a b l e are d e s c r i p t i v e - i n nature, f o c u s i n g on the extent of c o n t i n u i n g education and on the needs, i n t e r e s t s and o p i n i o n s of these p r o f e s s i o n a l s ( F r u i n & Bart,1978; H o l l i , l 9 8 l ; Vanderveen & Hubbard,1979; Wolczuk,1976). Although r e l i a b l e s t a t i s t i c s are l a c k i n g r e g a r d i n g the number of d i e t i t i a n s i n B. C. p a r t i c i p a t i n g i n c o n t i n u i n g education, Wolczuk's (1976) study i n d i c a t e d t h at d i e t i t i a n s appear i n t e r e s t e d i n c o n t i n u i n g t h e i r e d u c a t i o n . L i t t l e i s known, however, about what prompted t h e i r p a r t i c i p a t i o n or what form of p a r t i c i p a t i o n was most common among these p r o f e s s i o n a l s . No i n f o r m a t i o n i s a v a i l a b l e r e g a r d i n g why d i e t i t i a n s choose to p a r t i c i p a t e i n c o n t i n u i n g e d u c a t i o n . I n v e s t i g a t i n g the reasons f o r p a r t i c i p a t i o n i n c o n t i n u i n g education i s of p r a c t i c a l value s i n c e such i n f o r m a t i o n would be of great a s s i s t a n c e to educators and program p l a n n e r s . Such i n f o r m a t i o n i s e s s e n t i a l to the design and development of v a l i d c o n t i n u i n g education programs. Waste, i n p l a n n i n g and ex e c u t i n g programs which may not be attended by the p r o f e s s i o n a l s f o r whom they are intended c o u l d be avoided. The very b r i e f e s t survey of p u b l i s h e d s t u d i e s w i l l p r o v i d e evidence to s u b s t a n t i a t e the hi g h amount of r e s e a r c h i n t e r e s t t h a t has been generated with r e s p e c t to the a t t i t u d e of h e a l t h p r o f e s s i o n a l s and the r e l a t i o n s h i p of t h i s v a r i a b l e to p a r t i c i p a t i o n i n c o n t i n u i n g e d u c a t i o n . T r a d i t i o n a l r e s e a r c h methodology has been employed i n v i r t u a l l y "hundreds of i n v e s t i g a t i o n s of how much time groups of p r o f e s s i o n a l s spend i n c o n t i n u i n g education ... and ... how deeply they value the 4 experience ... " Houle, 1980, p. 125). P a r t i c i p a t i o n r e s e a r c h among h e a l t h p r o f e s s i o n a l s has concerned i t s e l f with i n v e s t i g a t i n g the reasons or causes of p a r t i c i p a t i o n and has been explored a c c o r d i n g to Houle (1980) along three b a s i c r e s e a r c h tangents. For example, P r i c e (1967) explo r e d p r a c t i t i o n e r inadequacy and the subsequent m o t i v a t i o n to engage i n c o n t i n u i n g education; Berg (1973) examined the p e r s o n a l t r a i t s of p a r t i c i p a n t and n o n - p a r t i c i p a n t nurses with r e s p e c t to c o n t i n u i n g education and B e v i s (1975) attempted to l i n k the value system of r e g i s t e r e d nurses with the reason why they p a r t i c i p a t e d in c o n t i n u i n g e d u c a t i o n . A l l of these and v i r t u a l l y every other p a r t i c i p a t i o n study i n v o l v i n g a wide range of h e a l t h p r o f e s s i o n a l s has been concerned about the a t t i t u d e s of the respondents with r e s p e c t to p a r t i c i p a t i o n . At best, the a t t i t u d e s measured were only s l i g h t l y c o r r e l a t e d with p a r t i c i p a t i o n and i n most cases, no r e l a t i o n s h i p between the a t t i t u d e s and subsequent p a r t i c i p a t i o n of h e a l t h p r o f e s s i o n a l s i n c o n t i n u i n g education c o u l d be demonstrated. In c o n t r a s t F i s h b e i n (1967) suggests t h a t a t t i t u d e s toward p a r t i c i p a t i o n shape a person's i n t e n t i o n to p a r t i c i p a t e . Thus, a t t i t u d e s can only be expected to i n d i r e c t l y i n f l u e n c e p a r t i c i p a t i o n . I n v e s t i g a t i o n of i n t e n t i o n to p a r t i c i p a t e i n c o n t i n u i n g education u s i n g the F i s h b e i n model o f f e r s both p r e d i c t i o n of f u t u r e behaviour and an understanding of the p a r t i c i p a t i o n behaviour being examined. According to the t h e o r e t i c a l model developed by F i s h b e i n (1967), i t was assumed t h a t the a c t u a l p a r t i c i p a t i o n behaviour 5 of i n d i v i d u a l s i s mediated by i n t e n t i o n to p a r t i c i p a t e , which c o u l d be p r e d i c t e d by measuring the a t t i t u d i n a l and normative aspects of t h i s v a r i a b l e . The purpose of t h i s study was to i n v e s t i g a t e , using the F i s h b e i n model, these u n d e r l y i n g determinants of d i e t i t i a n s ' i n t e n t i o n s to p a r t i c i p a t e i n c o n t i n u i n g education a c t i v i t i e s . The i d e a l way to i n v e s t i g a t e b e h a v i o u r a l i n t e n t i o n s would i n v o l v e a l o n g i t u d i n a l study whereby i n f o r m a t i o n on i n t e n t i o n to p a r t i c i p a t e would be c o l l e c t e d and then compared to subsequent p a r t i c i p a t i o n of the respondents. A lack of time and resources p r e c l u d e d t h i s approach. Thus, a d e c i s i o n was made to accept past p a r t i c i p a t i o n as a reasonable proxy of f u t u r e p a r t i c i p a t i o n . The author acknowledges that although past p a r t i c i p a t i o n has of t e n been c o n s i d e r e d by some a d u l t educators to be the best known approximation of f u t u r e p a r t i c i p a t i o n , no c o n c l u s i v e e m p i r i c a l evidence to support t h i s assumption has been r e p o r t e d . In s p i t e of t h i s s i n c e i n f o r m a t i o n r e g a r d i n g the past p a r t i c i p a t i o n of p r o f e s s i o n a l d i e t i t i a n s was co n s i d e r e d r e a d i l y a v a i l a b l e , a d e c i s i o n was made to i n v e s t i g a t e the r e l a t i o n s h i p between past p a r t i c i p a t i o n and i n t e n t i o n to p a r t i c i p a t e i n c o n t i n u i n g e d u c a t i o n . The F i s h b e i n model o f f e r e d a convenient, a l b e i t as yet untested, way to measure f u t u r e i n t e n t i o n s . Such resear c h was deemed to have p r a c t i c a l value s i n c e the procedure i n v o l v e s the a d m i n i s t r a t i o n of a paper and p e n c i l measure of the fu t u r e i n t e n t i o n s of p r o s p e c t i v e l e a r n e r s . Conceivably planners of e d u c a t i o n a l programs would be abl e to i d e n t i f y the f u t u r e i n t e n t i o n s of would-be p a r t i c i p a n t s p r i o r to the convening of 6 the course. Presumeably any m o d i f i c a t i o n s to the program or enticements to p r o s p e c t i v e l e a r n e r s c o u l d be put i n t o p l a c e to maximize p a r t i c i p a t i o n . I t was recognized at the time of t h i s study that the s i z e of the c o r r e l a t i o n between past p a r t i c i p a t i o n and i n t e n t i o n to p a r t i c i p a t e i n c o n t i n u i n g education would n e c e s s a r i l y have to be l a r g e and h i g h l y s i g n i f i c a n t i n order to have such p r a c t i c a l v a l u e . The f o l l o w i n g q u e s t i o n s were formed to guide t h i s i n v e s t i g a t i o n . What are the i n t e n t i o n s of d i e t i t i a n s toward c o n t i n u i n g education? Do t h e i r i n t e n t i o n s toward c o n t i n u i n g education i n f l u e n c e the extent of t h e i r f u t u r e c o n t i n u i n g education behaviour? Since past p a r t i c i p a t i o n i s the c l o s e s t known proxy to f u t u r e p a r t i c i p a t i o n that has yet been determined, can a r e l a t i o n s h i p between i n t e n t i o n to p a r t i c i p a t e i n c o n t i n u i n g education and the s e l f - r e p o r t of past p a r t i c i p a t i o n be demonstrated? A high c o r r e l a t i o n between i n t e n t i o n to p a r t i c i p a t e and past p a r t i c i p a t i o n would be i n d i c a t i v e of the u t i l i t y of the i n t e n t i o n a l model i n p r e d i c t i n g f u t u r e p a r t i c i p a t i o n behaviour p r o v i d i n g that the assumption s p e c i f y i n g past p a r t i c i p a t i o n as a good proxy of f u t u r e p a r t i c i p a t i o n i s a c c u r a t e . Since there i s a p e r s i s t e n t b e l i e f that p a r t i c i p a t i o n r a t e s can be changed by a l t e r i n g s i t u a t i o n a l v a r i a b l e s , then presumeably extended e f f o r t s may be d i r e c t e d toward those d i e t i t i a n s harbouring unfavourable i n t e n t i o n s to ensure v o l u n t a r y attendance at c o n t i n u i n g education programs. E f f e c t i v e c o n t i n u i n g education program plan n i n g c o u l d h e l p these p r o f e s s i o n a l s keep abreast of t e c h n o l o g i c a l change and h e l p them 7 demonstrate their c a p a b i l i t i e s to t h e i r peers, consumers of health service and employers, a l l of whom evaluate their job performance (Hart, 1974). No study was found which examined why professional d i e t i t i a n s v o l u n t a r i l y p a r t i c i p a t e in continuing education a c t i v i t i e s . The rationale for t h i s research i s based on the need to obtain an understanding of one aspect of why professional d i e t i t i a n s p a r t i c i p a t e in continuing education a c t i v i t i e s . The assumption made i s that each d i e t i t i a n ' s actual p a r t i c i p a t i o n in continuing education i s somehow influenced by a s p e c i f i c intention to p a r t i c i p a t e . According to Fishbein's (1967) theoreti c a l model the intention to p a r t i c i p a t e can be predicted by studying the a t t i t u d i n a l and normative be l i e f aspects of p a r t i c i p a t i o n behaviour (Figure 1). Beliefs about consequences of behavior X Normative beliefs about behavior X * I Influence Feedback Attitude toward behavior X Subjective _ norm concerning behavior X Intention to perform behavior X Behavior X Figure 1. Schematic presentation of conceptual framework for the prediction of s p e c i f i c intentions and behaviours. Although Fishbein's model has not been used to investigate 8 p a r t i c i p a t i o n i n e d u c a t i o n a l a c t i v i t i e s i t has been a p p l i e d to i n v e s t i g a t e a v a r i e t y of other behaviours with high c o r r e l a t i o n s between i n t e n t i o n s and the a c t u a l behaviour being r e p o r t e d . Grotelueschen and C a u l l e y (1977) presented F i s h b e i n ' s t h e o r e t i c a l model and advocated r e s e a r c h i n v e s t i g a t i n g the determinants of a p r o f e s s i o n a l ' s i n t e n t i o n to p a r t i c i p a t e i n c o n t i n u i n g e d u c a t i o n . Southern (1980) s t u d i e d the i n t e n t i o n s of educators to p a r t i c i p a t e i n graduate courses i n education and recommended that the F i s h b e i n model continue to be used i n f u t u r e r e s e a r c h as a p o t e n t i a l t o o l f o r i d e n t i f y i n g those v a r i a b l e s which are r e l a t e d to p a r t i c i p a t i o n behaviour. Purposes The g e n e r a l purpose of t h i s r e s e a r c h was to o b t a i n a fundamental understanding about the p a r t i c i p a t i o n of d i e t i t i a n s in c o n t i n u i n g e d u c a t i o n . Although s t a t i s t i c s r e g a r d i n g the p a r t i c i p a t i o n of p r o f e s s i o n a l s are not known the magnitude of h e a l t h p r o f e s s i o n a l p a r t i c i p a t i o n i n c o n t i n u i n g education p r o v i d e s p r a c t i c a l j u s t i f i c a t i o n f o r such an e n q u i r y . Grotelueschen and C a u l l e y (1977) estimated that n e a r l y 50 percent of a l l p r o f e s s i o n a l s p a r t i c i p a t e i n c o n t i n u i n g e d u c a t i o n . Johnstone and R i v e r a (1965) found that those employed i n p r o f e s s i o n a l and t e c h n i c a l occupations comprised n e a r l y 25 percent of a l l p a r t i c i p a n t s i n c o n t i n u i n g education a c t i v i t i e s . These f i n d i n g s support the need f o r r e s e a r c h that w i l l improve our understanding of the p a r t i c i p a t i o n phenomenon. Mechanisms f o r the p l a n n i n g and development of ongoing c o n t i n u i n g education a c t i v i t i e s f o r d i e t i t i a n s i n B r i t i s h 9 Columbia are w e l l e s t a b l i s h e d . T h i s study s p e c i f i c a l l y examines the f u t u r e i n t e n t i o n s of d i e t i t i a n s to p a r t i c i p a t e i n c o n t i n u i n g education as r e l a t e d to the s e l f - r e p o r t of past p a r t i c i p a t i o n behaviour. In a d d i t i o n , the study permits a broader understanding of the past p a r t i c i p a t i o n of these p r o f e s s i o n a l s and a d e s c r i p t i o n of the range of l e a r n i n g a c t i v i t i e s used by d i e t i t i a n s to continue t h e i r l e a r n i n g . As w e l l as p r o v i d i n g i n f o r m a t i o n about d i e t i t i a n s ' i n t e n t i o n s to p a r t i c i p a t e i n c o n t i n u i n g e d u c a t i o n , t h i s study was designed to o b t a i n i n f o r m a t i o n on the socioeconomic c h a r a c t e r i s t i c s of the respondents and whether these v a r i a b l e s are r e l a t e d to past p a r t i c i p a t i o n i n c o n t i n u i n g education or the i n t e n t i o n to p a r t i c i p a t e i n c o n t i n u i n g e d u c a t i o n . For the purposes of d e s c r i b i n g the c h a r a c t e r i s t i c s of d i e t i t i a n s i n B r i t i s h Columbia, e i g h t socioecomomic f a c t o r s were i d e n t i f i e d . These i n c l u d e d geographic l o c a t i o n of employment; age; l e v e l of formal education a t t a i n e d ; time s i n c e r e c e i p t of degree i n d i e t e t i c s ; type of employing i n s t i t u t i o n ; l e n g t h of time i n c u r r e n t p o s i t i o n ; number of years in d i e t e t i c s and type of p o s i t i o n c u r r e n t l y h e l d . Previous r e s e a r c h has suggested that, these v a r i a b l e s may be r e l a t e d to p a r t i c i p a t i o n i n c o n t i n u i n g education, and may even be used to p r e d i c t f u t u r e p a r t i c i p a t i o n . Hypotheses Based on p r e v i o u s l y s t a t e d purposes and on the d e s i r e to i d e n t i f y the r e l a t i v e c o n t r i b u t i o n of the a t t i t u d i n a l and normative determinants of i n t e n t i o n s toward understanding the past p a r t i c i p a t i o n of d i e t i t i a n s i n c o n t i n u i n g education 10 programs, the f o l l o w i n g hypotheses were proposed f o r t h i s study: 1. There w i l l be a s t a t i s t i c a l l y s i g n i f i c a n t c o r r e l a t i o n between i n t e n t i o n to p a r t i c i p a t e which F i s h b e i n approximates with a c t u a l p a r t i c i p a t i o n behaviour, and past p a r t i c i p a t i o n i n c o n t i n u i n g education a c t i v i t i e s as re p o r t e d by the respondent d i e t i t i a n s . Houle (1980) c i t i n g the work of Berg (1973) s t a t e d that among nurses past p a r t i c i p a t i o n appeared to be a good i n d i c a t o r of present p a r t i c i p a t i o n i n c o n t i n u i n g education ( i . e . the nurse most l i k e l y to be engaged i n l e a r n i n g i s l i k e l y the one who has a l r e a d y taken p a r t ) . I t i s g e n e r a l l y accepted that those i n d i v i d u a l s having e x h i b i t e d p a r t i c i p a t i v e behaviour i n the past are a l s o the most l i k e l y to repeat such behaviour i n the f u t u r e . T h e r e f o r e i t was p o s t u l a t e d that those d i e t i t i a n s r e p o r t i n g past p a r t i c i p a t i o n i n c o n t i n u i n g education are most l i k e l y to possess strong p o s i t i v e i n t e n t i o n s r egarding f u t u r e p a r t i c i p a t i o n . 2. S e l f r e p o r t of past p a r t i c i p a t i o n in c o n t i n u i n g education by d i e t i t i a n s w i l l not be s i g n i f i c a n t l y r e l a t e d to any of the s e l e c t e d demographic and socioeconomic c h a r a c t e r i s t i c s . Past r e s e a r c h i n d i c a t e s that c e r t a i n demographic and socioeconomic c h a r a c t e r i s t i c s may i n f l u e n c e p a r t i c i p a t i o n behaviour. In f a c t , many r e s e a r c h groups have attempted to i d e n t i f y those s i t u a t i o n a l f a c t o r s and pers o n a l c h a r a c t e r i s t i c s which d i s t i n g u i s h p a r t i c i p a n t s from non-p a r t i c i p a n t s (Berg, 1973; Curran, 1977; Deane, 1950; Gross, 11 1976; H o l l i , 1981; Johnstone and R i v e r a , 1965; Matthews & Schumacher, 1979; Puetz, 1980; Smornyski & Parochka, 1979). Acco r d i n g to the F i s h b e i n model i f s i t u a t i o n a l or i n d i v i d u a l d i f f e r e n c e v a r i a b l e s i n f l u e n c e p a r t i c i p a t i o n they w i l l i n f l u e n c e the determinants of i n t e n t i o n to p a r t i c i p a t e rather than d i r e c t l y i n f l u e n c i n g the p a r t i c i p a t i o n behaviour i n q u e s t i o n . Within the F i s h b e i n c o nceptual framework, i n t e n t i o n i s viewed as the immediate antecedent of p a r t i c i p a t i o n . Presumably i n t e n t i o n s may be changed by s i t u a t i o n a l v a r i a b l e s . However, such changes may or may not i n f l u e n c e the r e s u l t i n g behaviour depending upon the extent to which the a t t i t u d i n a l and normative b e l i e f f a c t o r s are a f f e c t e d . Since i t i s almost i m p o s s i b l e and i m p r a c t i c a l to measure the i n t e n t i o n s of d i e t i t i a n s to p a r t i c i p a t e immediately p r i o r to an act of p a r t i c i p a t i o n , i t i s reasonable to assume that the measure of i n t e n t i o n cannot account for any i n t e r v e n i n g events that may l e a d to changes i n i n t e n t i o n s before the b e h a v i o u r a l o b s e r v a t i o n . 3. While a p r o f e s s i o n a l d i e t i t i a n might intend to p a r t i c i p a t e in c o n t i n u i n g education a c t i v i t i e s c e r t a i n o b s t a c l e s or b a r r i e r s might a r i s e which prevent her from a c t u a l l y p a r t i c i p a t i n g . F i s h b e i n (1967) s t a t e s that such f a c t o r s or v a r i a t i o n s would a c t u a l l y i n f l u e n c e the determinants of i n t e n t i o n to p a r t i c i p a t e r a t h e r than p a r t i c i p a t i o n . For example, a d i e t i t i a n may h o l d a negative i n t e n t i o n with resp e c t to a t t e n d i n g a s p e c i f i c c o n t i n u i n g education event 12 but susequently l e a r n s that her employer, whom she holds i n h i g h regard, w i l l be i n attendance. Assuming t h a t the p r o f e s s i o n a l maintains that being seen at the event i s important, a p o s i t i v e i n t e n t i o n to a t t e n d the c o n t i n u i n g education a c t i v i t y i s l i k e l y to be formed. Based on t h i s r a t i o n a l e i t i s a n t i c i p a t e d that the i n t e n t i o n s of d i e t i t i a n s to p a r t i c i p a t e i n c o n t i n u i n g education w i l l be s i g n i f i c a n t l y r e l a t e d to a group of s e l e c t e d demographic and socioeconomic v a r i a b l e s . In other words, the i n t e n t i o n s of d i e t i t i a n s to p a r t i c i p a t e i n c o n t i n u i n g education may be i n f l u e n c e d by many v a r i a b l e s and p e r s o n a l f a c t o r s and the r e s u l t i n g i n t e n t i o n mediates susequent p a r t i c i p a t i o n behaviour. 4. The determinants of i n t e n t i o n to p a r t i c i p a t e ( i . e . a t t i t u d e (Ag, ), s u b j e c t i v e normative b e l i e f s (SSN) and s u b j e c t i v e p e r s o n a l normative b e l i e f s (SPN)) w i l l s i n g l y or in combination be more s i g n i f i c a n t l y r e l a t e d to the past p a r t i c i p a t i o n of d i e t i t i a n s i n c o n t i n u i n g education than w i l l any of the s e l e c t e d demographic and socioeconomic f a c t o r s . F i s h b e i n s t a t e s that " i t i s not very i l l u m i n a t i n g to d i s c o v e r that people u s u a l l y do what they in t e n d to do" (1975, p. 382). I t i s through examining the determinants of i n t e n t i o n s that understanding a person's behaviour may be accomplished. 13 D e f i n i t i o n s and Assumptions The term c o n t i n u i n g education has been d e f i n e d i n a v a r i e t y of ways among h e a l t h p r o f e s s i o n a l s . D e f i n i t i o n s range from being very broad, i n c l u d i n g a l l education f o l l o w i n g b a s i c p r o f e s s i o n a l p r e p a r a t i o n (Lemberger & McCormick, 1976; Randolph, 1963; S t e n s l a n d , 1977) to more r e s t r i c t i v e d e f i n i t i o n s f o c u s i n g on n o n - c r e d i t r e f r e s h e r courses f o r p r a c t i c i n g p r o f e s s i o n a l s (Dunlap, 1973; Hozid, 1969). C o n t i n u i n g education as used i n t h i s study was given a broad d e f i n i t i o n and i n c l u d e d a l l o r g a n i z e d and d i r e c t e d e d u c a t i o n a l a c t i v i t y beyond the attainment of the p r o f e s s i o n a l degree. The B r i t i s h Columbia D i e t i t i a n s ' and N u t r i t i o n i s t s ' A s s o c i a t i o n (BCDNA) Continuing Education G u i d e l i n e s (Appendix A) were assumed to be f a m i l i a r to a l l s u b j e c t s i n t h i s study. In a d d i t i o n to formal courses, any planned l e a r n i n g a c t i v i t y such as p a r t i c i p a t i n g i n a j o u r n a l c l u b or d i s c u s s i o n group, pursuing s p e c i a l i z e d i n d i v i d u a l study or l i s t e n i n g to a taped l e c t u r e q u a l i f i e d as c o n t i n u i n g e d u c a t i o n . The term a t t i t u d e was d e f i n e d as "a l e a r n e d p r e d i s p o s i t i o n to respond i n a c o n s i s t e n t l y f a v o u r a b l e manner with respect to a given o b j e c t " ( F i s h b e i n & Ajzen, 1975, p. 10). Learned p r e d i s p o s i t i o n was d e f i n e d as a general concept that d i d not p re dispose performance of any s p e c i f i c behaviour. In t h i s r e s e a r c h the object of concern was past p a r t i c i p a t i o n i n c o n t i n u i n g education. B e l i e f s represented the i n f o r m a t i o n that an i n d i v i d u a l has about an o b j e c t ; u s u a l l y b e l i e f s l i n k an o b j e c t to some 14 a t t r i b u t e or t r a i t , p r operty, q u a l i t y , c h a r a c t e r i s t i c , outcome or event. B e l i e f as used i n t h i s study was d e f i n e d as a measure of the s u b j e c t i v e p r o b a b i l i t y that an o b j e c t was r e l a t e d to an a t t r i b u t e ( F i s h b e i n & Ajzen, 1975, p. 12). For the purposes of t h i s r e s e a r c h , d i e t i t i a n s are presumed to have formed b e l i e f s about p a r t i c i p a t i o n i n c o n t i n u i n g e d u c a t i o n . C o n c u r r e n t l y d i e t i t i a n s w i l l have a c q u i r e d a t t i t u d e s toward p a r t i c i p a t i o n . Each b e l i e f l i n k s p a r t i c i p a t i o n to some consequences of p a r t i c i p a t i n g , with the a t t i t u d e dependent on the d i e t i t i a n ' s judgement of the value or worth of these consequences. The term b e h a v i o u r a l i n t e n t i o n r e f e r r e d to an i n d i v i d u a l ' s i n t e n t i o n to perform a s p e c i f i c behaviour. B e h a v i o r a l i n t e n t i o n s as used i n t h i s study was c o n s i d e r e d to be a measure of the p r o b a b i l i t y that the d i e t i t i a n s would engage i n p a r t i c i p a t i o n i n c o n t i n u i n g e d u c a t i o n . ( F i s h b e i n & Ajzen, 1975, p. 13). Behavior was d e f i n e d as those observable a c t s which c o u l d c o n c e i v a b l y be performed by an i n d i v i d u a l . Past p a r t i c i p a t i o n as r e p o r t e d by the respondents was d e f i n e d f o r the purposes of t h i s study as the observable act which was performed by the d i e t i t i a n s . The s p e c i f i c r e l a t i o n s h i p s between a t t i t u d e , b e l i e f s , b e h a v i o u r a l i n t e n t i o n s and behaviours as conceived by F i s h b e i n and Ajzen (1975, p. 15) are presented in F i g u r e 2. 15 B e l i e f s about ob j e c t X 1 . I n t e n t i o n s with respect to o b j e c t X 1 -Behaviors with res p e c t to o b j e c t X 1 . 2. 2. > 2 3. A t t i t u d e 3. > s 3. 4. toward A- f v 4. • o b j e c t X 7 > • • • • N. • • • N. • • • N. I I ' I I _ _ _ _ _ _ _ I I n f l u e n c e Feedback F i g u r e 2. F i s h b e i n and Ajzen Conceptual Framework The foundation of t h i s framework l i e s i n making a c l e a r d i s t i n c t i o n among the v a r i a b l e s , as w e l l as s p e c i f y i n g the r e l a t i o n s among them. From F i g u r e 2 i t i s apparent that an a t t i t u d e toward some o b j e c t i s determined by the i n d i v i d u a l ' s b e l i e f s that the o b j e c t has c e r t a i n a t t r i b u t e s as we l l as the i n d i v i d u a l ' s e v a l u a t i o n s of those a t t r i b u t e s . The r e l a t i o n s h i p s between b e l i e f s and a t t i t u d e s and a t t i t u d e s and i n t e n t i o n s are not s p e c i f i c , r a t h e r a t t i t u d e i s r e l a t e d to a set of i n t e n t i o n s j u s t as i t i s r e l a t e d to a set of b e l i e f s . Each i n t e n t i o n , however, i s viewed as being s p e c i f i c a l l y r e l a t e d to a behaviour. According t o the F i s h b e i n and Ajzen Conceptual Framework, a person's i n t e n t i o n s stem i n the f i n a l a n a l y s i s from b e l i e f s which i n f l u e n c e a t t i t u d e . " S p e c i f i c a l l y , h i s a t t i t u d e toward performing a given behaviour i s r e l a t e d to h i s b e l i e f s that performing the behaviour w i l l l e a d to c e r t a i n consequences and 16 h i s e v a l u a t i o n of those consequences" (1975, p. 16), as w e l l as h i s b e l i e f s about what s i g n i f i c a n t r e f e r e n t s t h i n k about the behaviour. For the purposes of t h i s r e s e a r c h consequence was d e f i n e d i n a broad sense and was "used to r e f e r to an a t t r i b u t e of a c o n t i n u i n g education experience or to something that can occur as a r e s u l t of the experience" (Grotelueschen & C a u l l e y , 1977 p. 27) . F i g u r e 1 (p. 7) p r e s e n t s b e h a v i o u r a l i n t e n t i o n s as a f u n c t i o n of two types of b e l i e f s . Normat ive b e l i e f s are those b e l i e f s that the i n d i v i d u a l p e r c e i v e s that c e r t a i n r e f e r e n t s have regarding whether he should or should not perform a p a r t i c u l a r behaviour. The s u b j e c t i v e s o c i a l norm (SSN) was d e f i n e d f o r t h i s study as a measure of an i n d i v i d u a l ' s normative b e l i e f s . A t t i t u d e , on the other hand rep r e s e n t s those b e l i e f s that behaviours l e a d to c e r t a i n consequences as w e l l as the i n d i v i d u a l ' s p e r s o n a l e v a l u a t i o n s of those consequences. In summary, the conceptual framework o u t l i n e d demonstrates that an i n d i v i d u a l ' s i n t e n t i o n to perform a given behaviour i s a f u n c t i o n of a t t i t u d e toward and s u b j e c t i v e norms concerning the behaviour. Design From n a t i o n a l (CDA) and p r o v i n c i a l (BCDNA) A s s o c i a t i o n m a i l i n g l i s t s , i t was approximated that there were about 400 d i e t i t i a n / n u t r i t i o n i s t s l o c a t e d i n nine regions of the p r o v i n c e . These r e g i o n s had been d e f i n e d by the BCDNA f o r the purpose of p r o v i d i n g f i n a n c i a l a s s i s t a n c e f o r r e g i o n a l p l a n n i n g committees wishing to implement c o n t i n u i n g education programs f o r area 17 membership. B r i t i s h Columbia's d i e t i t i a n s had been i n v o l v e d i n c o n t i n u i n g education s i n c e the e a r l y 1970's and programs f o r member d i e t i t i a n s of the BCDNA have been planned by the d i e t e t i c a s s o c i a t i o n on an ongoing b a s i s . With the implementation of r e g i o n a l program plan n i n g i t was hoped that a l l d i e t i t i a n s i n the p r o v i n c e would have had the op p o r t u n i t y to i n v o l v e themselves v o l u n t a r i l y with c o n t i n u i n g education a c t i v i t i e s over the l a s t few ye a r s . Since c o n t i n u i n g education programs were seemingly made a c c e s s i b l e to a l l , d i e t i t i a n s represented a good t a r g e t group f o r i n v e s t i g a t i n g past p a r t i c i p a t i o n i n c o n t i n u i n g e d u c a t i o n . In a d d i t i o n , a high r a t e of r e t u r n from a q u e s t i o n n a i r e survey was a n t i c i p a t e d due i n part to d i e t i t i a n s ' commitment t o c o n t i n u i n g education and a l s o due t o t h i s author's a c t i v e membership i n the a s s o c i a t i o n . In order to o b t a i n as l a r g e a p o p u l a t i o n as p o s s i b l e a l l d i e t i t i a n s whose m a i l i n g addresses were i n B.C. were i n c l u d e d in t h i s study. The p r o v i n c i a l membership l i s t was used to ob t a i n the most c u r r e n t m a i l i n g addresses. Seven d i e t i t i a n s were excluded from t h i s study by v i r t u e of t h e i r m a i l i n g addresses being o u t s i d e B. C. To maintain homogeneity of the po p u l a t i o n one male name was removed from the l i s t . Using an instrument developed by Grotelueschen (1977) the remaining 281 d i e t i t i a n s on the 1980 BCDNA m a i l i n g l i s t were surveyed to assess t h e i r i n t e n t i o n s with respect to f u t u r e p a r t i c i p a t i o n i n c o n t i n u i n g education. Necessary demographic and socioeconomic i n f o r m a t i o n was requested of respondents to f a c i l i t a t e 18 s t a t i s t i c a l a n a l y s e s . The data a n a l y s i s techniques i n c l u d e d Pearson product-moment c o r r e l a t i o n , t - t e s t , and d i r e c t and stepwise m u l t i p l e r e g r e s s i o n . O r g a n i z a t i o n of the Study Chapter II i n c l u d e s a review of the l i t e r a t u r e r e l a t e d to a t t i t u d e and p a r t i c i p a t i o n r e s e a r c h i n a d u l t and c o n t i n u i n g h e a l t h p r o f e s s i o n a l e d u c a t i o n . I t a l s o i n c l u d e s a review of the l i t e r a t u r e d e s c r i b i n g the socioeconomic c h a r a c t e r i s t i c s t r a d i t i o n a l l y thought to i n f l u e n c e p a r t i c i p a t i o n . A d e s c r i p t i o n of the methodology used f o r the development and implementation of t h i s study i s d e s c r i b e d i n Chapter I I I . Chapter IV r e p o r t s and i n t e r p r e t s the r e s u l t s of t h i s r e s e a r c h , and Chapter V c o n t a i n s the summary, c o n c l u s i o n s , i m p l i c a t i o n s and l i m i t a t i o n s of t h i s r e s e a r c h . 19 CHAPTER II LITERATURE REVIEW Only a few resea r c h s t u d i e s have been p u b l i s h e d that are r e l e v a n t to the present study, however an abundance of l i t e r a t u r e i s a v a i l a b l e which has i n v e s t i g a t e d the general concept of p a r t i c i p a t i o n and i t s r e l a t i o n s h i p to a number of v a r i a b l e s . Since the e a r l y 1960's, v a r i o u s r e s e a r c h e r s have attempted to d i s c o v e r why some a d u l t s engaged i n c o n t i n u i n g education whereas others d i d not. Over the yea r s , p a r t i c i p a t i o n r e s e a r c h has l a r g e l y been d e s c r i p t i v e i n nature, although the p e r s p e c t i v e has broadened tremendously. The act of p a r t i c i p a t i o n has been s c r u t i n i z e d as i n v e s t i g a t o r s have p r o f i l e d p a r t i c i p a n t s and n o n - p a r t i c i p a n t s and have sought to d e f i n e the extent of p a r t i c i p a t i o n among v a r i o u s p o p u l a t i o n s . V a r i o u s f a c t o r s have been i d e n t i f i e d which are f e l t to i n f l u e n c e p a r t i c i p a t i v e behaviour i n e d u c a t i o n a l a c t i v i t i e s . Among them, a t t i t u d e has emerged as a major v a r i a b l e which has remained the focus of r e s e a r c h f o r many y e a r s . Such r e s e a r c h has been based on the suggestion that a measure of a person's a t t i t u d e , be i t favourable or unfavourable, d i r e c t l y mediates h i s d e c i s i o n to p a r t i c i p a t e i n e d u c a t i o n a l programs and that such a measure can consequently be used to p r e d i c t f u t u r e p a r t i c i p a t i o n . T h i s review of the l i t e r a t u r e w i l l b r i e f l y d e s c r i b e t r a d i t i o n a l a t t i t u d e r e s e a r c h as i t has been used to p r e d i c t p a r t i c i p a t i o n i n e d u c a t i o n a l a c t i v i t i e s and w i l l summarize the developments i n a t t i t u d e theory research that l e d to the 20 f o r m u l a t i o n of the F i s h b e i n d e f i n i t i o n f o r a t t i t u d e . Since standard a t t i t u d e measurement techniques had f a i l e d to account f o r s i g n i f i c a n t v a r i a n c e i n p a r t i c i p a t i o n behaviour, F i s h b e i n (1967) developed a new t h e o r e t i c a l n o t i o n which c h a l l e n g e d acceptance of the contemporary d e f i n i t i o n s of a t t i t u d e . A review of the p u b l i s h e d l i t e r a t u r e demonstrates the a p p r o p r i a t e n e s s of F i s h b e i n ' s i n t e n t i o n a l model to i n v e s t i g a t e the a t t i t u d e s of p r o f e s s i o n a l d i e t i t i a n s toward p a r t i c i p a t i o n i n c o n t i n u i n g e d u c a t i o n . S p e c i f i c a l l y , t h i s review w i l l d e s c r i b e why the i n t e n t i o n a l model should be used r a t h e r than t r a d i t i o n a l a t t i t i t u d e or p a r t i c i p a t i o n r e s e a r c h methodology to study the u n d e r l y i n g determinants of a group of h e a l t h p r o f e s s i o n a l s ' i n t e n t i o n s to p a r t i c i p a t e i n c o n t i n u i n g education a c t i v i t i e s . To date, the i n t e n t i o n a l model has not been used to study the p a r t i c i p a t i o n of any h e a l t h p r o f e s s i o n a l s i n c o n t i n u i n g e ducation, however the a t t i t u d e of h e a l t h p r o f e s s i o n a l s as r e l a t e d to p a r t i c i p a t i o n has been thoroughly i n v e s t i g a t e d u s i n g t r a d i t i o n a l a t t i t u d e measurement techniques. The r e s u l t s of such i n v e s t i g a t i o n s have done l i t t l e to improve our understanding of why some p r o f e s s i o n a l s pursue higher and continued l e a r n i n g whereas others do not. A t t i t u d e s The concept of a t t i t u d e i s probably the most u b i q u i t o u s concept i n the l i t e r a t u r e of s o c i a l psychology and a wide range of techniques has been developed to measure i t (Green, 1954; Gutman, 1950; L i k e r t 1932; Osgood, Suci & Tannanbaum, 1957; 21 Thurstone, 1928). The t h r u s t of most measuring instruments has s t r e s s e d the s e l f - r e p o r t aspect of a t t i t u d e , l a r g e l y because a q u e s t i o n n a i r e survey i s both easy to conduct and economical. A c c o r d i n g l y r e s e a r c h has not made o b s e r v a t i o n s of overt behaviour but rather has been focused on paper and p e n c i l i n v e s t i g a t i o n s of a t t i t u d e s toward a given behaviour with i n f e r e n c e s made from the a t t i t u d e measure re g a r d i n g f u t u r e behaviour. I t has g e n e r a l l y been assumed that a t t i t u d e s are i n f a c t a measure of overt behaviour and scores of d i l i g e n t r e s e a r c h e r s have over the years concluded that t h e i r a t t i t u d e measures are i n f a c t a measure of the a n t i c i p a t o r y behaviour p a t t e r n s of the respondents. More than f o r t y years ago Gordon A l l p o r t p o i n t e d out that "no other term appears more f r e q u e n t l y {than a t t i t u d e } i n experimental and t h e o r e t i c a l l i t e r a t u r e " (1935, p. 799). The term has not been the p r o p e r t y of any one d i s c i p l i n e with the r e s u l t that i t has come to mean many d i f f e r e n t t h i n g s to many w r i t e r s and i s now a concept whose g e n e r a l meaning has become vague and i n d e f i n i t e . A l l p o r t (1935) reviewed the general areas of a t t i t u d e theory and r e s e a r c h and, a f t e r c o n s i d e r i n g more than one hundred d i f f e r e n t d e f i n i t i o n s , concluded that a t t i t u d e should be viewed as a s t a t e of r e a d i n e s s f o r p h y s i c a l and mental a c t i v i t y . A l l p o r t argued that one's a t t i t u d e should be regarded as a r e l a t i v e l y simple, b i p o l a r , u n i d i m e n s i o n a l concept and i t was apparent that most r e s e a r c h e r s agreed with t h i s d e f i n i t i o n . Many years a f t e r A l l p o r t ' s r e p o r t , F i s h b e i n (1967, p. 477) r e p o r t e d t h a t most i n v e s t i g a t o r s d e f i n e d a t t i t u d e s as s o c i o g e n i c 22 and l e a r n e d p r e d i s p o s i t i o n s to respond to an o b j e c t or c l a s s of o b j e c t s i n a c o n s i s t e n t l y f a v o u r a b l e or unfavourable way. The most s i g n i f i c a n t f i n d i n g of a t t i t u d e r e s e a r c h was, a c c o r d i n g to A l l p o r t , the f a i l u r e of more than t w e n t y - f i v e years of study to pro v i d e c o n s i s t e n t evidence to support the hypo t h e s i s that knowledge of one's a t t i t u d e c o u l d allow p r e d i c t i o n of f u t u r e behaviour. In the meantime the d e f i n i t i o n of a t t i t u d e has changed from a simple u n i d i m e n s i o n a l statement i n t o a m u l t i d i m e n s i o n a l concept c o n s i s t i n g of a f f e c t i v e , c o g n i t i v e and c o n a t i v e aspects (Campbell, 1963; DeFleur & Westie, 1963). The d i f f i c u l t y i n o b t a i n i n g a d i r e c t o p e r a t i o n a l d e f i n i t i o n f o r a t t i t u d e i n terms of observable b e h a v i o u r a l response l e d some t h e o r i s t s to r e f u t e the assumption that there was a d i r e c t correspondence between measures of a t t i t u d e and behaviour. For example, Doob (1947), proposed that a d i s t i n c t i o n be made between the p e r c e p t u a l and b e h a v i o u r a l aspects of a t t i t u d e . Although Doob made no attempt to separate the two concepts i n an o p e r a t i o n a l d e f i n i t i o n , he d i d propose that c e r t a i n s o c i a l f a c t o r s i n t e r a c t e d with b e h a v i o u r a l components to i n f l u e n c e behaviour. For example, Doob w r i t e s that "the i n d i v i d u a l ... may not express h i s a t t i t u d e i n overt behaviour because i t s exp r e s s i o n would be c o n t r a r y to h i s general p h i l o s o p h y ; but h i s a t t i t u d e p e r s i s t s " ( F i s h b e i n , 1967, p.53). U n f o r t u n a t e l y Doob's suggestion that there was not always a one-to-one r e l a t i o n s h i p between a t t i t u d e and behaviour simply focused the a t t e n t i o n of re s e a r c h e r s on the d e f i n i t i o n of a t t i t u d e , r a t h e r than 23 s t i m u l a t i n g a much needed i n v e s t i g a t i o n of the r e l a t i o n s h i p between the two v a r i a b l e s . For example, Chein (1948) p o i n t e d out that Doob's o b s e r v a t i o n s merely p r o v i d e d a d d i t i o n a l support f o r a multi-component d e f i n i t i o n of a t t i t u d e — a d e f i n i t i o n which p e r s i s t s i n most s o c i a l - p s y c h o l o g i c a l l i t e r a t u r e today. Chein was unabashedly c r i t i c a l of anyone who chose t o c r i t i c i z e the concept of a t t i t u d e , s t a t i n g that "to abandon a word because i t i s not p r e c i s e l y d e f i n e d i s to gi v e up the s c i e n t i f i c quest before i t has begun" ( F i s h b e i n , 1967, p. 51). McGuire (1969) reviewed e m p i r i c a l r e s e a r c h p e r t a i n i n g to A l l p o r t ' s (1935) d e f i n i t i o n and concluded that the wide v a r i e t y of i n d i c e s used has r e s u l t e d i n d i f f e r e n t d e f i n i t i o n s used by many d i f f e r e n t t h e o r i s t s with no s i n g l e index a t t a i n i n g s t a t u s as "the" measure of a t t i t u d e s . Development of the I n t e n t i o n a l Model In 1967 F i s h b e i n reviewed the e x i s t i n g l i t e r a t u r e on a t t i t u d e s and concluded that two reasons were o f t e n c i t e d as p o s s i b l e e x p l a n a t i o n s f o r the f a i l u r e of a t t i t u d e measures to p r e d i c t behaviour. "We have tended to blame our f a i l u r e s on our measuring instruments, on our d e f i n i t i o n of a t t i t u d e , or on both" (p. 447). Consequently F i s h b e i n , - b u i l d i n g on the work of Thurstone (1931) and Dulany (1961; 1968) proposed that a t t i t u d e s continue to be viewed as a unidimensional concept but that b e l i e f s and b e h a v i o u r a l i n t e n t i o n s be d e f i n e d independently. For the most p a r t , measures of b e l i e f s , a t t i t u d e s and i n t e n t i o n s had been used i n the l i t e r a t u r e i n t e r c h a n g e a b l y , based on the 24 assumption that a l l of the measures were i n d i c a t i v e of one's a t t i t u d e toward a given o b j e c t . F i s h b e i n ' s theory proposed that b e l i e f s were determinants of a t t i t u d e s , and b e h a v i o u r a l i n t e n t i o n s the consequents of an i n d i v i d u a l ' s a t t i t u d e . Using t h i s approach, he proposed t h a t the general concept a t t i t u d e c o u l d be measured by c o n s i d e r i n g e i t h e r b e l i e f s or b e h a v i o u r a l i n t e n t i o n s . A t t i t u d e was viewed as a general d i s p o s i t i o n t h a t does not predispose one to perform any s p e c i f i c behaviour, but does l e a d to a set of i n t e n t i o n s , each of which i s r e l a t e d to a s p e c i f i c behaviour. F i s h b e i n adapted Dulany's theory of p r o p o s i t i o n a l c o n t r o l (1961; 1968) to develop the c o n s t r u c t that knowledge of b e h a v i o u r a l i n t e n t c o u l d l e a d to the p r e d i c t i o n of subsequent behaviour. A c c o r d i n g to Dulany, i f one c o n s i d e r e d any very s p e c i f i c behaviour the immediate and measureable antecedent was b e h a v i o u r a l i n t e n t i o n . A c c o r d i n g l y , Dulany demonstrated near p e r f e c t c o r r e l a t i o n s i n p r e d i c t i n g the p r o b a b i l i t y with which an i n d i v i d u a l would make a p a r t i c u l a r v e r b a l response when presented with a stimulus under a s p e c i f i e d s i t u a t i o n . The c o r r e l a t i o n s between the measure of the b e h a v i o u r a l i n t e n t i o n and the overt behaviour were always > 0.90. T h i s theory o f f e r e d explanatory power only i n c o n s i d e r i n g s p e c i f i c behaviours and i n t e n t i o n s ( i . e . the more g e n e r a l i z e d the i n t e n t i o n , the lower would be i t s c o r r e l a t i o n with a s p e c i f i e d b e h a v i o u r ) . The c o n c l u s i o n stemming from Dulany's work i s that i f one can p r e d i c t a s p e c i f i e d b e h a v i o u r a l s i t u a t i o n , "one may, with only s l i g h t l y a t t e n u a t e d accuracy, p r e d i c t the overt behaviour" 25 ( F i s h b e i n , 1967, p.488). F i s h b e i n broadened Dulany's theory to suggest that i t would be u s e f u l i n p r e d i c t i n g a v a r i e t y of s o c i a l behaviours as shown in F i g u r e 3 ( F i s h b e i n and Ajzen, 1975, p.33). STIMULUS CONDITIONS Experimental s i t u a t i o n C h a r a c t e r i s t i c of t a r g e t person B e h a v i o r a l v a r i a t i o n s S i t u a t i o n a l v a r i a t i o n s V a r i a t i o n s i n time I n d i v i d u a l d i f f e r e n c e s C h a r a c t e r i s t i c s of r e f e r e n t s B e l i e f s About Consequences E v a l u a t i o n of Consequences Information Base: Normative B e l i e f s M o t i v a t i o n to Comply Information Base: £ b- m-INTENTION F i g u r e 3. Framework f o r understanding the formation of i n t e n t i o n s . From t h i s f i g u r e , i t can be seen that an i n d i v i d u a l ' s i n t e n t i o n to perform a s p e c i f i c act with respect to a given stimulus o b j e c t , i n a s p e c i f i e d s i t u a t i o n i s a f u n c t i o n o f : (a) the b e l i e f that the performance of a behaviour w i l l l e a d to some 26 s p e c i f i e d consequence, (b) an e v a l u a t i o n of the consequences of behaviour, (c) b e l i e f s about what the i n d i v i d u a l f e e l s he should do ( i . e . normative b e l i e f ) and (d) the m o t i v a t i o n or d e s i r e to comply with the normative b e l i e f , ( i . e . to do what he t h i n k s he should do. -. F i s h b e i n (1967) and l a t e r F i s h b e i n and Ajzen (1975) suggested a theory of b e h a v i o u r a l p r e d i c t i o n t h a t i d e n t i f i e d the primary determinant of behaviour to be i n t e n t i o n . According to t h i s theory d i s t i n c t i o n s had to be made among b e l i e f s , a t t i t u d e s and b e h a v i o u r a l i n t e n t i o n s . A c l a s s i f i c a t i o n as i n d i c a t e d i n Table 1, c o n s i s t i n g of four broad c a t e g o r i e s , was suggested by F i s h b e i n and Ajzen (1975, p.12). 27 Table 1 C l a s s i f i c a t i o n of Concepts Re l a t e d to A t t i t u d e Research CATEGORIES CONCEPTS a f f e c t f e e l i n g s , e v a l u a t i o n s , a t t i t u d e , a t t r a c t i o n , v a l u e , sentiment, valence c o g n i t i o n b e l i e f s , o p i n i o n s , knowledge, s t e r e o t y p e s conat ion b e h a v i o u r a l i n t e n t i o n s behaviour o v e r t , observable a c t s A t t i t u d e , a c c o r d i n g to t h i s schema, r e f e r s to a person's a f f e c t or degree of favourableness or unfavourableness f e l t about an o b j e c t . More s p e c i f i c a l l y a person g e n e r a l l y l i n k s an o b j e c t with i t s a t t r i b u t e s such that the a t t i t u d e r e f e r s to the e v a l u a t i o n of the o b j e c t a t t r i b u t e s i n q u e s t i o n . The a s s o c i a t e d a t t r i b u t e can be a t r a i t , p r o p e r t y , q u a l i t y , c h a r a c t e r i s t i c , outcome or event that i s l i n k e d with the o b j e c t forming the b a s i s of the i n d i v i d u a l ' s b e l i e f s . B e l i e f s about an o b j e c t are consequently d e f i n e d i n terms of the p r o b a b i l i t y (or i m p r o b a b i l i t y ) that a r e l a t i o n s h i p e x i s t s between the o b j e c t and any of i t s a t t r i b u t e s . B e l i e f s about an 28 o b j e c t are viewed i n terms of stimulus-response a s s o c i a t i o n s with the o b j e c t of the b e l i e f viewed as the 'stimulus' and the o b j e c t or concept r e l a t e d to the o b j e c t of b e l i e f as the 'response'. To summarize, both the a t t i t u d e toward an o b j e c t and the b e l i e f s about an o b j e c t have been d e f i n e d i n a behaviour theory framework ( F i s h b e i n , 1967, p.390). The t h i r d category of v a r i a b l e s l a b e l l e d c o n a t i o n , r e f e r s to a person's i n t e n t i o n s to perform v a r i o u s behaviours. The s t r e n g t h of an i n t e n t i o n can, a c c o r d i n g to F i s h b e i n and Ajzen, be measured by c o n s i d e r i n g the s u b j e c t i v e p r o b a b i l i t y that an i n d i v i d u a l w i l l engage i n a given behaviour. The b e h a v i o u r a l category l i s t e d i n Table 1 r e f e r s to overt behaviours, or a c t s that may be s t u d i e d by d i r e c t o b s e r v a t i o n . I n t e r e s t i n g l y , F i s h b e i n and Ajzen p o i n t out t h a t although most t h e o r i s t s appear to agree with the c l a s s i f i c a t i o n , i t has seldom been used i n research (1967, p.11). . Based on these separate and d i s t i n c t d e f i n i t i o n s , F i s h b e i n and Ajzen developed a conceptual framework demonstrating r e l a t i o n s between b e l i e f s , a t t i t u d e s , i n t e n t i o n s and behaviour (see F i g u r e 2, p.15). From F i g u r e 2 i t can be seen that an a t t i t u d e toward some object i s determined by a person's b e l i e f s t h a t the o b j e c t has c e r t a i n a t t r i b u t e s , and by h i s e v a l u a t i o n s of those a t t r i b u t e s . The r e l a t i o n s h i p s between b e l i e f s and a t t i t u d e s and between a t t i t u d e s and i n t e n t i o n s i s not s p e c i f i c , r a t h e r a t t i t u d e i s r e l a t e d to a set of i n t e n t i o n s and a set of b e l i e f s . Each i n t e n t i o n however, i s s p e c i f i c a l l y r e l a t e d to each behaviour. An i n d i v i d u a l ' s behaviour corresponds, a l b e i t 29 i n d i r e c t l y , to h i s a t t i t u d e toward some o b j e c t . According to the F i s h b e i n and Ajzen conceptual framework* a person's i n t e n t i o n s stem from b e l i e f s which i n turn i n f l u e n c e a t t i t u d e s . S p e c i f i c a l l y , one's a t t i t u d e toward performing a given behaviour i s r e l a t e d to one's b e l i e f s that performing the behaviour w i l l l e a d to c e r t a i n consequences. In a d d i t i o n the i n d i v i d u a l e v a l u a t e s the consequences of performing the behaviour and c o n s i d e r s h i s b e l i e f s about what s i g n i f i c a n t o t h ers or r e f e r e n t s may t h i n k about the behaviour i n q u e s t i o n . F i g u r e 1 (p. 7) d e p i c t s b e h a v i o u r a l i n t e n t i o n viewed as a f u n c t i o n of two types of b e l i e f s , namely normative and c o n s e q u e n t i a l b e l i e f s . Normative b e l i e f s are those that the i n d i v i d u a l p e r c e i v e s c e r t a i n r e f e r e n t s have r e g a r d i n g whether he should or should not perform a p a r t i c u l a r behaviour. S u b j e c t i v e norms are regarded as an a c c e p t a b l e measure of an i n d i v i d u a l ' s normative b e l i e f s . A t t i t u d e , on the other hand re p r e s e n t s those b e l i e f s an i n d i v i d u a l has that behaviours l e a d to c e r t a i n consequences. A person's i n t e n t i o n to perform a given behaviour i s governed by a t t i t u d e s toward and s u b j e c t i v e norms concerning the behaviour. A t t i t u d e s and I n t e n t i o n s F i s h b e i n and h i s a s s o c i a t e s p r o v i d e d e m p i r i c a l evidence to support t h e i r t h e o r e t i c a l model f o r the p r e d i c t i o n of i n t e n t i o n s . According to t h i s model, a person's i n t e n t i o n with regard to a p a r t i c u l a r behaviour was determined by h i s a t t i t u d e toward and a s u b j e c t i v e norm concerning the behaviour. These two components have been assi g n e d e m p i r i c a l weights which 30 allowed the F i s h b e i n and Ajzen theory to be represented by equation 1. In Equation 1, B i s the behaviour under c o n s i d e r a t i o n ; I r e p r e s e n t s the i n t e n t i o n to perform behaviour B; A 6 i s the i n d i v i d u a l ' s a t t i t u d e toward engaging i n behaviour B, and SSN are the s u b j e c t i v e s o c i a l norms. The two components of i n t e n t i o n s , A$ and SSN are comprised of weighted sums as shown in equations 2 and 3. From Equation 2 i t can be seen that a t t i t u d e s can be measured by the b e l i e f t h a t a behaviour B leads to a consequence or outcome i ; e i s the i n d i v i d u a l ' s e v a l u a t i o n of the p a r t i c u l a r outcome i ; and n r e p r e s e n t s the t o t a l number of b e l i e f s the i n d i v i d u a l holds about performing the behaviour B. F i s h b e i n maintained that although the f i r s t component A 6 i s a t t i t u d i n a l , the a t t i t u d e d e s c r i b e d concerns the i n d i v i d u a l ' s a t t i t u d e toward performing a given behaviour and not the a t t i t u d e toward the o b j e c t or t a r g e t of h i s behaviour. B^I=(A R)w1+(SSN)w2 (1 ) (2) summing the products of b and e The symbol "b" r e p r e s e n t s 31 SSK=? b,- m- (3) Equation 3 shows how the s u b j e c t i v e s o c i a l norms can be measured. The s u b j e c t i v e norm i s the i n d i v i d u a l ' s p e r c e p t i o n of whether s i g n i f i c a n t r e f e r e n t s t h i n k he should or should not perform a given behaviour. Normative b e l i e f i s represented by the symbol b; m , the m o t i v a t i o n to comply with the r e f e r e n t , and n, c o n s i d e r s the number of r e f e r e n t s , which may vary a c c o r d i n g to the s i t u a t i o n and behaviour i n q u e s t i o n . Referents must i n c l u d e a l l i n d i v i d u a l s or groups p e r c e i v e d by the i n d i v i d u a l to i n f l u e n c e performance of the s p e c i f i e d behaviour. The e m p i r i c a l weights (designated w1 and w2 i n Equation 1) have been assig n e d s t a n d a r d i z e d r e g r e s s i o n c o e f f i c i e n t s as s u f f i c i e n t r e s e a r c h has not been done to determine s p e c i f i c v a l u e s . In summary, Equation 1 can be c o n s i d e r e d a m u l t i p l e r e g r e s s i o n equation s i n c e r e s e a r c h evidence demonstrates that the two determinants A and SSN o f f e r high m u l t i p l e c o r r e l a t i o n s with b e h a v i o u r a l i n t e n t i o n s . T h i s theory maintains that i t i s u s e f u l to d i s t i n g u i s h between the types of b e l i e f s t h a t are determinants of b e h a v i o u r a l i n t e n t i o n s . F i s h b e i n and Ajzen s t a t e d that " i f one maintains the d i s t i n c t i o n between these two components, i t becomes p o s s i b l e to gain a b e t t e r understanding of the ways i n which b e h a v i o u r a l i n t e n t i o n s are formed" (1975, p. 304). F i s h b e i n ' s e a r l y work c o n s i d e r e d a s u b j e c t i v e p e r s o n a l normative b e l i e f (SPN) i n a d d i t i o n to the s u b j e c t i v e s o c i a l normative b e l i e f s (SSN) of s p e c i f i c r e f e r e n t s . I n c l u s i o n of the 32 s u b j e c t i v e p e r s o n a l normative b e l i e f f a c t o r was subsequently deemed by F i s h b e i n to confound r a t h e r than c l a r i f y the understanding of determinants of i n t e n t i o n s , and was thus d e l e t e d from the theory ( F i s h b e i n & Ajzen, 1975). The i n c l u s i o n of the i n d i v i d u a l ' s p e r s o n a l b e l i e f s about what he should or should not do was however, c o n s i d e r e d to be important by other r e s e a r c h e r s working with the model of b e h a v i o u r a l i n t e n t i o n . Schwartz and T e s s l e r (1972) s t a t e d : ... p e r s o n a l normative b e l i e f s and a t t i t u d e toward the act made c o n s i s t e n t , independent and s u b s t a n t i a l c o n t r i b u t i o n s to the e x p l a n a t i o n of v a r i a n c e i n i n t e n t i o n s . The independent c o n t r i b u t i o n of s o c i a l normative b e l i e f s , though u s u a l l y s i g n i f i c a n t , was l e s s s u b s t a n t i a l . Thus p e r s o n a l normative b e l i e f s and a t t i t u d e toward the act appear to be necessary p r e d i c t o r s of i n t e n t i o n s . (p. 234) For the purposes of t h i s r e s e a r c h the c e n t r a l equation of the F i s h b e i n and Ajzen theory was thus m o d i f i e d by the a d d i t i o n of the p e r s o n a l normative f a c t o r to that shown i n Equation 4. 33 B~I = W1(A 6)+ w2 (SSN)+ w3(SPN) (4) Where: B = behaviour I = i n t e n t i o n to perform B A 6 = a t t i t u d e toward performing B SSN = s u b j e c t i v e s o c i a l norm SPN = . s u b j e c t i v e p e r s o n a l norm w1,w2,w3= e m p i r i c a l l y determined weights to be obtained from r e g r e s s i o n a n a l y s i s . S u b j e c t i v e p e r s o n a l norms are r e l a t e d to the person's b e l i e f s that he ought to behave i n a p a r t i c u l a r way. Equation 5 shows that p e r s o n a l norms can be measured as a sum of the product of an i n d i v i d u a l ' s p e r s o n a l normative b e l i e f ( b t ) and h i s d e s i r e s or m o t i v a t i o n s to comply with the normative b e l i e f (m^). The t o t a l number of p e r s o n a l normative b e l i e f s h e l d by the i n d i v i d u a l i s c o n s i d e r e d . 34 SPN= fb-m; (5) i =i Many s t u d i e s have been conducted using the F i s h b e i n and Ajzen theory. C o n s i s t e n t l y the p r e d i c t i v e power of i n t e n t i o n s with regard to a s p e c i f i e d behaviour has been demonstrated. In a review of p u b l i s h e d r e s e a r c h F i s h b e i n and Ajzen r e p o r t e d that m u l t i p l e c o r r e l a t i o n c o e f f i c i e n t s f o r the p r e d i c t i o n of i n t e n t i o n to perform v a r i o u s behaviours ranged from 0.608 ( i n t e n t i o n to f o l l o w coworkers' i n s t r u c t i o n , F i s h b e i n , Landy & Hatch,1969) to 0.869 ( i n t e n t i o n to cheat i n c o l l e g e , DeVries & Ajzen, 1971). None of the fourteen s t u d i e s reviewed by F i s h b e i n and Ajzen (1975, p. 310) c o n s i d e r e d the i n t e n t i o n to p a r t i c i p a t e i n e d u c a t i o n a l a c t i v i t i e s . However, two a d u l t educators, Grotelueschen and C a u l l e y (1977) recommended that t h i s model be a p p l i e d to i n v e s t i g a t e p a r t i c i p a t i o n problems in c o n t i n u i n g a d u l t e d u c a t i o n . P a r t i c i p a t i o n and A t t i t u d e Research  in Adult Education P r o f e s s i o n a l educators have been concerned f o r many years about a t t i t u d e s toward a d u l t education and p a r t i c i p a t i o n of a d u l t s i n l e a r n i n g a c t i v i t i e s . Indeed, the massive i n f l u x of l e a r n e r s i n t o a d u l t and c o n t i n u i n g education programs has p r e c i p i t a t e d a vast a r r a y of l i t e r a t u r e concerned with p a r t i c i p a t i o n . In an overview of r e s e a r c h i n a d u l t education, Brunner, et a l . (1959) s t a t e d that the focus of p a r t i c i p a t i o n r e s e a r c h has been p r i m a r i l y i n two g e n e r a l areas: (a) the study 35 of the c h a r a c t e r i s t i c s of p a r t i c i p a n t s i n p a r t i c u l a r i n s t i t u t i o n s or types of i n s t i t u t i o n a l , programs and (b) the sampling of a p o p u l a t i o n or area to determine d i f f e r e n c e s between p a r t i c i p a n t s and n o n - p a r t i c i p a n t s i n v a r i o u s types of a d u l t education (p. 90). Some two decades a f t e r Brunner's overview, D i c k i n s o n and Blunt (1980) noted that the focus of a d u l t education r e s e a r c h had not s h i f t e d much over the ensuing twenty y e a r s . Although d i f f e r e n t groups and v a r i e d approaches have been used, the bulk of the l i t e r a t u r e has been concerned with d e s c r i b i n g the extent and nature of p a r t i c i p a t i o n by a d u l t l e a r n e r s . Boshier (1978) concurred suggesting that i t was now t i m e l y f o r r e s e a r c h e r s "to q u e s t i o n the extent to which more d e s c r i p t i v e c l i e n t e l e surveys are r e q u i r e d " (p.4). The nature of l e a r n e r s ' a t t i t u d e s toward p a r t i c i p a t i o n i n c o n t i n u i n g e d u c a t i o n has been i d e n t i f i e d i n r e s e a r c h as a major f a c t o r i n f l u e n c i n g p a r t i c i p a t i o n . In most i n s t a n c e s a t t i t u d e has been c o n s i d e r e d a m o t i v a t i o n a l f a c t o r which d i r e c t l y i n f l u e n c e s b e h a v i o u r a l a c t i v i t i e s . C o n s i s t e n t with t r a d i t i o n a l a t t i t u d e theory, a one-to-one r e l a t i o n s h i p has been assumed to e x i s t between a t t i t u d e and p a r t i c i p a t i o n behaviour. A t t i t u d e r e s e a r c h i n a d u l t education, although using d i f f e r e n t groups or a t t i t u d e measuring techniques has almost u n i v e r s a l l y employed t r a d i t i o n a l a t t i t u d e theory methodology. One of the most f r e q u e n t l y c i t e d comprehensive a d u l t education p a r t i c i p a t i o n surveys was conducted i n 1965 by Johnstone and R i v e r a . According to these analyses, 36 p a r t i c i p a t i o n r a t e s among U. S. a d u l t s stemmed from a number of v a r i a b l e s such as age, o c c u p a t i o n , country of b i r t h and r e l i g i o u s a f f i l i a t i o n . The i n t e r e s t s and a t t i t u d e s of the a d u l t l e a r n e r s were examined and subsequently i n t e r p r e t e d to be r e p r e s e n t a t i v e of t h e i r general b e h a v i o u r a l tendencies (1965, p. 378). However a n a l y s i s of the p s y c h o l o g i c a l r e a d i n e s s of respondents to engage i n e d u c a t i o n a l study d i d not i n f a c t account f o r any of the c o n s i d e r a b l e d i f f e r e n c e i n p a r t i c i p a t i o n r a t e s between the groups of people i n two c i t i e s . Such a r e s u l t i n f a c t appears to undermine the v a l i d i t y of the assumption made by the r e s e a r c h e r s that determining a t t i t u d e s can subsequently be i n t e r p r e t e d as e q u i v a l e n t to measuring behaviour. Rather than d i s c o u n t i n g the a t t i t u d e ~ p a r t i c i p a t i o n assumption, the authors simply r e p o r t e d t h a t they c o u l d not account f o r the f a i l u r e to demonstrate a s i g n i f i c a n t r e l a t i o n s h i p between a t t i t u d e and p a r t i c i p a t i o n . Of the few a t t i t u d e s t u d i e s .which have appeared i n the l i t e r a t u r e of a d u l t education over the past few y e a r s , n e a r l y a l l have employed t r a d i t i o n a l a t t i t u d e theory which suggests that p a r t i c i p a t i v e behaviour i n e d u c a t i o n a l a c t i v i t i e s can be measured by a s s e s s i n g a t t i t u d e s toward ed u c a t i o n . For example, f o r t y members i n an i n t r o d u c t o r y a d u l t education course were asked to judge 164 statements expressing v a r i o u s a t t i t u d e s toward a d u l t education (Adolph and Whaley, 1967). In order to determine a t t i t u d e s the authors c o n s t r u c t e d an a t t i t u d e s c a l e designed to measure favourable and unfavourable a t t i t u d e s toward e d u c a t i o n . Although the r e s u l t s of the a t t i t u d e scores 37 i n d i c a t e d a fa v o u r a b l e d i s p o s i t i o n toward a d u l t education among p a r t i c i p a n t s , such data has l i t t l e other r e l e v a n c e . I t would be erroneous to suggest that a l l p a r t i c i p a n t s i n a d u l t education possess f a v o u r a b l e a t t i t u d e s toward education and e q u a l l y unsound to c o n s i d e r that a l l n o n - p a r t i c i p a n t s must harbour unfavourable a t t i t u d e s toward a d u l t education. Employing s t u d i e s of even l a r g e r samples of p a r t i c i p a n t s i n a d u l t education would produce s t r i c t l y d e s c r i p t i v e c l i e n t e l e surveys about the respondents i n q u e s t i o n and would not p r o v i d e s u f f i c i e n t g e n e r a l i z a b l e i n f o r m a t i o n concerning p a r t i c i p a t i o n phenomena. Seaman and Schroeder (1970) i n v e s t i g a t e d the r e l a t i o n s h i p between extent of educative behaviour by a d u l t s and t h e i r a t t i t u d e s toward c o n t i n u i n g e d u c a t i o n . T h i s a n a l y s i s , too, f a i l e d to demonstrate a s i g n i f i c a n t r e l a t i o n s h i p between a t t i t u d e s toward c o n t i n u i n g education and extent of p a r t i c i p a t i o n behaviour. Most r e s e a r c h e r s would agree that p a r t i c i p a t i o n occurs as a f u n c t i o n of i n t e r a c t i o n between p s y c h o l o g i c a l and s o c i a l v a r i a b l e s , thus i t i s not s u r p r i s i n g that a t t e n t i o n has been d i r e c t e d toward a t t i t u d e s and t h e i r r e l a t i o n s h i p to p a r t i c i p a t i o n of a d u l t s i n e d u c a t i o n a l a c t i v i t i e s . But the r e l a t i o n s h i p between p a r t i c i p a t i o n i n education and a t t i t u d e toward e d u c a t i o n , when measured u s i n g t r a d i t i o n a l r e s e a r c h methodology, appears weak. Grotelueschen and C a u l l e y (1977) argued f o r a departure from t r a d i t i o n a l a t t i t u d e theory with the hope that understanding of p a r t i c i p a t i o n phenomena would be 38 enhanced. These r e s e a r c h e r s advocated use of the F i s h b e i n model to study b e h a v i o u r a l i n t e n t i o n s of a d u l t l e a r n e r s as a p o t e n t i a l approach f o r i n c r e a s i n g r e s e a r c h e r s ' understanding of why people engage in c o n t i n u i n g e d u c a t i o n . While acknowledging the importance of d e s c r i p t i v e r e s e a r c h , Grotelueschen and C a u l l e y draw a t t e n t i o n to the u t i l i t y of the i n t e n t i o n a l model i n p r e d i c t i n g and understanding a s p e c i f i e d behaviour. They s t a t e t hat although F i s h b e i n ' s model has not been t e s t e d i n the f i e l d of c o n t i n u i n g education, i t s success i n p r e d i c t i n g a v a r i e t y of other behaviours ranging from c h e a t i n g i n c o l l e g e to s i g n i n g up f o r an a l c o h o l i c treatment u n i t ( F i s h b e i n and Ajzen, 1975, p. 310) should not be overlooked by a d u l t educators. According to the F i s h b e i n model only two v a r i a b l e s are f e l t to d i r e c t l y i n f l u e n c e b e h a v i o u r a l i n t e n t i o n s ( i . e . a t t i t u d e s and normative b e l i e f s ) . P e r s o n a l i t y or demographic c h a r a c t e r i s t i c s , the nature of the s p e c i f i c behaviour or s i t u a t i o n a l v a r i a b l e s , are c o n s i d e r e d but only to the extent, that they would i n f l u e n c e a t t i t u d e s and the normative b e l i e f s f a c t o r s . In essence the F i s h b e i n a t t i t u d e theory r e p r e s e n t s one of the f i r s t m u l t i -v a r i a t e approaches which may be used to study p a r t i c i p a t i o n phenomena. In one i n s t a n c e the F i s h b e i n t h e o r e t i c a l model was a p p l i e d d i r e c t l y i n the f i e l d of a d u l t e d u c a t i o n . Southern (1980) used F i s h b e i n ' s model to determine f a c t o r s d i f f e r e n t i a t i n g educators who p a r t i c i p a t e d i n a graduate course i n education from those who d i d not. F i n d i n g s of t h i s study suggested that p a r t i c i p a n t s i n the graduate courses harboured more p o s i t i v e a t t i t u d e s than n o n - p a r t i c i p a n t s . A high measure 39 of i n t e n t was re p o r t e d by p a r t i c i p a n t s as a group and the a t t i t u d e measure c o r r e l a t e d best with i n t e n t i o n to p a r t i c i p a t e f o r both p a r t i c i p a n t and n o n - p a r t i c i p a n t educators. P a r t i c i p a t i o n and A t t i t u d e Research x  Among Health P r o f e s s i o n a l s Knowledge about the a t t i t u d e s of h e a l t h p r o f e s s i o n a l s toward c o n t i n u i n g education i s l i m i t e d . The p u b l i s h e d l i t e r a t u r e p r o v i d e s i n f o r m a t i o n about the impact of c o n t i n u i n g education on p r a c t i c e ; the extent of p a r t i c i p a t i o n - by s e l e c t e d groups of h e a l t h p r o f e s s i o n a l s ; techniques f o r e v a l u a t i n g and improving c o n t i n u i n g education programs and the r e l a t i o n s h i p s between c h a r a c t e r i s t i c s of i n d i v i d u a l s and t h e i r c o n t i n u i n g education i n t e r e s t s . D e t a i l e d understanding of a t t i t u d e s toward c o n t i n u i n g education i s not a v a i l a b l e . What l i t t l e data have been gathered have e i t h e r been c o l l e c t e d i n an attempt to measure a t t i t u d e s through the use of o f t e n very s o p h i s t i c a t e d s e l f - r e p o r t i t e m - i n t e r e s t i n v e n t o r i e s , or have c o n s i s t e d of i n d i r e c t measures of a t t i t u d e s of h e a l t h p r o f e s s i o n a l s . The authors of the l a t t e r s t u d i e s i n f e r a t t i t u d e s toward c o n t i n u i n g education and l i k e l y p a r t i c i p a t i o n i n e d u c a t i o n a l programs from responses to items as k i n g whether or not the respondents are " i n t e r e s t e d " i n c o n t i n u i n g e d u c a t i o n . G e n e r a l l y , r e s e a r c h e r s s t r i v e d to l e a r n more about why i n d i v i d u a l s attended e d u c a t i o n a l programs s i n c e such i n f o r m a t i o n would allow arrangement of environmental and l e a r n i n g c o n d i t i o n s conducive to even higher l e v e l s of p a r t i c i p a t i o n . Numerous 40 s t u d i e s have suggested that p a r t i c i p a t i o n i s r e l a t e d to a l a r g e number of v a r i a b l e s (Brunner et a l , 1959; Deane,l950; Johnstone & R i v e r a , 1965; Verner & Newberry, 1958), and among them, res e a r c h i n t o the " a f f e c t i v e domain" or the study of a t t i t u d e s (Krathwohl, Bloom, & Masia, 1964), has emerged as a major area of study. Larocco and P o l i t (1978) r e p o r t e d that a m a j o r i t y of 115 nurses surveyed were h i g h l y s u p p o r t i v e of c o n t i n u i n g e d u c a t i o n . T h i s c o n c l u s i o n was based e n t i r e l y on the f i n d i n g that 95% of the group agreed with the statement that c o n t i n u i n g education was v a l u a b l e f o r a nurse's p r o f e s s i o n a l p r a c t i c e . In another study with nurses, B e l l and Rix (1979) a s c e r t a i n e d that the m a j o r i t y of nurses i n d i c a t e d a d e s i r e to r e t u r n to s c h o o l . The authors concluded that t h i s i n t e r e s t i n f o r m a l l y c o n t i n u i n g t h e i r education was s u f f i c i e n t evidence to i n d i c a t e that nurses possessed a f a v o u r a b l e a t t i t u d e toward c o n t i n u i n g e d u c a t i o n . Three separate r e s e a r c h groups concluded t h a t p a r t i c i p a n t pharmacists have more favo u r a b l e a t t i t u d e s than those c l a s s e d as n o n - p a r t i c i p a n t s based on • respondents' assessments of the importance of c o n t i n u i n g t h e i r education (Bernardi & McCook, 1977; Gross, 1976; Kotzan & Jowdy, 1970). Many s i m i l a r s t u d i e s have been r e p o r t e d i n the l i t e r a t u r e with many d i f f e r e n t groups of h e a l t h p r o f e s s i o n a l s i n c l u d i n g nurses, pharmacists, d o c t o r s , medical students, d e n t i s t s and p h y s i c a l t h e r a p i s t s (Awty & Balk, 1975; Bauer & Bush, 1978; B e r n a r d i , 1974; Buchanan, 1970; Bush & Lewis, 1978; C a f f e r a t a , et al.,1975; Cohen, et al.,1977; Cowan, 1976; Curran, 1977; 41 Krowka & Peck, 1979; Matthews & Schumacher, 1979; M i l l e r & Rea, 1977; Seymour, Connelly & Gardner,1979; Vaughan, McCarthy & Saegert,1979). Health p r o f e s s i o n a l s are, at i n c r e a s i n g r a t e s , p a r t i c i p a t i n g i n c o n t i n u i n g education programs i n an e f f o r t to r e f r e s h t h e i r knowledge and a b i l i t i e s and to remain up to date with new developments. However, d e s p i t e the i n c r e a s i n g a v a i l a b i l i t y of c o n t i n u i n g education programs, some d i e t i t i a n s a t t e n d whereas others e l e c t not to do so. Contained i n the c o n t i n u i n g education l i t e r a t u r e are a few d e s c r i p t i v e r e p o r t s r e g a r d i n g the p a r t i c i p a t i o n a c t i v i t i e s of d i e t i t i a n s i n c o n t i n u i n g e d u c a t i o n . Vanderveen and Hubbard (1979) e x p l o r e d the p e r c e i v e d e d u c a t i o n a l needs of d i e t i t i a n s employed i n h e a l t h care f a c i l i t i e s as w e l l as the needs of a group of unemployed p r o f e s s i o n a l d i e t i t i a n s p l a n n i n g to r e - e n t e r the work f o r c e . That same year, B r o s k i and Upp (1979) r e p o r t e d on what d i e t i t i a n s , along with four other a l l i e d h e a l t h p r o f e s s i o n a l groups, wanted from c o n t i n u i n g education programs i n terms of content and delivery'. The p r a c t i c a l i t y of i n t e g r a t i n g l e a r n i n g sequences and h i e r a r c h i e s i n the c o n t i n u i n g education of d i e t i t i a n s was i n v e s t i g a t e d by F r u i n and Bart (1978) who recommended that by i d e n t i f y i n g and v a l i d a t i n g " l o c a l h i e r a r c h i e s " , c o n t i n u i n g education f o r d i e t i t i a n s would be more c l o s e l y r e l a t e d to needs r a t h e r than d e s i r e s . The BCDNA Con t i n u i n g Education Committee conducted a survey of c o n t i n u i n g education needs and i n t e r e s t s of d i e t i t i a n s i n B. C. (Wolczuk, 1976). Wolczuk's study, s i m i l a r to surveys 42 with other p r o f e s s i o n a l - groups, was c a r r i e d out to o b t a i n p r a c t i c a l i n f o r m a t i o n to use i n p l a n n i n g f u t u r e c o n t i n u i n g education programs. None of t h i s research d e s c r i b e d a t h e o r e t i c a l b a s i s f o r the " a t t i t u d e " measurement d e s c r i b e d i n the s t u d i e s . Although the q u e s t i o n s asked v a r i e d s l i g h t l y and d i f f e r e n t groups of h e a l t h p r o f e s s i o n a l s were used, a l l of the i n v e s t i g a t o r s assumed that a s t a t e d i n t e r e s t i n or a f a v o u r a b l e d i s p o s i t i o n toward c o n t i n u i n g education was i n f a c t , a r e f l e c t i o n of a c t u a l p a r t i c i p a t i o n behaviour. The " a t t i t u d e s " as they have been r e p o r t e d are simply d e s c r i p t i v e e v a l u a t i v e statements and c o n t r i b u t e l i t t l e to our understanding of what prompts h e a l t h p r o f e s s i o n a l s to p a r t i c i p a t e i n c o n t i n u i n g e d u c a t i o n . F i s h b e i n ' s t h e o r e t i c a l framework p r o v i d e s a c o n c e p t u a l l y sound way of i n v e s t i g a t i n g p a r t i c i p a t i o n behaviour. As mentioned by F i s h b e i n (1967), and r e i t e r a t e d by Grotelueschen and C a u l l e y (1977), there i s a need to set a s i d e the assumption "that a p r o f e s s i o n a l ' s a t t i t u d e toward p a r t i c i p a t i n g i n c o n t i n u i n g education can p r e d i c t a c t u a l p a r t i c i p a t i o n " (p. 23). Instead r e s e a r c h e f f o r t s must co n c e n t r a t e on ways to o b t a i n a b e t t e r understanding of p r o f e s s i o n a l p a r t i c i p a t i o n i n c o n t i n u i n g education a c t i v i t i e s . The model advocated by Grotelueschen and C a u l l e y has a good foundation i n s o c i a l p s y c h o l o g i c a l theory and p r o v i d e s a framework for i n q u i r y i n t o p a r t i c i p a t i o n by a d u l t s i n education a c t i v i t i e s . An i n d i v i d u a l ' s i n t e n t i o n to p a r t i c i p a t e which can be p r e d i c t e d using the F i s h b e i n model i s assumed to be the immediate antecedent of p a r t i c i p a t i o n and thus p u r p o r t s to 43 be a b e t t e r measure of p a r t i c i p a t i o n than simple a t t i t u d e s c a l e s or measurement of other s i t u a t i o n a l v a r i a b l e s . An u n d e r l y i n g assumption of the F i s h b e i n Conceptual Framework i s that s i t u a t i o n a l and socioeconomic b a r r i e r s do not impair an i n d i v i d u a l ' s a b i l i t y to perform a . p a r t i c u l a r behaviour. Yet the lack of time and money have been c o n s i s t e n t l y i d e n t i f i e d by r e s e a r c h e r s as reasons f o r n o n p a r t i c i p a t i o n (Dao,1975; Johnstone & R i v e r a , 1965). The F i s h b e i n model operates on the assumption that such d e c i s i o n f i l t e r s do not d i r e c t l y determine b e h a v i o u r a l i n t e n t i o n s , r a t h e r that such f a c t o r s , i f they have a p a r t i n the paradigm, are i n f l u e n t i a l on the a t t i t u d i n a l and normative b e l i e f components. A number of p e r s o n a l c h a r a c t e r i s t i c s have been shown in past r e s e a r c h to be l i n k e d to e d u c a t i o n a l behaviour. Johnstone and R i v e r a (1965) analyzed v a r i o u s p e r s o n a l , s o c i a l and economic c h a r a c t e r i s t i c s as r e l a t e d to the extent of a d u l t p a r t i c i p a t i o n in l i f e l o n g l e a r n i n g . Nine years l a t e r , Carp, Peterson & R o e l f s (1974) r e p o r t e d on a comprehensive n a t i o n a l study of p a r t i c i p a t i o n by U.S. p r o f e s s i o n a l s and found that a number of c h a r a c t e r i s t i c s s u b s t a n t i a l l y d i f f e r e n t i a t e d l e a r n e r s from would be l e a r n e r s as w e l l as from people i n the general p o p u l a t i o n . - Based on these two l a r g e n a t i o n a l surveys, as w e l l as s t u d i e s i n v o l v i n g s m a l l e r numbers of a d u l t and h e a l t h p r o f e s s i o n a l l e a r n e r s p a r t i c i p a t i n g i n c o n t i n u i n g education, the author s e l e c t e d the f o l l o w i n g v a r i a b l e s as most l i k e l y to account f o r d i f f e r e n c e s i n i n t e n t i o n s to p a r t i c i p a t e among respondent d i e t i t i a n s : geographic l o c a t i o n ; age; l e v e l of formal 44 e d u c a t i o n achieved; time s i n c e r e c e i p t of degree i n d i e t e t i c s ; type of agency with which employed; le n g t h of time i n the c u r r e n t p o s i t i o n ; number of years i n d i e t e t i c s and the type of p o s i t i o n c u r r e n t l y h e l d . In summary, t h i s review of a t t i t u d e and p a r t i c i p a t i o n l i t e r a t u r e i n d i c a t e s that t r a d i t i o n a l measures of a t t i t u d e are not l i k e l y to be c o n s i s t e n t l y r e l a t e d to p a r t i c i p a t i o n behaviour. Rarely has the a t t i t u d e ' b e h a v i o u r assumption been questioned, r a t h e r a host of i n v e s t i g a t o r s have condemned the measure of a t t i t u d e being used, always seeking to p e r f e c t i n s t r u m e n t a t i o n or d e f i n i t i o n . The main c r i t i c i s m stemming from r e s e a r c h e r s has been that too many of the measures c o n s i d e r e d only the a f f e c t i v e p o r t i o n of a t t i t u d e s and f a i l e d to c o n s i d e r the c o g n i t i v e and c o n a t i v e aspects of t h i s concept. A c c o r d i n g l y the d e f i n i t i o n of a t t i t u d e has grown to i n c l u d e a f f e c t i v e , c o g n i t i v e and c o n a t i v e a s p e c t s . F i s h b e i n d e v i a t e d from the h o l i s t i c d e f i n i t i o n approach and attempted to d e f i n e b e l i e f s ( c o g n i t i o n s ) and b e h a v i o u r a l i n t e n t i o n s (conations) as independent phenomena. B e l i e f s and b e h a v i o u r a l i n t e n t i o n s were d e f i n e d as determinants and consequents of a t t i t u d e r a t h e r than as a part of the a t t i t u d e concept. F o l l o w i n g F i s h b e i n ' s argument f o r a departure from t r a d i t i o n a l a t t i t u d e d e f i n i t i o n , i t can be i l l u s t r a t e d that p a r t i c i p a t i o n behaviour occurs as a f u n c t i o n of many v a r i a b l e s , of which a t t i t u d e i s j u s t one. I n v e s t i g a t i o n i n t o p a r t i c i p a t i o n phenomena among h e a l t h p r o f e s s i o n a l s has had r e s e a r c h e r s r e p o r t almost u n f a i l i n g l y that 45 a t t i t u d e s are r e l a t e d to p a r t i c i p a t i o n behaviour and are i n f a c t one of the measures which may be used to p r e d i c t f u t u r e p a r t i c i p a t i o n . In f a c t , h i g h c o r r e l a t i o n s between a t t i t u d e s and p a r t i c i p a t i o n have not been demonstrated. In concert with other a t t i t u d e t h e o r i s t s , r e s e a r c h e r s have been c r i t i c a l of the a t t i t u d e measure used r a t h e r than q u e s t i o n i n g whether a one-to-one r e l a t i o n s h i p e x i s t s between a t t i t u d e and p a r t i c i p a t i o n . A v a r i e t y of other socioeconomic and demographic v a r i a b l e s has emerged which i s a l s o presumed to p r e d i c t a c t u a l p a r t i c i p a t i o n . According to the F i s h b e i n model, such v a r i a b l e s may i n f l u e n c e a s p e c i f i e d behaviour but only to the p o i n t that they a f f e c t the determinants of i n t e n t i o n s to engage i n that behaviour. For the purposes of t h i s study the p r e s e l e c t e d socioeconomic and demographic v a r i a b l e s would c o n c e i v a b l y i n f l u e n c e the a t t i t u d i n a l and normative a s p e c t s t o f i n t e n t i o n to p a r t i c i p a t e i n c o n t i n u i n g education r a t h e r than being r e l a t e d to p a r t i c i p a t i o n . The F i s h b e i n model has been o p e r a t i o n a l i z e d to study the i n t e n t i o n s of p r o f e s s i o n a l d i e t i t i a n s to p a r t i c i p a t e in c o n t i n u i n g education a c t i v i t i e s . S e l f - r e p o r t of past p a r t i c i p a t i o n , the best known proxy f o r f u t u r e p a r t i c i p a t i o n , has been e x p l o r e d with a n t i c i p a t i o n of a high c o r r e l a t i o n between the i n t e n t i o n s of d i e t i t i a n s and t h e i r past p a r t i c i p a t i o n . 46 CHAPTER III METHODOLOGY Th i s study was designed to apply a t h e o r e t i c a l model d e s c r i b i n g the determinants of p r o f e s s i o n a l d i e t i t i a n s ' i n t e n t i o n s to p a r t i c i p a t e i n c o n t i n u i n g e d u c a t i o n . The gen e r a l purpose of t h i s i n v e s t i g a t i o n was to o b t a i n a f u l l e r understanding of why p r o f e s s i o n a l d i e t i t i a n s p a r t i c i p a t e i n c o n t i n u i n g education by examining the b e l i e f s and a t t i t u d e s h e l d by them. T h i s i n v e s t i g a t i o n examined the extent of past p a r t i c i p a t i o n from s e l f - r e p o r t of these p r o f e s s i o n a l s and then looked at the r e l a t i o n s h i p between past p a r t i c i p a t i o n and f u t u r e i n t e n t i o n to p a r t i c i p a t e i n c o n t i n u i n g e d u c a t i o n . The r e l a t i o n s h i p s between c e r t a i n p r e s e l e c t e d socioeconomic f a c t o r s and past p a r t i c i p a t i o n and i n t e n t i o n to p a r t i c i p a t e i n c o n t i n u i n g education were a l s o examined. T h i s chapter d e s c r i b e s the p o p u l a t i o n used i n t h i s r e s e a r c h and d i s c u s s e s how the re s e a r c h instrument was adapted f o r use with d i e t i t i a n s . The pl a n f o r s t a t i s t i c a l a n a l y s es i s presented along with d i s c u s s i o n r e g a r d i n g t e s t s f o r the hypotheses. P o p u l a t i o n The p o p u l a t i o n d e f i n e d f o r the purposes of t h i s study i n c l u d e d a l l those female d i e t i t i a n s who were employed on a f u l l or p a rt-time b a s i s and were members of the BCDNA i n the Spring of 1980. An ef f o r t . w a s made to cont a c t a l l d i e t i t i a n s based on 47 a m a i l i n g l i s t s u p p l i e d by t h e i r p r o f e s s i o n a l a s s o c i a t i o n (BCDNA, 1980 m a i l i n g l i s t ) . Since the d i e t e t i c s p r o f e s s i o n i n Canada i s almost e x c l u s i v e l y female the s i n g l e male was excluded from t h i s study to maintain homogeneity. A c c o r d i n g to the BCDNA membership l i s t a v a i l a b l e i n January of 1980, a t o t a l of 281 female d i e t i t i a n s had m a i l i n g addresses in B r i t i s h Columbia. An attempt was made to c o n t a c t a l l of the 281 d i e t i t i a n s r e s i d i n g i n the p r o v i n c e . A major o b j e c t i v e of t h i s study was to c o l l e c t as much in f o r m a t i o n as p o s s i b l e from as many of these p r o f e s s i o n a l s as p o s s i b l e . The bulk of c o n t i n u i n g education programs are sponsored or a d v e r t i z e d by the p r o v i n c i a l a s s o c i a t i o n , thus the p r o v i n c i a l (BCDNA) m a i l i n g l i s t was used i n order to survey the g r e a t e s t number of d i e t i t i a n s i n B. C. G e n e r a l l y , a l l d i e t i t i a n s responding i n t h i s study were expected to have achieved about the same l e v e l of formal e d u c a t i o n . A l l members of t h i s p o p u l a t i o n w i l l have graduated from a r e c o g n i z e d u n i v e r s i t y program and have ob t a i n e d b a s i c t r a i n i n g i n human n u t r i t i o n and d i e t e t i c s . A c c o r d i n g to Houle (1980), i f d i f f e r e n c e s i n the l e n g t h of formal t r a i n i n g do e x i s t , a s i g n i f i c a n t p o s i t i v e a s s o c i a t i o n with the extent of p a r t i c i p a t i o n i n c o n t i n u i n g education w i l l be apparent -(p. 147). I t was a n t i c i p a t e d that the m a j o r i t y of d i e t i t i a n s responding to t h i s survey would have obtained membership i n the BCDNA as a r e s u l t of completing a d i e t e t i c i n t e r n s h i p program at a CDA a c c r e d i t e d t r a i n i n g f a c i l i t y . I t was a l s o assumed that most of the d i e t i t i a n s would be 48 aware of c o n t i n u i n g education program o f f e r i n g s and have p a r t i c i p a t e d i n some way. T h i s assumption was made, based on the c i r c u l a t i o n of i n f o r m a t i o n r e g a r d i n g c o n t i n u i n g education through the p r o v i n c i a l and n a t i o n a l m a i l i n g s of n e w s l e t t e r s and the Canadian D i e t e t i c A s s o c i a t i o n J o u r n a l to a l l members. D i e t i t i a n s i n B r i t i s h Columbia have been i n t e r e s t e d i n c o n t i n u i n g education s i n c e the e a r l y 1970's ( W i l l i c k , 1980, p. 18). In 1975 t h i s group of p r o f e s s i o n a l s took p a r t i n a p i l o t p r o j e c t to t e s t the f e a s i b i l i t y of executing a c o n t i n u i n g education p o i n t c o l l e c t i o n program. C o n s i d e r i n g the hig h l e v e l of p a r t i c i p a t i o n i n t h i s p i l o t p r o j e c t , the p r o v i n c i a l A s s o c i a t i o n endorsed a mandatory p o i n t r e p o r t i n g system as a requirement f o r membership i n the BCDNA. Continuing education has a p p a r e n t l y evolved as an important p a r t of d i e t i t i a n s ' p r o f e s s i o n a l l i v e s and the A s s o c i a t i o n has made repeated e f f o r t s to ensure that each member d i e t i t i a n i s made aware of the n e c e s s i t y to engage i n c o n t i n u i n g education. A b e t t e r understanding of d i e t i t i a n s ' commitment to c o n t i n u i n g education would be pr o v i d e d by studying the reasons why they p a r t i c i p a t e in such e d u c a t i o n a l a c t i v i t i e s . Data re g a r d i n g past p a r t i c i p a t i o n of these p r o f e s s i o n a l s were c o n s i d e r e d by t h i s author to be r e a d i l y a v a i l a b l e f o r study s i n c e every member of the BCDNA was a f f o r d e d the o p p o r t u n i t y over the past f i v e years to r e c o r d her c o n t i n u i n g education p o i n t s with the a s s o c i a t i o n o f f i c e . In tu r n she r e c e i v e d annual n o t i f i c a t i o n of the number of approved c o n t i n u i n g education p o i n t s she had on f i l e with the a s s o c i a t i o n . The ease with which such inf o r m a t i o n c o u l d be 49 o b t a i n e d f i g u r e d prominantly i n the s e l e c t i o n of B.C.'s d i e t i t i a n s as a study group. In a d d i t i o n , t h i s author had p r e v i o u s l y e s t a b l i s h e d c o n t a c t with a great many of these p r o f e s s i o n a l s and i t was b e l i e v e d that t h i s p r e v i o u s a s s o c i a t i o n would prove advantageous in s e c u r i n g the r e t u r n of a l a r g e number of completed q u e s t i o n n a i r e s i n a m a i l survey. At an annual general meeting of the membership B r i t i s h Columbia's d i e t i t i a n s had v o i c e d t h e i r commitment to the concept of c o n t i n u i n g education s t a t i n g t h a t , " i t i s the p r o f e s s i o n a l r e s p o n s i b i l i t y of each BCDA member to a t t a i n a minimum of 75 c o n t i n u i n g education p o i n t s w i t h i n a f i v e year p e r i o d " , with the f i r s t p e r i o d to end March 31, 1980. Subsequently mandatory p a r t i c i p a t i o n i n c o n t i n u i n g education and a c o n t i n u a t i o n of the p o i n t r e p o r t i n g system was endorsed by BCDNA members (Nov, 1980). The p r o f e s s i o n a l a s s o c i a t i o n (BCDNA formerly BCDA) c o o r d i n a t e s a s e l f - r e p o r t system of c o n t i n u i n g , education p o i n t s f o r every member d i e t i t i a n . D i e t i t i a n s are asked to assess each c o n t i n u i n g education event attended as to whether i t has enhanced t h e i r p r o f e s s i o n a l e x p e r t i s e and to a l l o c a t e a p r o p o r t i o n of maximum a l l o w a b l e p o i n t s a c c o r d i n g l y . I t i s the r e s p o n s i b i l i t y of member d i e t i t i a n s to submit r e p o r t i n g schedules f o r p o i n t s to be recorded f o r the designated p r e v i o u s twelve (12) months. Over a f i v e year p e r i o d i t i s expected that each d i e t i t i a n should report a t o t a l of at l e a s t s e v e n t y - f i v e (75) p o i n t s with a recommended average y e a r l y accumulation of f i f t e e n (15) p o i n t s . One p o i n t i s roughly e q u i v a l e n t to one 50 c o n t a c t hour of p a r t i c i p a t i o n i n an approved e d u c a t i o n a l a c t i v i t y . Approved c o n t i n u i n g education a c t i v i t i e s are d e t a i l e d i n the G u i d e l i n e s which are d i s t r i b u t e d to a l l BCDNA members (see Appendix A: Con t i n u i n g Education G u i d e l i n e s ; B r i t i s h Columbia D i e t i t i a n s ' and N u t r i t i o n i s t s ' A s s o c i a t i o n , 1980), and f r e q u e n t l y l i s t i n g s of approved programs appear i n the a s s o c i a t i o n n e w s l e t t e r . Although not a l l BCDNA members report t h e i r p a r t i c i p a t i o n a c t i v i t y , a hig h p r o p o r t i o n of d i e t i t i a n s appear to be c o n t i n u i n g t h e i r education beyond the basic p r e p a r a t i o n f o r the p r o f e s s i o n . Over the past f i v e years, approximately two-thirds of the BCDNA membership have submitted s e l f - r e p o r t c o n t i n u i n g education forms to the Continuing Education Committee f o r s c r u t i n y . In order to be c o n s i d e r e d as c o n t i n u i n g education f o r d i e t i t i a n s , the education event must apply to the f i e l d of n u t r i t i o n and d i e t e t i c s ; provide p r o f e s s i o n a l growth; update knowledge; or teach a new s k i l l or technique r e l a t e d to the f i e l d ( B r i t i s h Columbia D i e t i t i a n s ' and N u t r i t i o n i s t s ' A s s o c i a t i o n , 1980). At the time of t h i s study, c o n t i n u i n g education f o r d i e t i t i a n s was not mandatory, although l a t e r i n 1980 d i e t i t i a n s endorsed mandatory c o n t i n u i n g education f o r a l l members of the B r i t i s h Columbia D i e t e t i c s and N u t r i t i o n i s t s ' A s s o c i a t i o n . In an e f f o r t to determine which d i e t i t i a n s had p a r t i c i p a t e d i n c o n t i n u i n g education and whether or not they chose to a v a i l themselves of the r e p o r t i n g system set up by the BCDNA, respondents i n the c u r r e n t r e s e a r c h were asked to provide i n f o r m a t i o n regarding the number of c o n t i n u i n g education p o i n t s 51 they had accumulated over the past f i v e y e a r s . The p r o v i n c i a l a s s o c i a t i o n (BCDNA) had r e c e n t l y grouped member d i e t i t i a n s on a r e g i o n a l b a s i s and s u p p l i e d f i n a n c i a l support to encourage the l o c a l development of c o n t i n u i n g education i n the v a r i o u s r e g i o n s . P r i o r to the r e g i o n a l i z a t i o n n e a r l y a l l of the c o n t i n u i n g education o p p o r t u n i t i e s f o r d i e t i t i a n s were l i m i t e d to the lower mainland, m e t r o p o l i t a n Vancouver and Vancouver I s l a n d r e g i o n s . A l s o , the l a r g e s t h o s p i t a l s and community agencies are l o c a t e d i n these more h e a v i l y populated a r e a s . Even though r e g i o n a l i z a t i o n was a f a i r l y recent phenomena i t was a n t i c i p a t e d that d i e t i t i a n s from the more remote g e o g r a p h i c a l regions of the p r o v i n c e would now r e p o r t some access to c o n t i n u i n g education o p p o r t u n i t i e s i n t h e i r l o c a l a r e a s . Such r e p o r t would l i k e l y have been uncommon p r i o r to the r e g i o n a l p l a n n i n g system. Geographic l o c a t i o n , age and education were three f a c t o r s which p e r s i s t e n t l y d i s t i n g u i s h e d p a r t i c i p a n t s from non-p a r t i c i p a n t s i n the Johnstone and R i v e r a (1965) f i n d i n g s . A d u l t s s i t u a t e d i n small c i t i e s , towns and predominantly r u r a l areas p a r t i c i p a t e d i n a d u l t education to a l e s s e r degree than those r e s i d i n g i n l a r g e r urban c e n t e r s . Kubat (1976) and Curran (1977) confirmed that nurses from small communities are l e s s l i k e l y to p a r t i c i p a t e i n c o n t i n u i n g education than t h e i r urban peers. A c c o r d i n g l y , i t i s expected that respondent d i e t i t i a n s in the p r o v i n c e of B r i t i s h Columbia l o c a t e d i n any region other than Greater Vancouver, would i n d i c a t e fewer hours of p a r t i c i p a t i o n i n c o n t i n u i n g e d u c a t i o n , due in p a r t to the 52 r e l a t i v e l a c k of o p p o r t u n i t y i n the l e s s densely populated a r e a s . Seaman and Schroeder (1970) pr o v i d e d evidence to support p r e v i o u s r e s e a r c h i n d i c a t i n g that the extent to which an i n d i v i d u a l p a r t i c i p a t e s i n e d u c a t i o n a l a c t i v i t i e s i s i n v e r s e l y r e l a t e d to h i s age. C o n s i s t e n t with the Johnstone and R i v e r a study, Berg (1973) and Gross (1976) s t u d y i n g nurses and pharmacists, r e s p e c t i v e l y , concluded that younger respondents more f r e q u e n t l y p a r t i c i p a t e d in c o n t i n u i n g e d u c a t i o n a c t i v i t i e s . Presumably, younger d i e t i t i a n s , having r e c e n t l y secured employment would have l i g h t e r job r e s p o n s i b i l i t i e s and fewer f a m i l y commitments, thus f r e e i n g up both time and money to devote to c o n t i n u i n g education (Dao, 1975; Carp, Peterson & R o e l f s , 1974). I t i s a n t i c i p a t e d that the younger d i e t i t i a n s w i l l r e p o r t having p a r t i c i p a t e d more of t e n than the more s e n i o r p r o f e s s i o n a l s . T h i s would be c o n s i s t e n t with Gross's f i n d i n g t h a t younger pharmacists have a gre a t e r regard f o r the importance of c o n t i n u i n g education to t h e i r c a r e e r s . A number of r e s e a r c h e r s have r e p o r t e d that p a r t i c i p a t i o n was most l i k e l y to predominate among younger nurses (Berg, 1973; Curran, 1977; Kubat, 1976). Due to the r e l a t i v e l y high l e v e l of education obtained by a l l BCDNA members, a p o s i t i v e r e l a t i o n s h i p between past p a r t i c i p a t i o n and l e v e l of education a t t a i n e d was a n t i c i p a t e d i n t h i s r e s e a r c h . Puetz (1980) and Gross (1976) looked at s e l e c t e d demographic v a r i a b l e s as they r e l a t e d to the p a r t i c i p a t i o n of hospital-employed and community-based h e a l t h p r o f e s s i o n a l s and 53 found that pharmacists and nurses employed i n h o s p i t a l s more f r e q u e n t l y p a r t i c i p a t e d i n c o n t i n u i n g education. D i e t i t i a n s were asked to s e l e c t the agency that best d e s c r i b e d t h e i r primary p l a c e of employment and to r e p o r t the l e n g t h of time they had been employed i n t h e i r l a s t p o s i t i o n . I t was a n t i c i p a t e d that those d i e t i t i a n s having job s t a b i l i t y might be more aware of c o n t i n u i n g education a c t i v i t i e s a v a i l a b l e i n the l o c a l a r e a . The t o t a l p o p u l a t i o n of d i e t i t i a n s who had m a i l i n g addresses i n B. C. and were on the c u r r e n t 1980 BCDNA m a i l i n g l i s t as of January 1, 1980 c o n s t i t u t e d the p o p u l a t i o n used i n t h i s study. L e t t e r s were sent to each of the 281 d i e t i t i a n s r e q u e s t i n g access to c o n t i n u i n g education f i l e i n f o r m a t i o n l o c a t e d i n the BCDNA o f f i c e , should i t be r e q u i r e d f o r t h i s study (Appendix B). Data C o l l e c t i o n Instrument Data r e q u i r e d f o r t h i s study were c o l l e c t e d by mail survey of d i e t i t i a n s r e s i d i n g i n the p r o v i n c e of B r i t i s h Columbia. The instrument developed by Grotelueschen (© 1977) f o r the study of c o n t i n u i n g p r o f e s s i o n a l education at the U n i v e r s i t y of I l l i n o i s was adapted f o r t h i s study. In correspondence with Grotelueschen on two separate o c c a s i o n s i t was l e a r n e d that r e l i a b i l i t y and v a l i d i t y data f o r the t e s t instrument were not a v a i l a b l e . The instrument (Appendix C) has been developed i n four p a r t s : a) consequence of p a r t i c i p a t i n g i n c o n t i n u i n g education item pool b) e x p e c t a t i o n s of s i g n i f i c a n t others about 54 p a r t i c i p a t i o n . c) i n t e n t i o n to . p a r t i c i p a t e s c a l e and d) a demographic i n f o r m a t i o n form. Minor m o d i f i c a t i o n s were made to the demographic i n f o r m a t i o n p o r t i o n of the instrument to r e f l e c t and f a c i l i t a t e the study of d i e t i t i a n s i n B r i t i s h Columbia. Since i t was h i g h l y d e s i r a b l e to maintain b r e v i t y and the main t e s t instrument was a l r e a d y q u i t e lengthy, a l l r e f e r e n c e to i n f o r m a t i o n on spouses and c h i l d r e n was d e l e t e d . In a d d i t i o n any q u e s t i o n s regarding r e l i c e n s u r e , p r o f e s s i o n a l o c c u p a t i o n a l t i t l e , or s t a t e i n which employed were d i s c a r d e d s i n c e these q u e s t i o n s are not r e l e v a n t to a group of p r o f e s s i o n a l d i e t i t i a n s i n a Canadian p r o v i n c e . E s s e n t i a l l y , the respondent i n f o r m a t i o n form was e n t i r e l y r e c a s t to e l i c i t only i n f o r m a t i o n on the d e s i r e d p r e - s e l e c t e d socioeconomic v a r i a b l e s . Consequence I tern Pool The instrument c o n s i s t e d of 30 items which measured the b e l i e f s of an i n d i v i d u a l r e g a r d i n g the p e r c e i v e d consequences of p a r t i c i p a t i n g i n c o n t i n u i n g e d u c a t i o n . A consequence as used i n t h i s r e s e a r c h r e f e r s to an a t t r i b u t e or to something that may occur as a r e s u l t of a c o n t i n u i n g education experience. T h i s r e s u l t does not n e c e s s a r i l y immediately f o l l o w the p a r t i c i p a t i o n behaviour and can, i n f a c t , be q u i t e removed from the experience. The second p a r t of. each item asked the respondent to e v aluate the consequences in terms of her own p a r t i c i p a t i o n behaviour. The s c a l e p r o v i d e d f o r two s c o r e s ; one f o r the e v a l u a t i o n of the consequence, and one f o r the consequence as p e r c e i v e d by the respondent. 55 The f o l l o w i n g b e l i e f statement demonstrates how the scores were assessed: P a r t i c i p a t i o n i n Continuing e d u c a t i o n : Would i n c r e a s e my job s e c u r i t y High Value 6 [ 5 |~ 4 [~ 3 [ 2 [ 1 [ 0 No Value L i k e l y i i i I I I 6 '[ 5 [ 4 [ 3 \ 2 \ 1 [ 0 I I I 1 1 I U n l i k e l y The responses were then scor e d using a l l the p o i n t s on the seven p o i n t s c a l e f o r each of the 30 items and summed to o b t a i n a value of the p r o f e s s i o n a l s ' a t t i t u d e toward p a r t i c i p a t i n g i n c o n t i n u i n g education a c c o r d i n g to Equation 2. V £ b i e c ( 2 ) Where b;, = the p r o f e s s i o n a l s ' s u b j e c t i v e p r o b a b i l i t y of occurrence of consequence i , ( l i k e l y , u n l i k e l y — seven point s c a l e ) e^= the value p l a c e d on the consequence i by the p r o f e s s i o n a l , and, (high v a l u e , no v a l u e — s e v e n p o i n t s c a l e ) n = the number of consequences l i s t e d i n the consequence item p o o l (30 item s ) . 56 The "High Value--No Value" s c a l e was used to assess e; whereas the " L i k e l y - U n l i k e l y " s c a l e p r o v i d e d a measure of b. According to the s c o r i n g format the r e s u l t i n g bXe products f o r v a r i o u s p o i n t s on the s c a l e s were as i l l u s t r a t e d i n Table 2. Table 2 Score Determination f o r the Consequence Scale High Value (6) (5) (4) (3) (2) (1) Low Value (0) L i k e l y (6) 36 30 24 18 12 6 0 (5) 30 25 20 15 10 5 0 (4) 24 20 16 1 2 8 4 0 (3) 18 1 5 12 9 6 3 0 (2) 1 2 10 8 6 4 2 0 (1) 6 5 4 3 2 1 0 U n l i k e l y (0) 0 0 0 0 0 0 0 From Equation 2 i t was determined that the p r o f e s s i o n a l ' s a t t i t u d e was dependent on the number of consequences l i s t e d i n the p o o l . Non s a l i e n t consequences were a u t o m a t i c a l l y d i s c o u n t e d s i n c e any bXe products e q u a l l i n g zero c o u l d not c o n t r i b u t e to the t o t a l s c o r e . For example, a p r o f e s s i o n a l who i n d i c a t e d that p a r t i c i p a t i o n i n a p a r t i c u l a r c o n t i n u i n g education experience o f f e r e d high job s e c u r i t y but subsequently p l a c e d a zero value on that consequence, i n d i c a t e d that t h i s 57 consequence had no c o n t r i b u t i o n to her a t t i t u d e toward p a r t i c i p a t i n g i n the c o n t i n u i n g education a c t i v i t y . E x p e c t a t i o n Scale The p e r c e p t i o n s of p r o f e s s i o n a l s r e g a r d i n g the e x p e c t a t i o n s of s i g n i f i c a n t o t h e r s , and the value p r o f e s s i o n a l s p l a c e d on these e x p e c t a t i o n s , c o n t r i b u t e toward the p a r t i c i p a t i o n of an i n d i v i d u a l in c o n t i n u i n g e d u c a t i o n . In responding to items i n t h i s s c a l e the respondent c o n s i d e r e d the e x p e c t a t i o n s of persons important to her regarding p a r t i c i p a t i o n . For example: respondents were asked to c o n s i d e r the f o l l o w i n g s i t u a t i o n as i t a p p l i e d to t h e i r p a r t i c i p a t i o n i n c o n t i n u i n g e d u c a t i o n . My s u p e r v i s o r 1.1 In general how important i s i t to you what your s u p e r v i s o r t h i n k s about your c o n t i n u i n g education? Thinks I Should Thinks I Should Not Doesn't care whether or not I continue my e d u c a t i o n . Very Important The two sub scores f o r each r e f e r e n t were combined as shown in Equation 3: 58 y> SSN= £ b. m. (3) Where SSN = s u b j e c t i v e s o c i a l norm b; = the p r o f e s s i o n a l ' s b e l i e f that a r e f e r e n t t h i n k s she should or should not perform behaviour i n que s t i o n m^ = the value the p r o f e s s i o n a l p l a c e s on what the r e f e r e n t t h i n k s n = the number of r e l e v a n t r e f e r e n t s i n the given s i t u a t i o n The f o l l o w i n g t a b l e shows bXm f o r v a r i o u s responses on the two s c a l e s . 59 Table 3 Score Determination f o r the E x p e c t a t i o n Scale Thinks I should + 2. + 1 Doesn't Care 0 -1 Thinks I Should not -2 Very Important +4 + 8 + 4 0 -4 -8 + 3 + 6 + 3 0 -3 -6 Somewhat Important +2 + 4 + 2 0 -2 -4 + 1 + 1 + 1 0 -1 -2 Not At A l l Important 0 0 0 0 0 0 The bXm product was summed f o r a l l r e f e r e n t s as they were r e l e v a n t to d i e t i t i a n s i n the p r o v i n c e . Respondents were asked not to answer items f o r which the r e f e r e n t was not r e l e v a n t and were requested to "write i n " r e f e r e n t s not otherwise p r o v i d e d f o r on the s c a l e . B e l i e f s About P a r t i c i p a t i o n In C o n t i n u i n q Education 60 The p r o f e s s i o n a l ' s p e r s o n a l b e l i e f about her p a r t i c i p a t i o n i n c o n t i n u i n g p r o f e s s i o n a l education c o n t r i b u t e s to her i n t e n t i o n s to p a r t i c i p a t e i n education a c t i v i t i e s . In a d d i t i o n , the m o t i v a t i o n of the p r o f e s s i o n a l to comply with the b e l i e f i n f l u e n c e s the p a r t i c i p a t i o n d e c i s i o n . A c c o r d i n g l y , a group of qu e s t i o n s was d e v i s e d to assess the i n t e n t i o n s of a p r o f e s s i o n a l to p a r t i c i p a t e i n c o n t i n u i n g e d u c a t i o n . 1.0 Do you b e l i e v e you should p a r t i c i p a t e i n c o n t i n u i n g p r o f e s s i o n a l education? Very 6 5 4 3 2 1 0 St r o n g l y Do Not Moderately 1.1 To what extent do you f e e l w i l l i n g to act on t h i s b e l i e f ? Very 6 [ s [ 4 [ 3 [ 2 [ l [ o I Somewhat Not At A l l The f i r s t p a r t of the q u e s t i o n asked the p r o f e s s i o n a l to s t a t e her o p i n i o n r e g a r d i n g p a r t i c i p a t i o n and subsequently r e q u i r e d the respondent to i n d i c a t e what m o t i v a t i o n was f e l t to comply with her b e l i e f . A l l of the items were summed as shown i n Equation 5 by c o n s i d e r i n g a l l of the bXm products: SPN = Z b- m- (5) 61 Where SPN = the s u b j e c t i v e p e r s o n a l norm bj= the p e r s o n a l normative b e l i e f m;= the m o t i v a t i o n to comply with the b e l i e f , and n = the t o t a l number of p e r s o n a l normative b e l i e f s . Values were assig n e d f o r the v a r i o u s p o i n t s of the two s c a l e s as shown i n Table 4. Twenty-two unique scores are p o s s i b l e when every bXm product was c o n s i d e r e d . Table 4 Score Determination f o r B e l i e f s About P a r t i c i p a t i o n Very S t r o n g l j (6) 7 (5) (4) (3) (2) (1 ) Do Not (0) Very (6) 36 30 24 18 1 2 6 0 (5) 30 25 20 1 5 10 5 * 0 (4) 24 20 16 1 2 8 4 0 (3) 18 1 5 12 9 6 3 0 (2) 12 10 8 6 4 2 0 (1 ) 6 5 4 3 2 1 0 Not at A l l (0) 0 0 0 0 0 0 0 62 P a r t i c i p a t i o n — P a s t and Future Berg (1973) found that past p a r t i c i p a t i o n in continuing education was a good indicator of present p a r t i c i p a t i o n . This was interpreted to suggest that those persons who are most l i k e l y to engage in future learning were also the ones who have already taken part in education a c t i v i t i e s . Respondent d i e t i t i a n s were asked to report the extent of their past p a r t i c i p a t i o n in continuing professional education and to indicate how many months had passed since they had attended their l a s t continuing education a c t i v i t y . In addition, methods and techniques employed by d i e t i t i a n s seeking higher learning were explored by asking respondents to indicate which method of study they used most recently in continuing education. The extent of involvement over the past f i v e year period was assessed by asking d i e t i t i a n s to state the number of continuing education points which had been reported to BCDNA, up to March 1980. Since i t was anticipated that some d i e t i t i a n s may have chosen not to report points to the BCDNA, respondents were asked to state the number of points, i f any, which had been accumulated but not reported. To enhance scale information concerning their personal b e l i e f s about continuing education, d i e t i t i a n s were asked to specify their intention to pa r t i c i p a t e in continuing professional education during the next year and to estimate how many hours they actually intended to devote to continuing education during that time. Since the BCDNA membership policy regarding continuing education had recently changed, d i e t i t i a n s 63 were asked to report whether their intentions to par t i c i p a t e in continuing education a c t i v i t i e s had changed in any way. D i e t i t i a n s were asked to compare their future intentions with their l e v e l of p a r t i c i p a t i o n in the past year. F i n a l l y , d i e t i t i a n s were asked to indicate their f i v e most preferred methods of study in completing their continuing education requirements. Demographic Information Personal and geographic data were c o l l e c t e d from the respondents in order to esta b l i s h c h a r a c t e r i s t i c s of the population and to define relationships among the socioeconomic variables, past p a r t i c i p a t i o n and intentions to par t i c i p a t e in continuing education. Several factors have been i d e n t i f i e d by other investigations as being p a r t i c u l a r l y i n f l u e n t i a l with respect to the p a r t i c i p a t i o n of health professionals in continuing education. D i e t i t i a n s were asked to respond to ten questions regarding their geographic place of employment; type of agency with which employed; hours of work each week; highest l e v e l of formal education completed; year degree in d i e t e t i c s completed; means of obtaining membership in the BCDNA; years of membership in BCDNA; age; t o t a l years employed and years employed in their current p o s i t i o n . Since the f i e l d of d i e t e t i c s has over the years become increasingly specialized, respondents were asked to ide n t i f y what percentage of time was devoted to various duties in their current position, (e.g. c l i n i c a l , administrative, research, education and community nutr i t i o n . ) 64 P r e - t e s t of the Instrument The q u e s t i o n n a i r e was c r i t i q u e d f o r c l a r i t y and ease of understanding by a group of s i x d i e t i t i a n s occupying s e n i o r management p o s i t i o n s at the Vancouver General H o s p i t a l . In a d d i t i o n seven graduate students i n human n u t r i t i o n and d i e t e t i c s (School of Home Economics, UBC) and ten d i e t e t i c i n t e r n s at the Vancouver General H o s p i t a l were asked to read and respond to the q u e s t i o n n a i r e . No changes were made to the q u e s t i o n n a i r e based on advice from these respondents that the i n s t r u c t i o n s were very c l e a r and e a s i l y understood. Data C o l l e c t i o n The q u e s t i o n n a i r e was mailed on March 17, 1980, to the home addresses of 281 d i e t i t i a n s a c c o r d i n g to the BCDNA m a i l i n g l i s t as of January 1980. The accompanying cover l e t t e r requested d i e t i t i a n s to complete the q u e s t i o n n a i r e regarding i n t e n t i o n s to p a r t i c i p a t e i n c o n t i n u i n g education a c t i v i t y and general p e r s o n a l i n f o r m a t i o n (Appendix B). A stamped, addressed envelope was enclosed f o r q u e s t i o n n a i r e r e t u r n . Complete anonymity was maintained. By A p r i l 6, 1980 a t o t a l of 142 q u e s t i o n n a i r e s , or 50.5% of the mailout had been r e t u r n e d . At that time, i n order to ob t a i n a higher rate of r e t u r n , the i n v e s t i g a t o r mailed a followup l e t t e r to each s u b j e c t reminding her to complete the q u e s t i o n n a i r e and r e t u r n i t and to thank her fo r her p a r t i c i p a t i o n i f she had a l r e a d y done so. An a d d i t i o n a l 65 completed q u e s t i o n n a i r e s were r e c e i v e d , y i e l d i n g an o v e r a l l 65 response r a t e of 73.7%. Seven of these q u e s t i o n n a i r e s were r e c e i v e d a f t e r the A p r i l 17, 1980 d e a d l i n e and were not i n c l u d e d i n the s t a t i s t i c a l a n a l y s i s . Another ten respondents re t u r n e d blank q u e s t i o n n a i r e s a d v i s i n g that they were e i t h e r unemployed or r e t i r e d and c o u l d not respond to the q u e s t i o n s . The number of returned and completed q u e s t i o n n a i r e s used i n the s t a t i s t i c a l a n a l y s e s was 190, which c o n s t i t u t e d 67.6% of the survey p o p u l a t i o n . Data A n a l y s i s Data from the 190 completed q u e s t i o n n a i r e s were coded, scored and t r a n s f e r r e d to key punching i n f o r m a t i o n sheets. The U n i v e r s i t y of B r i t i s h Columbia's keypunching S e r v i c e was used to keypunch and check computer c a r d s . The U n i v e r s i t y of B r i t i s h Columbia Computing Center's S t a t i s t i c a l Package f o r the S o c i a l S ciences V e r s i o n 8.00 (Under MTS) was used to analyze the data. C h a r a c t e r i s t i c s of the Sample U n i v a r i a t e and b i v a r i a t e frequency d i s t r i b u t i o n t a b l e s were c o n s t r u c t e d to represent the v a r i o u s demographic and socioeconomic c h a r a c t e r i s t i c s of the sample. Where a p p r o p r i a t e , means, standard d e v i a t i o n s , minimums, maximums, modes, ranges and percentages were computed. Although a 67.6% response r a t e was c o n s i d e r e d a c c e p t a b l e f o r r e t u r n of a lengthy q u e s t i o n n a i r e , i t was important to a s c e r t a i n the e f f e c t of non-response b i a s . D i e t i t i a n s who 66 responded l a t e were o b v i o u s l y harder to reach and i t was a n t i c i p a t e d that along a continuum l a t e responders would be expected to f a l l between e a r l y responders and non-responders. The t - t e s t s t a t i s t i c was used to compare d i e t i t i a n s who responded to the f i r s t m a i l i n g with those who responded l a t e r , on the b a s i s of age; geographic l o c a t i o n ; l e n g t h of education; years s i n c e degree; type of employment agency; hours of work and years employed as a d i e t i t i a n . Based on the r e s u l t s of the t e s t s f o r a l l but one of the v a r i a b l e s t e s t e d , no s i g n i f i c a n t d i f f e r e n c e s (p= 0.05) between the two groups were found. The two groups of respondents were s i g n i f i c a n t l y d i f f e r e n t with r e s p e c t to geographic region from which they r e p o r t e d . The r e s u l t was h i g h l y s i g n i f i c a n t (p= 0.001) i n d i c a t i n g a l e s s than 1% chance that the c o r r e l a t i o n , r=0.545, was a random r e l a t i o n s h i p . In f a c t t h i s f i n d i n g was not unexpected i n that the m a i l s e r v i c e has f r e q u e n t l y been r e p o r t e d as being u n r e l i a b l e . Such v a r i a n c e i n h a n d l i n g of the mail c o u l d c e r t a i n l y i n f l u e n c e the r e t r i e v a l of mail i n a survey such as t h i s . In a d d i t i o n , the p r o v i n c e ' s d i e t i t i a n s are unevenly d i s t r i b u t e d i n the nine regions of the p r o v i n c e and with q u e s t i o n n a i r e s being returned from o u t l y i n g areas i t was a n t i c i p a t e d that s t a t i s t i c a l a nalyses might p i n p o i n t a d i f f e r e n c e among r e g i o n s . 67 Test ing the Hypotheses, The frequency d i s t r i b u t i o n s together with the means, standard d e v i a t i o n s and ranges of scores on the three determinants of i n t e n t i o n s ( i . e . a t t i t u d e s (Ag), s u b j e c t i v e normative b e l i e f s (SSN), and s u b j e c t i v e p e r s o n a l normative b e l i e f s (SPN) were computed. M u l t i p l e r e g r e s s i o n was then s e l e c t e d as the s t a t i s t i c a l procedure to develop a c a u s a l model among the determinants of i n t e n t i o n s , past p a r t i c i p a t i o n and the s e l e c t e d socioeconomic and demographic v a r i a b l e s . Since determining the r e l a t i o n s h i p s between v a r i a b l e s which p r o v i d e d the most s t a t i s t i c a l s i g n i f i c a n c e was a' g e n e r a l aim of t h i s r e s e a r c h , step-wise r e g r e s s i o n was used. T h i s s t a t i s t i c a l procedure c o n t r u c t s an equation by adding one independent v a r i a b l e at a time, while c o n t r o l l i n g a l l other independent v a r i a b l e s . L o g i c a l l y , the independent v a r i a b l e added i n the f i r s t step would be the most s t a t i s t i c a l l y and s i g n i f i c a n t l y r e l a t e d to the dependent v a r i a b l e (past p a r t i c i p a t i o n ) , whereas the second v a r i a b l e added to the r e g r e s s i o n equation would be the one, which, i n c o n j u n c t i o n with the f i r s t v a r i a b l e , p rovided the next best s t a t i s t i c a l s i g n i f i c a n c e . A l l other v a r i a b l e s were added step-wise, u n t i l a l l the v a r i a b l e s s e l e c t e d were accounted f o r ( K e r l i n g e r , 1979). The s t a n d a r d i z e d r e g r e s s i o n c o e f f i c i e n t , or Beta weight, i n d i c a t e d the r e l a t i v e weights of each v a r i a b l e i n the equation with the e f f e c t s of a l l other v a r i a b l e s h e l d c onstant. The Beta weight i s an i n d i c a t o r of the d i r e c t e f f e c t of. each independent v a r i a b l e on the dependent v a r i a b l e . 68 Multiple regression was then used to develop a causal model of the relationships between the dependent variable (past part i c i p a t i o n ) and the three determinants of intentions (Ag, SSN, and SPN). Pearson's product-moment c o e f f i c i e n t of co r r e l a t i o n (r) was used to test for s i g n i f i c a n t relationships between past p a r t i c i p a t i o n and intentions, and between past p a r t i c i p a t i o n and the demographic and socioeconomic variables. Intention to parti c i p a t e scores were then correlated with each of the demographic and socioeconomic variables to determine s i g n i f i c a n t relationships. Summary Chapter III has defined the population used in th i s study and provided an outline of the procedures c a r r i e d out in t h i s research. The questionnaire has been described in terms of i t s source, and adaptation for use in th i s study. Data c o l l e c t i o n and a plan for s t a t i s t i c a l analyses have been explained. 69 CHAPTER IV RESULTS AND DISCUSSION This chapter has been organized to present the findings as they relate to the major purposes of this research. Respondent d i e t i t i a n s are p r o f i l e d in terms of the general demographic and socioeconomic data they provided. Si g n i f i c a n t differences with respect to socioeconomic variables and past p a r t i c i p a t i o n in continuing education among respondents are reported and discussed. The results of hypotheses testing are presented and di scussed Behavioral intention scores for the group are presented and compared to the findings of previous studies. Lastly, the potential of Fishbein's t h e o r e t i c a l model for use in prediction of health professionals' intentions to par t i c i p a t e in continuing education for health professionals i s discussed. Description of Respondents A summary of the socioeconomic c h a r a c t e r i s t i c s of the respondents i s found in Table 5. The respondents ranged in age from 23 to 67 years with the mean age being 35.8 years. Respondents had been employed an average 9.5 years and reported that 4.1 years related to employment in their present p o s i t i o n . Of the 190 respondent d i e t i t i a n s , 86 (45.3%) were less than 30 years of age, 71(37.3%) were between the ages of 31 and 50 years, and 16.3% reported their age to be greater than 50 years (Table 6). Table 5 Summary of Socioeconomic C h a r a c t e r i s t i c s of Respondents ( I n t e r v a l Data) C h a r a c t e r i s t i c s Mean Standard Deviat ion Range Age (years) 35.8 11.1 23-67 Years s i n c e g r a duation 13.6 11.0 1-45 T o t a l years employed 9.5 8.4 .25-36 Years employed i n present p o s i t ion 4.1 4.9 .25-26 Hours worked each week 32.8 9.4 0-55 71 Table 6 D i s t r i b u t i o n of Respondents by Age i n Years Age Number Percentage 23-30 86 45.3 31-40 47 24.7 41-50 24 12.6 51-67 31 16.3 M i s s i n g Cases 2 1 .1 TOTAL 190 100.0 Mode 26.0 y r s . Educat ion A m a j o r i t y of the d i e t i t i a n s (84.2%) r e p o r t e d having completed only the r e q u i r e d b a c c a l a u r e a t e degree i n human n u t r i t i o n and d i e t e t i c s . T h i r t y of the d i e t i t i a n s responding i n t h i s survey had completed an a d d i t i o n a l u n i v e r s i t y degree, with only one respondent having obtained a degree at the d o c t o r a l l e v e l (Table 7). 72 Table 7 Education C h a r a c t e r i s t i c s of Respondents Education Number Percentage Bachelor's Degree 160 84.2 Master's Degree 29 15.3 Ph.D. 1 0.5 T o t a l 190 100.0 Years Since Degree Number Percent of T o t a l < 5 years 54 28.4 6-10 years 53 27.9 11-15 years 24 12.6 > 15 years 58 30.5 M i s s i n g Cases 1 0.5 TOTAL 190 99.9 Range 1-45 years Mode 5 years 73 Greater than one-half of the d i e t i t i a n s had r e c e i v e d t h e i r most recent degree in the l a s t 10 y e a r s . The average number of years s i n c e g r aduation f o r a l l respondents was 13.6 years (S.D., 11.0 yea r s ; range, 1-45 years) (Table 7). Employment C h a r a c t e r i s t i c s D i e t i t i a n s i n t h i s study had been employed f o r an average 9.5 years (standard d e v i a t i o n , 8.4 years) with 45.2% r e p o r t i n g t h e i r t o t a l years employment in the range of 3-10 years (Table 8). Job turnover among these p r o f e s s i o n a l d i e t i t i a n s may be s u b s t a n t i a l as i n d i c a t e d by the 53.7% of respondents who r e p o r t e d that they had assumed t h e i r most recent p o s i t i o n w i t h i n the l a s t two y e a r s . However s i n c e n e a r l y one-half of the respondents are l e s s than 30 years of age many of the d i e t i t i a n s may i n f a c t have been r e p o r t i n g t h e i r very f i r s t employment s i n c e g r a d u a t i o n . Nearly t w o - t h i r d s (66.8%) of the d i e t i t i a n s i n t h i s study r e p o r t e d t h e i r average work week to range between 35 and 40 hours(Table 8 ) . Acute care general h o s p i t a l s employed by f a r the l a r g e s t number of d i e t i t i a n s (45.3%) and i f every type of h o s p i t a l i s c o n s i d e r e d , a t o t a l of 130 d i e t i t i a n s i n d i c a t e d employment with e i t h e r acute or extended c a r e , c h i l d r e n ' s , p r i v a t e , p s y c h i a t r i c or r e h a b i l i t a t i o n h o s p i t a l s (Table 8 ) . The second l a r g e s t employer of d i e t i t i a n s i n the p r o v i n c e of B r i t i s h Columbia i s the government under whose v a r i o u s j u r i s t i c t i o n s are the c i t y and p r o v i n c i a l community h e a l t h departments. 74 Table 8 Employment C h a r a c t e r i s t i c s of Respondents Years Employed Number Percentage < 1 year 1 0.5 1- 2 years 33 17.4 3- 5 years 46 24.2 6-10 years 40 21 .0 11-15 years 25 13.2 > 15 years 44 23.2 M i s s i n g cases 1 0.5 TOTAL 190 100.0 Years i n Present P o s i t i o n Number Percentage < 1 year 16 8.4 1- 2 years 86 45.3 3- 5 years 32 16.8 6-10 years 32 16.8 11-15 years 9 4.7 > 15 years 8 4.2 M i s s i n g cases 7 3.7 TOTAL 1 90 99.9 (Table 8 Continued) 75 Table 8 (Continued) Hours of Work/Week Number Percentage 35.0 - 40.0 1 27 66.8 <35.0 47 24.7 >40.0 8 4.2 Mi s s i n g Cases 8 4.2 TOTAL 190 99.9 Place of Employment Number Percentage Acute Care General H o s p i t a l 86 45.3 Community 23 12.1 Extended Care 18 9.5 Acute and Extended Care 1 3 6.8 Education 6 3.1 C h i l d r e n ' s H o s p i t a l 5 2.6 P s y c h i a t r i c F a c i l i t y 5- 2.6 Unemployed 4 2.1 R e h a b i l i t a t i o n Centre 2 1 .1 P r i v a t e H o s p i t a l 1 0.5 Other 25 13.2 M i s s i n g Cases 2 1 . 1 TOTAL 190 100.0 76 Job R e s p o n s i b i l i t y Table 9 shows what p r o p o r t i o n of t h e i r job d u t i e s l a y w i t h i n the f i v e most commonly known s p e c i a l i t i e s of the d i e t e t i c s p r o f e s s i o n . " Table 9 D i s t r i b u t i o n of Respondents by Percentage of Time Devoted to V a r i o u s Job D u t i e s Percentage Jc >b D u t i e s C l i n i c a l Admin. Research 100 51-99 1-50 0 M i s s i n g 15 36 72 58 9 7 50 65 59 9 1 0 30 1 50 9 TOTAL 1 90 190 190 Educat ion Community Other 100 51-99 1-50 0 M i s s i n g 2 6 91 82 9 6 18 57 100 9 2 3 1 4 162 9 TOTAL 190 190 190 Very few of the respondents i n d i c a t e d that t h e i r job r e s p o n s i b i l i t i e s were t r u l y s p e c i a l i z e d . For example, only 15 and 7 d i e t i t i a n s r e s p e c t i v e l y , i n d i c a t e d that t h e i r job d u t i e s as p e r c e i v e d by themselves, were p u r e l y w i t h i n the c l i n i c a l and a d m i n i s t r a t i v e s p e c i a l i t i e s . By f a r the g r e a t e s t number of d i e t i t i a n s r e p o r t e d a mixture of job r e s p o n s i b i l i t i e s among the 77 v a r i o u s c a t e g o r i e s o f f e r e d . For example, 115 d i e t i t i a n s i n d i c a t e d t h e i r job d u t i e s were concerned with a d m i n i s t r a t i o n but a l s o c o n t a i n e d other aspects such as c l i n i c a l , r e s e a r c h or e d u c a t i o n . Almost the same number of d i e t i t i a n s (108) i n d i c a t e d c l i n i c a l r e s p o n s i b i l i t i e s combined with r e s p o n s i b i l i t i e s w i t h i n another s p e c i a l t y . One d i e t i t i a n r e p o r t e d being e x c l u s i v e l y engaged with r e s e a r c h , two r e p o r t e d e x c l u s i v e involvement with education and s i x of the respondents i n d i c a t e d a t o t a l involvement with community c o u n s e l l i n g . Geographic Region and Continuing Education Table 10 shows the geographic region i n which respondents were employed. Due i n p a r t to the BCDNA s e p a r a t i o n of the membership i n t o v a r i o u s regions i t was a n t i c i p a t e d that v a r y i n g p a r t i c i p a t i o n i n c o n t i n u i n g education a c t i v i t i e s would become apparent. Of the 190 respondents a t o t a l of 183 i n d i c a t e d that they had p a r t i c i p a t e d i n c o n t i n u i n g education w i t h i n the past 36 months (mean 2.3 months). Only seven d i e t i t i a n s i n t h i s study i n d i c a t e d t h at they had never p a r t i c i p a t e d i n c o n t i n u i n g education a c t i v i t i e s . Regional response r a t e s are a l s o d i s p l a y e d i n Table 10. Less than f i f t y percent r e t u r n was obtained from only one of the nine regions i n the study. 78 Table 10 Response Rates and P a r t i c i p a t i o n of D i e t i t i a n s in C o n t i n u i n g Education by Geographic Region Geographic Region Q u e s t i o n n a i r e s Number Sent Returned P a r t i c i p a t i o n i n C o n t i n u i n g Education Number Yes No Greater Vane. Vancouver I s . F r a s e r V a l l e y Okanagan Thompson North East West Kootenay North West East Kootenay M i s s i n g Information 122 55 56 1 1 1 1 12 6 2 6 91 33 30 1 1 9 6 4 2 2 74.6 60.0 53.6 100.0 81 .8 50.0 66.7 100.0 33.3 87 33 28 1 1 9 6 4 2 2 TOTAL 281 190 67.6 183 Table 11 shows which method of study respondents used i n t h e i r most recent c o n t i n u i n g education a c t i v i t y . Greater than 65% of the d i e t i t i a n s i n d i c a t e d t h a t l e c t u r e s , addresses, conferences, seminars, workshops and i n s t i t u t e s were the most recent methods, with f a r fewer i n v o l v e d i n d i s c u s s i o n groups, medical rounds and academic and non-academic courses. 79 Table 11 Most Recent and P r e f e r r e d Methods of Study Used by D i e t i t i a n s to Obtain C o n t i n u i n g Education Method Most I lecent Most E } r e f err •ed No. % No. % Rank L e c t u r e s , addresses 73 38.4 81 42.6 2 Conferences, seminars, workshops, i n s t i t u t e s 52 27.4 109 57.4 1 Jo u r n a l c l u b s 10 5.3 D i s c u s s i o n group 7 3.7 33 17.4 3 - Medical rounds 7 3.7 Academic courses 5 2.6 24 12.6 4 Non-academic courses 5 2.6 23 12.1 5 I n d i v i d u a l study 3 1 .6 E d u c a t i o n a l T.V. 3 1 .6 Study with prepared tapes 2 1 . 1 Correspondence study 1 0.5 Observation study 1 0.5 V i s i t i n g at e x h i b i t s 1 0.5 M i s s i n g cases 13 6.8 Never p a r t i c i p a t e d 7 3.7 TOTAL 190 100.0 142. 1 * * Note: Column adds up to more than 100% because respondents c o u l d mark more than one response i n t h e i r ranking 1-5. The predominant l e a r n i n g methods used by d i e t i t i a n s to 80 continue t h e i r l e a r n i n g represent commonly a v a i l a b l e and t r a d i t i o n a l forms of ed u c a t i o n . Many of the other methods l i s t e d represent recent i n n o v a t i o n s and may be u n f a m i l i a r to many of the respondents. Indeed, the p r o f e s s i o n a l a s s o c i a t i o n BCDNA, which p u b l i c i z e s the a v a i l a b i l i t y of c o n t i n u i n g education m a t e r i a l , had only j u s t r e c e n t l y committed i t s e l f to the use of vide o t a p e s which c o u l d subsequently be made a v a i l a b l e to members unable to at t e n d the s e r i e s of c o n t i n u i n g education courses o f f e r e d . I n d i v i d u a l study tapes on a wide range of t o p i c s are a v a i l a b l e from The American D i e t e t i c A s s o c i a t i o n (ADA). These tapes are p u b l i c i z e d by that a s s o c i a t i o n to i t s own membership fo r purchase or r e n t a l . I t would be i n t e r e s t i n g to know how many of t h i s p r o v i n c e ' s d i e t i t i a n s are aware of such l e a r n i n g o p p o r t u n i t i e s . Membership i n the P r o f e s s i o n a l A s s o c i a t i o n and Cont i n u i n g  Education Nearly 87% of the respondents i n d i c a t e d that they had q u a l i f i e d f o r membership i n the BCDNA through the t r a d i t i o n a l route of completing a d i e t e t i c i n t e r n s h i p . Far fewer had used work experience (n=9), master's degree (n=4), the CDA examination (n=3), or r e c i p r o c i t y with the American D i e t e t i c A s s o c i a t i o n (n=l) as a means of o b t a i n i n g membership i n the p r o f e s s i o n a l a s s o c i a t i o n . More than one-half of the d i e t i t i a n s had j o i n e d the BCDNA w i t h i n . t h e past f i v e years and g r e a t e r than t h r e e - q u a r t e r s of the d i e t i t i a n s i n d i c a t e d they had h e l d 81 membership f o r between one and ten y e a r s . On average, d i e t i t i a n s had been memebers of BCDNA f o r 6.5 years (S.D.±6.7 years; range, 1-40 y e a r s ) . Since p a r t i c i p a t i o n i n c o n t i n u i n g education has j u s t r e c e n t l y become a compulsory aspect of membership i n the p r o f e s s i o n a l a s s o c i a t i o n f o r d i e t i t i a n s , respondents were asked to r e f l e c t on t h i s change r e g a r d i n g any e f f e c t i t may have on t h e i r i n t e n t i o n to p a r t i c i p a t e i n c o n t i n u i n g e d u c a t i o n . A c c o r d i n g l y , when asked whether the change to compulsory c o n t i n u i n g education would a f f e c t t h e i r p a r t i c i p a t i o n i n the next year as compared to the past year, g r e a t e r than 85% of the d i e t i t i a n s i n d i c a t e d that they a n t i c i p a t e d no change i n the l e v e l of t h e i r p a r t i c i p a t i o n . An a d d i t i o n a l 8.9% of respondents i n d i c a t e d t hat they would p a r t i c i p a t e more than they had done i n the past year compared to a very small number (5.3%) who a d v i s e d that they intended to p a r t i c i p a t e to a l e s s e r degree. When d i e t i t i a n s were asked to estimate the s p e c i f i c number of hours they intended to devote to c o n t i n u i n g education i n the next year n e a r l y the same number i n d i c a t e d they would devote 1-25 hours (n=86) as would devote 26-75 hours (n=87). O v e r a l l , d i e t i t i a n s i n d i c a t e d they intended to devote an average 34.9 hours (S.D.±20.5; range, 8-91 hours) to c o n t i n u i n g education i n the next year. T h i s f i n d i n g i s comparatively low when compared to m e t r o p o l i t a n Chicago d i e t i t i a n s who r e p o r t e d an average 19.6 p a r t i c i p a t i o n hours per month ( H o l l i , 1981). Of a l l the respondents, only 1.1% of the p o p u l a t i o n i n d i c a t e d that there was no chance they would p a r t i c i p a t e i n c o n t i n u i n g education i n 82 the next year. A d d i t i o n a l comments on the in f o r m a t i o n sheet i n d i c a t e d that of the two d i e t i t i a n s i n q u e s t i o n , one foresaw l i t t l e time to devote s i n c e she was expecting a baby, whereas the other respondent i n d i c a t e d she was l e a v i n g f o r an extended v a c a t i o n from her p r o f e s s i o n a l r o l e . One hundred and twenty-six d i e t i t i a n s , r e p r e s e n t i n g 66.3% of the sample, i n d i c a t e d t h a t there was a 100% chance of t h e i r p a r t i c i p a t i n g i n c o n t i n u i n g education i n t h e i r next year. F i f t e e n (7.9%) i n d i c a t e d a 1-49% chance with g r e a t e r than three times as many d i e t i t i a n s (n=47 or 24.7%) r e p o r t i n g a 50-99% chance of t h e i r p a r t i c i p a t i n g d u r i n g the next 12 months. Each member d i e t i t i a n i s requested by the BCDNA Continuing Education Committee to submit a n n u a l l y a summary sheet d e t a i l i n g her p a r t i c i p a t i o n i n c o n t i n u i n g education over the past year. The BCDNA Co n t i n u i n g Education Committee examines each r e p o r t t o ensure that each member was c l a i m i n g only a c c e p t a b l e c o n t i n u i n g education experiences f o r d i e t i t i a n s as d e t a i l e d i n the Con t i n u i n g Education G u i d e l i n e s (Appendix A ) . Each member r e c e i v e s w r i t t e n n o t i f i c a t i o n of how many c o n t i n u i n g education p o i n t s have been recorded f o r the past year. Members are advi s e d of any changes made to t h e i r r e p o r t s . For example, p o i n t s which have not been deemed ac c e p t a b l e a c c o r d i n g to the G u i d e l i n e s are i d e n t i f i e d . Respondents i n t h i s sample r e p o r t e d an average 38 p o i n t s (S.D.±43.9) submitted d u r i n g the past f i v e year r e p o r t i n g p e r i o d . Assuming that f o r most c o n t i n u i n g education a c t i v i t i e s one c o n t a c t hour i s approximately e q u i v a l e n t to one p o i n t , 83 d i e t i t i a n s had accumulated i n some cases, impressive t o t a l s of p o i n t s over the past f i v e years (range 0-212.0 p o i n t s ) . Twenty-nine respondents advised they had re p o r t e d to the BCDNA a t o t a l i n excess of the recommended minimum 75 p o i n t s over a f i v e year p e r i o d . A t o t a l of 70 d i e t i t i a n s i n d i c a t e d t hat they had not submitted to the BCDNA any p o i n t s over the past f i v e y e a r s . J u s t over one-tenth of these (n=1l) i n d i c a t e d that they had only r e c e n t l y become BCDNA members and had not yet accumulated any p o i n t s , whereas the remainder (n=59) simply d i d not wish to repo r t any p o i n t s to t h e i r p r o f e s s i o n a l o r g a n i z a t i o n . A d d i t i o n a l comments from some of those who had not re p o r t e d c o n t i n u i n g education p o i n t s advised of lack of time (n=8) or a f i r m u n w i l l i n g n e s s to have p o i n t s s c r u t i n i z e d (n=l0) as t h e i r reasons f o r not submitting r e p o r t s . A great number of d i e t i t i a n s (n=l06) i n d i c a t e d that they had accumulated some c o n t i n u i n g education p o i n t s which had not been submitted f o r c r e d i t to BCDNA over the l a s t f i v e y e a r s . On average 30 p o i n t s per d i e t i t i a n had not been submitted f o r c r e d i t with a S.D.±52.3 p o i n t s and a range 2-350.0 p o i n t s . No attempt had been made to have d i e t i t i a n s i n d i c a t e why p o i n t s had not been submitted f o r c r e d i t , and although some respondents (n=l8) v o l u n t e e r e d comments i n t h i s s e c t i o n , the m a j o r i t y d i d not. One can only s p e c u l a t e that perhaps these p o i n t s d i d not q u a l i f y under the g u i d e l i n e s c i r c u l a t e d by the BCDNA, or that these represent an excess over the 75 recommended p o i n t s or tha t , as a few respondents had i n d i c a t e d , they had n e i t h e r the time nor the compunction to submit p o i n t s f o r c r e d i t . 84 D i s c u s s i o n The p r o f i l e of the average " t y p i c a l " d i e t i t i a n i n c l u d e d i n t h i s study i n d i c a t e s that she was employed by a h o s p i t a l and had secured her c u r r e n t p o s i t i o n w i t h i n the l a s t two y e a r s . She had earned a b a c c a l a u r e a t e degree i n human n u t r i t i o n and d i e t e t i c s w i t h i n the l a s t ten years, was most l i k e l y between the age of 23 and 30 years and has been employed i n d i e t e t i c s f o r an average of 9.5 ye a r s . The t y p i c a l respondent was not l i k e l y to occupy a s p e c i a l t y p o s i t i o n , but ra t h e r to have a p o s i t i o n which o f f e r s a v a r i e t y of d u t i e s (e.g. c l i n i c a l , a d m i n i s t r a t i v e , e d u c a t i o n a l , r e s e a r c h and/or community c a r e ) . D i e t i t i a n s i n B r i t i s h Columbia appear to be very a c t i v e l y i n v o l v e d i n and committed to c o n t i n u i n g t h e i r education over t h e i r e n t i r e p r o f e s s i o n a l l i v e s . S e l f - r e p o r t r e g a r d i n g the most « recent and the most p r e f e r r e d methods of study used by d i e t i t i a n s i n d i c a t e s that f a i r l y t r a d i t i o n a l e d u c a t i o n a l program o f f e r i n g s are frequented and p r e f e r r e d by t h i s group of respondents. The r e l a t i v e l y small numbers of d i e t i t i a n s who rep o r t e d having used i n d i v i d u a l study methods, e d u c a t i o n a l T.V., study from prepared tapes, o b s e r v a t i o n study and correspondence study i s not s u r p r i s i n g s i n c e not only do these represent f a i r l y recent e d u c a t i o n a l o f f e r i n g s i n the f i e l d of d i e t e t i c s , but a l s o t h e i r a v a i l a b i l i t y i s not widespread. R e s u l t s of t h i s survey i n d i c a t e d that n e a r l y the same number of c o n t i n u i n g education p o i n t s were re p o r t e d (mean=38 p o i n t s ; S.D.±43.9) as not r e p o r t e d (mean=30 p o i n t s ; S.D.±52.3) to the BCDNA. T h i s f i n d i n g may be of i n t e r e s t to the 85 p r o f e s s i o n a l o r g a n i z a t i o n . H o l l i (1981) r e p o r t e d that r e g i s t e r e d d i e t i t i a n s devoted s i g n i f i c a n t l y more hours to a c t i v i t i e s not e l i g i b l e f o r ADA c o n t i n u i n g education c r e d i t than to a c t i v i t i e s t h a t were e l i g i b l e . Based on the responses from the 194 respondents i n a random sample of Chicago based d i e t i t i a n s , H o l l i concluded that d i e t i t i a n s are not i n t e r e s t e d in c o n t i n u i n g t h e i r education s t r i c t l y f o r c r e d e n t i a l l i n g purposes. The r e p o r t i n g of c o n t i n u i n g education p o i n t s to the BCDNA appears a c o n t e n t i o u s i s s u e f o r approximately 49 of the respondents i n t h i s survey. I t w i l l be important to understand more c l e a r l y why these d i e t i t i a n s e l e c t e d not to submit p o i n t s on a r e g u l a r b a s i s f o r s c r u t i n y by the p r o f e s s i o n a l a s s o c i a t i o n , whether these d i e t i t i a n s w i l l change t h e i r minds r e g a r d i n g t h i s matter or whether the a s s o c i a t i o n w i l l re-examine the r e l a t i v e importance of the r e p o r t i n g e x e r c i s e by i t s membership. The o u t s t a n d i n g i s s u e , i s of course,whether the report of p o i n t s i s as or more important than the p a r t i c i p a t i o n behaviour i t s e l f . B e l i e f s About P a r t i c i p a t i o n i n C o n t i n u i n g Education A seven p o i n t s c a l e was used to assess d i e t i t i a n s ' s u b j e c t i v e p e r s o n a l normative (SPN) b e l i e f s about t h e i r p a r t i c i p a t i o n i n c o n t i n u i n g e d u c a t i o n . A score of s i x was used to i n d i c a t e s t r o n g commitment toward, strong b e l i e f about, or a pronounced w i l l i n g n e s s to p a r t i c i p a t e i n c o n t i n u i n g education. Zero on the other hand, represented the opposite extreme or no commitment, d i s b e l i e f or an u n w i l l i n g n e s s to p a r t i c i p a t e i n 86 c o n t i n u i n g e d u c a t i o n . Those respondents harbouring strong negative b e l i e f s about p a r t i c i p a t i o n i n c o n t i n u i n g education would tend to mark the zero score i n responding to t h i s s e c t i o n of the q u e s t i o n n a i r e . D i e t i t i a n s were asked to eva l u a t e a set of qu e s t i o n s r e g a r d i n g t h e i r m o t i v a t i o n to p a r t i c i p a t e i n c o n t i n u i n g education a c t i v i t i e s . The f i r s t p a r t of each q u e s t i o n asked the respondent to s t a t e her o p i n i o n and subsequently to advise what m o t i v a t i o n she f e l t to comply with her b e l i e f (Table 12). Using Equation 5 (see p. 34), the responses were summed to co n s i d e r a l l q u e s t i o n s regarding the p e r s o n a l m o t i v a t i o n s of d i e t i t i a n s to p a r t i c i p a t e i n c o n t i n u i n g e d u c a t i o n . E i g h t y - n i n e respondents, and a s l i g h t l y higher number (n=99) b e l i e v e d that d i e t i t i a n s were "very" and "somewhat" committed r e s p e c t i v e l y , to c o n t i n u i n g t h e i r education over t h e i r e n t i r e p r o f e s s i o n a l l i v e s (Table 12). Only two of the respondents f e l t that d i e t i t i a n s were not committed to the concept of l i f e l o n g l e a r n i n g . An overwhelming 94.2% of d i e t i t i a n s f e l t that d i e t i t i a n s should engage i n c o n t i n u i n g education throughout t h e i r p r o f e s s i o n a l l i v e s with a s i m i l a r high number, 94.8%, i n d i c a t i n g that they p e r s o n a l l y b e l i e v e d they should continue t h e i r own edu c a t i o n . Only a s l i g h t l y s m a l l e r percentage of the respondents, r e p r e s e n t i n g 84.7% of the p o p u l a t i o n , i n d i c a t e d , however, that they f e l t very strongly' w i l l i n g to act on t h e i r b e l i e f to continue t h e i r e ducation. None of the respondent d i e t i t i a n s were u n w i l l i n g to act on t h e i r b e l i e f that they should p a r t i c i p a t e i n c o n t i n u i n g education and 87 none o f . t h e respondents f e l t that d i e t i t i a n s should not continue t h e i r education over t h e i r e n t i r e p r o f e s s i o n a l l i v e s . Table 12 S u b j e c t i v e Personal Normative B e l i e f s (SPN) of D i e t i t i a n s Regarding C o n t i n u i n g Education Statement Score: Frequenc •y of Resf )onse Very £ (6 Strongly 5,5) Some (4, •what 3,2) Not ; (1 i t A l l ,0) N % N % N % 1 . Do. persons i n your p r o f e s s i o n seem committed to c o n t i n u i n g t h e i r education over t h e i r e n t i r e p r o f e s s i o n a l l i f e ? 89 46.8 99 52. 1 2 1 . 1 2. To what extent do you b e l i e v e that persons i n your p r o f e s s i o n should continue t h e i r education over t h e i r p r o f e s s i o n a l l i f e ? 1 79 94.2 1 1 5.8 0 0 3. Do you p e r s o n a l l y b e l i e v e you should p a r t i c i p a t e i n c o n t i n u i n g p r o f e s s i o n a l education throughout your p r o f e s s i o n a l l i f e ? 180 94.7 9 4.7 1 0.5 4. To what extent do you f e e l w i l l i n g to act on your b e l i e f t o 161 84.7 29 15.3 0 0 88 The Consequences of P a r t i c i p a t i n g i n Continuing Education Whether a p r o f e s s i o n a l w i l l p a r t i c i p a t e i n c o n t i n u i n g e d u c a t i o n depends i n p a r t , on what she b e l i e v e s . t h e consequences or r e s u l t s of the experience would be and how she eva l u a t e s these consequences. Respondents were asked to r a t e a t o t a l of 30 s e t s of statements regarding the consequences of t h e i r p a r t i c i p a t i o n i n c o n t i n u i n g education a c t i v i t i e s . Based on the p r e v i o u s l y d e s c r i b e d s c o r i n g system (p. 55) the responses were summed as i n d i c a t e d i n Equation 2 (p. 55) u s i n g two 7-point ( l i k e l y — u n l i k e l y and hig h value--no value) s c a l e s . According to the s c o r i n g format the d i e t i t i a n s ' a t t i t u d e s were determined using only s a l i e n t consequences. N o n - s a l i e n t items were a u t o m a t i c a l l y d i s c o u n t e d s i n c e any score e q u a l l i n g zero c o n t r i b u t e d nothing to the summed t o t a l . Mean s c o r e s , standard d e v i a t i o n and most f r e q u e n t l y a t t a i n e d score f o r each set of statements are l i s t e d i n Table 13 i n order of c o n t r i b u t i o n to the a t t i t u d e score (Ag). A response r a t e of n e a r l y 97% was obta i n e d f o r each statement l i s t e d i n the a t t i t u d e score p o o l , as demonstrated by a response by more than 184 respondents f o r each item. D i e t i t i a n s b e l i e v e d that the op p o r t u n i t y to update and r e f r e s h t h e i r knowledge was the s i n g l e most important consequence of t h e i r p a r t i c i p a t i o n i n c o n t i n u i n g e d u c a t i o n . Mean scores of 25.9, 24.9 and 24.0 i n d i c a t e d that d i e t i t i a n s b e l i e v e d t h e i r p a r t i c i p a t i o n i n c o n t i n u i n g education would p r o v i d e p e r s o n a l i n t e l l e c t u a l s t i m u l a t i o n as w e l l as the s p e c i a l i z e d s k i l l s to serve t h e i r c l i e n t s i n a competent manner. 89 In order of d e c r e a s i n g importance d i e t i t i a n s judged that t h e i r p a r t i c i p a t i o n i n c o n t i n u i n g education c o u l d improve t h e i r p r o f e s s i o n a l competence, remedy d e f i c i e n c i e s i n t r a i n i n g and improve t h e i r p e r s o n a l a b i l i t y to e v a l u a t e job performance. Of almost equal importance, p a r t i c i p a t i o n appeared i n the minds of respondents to be one way of s a t i s f y i n g mandatory c o n t i n u i n g education requirements while improving t h e i r . p r o f e s s i o n a l v i s i b i l i t y and subsequently b e n e f i t i n g employers. Table 13 d i s p l a y s the numbers of respondents and the most f r e q u e n t l y marked score f o r items i n the a t t i t u d e p o o l . Middle range scores of 18.5 and 18.3 i n d i c a t e d that respondent d i e t i t i a n s b e l i e v e c o n t i n u i n g education can p r o v i d e job c h a l l e n g e and work s a t i s f a c t i o n . Very l i t t l e value was p l a c e d on the p o s s i b i l i t y that as a d i r e c t r e s u l t of p a r t i c i p a t i o n i n c o n t i n u i n g education the chances f o r job promotion or c a r e e r m o b i l i t y would improve. As i n d i c a t e d by very low s c o r e s , very few d i e t i t i a n s f e l t that t h e i r p a r t i c i p a t i o n would provide any f i n a n c i a l g a i n , was too c o s t l y or would i n any way cause t h e i r own workload or that of t h e i r co-workers to be i n c r e a s e d . 90 Table 13 Statements Concerning the Consequences of . P a r t i c i p a t i n g i n Order of S a l i e n t C o n t r i b u t i o n to the A t t i t u d e Score (A 6) Statement Me a in S.D • Mode Score N Score N P a r t i c i p a t i o n i n c o n t i n u i n g education would: h e l p me r e f r e s h my p r o f e s s i o n a l knowledge 27 . 7 188 8 . 0 36 71 h e lp me keep up i n my f i e l d 27 . 3 186 7 . 8 36 64 s t i m u l a t e me i n t e l l e c t u a l l y 25 . 9 1 90 8 . 2 36 54 enable me to serve my c l i e n t s b e t t e r 25 . 9 188 8 . 6 36 54 improve the q u a l i t y of my p r o f e s s i o n a l s e r v i c e 24 . 9 185 8 . 6 36 43 c h a l l e n g e my i n t e l l e c t u a l a b i l i t i e s 24 . 0 188 8 . 2 25 44 give me a gr e a t e r sense of p r o f e s s i o n a l competence 23 . 6 185 9 . 0 36 36 h e lp me examine the q u a l i t y of my p r o f e s s i o n a l work 2 2 . 9 188 9 . 9 36 47 i n c r e a s e my net work of p r o f e s s i o n a l c o n t a c t s 2 2 . 8 185 9 . 7 25 37 i n c r e a s e my s p e c i a l i z e d s k i l l 2 2 . 5 189 9 . 7 36 43 remedy d e f i c i e n c i e s i n my p r o f e s s i o n a l t r a i n i n g 2 1 . 8 185 9 . 8 36 36 c o n t r i b u t e to mandatory c o n t i n u i n g educat ion 2 0 . 9 186 1 1 . 9 36 46 i n c r e a s e my p r o f e s s i o n a l v i s i b i l i t y 2 0 . 2 189 1 1 . 4 36 38 b e n e f i t my employer 19 .7 187 1 0 . 6 36 34 Number of respondents = N Range of p o s s i b l e scores = 0-36 (Table 13 Continued) 91 Table 13 (Continued) Statement Me a tn S.D • Mode Score N Score N P a r t i c i p a t i o n i n c o n t i n u i n g education would: allow me to be more v e r s a t i l e i n the work I do 19.6 185 10. 3 25 33 improve my work s a t i s f a c t i o n 18.5 184 10. 8 25 26 make my work more c h a l l e n g i n g 18.3 188 10. 7 36 25 c o n t r i b u t e to the attainment of my pe r s o n a l c a r e e r goals 17.3 189 1 1 . 3 36 27 allow me to i n t e r m i n g l e s o c i a l l y with my p r o f e s s i o n a l c o l l e a g u e s 17.1 186 10. 0 25 26 improve my p r o f e s s i o n a l s t a t u s 16.1 186 10. 6 36 22 r e s u l t i n b e n e f i t s to person 13.4 189 1 1 . 6 0 36 in c r e a s e my job s e c u r i t y 11.8 187 9. 6 9 23 enhance my f u t u r e c a r e e r prospects 10.8 189 10. 9 16 27 a s s i s t me to develop a new car e e r 10.0 188 1 1 . 1 0 54 a s s i s t me i n g a i n i n g a promotion 8.3 188 8. 3 0 53 use up some of my spare time 7. 1 188 10. 3 0 96 cos t too much f o r the b e n e f i t s gained 5.8 189 6. 9 0 58 i n c r e a s e the work l o a d on my co-workers 5.4 187 7. 7 0 86 cause me to get behind i n my work 4.9 186 8. 1 0 95 give me f i n a n c i a l gains 3.5 188 6. 7 0 109 Number of respondents= N P o s s i b l e range of scores= 0-36 92 Subject ive Normative B e l i e f s Regarding P a r t i c i p a t i o n Whether a p r o f e s s i o n a l w i l l p a r t i c i p a t e i n c o n t i n u i n g education depends i n p a r t , on her p e r c e p t i o n s of the ex p e c t a t i o n s of other people and the importance p l a c e d on those e x p e c t a t i o n s . Some of the types of people who might h o l d such e x p e c t a t i o n s f o r p r o f e s s i o n a l d i e t i t i a n s i n c l u d e t h e i r s u p e r v i s o r s , c l o s e p r o f e s s i o n a l a s s o c i a t e s , c l i e n t s ( i n c l u d i n g p a t i e n t s or s t u d e n t s ) , f a c u l t y members, l e a d e r s of the p r o f e s s i o n a l a s s o c i a t i o n to which they belong, employers and fa m i l y members. D i e t i t i a n s were asked to respond to a t o t a l of nine s e t s of statements r e g a r d i n g persons or groups who have e x p e c t a t i o n s about t h e i r p a r t i c i p a t i o n i n c o n t i n u i n g e d u c a t i o n . I f the persons or groups d i d not e x i s t i n t h e i r s i t u a t i o n , respondents were asked to d i s r e g a r d that p a r t i c u l a r set of statements. Based on the p r e v i o u s l y d e s c r i b e d s c o r i n g format (p. 57), the responses were summed f o r each r e f e r e n t as i n d i c a t e d i n Equation 3. D i e t i t i a n s were i n v i t e d to "write i n " r e f e r e n t s which were not otherwise p r o v i d e d f o r on the s c a l e . The p e r c e p t i o n s of respondent d i e t i t i a n s with r e s p e c t to the e x p e c t a t i o n s h e l d by s i g n i f i c a n t o t h e r s regarding t h e i r p a r t i c i p a t i o n i n c o n t i n u i n g education are summarized i n Table 14. 93 Table 14 S o c i a l S u b j e c t i v e Normative (SSN) Scores Regarding the E x p e c t a t i o n s of S i g n i f i c a n t Referents and the P a r t i c i p a t i o n of D i e t i t i a n s i n Co n t i n u i n g Education S i g n i f i c a n t R e f e rents Me£ in S.D. Mode Score N Score N p r o f e s s i o n a l a s s o c i a t i o n 5.8 189 2.4 8 79 fa m i l y , parents 5.6 37 3.3 8 18 le a d e r s i n p r o f e s s i o n a l a s s o c i a t i o n 5.5 189 2.4 8 69 su p e r v i s o r 4.9 1 73 2.9 8 48 employer 4.3 182 3.1 8 54 spouse 4.0 1 34 3.4 8 45 f a c u l t y who t r a i n e d 3.6 1 62 3.0 0 41 c l o s e p r o f e s s i o n a l a s s o c i a t e s 3.3 188 2.6 0 43 c l i e n t s 2.1 171 2.7 0 86 N= number of respondents Maximum score= 8.0 p o i n t s Minimum score= 0 p o i n t s C l i e n t s , c l o s e p r o f e s s i o n a l a s s o c i a t e s and the f a c u l t y who had t r a i n e d them were p e r c e i v e d by respondent d i e t i t i a n s to have very l i t t l e impact on t h e i r reasons f o r p a r t i c i p a t i n g i n c o n t i n u i n g e d u c a t i o n . T h e i r p r o f e s s i o n a l a s s o c i a t i o n and le a d e r s of the a s s o c i a t i o n were given mean scores of 5.8 and 5.5 p o i n t s r e s p e c t i v e l y i n d i c a t i n g they p l a y a very strong r o l e i n 94 the shaping of d i e t i t i a n s ' i n t e n t i o n s t o p a r t i c i p a t e i n c o n t i n u i n g education a c t i v i t i e s . . Mean scores f o r each r e f e r e n t were based on the number of responses obtained f o r each item on the s o c i a l s u b j e c t i v e normative (SSN) s c a l e . T h i r t y - s e v e n respondent d i e t i t i a n s 'wrote i n ' f a m i l y , and t h e i r parents as r e f e r e n t s not otherwise p r o v i d e d f o r on the s o c i a l s u b j e c t i v e normative b e l i e f (SSN) s c a l e . These 'write i n ' r e f e r e n t s emerged second only to the p r o f e s s i o n a l a s s o c i a t i o n as being powerful determinants of d i e t i t i a n s ' i n t e n t i o n s to p a r t i c i p a t e i n c o n t i n u i n g e d u c a t i o n . N e v e r t h e l e s s i t should be noted that 153 respondents made no mention of fa m i l y as s i g n i f i c a n t r e f e r e n t s . D i s c u s s i o n As a group, respondent d i e t i t i a n s h e l d almost uniform b e l i e f s r e g a r d i n g the p a r t i c i p a t i o n of members of t h e i r p r o f e s s i o n a l group i n c o n t i n u i n g h e a l t h p r o f e s s i o n a l e d u c a t i o n . An overwhelming number of respondents b e l i e v e d that d i e t i t i a n s should continue t h e i r education and f e l t p e r s o n a l l y o b l i g e d to act on those b e l i e f s . The p a r t i c i p a t i o n data support the b e l i e f s these p r o f e s s i o n a l s r e p o r t r e g a r d i n g t h e i r p a r t i c i p a t i o n . A t o t a l of 96.3% of the d i e t i t i a n s surveyed i n d i c a t e d that they had p a r t i c i p a t e d i n c o n t i n u i n g education at some time d u r i n g the past 36 months. Only 2 of the respondents i n d i c a t e d that they d i d not inte n d to engage i n a c t i v i t i e s of continued l e a r n i n g i n the next year. Over one-half of the 175 d i e t i t i a n ~ n u t r i t i o n i s t s responding to Wolczuk's (1976) study 95 i n d i c a t e d t h a t they had p a r t i c i p a t e d i n a c o n t i n u i n g education experience d u r i n g the p r e v i o u s 18 months. At that time Wolczuk spe c u l a t e d t h a t d i e t i t i a n s and n u t r i t i o n i s t s i n B r i t i s h Columbia "might v o l u n t a r i l y p a r t i c i p a t e i n n u t r i t i o n c o n t i n u i n g education without the o r g a n i z a t i o n a l pressure of a mandatory requirement" (p.8). In a more recent study examining the extent of c o n t i n u i n g education among p r o f e s s i o n a l d i e t i t i a n s , i n the m e t r o p o l i t a n Chicago area, H o l l i (1981) r e p o r t e d that of 194 respondents only two d i e t i t i a n s had never p a r t i c i p a t e d i n c o n t i n u i n g p r o f e s s i o n a l l e a r n i n g . These f i n d i n g s i n d i c a t e that the m a j o r i t y of d i e t i t i a n s v o l u n t a r i l y engage i n c o n t i n u i n g t h e i r e d u c a t i o n . These f i n d i n g s are good news f o r the p r o f e s s i o n a l a s s o c i a t i o n which had so r e c e n t l y i d e n t i f i e d mandatory c o n t i n u i n g education as one of the c r i t i c a l a s p e c t s of m a i n t a i n i n g a c t i v e membership s t a t u s . Campaigns to pursuade p r o f e s s i o n a l d i e t i t i a n s to p a r t i c i p a t e i n c o n t i n u i n g education do not appear necessary. As.mentioned p r e v i o u s l y , a much bigger c h a l l e n g e f o r the a s s o c i a t i o n l i e s i n i n v e s t i g a t i n g the d i f f e r e n t e d u c a t i o n a l methods at i t s d i s p o s a l to p r o v i d e e d u c a t i o n a l o p p o r t u n i t y to the g r e a t e s t number at the l e a s t c o s t . In a d d i t i o n , the value of the p o i n t r e c o r d i n g system may r e q u i r e r e - e v a l u a t i o n , s i n c e j u s t over o n e - t h i r d of the respondents i n t h i s study had not s u b s c r i b e d to i t s worth. The s i n g l e most important consequence or p e r c e i v e d r e s u l t of p a r t i c i p a t i n g i n c o n t i n u i n g education was r e p o r t e d by n e a r l y a l l the respondents, as the o p p o r t u n i t y to update and r e f r e s h d i e t e t i c knowledge. T h i s being the case, c o n t i n u i n g education 96 courses o f f e r i n g i n f o r m a t i o n r e l a t i v e to recent t e c h n o l o g i c a l advance are as l i k e l y to be attended by d i e t i t i a n s as those courses o f f e r i n g review i n f o r m a t i o n . In a d d i t i o n , d i e t i t i a n s r e p o r t e d that they p e r c e i v e d c o n t i n u i n g education to be one way of p r o v i d i n g them with i n t e l l e c t u a l s t i m u l a t i o n , e n a b l i n g them a l s o to serve t h e i r c l i e n t s b e t t e r . Very few d i e t i t i a n s f e l t t hat c o n t i n u i n g education was a v e h i c l e that c o u l d be used to p r o v i d e a new c a r e e r or as a means of g a i n i n g promotion. P a r t i c i p a t i n g i n c o n t i n u i n g education was not p e r c e i v e d by d i e t i t i a n s to o f f e r f i n a n c i a l reward as a primary consequence. The m a j o r i t y of respondents i n t h i s survey i n d i c a t e d that t h e i r p r o f e s s i o n a l a s s o c i a t i o n b e l i e v e d c o n t i n u i n g education was important to i t s membership and f u r t h e r , that t h i s b e l i e f was p e r s o n a l l y very important to each of them. Leaders i n the p r o f e s s i o n a l a s s o c i a t i o n , f a m i l y , and f r i e n d s were ranked as next important with respect to the shaping of d i e t i t i a n ' s s u b j e c t i v e s o c i a l normative b e l i e f s r egarding p a r t i c i p a t i o n i n c o n t i n u i n g e d u c a t i o n . H o l l i (1981) repo r t e d that the m a j o r i t y of d i e t i t i a n s p r e f e r r e d the d i e t e t i c a s s o c i a t i o n s r a t h e r than employers as the p r o v i d e r s of c o n t i n u i n g education programs. Since the p r o f e s s i o n a l a s s o c a t i o n was ranked so h i g h l y by so many of the respondents there e x i s t s a tremendous o p p o r t u n i t y to have members p a r t i c i p a t e i n as yet u n t r i e d methods of c o n t i n u i n g e d u c a t i o n . Donaldson (1968) d e s c r i b e d the need to i n v e s t i g a t e e f f e c t i v e e d u c a t i o n a l methods which c o u l d e a s i l y and economically be d i s t r i b u t e d to a l a r g e number of h e a l t h p r o f e s s i o n a l s . A c c o r d i n g l y , she argued that c o n t i n u i n g 97 education courses may have to be redesigned to u t i l i z e e f f e c t i v e l y newer i n s t r u c t i o n a l technology. As long as the a c t i v i t y i s sanctioned by the p r o f e s s i o n a l o r g a n i z a t i o n , p a r t i c i p a t i o n i s l i k e l y to be high by t h i s group of h e a l t h p r o f e s s i o n a l s . I t should be noted that l e a d e r s of the p r o f e s s i o n a l a s s o c i a t i o n are l i k e l y to have good success i n i n v o l v i n g new members in c o n t i n u i n g e d u c a t i o n . I n t e n t i o n to Part i c i p a t e I n t e n t i o n to p a r t i c i p a t e scores f o r respondent d i e t i t i a n s are d i s p l a y e d i n Table 15. According to Equation 4 (see page 33) the i n t e n t i o n score i s determined by summing the a t t i t u d e toward p a r t i c i p a t i o n (Ag), s u b j e c t i v e s o c i a l normative b e l i e f (SSN) and s u b j e c t i v e p e r s o n a l normative b e l i e f (SPN) s c o r e s . 98 Table 15 D i s t r i b u t i o n of Respondents by I n t e n t i o n Score I n t e n t i o n Score Number Percent of Respondents < 249 2 1 .1 250-499 55 28.9 500-749 105 55.3 750-999 25 13.1 1000 + 3 1.6 T o t a l 1 90 100.0 Range of Scores: -182 1018 Highest P o s s i b l e Score: 1224 Mean Score: 583.27 Greater than one-half of the respondents achieved i n t e n t i o n scores i n the 500 to 749 p o i n t range and almost equal numbers were d i s t r i b u t e d on e i t h e r s i d e of the middle range scores, p r e s e n t i n g a normal d i s t r i b u t i o n of scores about the mean score of 583.27 p o i n t s . D i e t i t i a n s ' i n t e n t i o n scores were subsequently p a r t i t i o n e d f o r form f i v e equal groups c o n s i s t i n g of 38 respondent scores i n each group a c c o r d i n g to the v a r i o u s socioeconomic c h a r a c t e r i s t i c s and past p a r t i c i p a t i o n (Table 16). Only s l i g h t v a r i a t i o n s among the groups e x i s t s with respect to the mean val u e s of the socioeconomic v a r i a b l e s . 99 Table 16 P a r t i t i o n i n g of I n t e n t i o n Score with the Mean Values of V a r i o u s Socioeconomic V a r i a b l e s and Past P a r t i c i p a t i o n I n t e n t i o n Score Hours of work Y r s . Since Degree Yr s . BCDNA Age Yrs. Employ -ed Y r s . Present P o s i t i o n Past P a r t i e . <429 30.7 14.6 6.9 36.6 10.1 4.2 .921.28 >429<543 32.5 14.6 6.9 36.6 11.3 4.9 .95±.28 >543<619 32.7 13.1 5.1 35.4 8.8 3.1 .971.16 >619<722 33.5 12.7 7.2 34.9 8.5 4.9 .971.16 >722 34.5 12.8 6.4 35.0 8.8 3.5 1.0010 Respondents appeared to p a r t i t i o n i n t o f a i r l y homogeneous groups with respect to the i n t e n t i o n s c o r e s . At best, minor trends can be seen w i t h i n some of the v a r i a b l e s . The 38 d i e t i t i a n s with the h i g h e s t i n t e n t i o n to p a r t i c i p a t e scores worked the g r e a t e s t number of hours each week, had graduated an average 1.8 years e a r l i e r , were somewhat younger, had been employed f o r a fewer number of years and have a l l p a r t i c i p a t e d i n c o n t i n u i n g education a c t i v i t i e s as compared to t h e i r c o u n t e r p a r t s i n the four groups of respondents with lower s c o r e s . P a r t i c i p a t i o n data were scored as e i t h e r 1.0 (have p a r t i c i p a t e d ) or 0.0 (have not p a r t i c i p a t e d ) i n c o n t i n u i n g education w i t h i n the l a s t f i v e y e a r s . From Table 16 i t i s evident that each of the 38 100 d i e t i t i a n s with i n t e n t i o n to p a r t i c i p a t e scores >722 p o i n t s had p a r t i c i p a t e d i n c o n t i n u i n g education w i t h i n the f i v e year c u t o f f whereas, the p a r t i c i p a t i o n among the other groups was s l i g h t l y l e s s than unanimous. Since these trends are so exce e d i n g l y small there i s no j u s t i f i c a t i o n f o r commenting f u r t h e r r e g a r d i n g the d i s p e r s i o n of i n t e n t i o n to p a r t i c i p a t e scores and the socioeconomic v a r i a b l e s . M u l t i p l e R e g r e s s i o n : Past  P a r t i c i p a t i o n , I n t e n t i o n to P a r t i c i p a t e  Score and Socioeconomic V a r i a b l e s The m u l t i p l e r e g r e s s i o n prodedure was s e l e c t e d as a t o o l to explo r e the r e l a t i o n s h i p between past p a r t i c i p a t i o n , i n t e n t i o n to p a r t i c i p a t e and the s e l e c t e d socioeconomic v a r i a b l e s as o u t l i n e d i n the f i r s t h y p o t h e s i s . 101 Table 17 Summary fo r M u l t i p l e Regression: Past P a r t i c i p a t i o n with A t t i t u d e (Ag,) , S u b j e c t i v e S o c i a l Normative (SSN),and S u b j e c t i v e Personal Normative (SPN) Scores Independent V a r i a b l e M u l t i p l e C o r r e l a t i o n R-square (Variance) Simple C o r r e l a t i o n Beta SSN .1611 .0259 .1611 .1415 A t t i t u d e .1681 .0283 .1055 .5998 SPN .1682 .0283 .0540 . 1 250 For the f i r s t c a l c u l a t i o n step-wise m u l t i p l e r e g r e s s i o n was used. T h i s procedure b u i l d s an equation by adding one independent v a r i a b l e at a time while c o n t r o l l i n g a l l o t h e r s . The f i r s t step was to choose the independent v a r i a b l e that was the most s t a t i s t i c a l l y and s i g n i f i c a n t l y r e l a t e d to past p a r t i c i p a t i o n i n c o n t i n u i n g e d u c a t i o n . The s u b j e c t i v e s o c i a l normative score (SSN) by i t s e l f c o r r e l a t e d r=.1611 with past p a r t i c i p a t i o n and the a d d i t i o n of the a t t i t u d i n a l (Ag) and s u b j e c t i v e p e r s o n a l normative (SPN) scores brought the m u l t i p l e c o r r e l a t i o n with past p a r t i c i p a t i o n to r=.1682. Only 3% of the v a r i a n c e i n past p a r t i c i p a t i o n c o u l d be accounted f o r by the three v a r i a b l e s used i n t h i s r e g r e s s i o n e q u a t i o n . A s s i g n i n g numbers Equation 4 (see page 33) was as f o l l o w s : 1 02 B*I=.14154(A B)+.59975(SSN)+.12498(SPN)+.8999 Where: B = behaviour ( past p a r t i c i p a t i o n i n c o n t i n u i n g education) I = i n t e n t i o n to p a r t i c i p a t e i n c o n t i n u i n g education A & = a t t i t u d e toward p a r t i c i p a t i o n i n c o n t i n u i n g education SSN = s u b j e c t i v e s o c i a l norm ( i . e . p e r c e p t i o n s regarding the e x p e c t a t i o n s of others and p a r t i c i p a t i o n i n c o n t i n u i n g education) SPN = s u b j e c t i v e p e r s o n a l norm ( i . e . b e l i e f s r e g a r d i n g c o n t i n u i n g education and m o t i v a t i o n to comply with those b e l i e f s ) . .8999 = r e g r e s s i o n constant C o r r e l a t i o n of the three independent v a r i a b l e s with past p a r t i c i p a t i o n showed that the s u b j e c t i v e s o c i a l normative (SSN) v a r i a b l e r e l a t e d b e t t e r than any other f a c t o r . Although the c o r r e l a t i o n s were s t a t i s t i c a l l y s i g n i f i c a n t , none of the r e l a t i o n s h i p s was s t a t i s t i c a l l y s trong (Table 17). Since the g r e a t e s t p r o p o r t i o n of v a r i a n c e i n past p a r t i c i p a t i o n was a l s o accounted f o r by the s o c i a l s u b j e c t i v e normative f a c t o r i t was co n s i d e r e d the best s i n g l e i n d i c a t o r of d i e t i t i a n s ' past p a r t i c i p a t i o n i n c o n t i n u i n g e d u c a t i o n . In essence t h i s f i n d i n g suggests that a s t a t e d commitment to c o n t i n u i n g education by t h i s group of p r o f e s s i o n a l s was i n d i c a t i v e of past p a r t i c i p a t i o n i n c o n t i n u i n g education a c t i v i t i e s . The m u l t i p l e r e g r e s s i o n technique was next used to i n v e s t i g a t e the r e l a t i o n s h i p s between the v a r i o u s socioeconomic v a r i a b l e s and past p a r t i c i p a t i o n . Table 18 d i s p l a y s the 1 03 c o r r e l a t i o n of the socioeconomic v a r i a b l e s with past p a r t i c i p a t i o n . The step-wise r e g r e s s i o n procedure was implemented to determine i n which order the v a r i a b l e s were added to the r e g r e s s i o n equation to account f o r the g r e a t e s t amount of v a r i a n c e i n the past p a r t i c i p a t i o n v a r i a b l e . Table 18 Summary of M u l t i p l e R egression: Past P a r t i c i p a t i o n with S e l e c t e d Socioeconomic V a r i a b l e s Independent Var i a b l e s M u l t i p l e C o r r e l a t ion R-square (Variance) Simple C o r r e l a t ion Beta Yrs Employed .1301 .01 69 .1301 .1590 Education . 1 458 .021 3 .0820 .3700 Geographic Region .1519 .0231 .0007 .5283 Age . 1 578 .0249 . 1245 . 1 720 Employment Agency .1604 .0257 -.0255 -.1639 Membership i n BCDNA .1624 .0264 .0573 .6241 Yrs i n BCDNA . 1 641 .0269 .0931 .1067 Yrs Present P o s i t i o n . 1 648 .0272 .0706 -.1093 Hours of Work . 1 659 .0275 .0024 .4478 Yrs Since Graduation . 1 663 .0277 . 1 1 63 .5960 1 04 Although none of the r e l a t i o n s h i p s were s t a t i s t i c a l l y s i g n i f i c a n t , c o r r e l a t i o n of the socioeconomic v a r i a b l e s with past p a r t i c i p a t i o n showed that the number of years d i e t i t i a n s were employed r e l a t e d more h i g h l y than any of the other v a r i a b l e s (Table 18). A l l of the socioeconomic v a r i a b l e s combined c o r r e l a t e d very weakly with the past p a r t i c i p a t i o n v a r i a b l e r = .1663. Together the ten socioeconomic v a r i a b l e s accounted f o r approximately the same amount of v a r i a n c e i n past p a r t i c i p a t i o n (r = .0277) as the determinants of i n t e n t i o n to p a r t i c i p a t e (r = .0283). A l l of the socioeconomic v a r i a b l e s were i n c l u d e d i n the f i n a l r e g r e s s i o n equation. Another r e g r e s s i o n was c a r r i e d out (Table 19) i n order to examine the r e l a t i o n s h i p of the socioeconomic v a r i a b l e s and the determinants of i n t e n t i o n to p a r t i c i p a t e to past p a r t i c i p a t i o n . 105 Table 19 Summary of M u l t i p l e Regression: Past P a r t i c i p a t i o n with S e l e c t e d Socioeconomic V a r i a b l e s and the Determinants of I n t e n t i o n s (Ag,SSN,SPN) Independent V a r i a b l e s M u l t i p l e C o r r e l a t i o n R-square (Variance) Simple C o r r e l a t i o n Beta SSN .1611 .0259 .1611 .1872 Yrs Employed .21-44 .0460 . 1 301 .2540 Geographic Region .2479 .061 5 .0007 .6619 A t t i t u d e .2579 .061 5 .0007 .6619 Membership to BCDNA .2549 .0650 .0573 .651 1 Age .2569 .0660 . 1243 .1708 Yrs Since Graduation .2575 .0663 . 1 1 63 -.1000 SPN .2577 .0664 .0548 -.1394 F i v e of the socioeconomic v a r i a b l e s were not i n c l u d e d i n the f i n a l r e g r e s s i o n equation s i n c e the F - l e v e l ( t o l e r a n c e l e v e l ) was i n s u f f i c i e n t f o r f u r t h e r computation. N e v e r t h e l e s s , a l l of the remaining socioeconomic v a r i a b l e s and a l l of the determinants of i n t e n t i o n to p a r t i c i p a t e (Ag,SSN,SPN) accounted fo r approximately 7% of the v a r i a t i o n i n the past p a r t i c i p a t i o n v a r i a b l e . Although none of these f i n d i n g s are s t a t i s t i c a l l y s i g n i f i c a n t , i t should be noted that the p r e d i c t i o n of the past 106 p a r t i c i p a t i o n f o r t h i s group of respondents was improved by over 100% compared to the p r e v i o u s two r e g r e s s i o n s . In the r e g r e s s i o n with the determinants and the socioeconomic v a r i a b l e s , the s u b j e c t i v e s o c i a l normative f a c t o r (SSN) again emerged as the s i n g l e best p r e d i c t o r of the past p a r t i c i p a t i o n of d i e t i t i a n s . The a d d i t i o n a l seven v a r i a b l e s l i s t e d i n Table 19 account f o r approximately 4% more v a r i a n c e than the s u b j e c t i v e s o c i a l normative f a c t o r by i t s e l f . Part i a l C o r r e l a t i o n Pearson's product-moment c o e f f i c i e n t of c o r r e l a t i o n (r) was used to t e s t f o r s i g n i f i c a n t r e l a t i o n s h i p s between each of the socioeconomic v a r i a b l e s and the scores on the a t t i t u d e and s u b j e c t i v e normative (personal and s o c i a l ) s c a l e s . Table 20 shows the val u e s obtained from the c o r r e l a t i o n m atrix. 107 Table '20 C o r r e l a t i o n s Between Past P a r t i c i p a t i o n . , Determinants of I n t e n t i o n and S e l e c t e d Independent Socioeconomic V a r i a b l e s Independent V a r i a b l e s Education Years s i n c e graduat ion Age Years employed Years i n present p o s i t i o n Past p a r t i c i p a t i o n . Dependent V a r i a b l e s Past P a r t i e . .08 .12 .12* .13* .07 A t t i t u d e .05 -.10' -.09 -.12 -.13 . 1 1 SSN .24** .02 .02 -.07 .01 . 1 6* SPN -.06 .06 .09 .07 .09 .05 * i n d i c a t e s v a l u e s s i g n i f i c a n t at the .05 l e v e l ** i n d i c a t e s v a l u e s s i g n i f i c a n t at the .001 l e v e l S i g n i f i c a n t r e l a t i o n s h i p s were found between two of the independent v a r i a b l e s and past p a r t i c i p a t i o n . In a d d i t i o n , the c o e f f i c i e n t of c o r r e l a t i o n between s u b j e c t i v e s o c i a l normative (SSN) scores and education was low, s i g n i f i c a n t and n e g a t i v e . E s s e n t i a l l y t h i s f i n d i n g suggests that those 30 respondents with a l e v e l of education higher than the b a c c a l a u r e a t e degree which i s the b a s i c requirement f o r the p r a c t i c e of d i e t e t i c s , do not p e r c e i v e the e x p e c t a t i o n s of others regarding p a r t i c i p a t i o n i n c o n t i n u i n g education to be as important a c o n t r i b u t i n g f a c t o r to 108 t h e i r b e l i e f s about p a r t i c i p a t i n g i n c o n t i n u i n g education as do d i e t i t i a n s with l e s s e d u c a t i o n . When respondents are grouped together the i n f l u e n c e of the s i g n i f i c a n t r e f e r e n t s i s an important c o n s i d e r a t i o n with respect to t h e i r p a r t i c i p a t i o n experiences as evidenced by the s i g n i f i c a n t and p o s i t i v e r e l a t i o n s h i p (r=.l6) between the s u b j e c t i v e s o c i a l normative (SSN) b e l i e f s and past p a r t i c i p a t i o n (p=0.05). Table 20 shows that the past p a r t i c i p a t i o n of d i e t i t i a n s i s s i g n i f i c a n t l y and p o s i t i v e l y r e l a t e d to only two of the socioeconomic v a r i a b l e s that were examined i n t h i s r e s e a r c h . Although the m a j o r i t y of p u b l i s h e d r e s e a r c h i n d i c a t e s that younger, more recent graduates are more l i k e l y to p a r t i c i p a t e i n c o n t i n u i n g education, recent r e s e a r c h of Curran (1977) with r e g i s t e r e d nurses i n d i c a t e s that " g r e a t e r r e c o g n i t i o n should be given to the f a c t that perhaps o l d e r nurses f e e l the need f o r more c u r r e n t i n f o r m a t i o n " (p.21). U n f o r t u n a t e l y Curran had not s p e c i f i e d the number of respondents i n v o l v e d i n that r e s e a r c h . She s p e c i f i c a l l y r eported that o l d e r nurses read more f r e q u e n t l y as compared to t h e i r younger c o u n t e r p a r t s who more o f t e n attended workshops or e n r o l l e d i n courses f o r c o l l e g e c r e d i t . The r e s u l t s of the present study i n d i c a t e t h a t those o l d e r d i e t i t i a n s who had been employed the longest were most o f t e n p a r t i c i p a t i n g i n c o n t i n u i n g e d u c a t i o n . Although t h i s f i n d i n g i s s t a t i s t i c a l l y s i g n i f i c a n t i t must be noted that o n l y 7 of the respondent d i e t i t i a n s i n t h i s study r e p o r t e d that they had not p a r t i c i p a t e d i n c o n t i n u i n g education w i t h i n the l a s t f i v e y e a r s . In the face of such a small v a r i a t i o n among respondents f u r t h e r 109 comments are not j u s t i f i a b l e . D i s c u s s i o n The f i r s t h ypothesis formulated for the purposes of t h i s r e s e a r c h sought a s t a t i s t i c a l l y s i g n i f i c a n t c o r r e l a t i o n between i n t e n t i o n to p a r t i c i p a t e i n c o n t i n u i n g education and past p a r t i c i p a t i o n i n c o n t i n u i n g education experiences as r e p o r t e d by p r o f e s s i o n a l d i e t i t i a n s . The l o g i c a l j u s t i f i c a t i o n f o r a n t i c i p a t i n g t h i s r e l a t i o n s h i p l i e s i n Houle's (1980) t h e s i s that past p a r t i c i p a t i o n i s a good i n d i c a t o r of present p a r t i c i p a t i o n i n c o n t i n u i n g e d u c a t i o n . In a d d i t i o n , i t has g e n e r a l l y been accepted i n a d u l t education that those i n d i v i d u a l s having e x h i b i t e d past p a r t i c i p a t i o n are the most l i k e l y to repeat such behaviour i n the f u t u r e . M u l t i p l e r e g r e s s i o n demonstrated c o n s i s t e n t , p o s i t i v e but low r e l a t i o n s h i p s between past p a r t i c i p a t i o n and each of the three determinants of i n t e n t i o n s . Although each of the f a c t o r s was i n c l u d e d i n the r e s u l t i n g r e g r e s s i o n equation, only a small amount of the t o t a l v a r i a n c e i n past p a r t i c i p a t i o n was accounted f o r . The s u b j e c t i v e s o c i a l normative (SSN) b e l i e f score accounted f o r the g r e a t e s t amount of the v a r i a t i o n i n the past p a r t i c i p a t i o n of p r o f e s s i o n a l d i e t i t i a n s ( r = . l 6 1 l ) . T h i s f i n d i n g i n d i c a t e s that the e x p e c t a t i o n s of s i g n i f i c a n t others played a l a r g e r o l e i n shaping the past p a r t i c i p a t i o n of these h e a l t h p r o f e s s i o n a l s and undoubtedly f i g u r e s prominently i n t h e i r f u t u r e i n t e n t i o n s to continue t h e i r l e a r n i n g . From Table 14 i t i s apparent that the most s i g n i f i c a n t r e f e r e n t s are those 110 that are e x t e r n a l to the would-be l e a r n e r s . The p r o f e s s i o n a l a s s o c i a t i o n was scored above a l l other r e f e r e n t s . No p u b l i s h e d s t u d i e s are a v a i l a b l e i n v e s t i g a t i n g the p e r c e p t i o n s of d i e t i t i a n s r e g a r d i n g the e x p e c t a t i o n s of o t hers and p a r t i c i p a t i o n i n c o n t i n u i n g e d u c a t i o n . Parochka (1981) a p p l i e d the F i s h b e i n model in a random sample of n o n - p a r t i c i p a n t nurses i n I l l i n o i s . The f i n d i n g s i n that study i n d i c a t e d that the s o c i a l s u b j e c t i v e normative (SSN) b e l i e f s were p o s i t i v e f o r p r o f e s s i o n a l a s s o c i a t i o n , p r o f e s s i o n a l peers, s u p e r v i s o r and the s o c i e t y at l a r g e . Parochka concluded that these p o s i t i v e b e l i e f s were a s s o c i a t e d with p o s i t i v e general i n t e n t i o n s to p a r t i c i p a t e . However, when presented with three very s p e c i f i c course o f f e r i n g s , the respondent nurses demonstrated negative i n t e n t i o n s . Based on the r e s u l t s obtained i n t h i s survey the f i r s t h y pothesis was r e j e c t e d . Although small p o s i t i v e c o r r e l a t i o n s were demonstrated between the determinants of i n t e n t i o n to p a r t i c i p a t e and the past p a r t i c i p a t i o n of d i e t i t i a n s , only the s u b j e c t i v e s o c i a l normative (SSN) b e l i e f f a c t o r was s t a t i s t i c a l l y and s i g n i f i c a n t l y r e l a t e d to past p a r t i c i p a t i o n . Socioeconomic and demographic c h a r a c t e r i s t i c s have c o n s i s t e n t l y been examined by v a r i o u s r e s e a r c h e r s i n v e s t i g a t i n g p a r t i c i p a t i o n phenomena among h e a l t h p r o f e s s i o n a l s ( Curran, 1977; Gross, 1976; H o l l i , 1981; Matthews & Schumacher, 1979 and Puetz 1980). Based on t h i s r e s e a r c h and on the f i n d i n g s from a much l a r g e r study by Johnstone and R i v e r a (1965), p a r t i c i p a n t s among h e a l t h p r o f e s s i o n a l s are g e n e r a l l y a n t i c i p a t e d to be 111 l i v i n g i n urban, more densely populated c e n t r e s ; be s i g n i f i c a n t l y younger; be more recent graduates; have a t t a i n e d higher l e v e l s of education; be employed f u l l - t i m e and occupy h o s p i t a l based employment p o s i t i o n s as compared to non-p a r t i c i p a n t h e a l t h care workers. F i s h b e i n ( 1967 and ^9-75) contends that these c h a r a c t e r i s t i c s are not d i r e c t l y r e l a t e d to p a r t i c i p a t i o n , basing h i s c r i t i c i s m on the f a i l u r e of these v a r i a b l e s to . account f o r a p p r e c i a b l e d i f f e r e n c e s i n p a r t i c i p a t i o n r a t e s . The F i s h b e i n model p o r t r a y s these v a r i a b l e s as i n f l u e n t i a l at the i n t e n t i o n a l l e v e l . Based on t h i s argument i t was p o s t u l a t e d that the s e l f - r e p o r t of past p a r t i c i p a t i o n i n c o n t i n u i n g education by d i e t i t i a n s would not be s i g n i f i c a n t l y r e l a t e d to the p r e s e l e c t e d socioeconomic and demographic v a r i a b l e s . None of the ten socioeconomic v a r i a b l e s was h i g h l y c o r r e l a t e d with past p a r t i c i p a t i o n . Pearson's product-moment c o r e l a t i o n s demonstrated that only two of the c h a r a c t e r i s t i c s , age and the number of years employed, were s t a t i s t i c a l l y and s i g n i f i c a n t l y r e l a t e d to past p a r t i c i p a t i o n . In f a c t , although the d i f f e r e n c e i s s m a l l , the a t t i t u d i n a l and normative f a c t o r s accounted f o r a g r e a t e r percentage of the v a r i a n c e i n past p a r t i c i p a t i o n than the combined power of the ten socioeconomic v a r i a b l e s e v a l u a t e d i n t h i s r e s e a r c h . In g e n e r a l , none of the socioeconomic v a r i a b l e s was s t r o n g l y r e l a t e d to past p a r t i c i p a t i o n . Only two the socioeconomic v a r i a b l e s t e s t e d c o u l d be used to determine or estimate the past p a r t i c i p a t i o n of d i e t i t i a n s although the h i g h e s t s i g n i f i c a n t r value computed was r= .13 (Table 20). The 1 12 second hypothesis was accepted based on the f i n d i n g that past p a r t i c i p a t i o n was not s t r o n g l y r e l a t e d to any of the ten socioeconomic v a r i a b l e s . The t h i r d h y p o t h e s i s formulated and t e s t e d i n t h i s r e s e a r c h e x p l o r e d F i s h b e i n ' s c o n t e n t i o n that the socioeconomic v a r i a b l e s are i n d i r e c t l y r e l a t e d to p a r t i c i p a t i o n and t h a t t h e i r e f f e c t , i f any, can be demonstrated on the determinants of i n t e n t i o n to p a r t i c i p a t e i n c o n t i n u i n g e d u c a t i o n . Only two of the socioeconomic v a r i a b l e s were r e l a t e d to the determinants of i n t e n t i o n s (Table 20). Based on these f i n d i n g s the t h i r d h y p o t h e s i s a n t i c i p a t i n g s t a t i s t i c a l l y s i g n i f i c a n t r e l a t i o n s h i p s between i n t e n t i o n to p a r t i c i p a t e and the socioeconomic v a r i a b l e s was r e j e c t e d . The f o u r t h hypothesis examined the v a r i a b l e i n t e r r e l a t i o n s h i p s of the F i s h b e i n model and p o s t u l a t e d that the a t t i t u d i n a l and normative aspects of i n t e n t i o n to p a r t i c i p a t e would s i n g l y , or i n combination, be more s i g n i f i c a n t l y and more h i g h l y r e l a t e d to past p a r t i c i p a t i o n than the socioeconomic v a r i a b l e s s e l e c t e d i n t h i s r e s e a r c h . In an e f f o r t to determine the combined e f f e c t of the a t t i t u d i n a l and normative f a c t o r s and the socioeconomic v a r i a b l e s with past p a r t i c i p a t i o n a l l were combined and another r e g r e s s i o n equation was generated (Table 19). The s u b j e c t i v e s o c i a l normative (SSN) f a c t o r accounted f o r approximately 3% of the t o t a l v a r i a t i o n (r= .1611). The number of years employed and the geographic region were entered on steps two and three of the r e g r e s s i o n . The a t t i t u d i n a l f a c t o r was entered on the 1 13 f o u r t h step of the r e g r e s s i o n , accounting f o r a combined a d d i t i o n a l 3% of the v a r i a n c e and a combined c o r r e l a t i o n c o e f f i c i e n t (r) of .2524. The a d d i t i o n of means of o b t a i n i n g membership i n the BCDNA, age, years s i n c e graduation and the s u b j e c t i v e p e r s o n a l normative (SPN) f a c t o r p r o v i d e d f o r very l i t t l e more explanatory power as i n d i c a t e d by the marginal i n c r e a s e i n the c o e f f i c i e n t of c o r r e l a t i o n (r= .2577). As a r e s u l t of t h i s r e g r e s s i o n a n a l y s i s the f o u r t h h y p o t h e s i s formulated f o r purposes of t h i s r e s e a r c h was r e j e c t e d . The determinants of i n t e n t i o n to p a r t i c i p a t e d i d not emerge as the best i n d i c a t o r s of past p a r t i c i p a t i o n when regres s e d together with the socioeconomic v a r i a b l e s a g a i n s t past p a r t i c i p a t i o n . Summary T h i s chapter has presented the f i n d i n g s and i n t e r p r e t a t i o n of the s t a t i s t i c a l a n a l y s es which were computed on q u e s t i o n n a i r e responses from 190 p r o f e s s i o n a l d i e t i t i a n s . The socioeconomic c h a r a c t e r i s t i c s of the d i e t i t i a n s sampled i n t h i s study were presented i n frequency d i s t r i b u t i o n t a b l e s . Responses to the other three s e c t i o n s of the q u e s t i o n n a i r e were then presented and r e l a t e d to the r e s e a r c h hypotheses developed f o r t h i s study. The r e s e a r c h hypotheses were presented and the f i n d i n g s from t h i s r e s e a r c h were d i s c u s s e d as they supported the acceptance or r e j e c t i o n of the hypotheses. 1 1 4 CHAPTER V SUMMARY AND IMPLICATIONS For many years c o n t i n u i n g education has been acknowledged by h e a l t h care p r o f e s s i o n a l s as an e s s e n t i a l part of t h e i r p r o f e s s i o n a l a c t i v i t i e s and r e s p o n s i b i l i t i e s . C l e a r l y one of the main ways of m a i n t a i n i n g p r o f e s s i o n a l competence and keeping abreast of the changes i n h e a l t h care knowledge and technology i s f o r p r o f e s s i o n a l s to engage r e g u l a r l y i n a c t i v i t i e s of c o n t i n u i n g l e a r n i n g . The membership of the d i e t e t i c a s s o c i a t i o n in B r i t i s h Columbia has deemed that p a r t i c i p a t i o n i n c o n t i n u i n g education a c t i v i t i e s i s h i g h l y d e s i r a b l e and has a c c o r d i n g l y s p e c i f i e d mandatory c o n t i n u i n g education f o r m a i n t a i n i n g a c t i v e membership s t a t u s . A l a r g e number of c o n t i n u i n g education o p p o r t u n i t i e s f o r d i e t i t i a n s i s c u r r e n t l y a v a i l a b l e . Seemingly l a r g e numbers of d i e t i t i a n s have a v a i l e d themselves of these o p p o r t u n i t i e s i n the past, however i t i s known that not a l l d i e t i t i a n s are a c t i v e to the same degree i n c o n t i n u i n g t h e i r e d u c a t i o n . L i t t l e r e s e a r c h has been done that s p e c i f i c a l l y r e l a t e s to the c o n t i n u i n g education a c t i v i t i e s of p r o f e s s i o n a l d i e t i t i a n s . What s t u d i e s are a v a i l a b l e have i n v e s t i g a t e d the extent of d i e t i t i a n s ' involvement i n c o n t i n u i n g education ( H o l l i , 1981) or have exp l o r e d the needs and i n t e r e s t s of these p r o f e s s i o n a l s ( B r o s k i & Upp, 1979). The primary focus of t h i s study was to expl o r e and d e s c r i b e the i n t e n t i o n s of d i e t i t i a n s to p a r t i c i p a t e i n c o n t i n u i n g 115 education. In addition to investigating the relationship between past p a r t i c i p a t i o n and intention to p a r t i c i p a t e , t h i s study sought to provide a better understanding of why d i e t i t i a n s p a r t i c i p a t e in continuing education by examining the a t t i t u d i n a l (Ag) and normative be l i e f (SSN and SPN) aspects of - behavioural intentions as defined by Fishbein (1967 and 1975). The relationships of past p a r t i c i p a t i o n to various socioeconomic factors and intention to p a r t i c i p a t e were also investigated. Summary In order to investigate the intentions of a large number of d i e t i t i a n s to participate in continuing education and information related to past p a r t i c i p a t i o n and the socioeconomic variables the mail survey method of research was used. It was decided that the greatest number of these professionals could be reached using the mail survey method. A questionnaire developed by Grotelueschen (© 1977) was adapted for the c o l l e c t i o n of data from d i e t i t i a n s in B r i t i s h Columbia. Several s t a t i s t i c a l procedures were used to provide descriptive and a n a l y t i c a l r e s u l t s . Methodology Female d i e t i t i a n s employed on a f u l l - or part-time basis in a variety of employment situations in B r i t i s h Columbia constituted the population used in t h i s study. For reasons of convenience and the desire to obtain as large a sample size as 116 p o s s i b l e , a l l member d i e t i t i a n s of the BCDNA with m a i l i n g addresses i n the prov i n c e of B r i t i s h Columbia were sent q u e s t i o n n a i r e s d u r i n g the month of March 1980. The q u e s t i o n n a i r e was designed to c o l l e c t the data r e q u i r e d in t h i s r e s e a r c h , i n four p a r t s : a) consequence of p a r t i c i p a t i n g in c o n t i n u i n g education item pool b) e x p e c t a t i o n s of s i g n i f i c a n t o t h ers r e g a r d i n g p a r t i c i p a t i o n c) i n t e n t i o n to p a r t i c i p a t e s c a l e , and d) demographic and socioeconomic i n f o r m a t i o n form. During the p r e t e s t i n g the instrument was reviewed to ensure c l a r i t y , ease of understanding and the a b i l i t y of d i e t i t i a n s to respond to the d i r e c t i o n s . To enhance the ra t e of r e t u r n a followup l e t t e r was mailed to each s u b j e c t . E v e n t u a l l y an o v e r a l l response r a t e of 73.7% or a t o t a l of 207 q u e s t i o n n a i r e s were r e c e i v e d . The number of returned and completed q u e s t i o n n a i r e s used i n the s t a t i s t i c a l a n a l y s e s was 190 which c o n s t i t u t e d a response r a t e of 68.0%. The data were coded , scored and t r a n s f e r r e d to key punching i n f o r m a t i o n sheets and the U n i v e r s i t y of B r i t i s h Columbia Computing Center's S t a t i s t i c a l Package f o r the S o c i a l Sciences V e r s i o n 8.00 (under MTS) was used to analyze the data, determine d e s c r i p t i v e c h a r a c t e r i s t i c s f o r the respondents and t e s t the v a r i o u s hypotheses. 1 17 F i n d i n g s S t a t i s t i c a l t e s t s were done to e s t a b l i s h whether s i g n i f i c a n t d i f f e r e n c e s e x i s t e d between e a r l y and l a t e responders. The two groups were found to be s i g n i f i c a n t l y d i f f e r e n t with respect to the geographic region from which they r e p o r t e d (r=0.545, p=0.00l). T h i s d i f f e r e n c e was probably p a r t l y a t t r i b u t a b l e to the e r r a t i c m a i l s e r v i c e . Since only one s i g n i f i c a n t d i f f e r e n c e was o b t a i n e d f o r a l l of the socioeconomic and demographic v a r i a b l e s t e s t e d , the 190 respondents were t r e a t e d as a t o t a l group in a n a l y z i n g and i n t e r p r e t i n g the data. The t y p i c a l d i e t i t i a n respondent i n t h i s study i n d i c a t e d t h at she was employed by a h o s p i t a l and had secured her c u r r e n t p o s i t i o n w i t h i n the l a s t two y e a r s . She had obtained a b a c c a l a u r e a t e degree in human n u t r i t i o n and d i e t e t i c s i n the l a s t ten years, was most l i k e l y between the age of 23 and 30 years and had been employed i n d i e t e t i c s f o r an average 9.5 y e a r s . The average respondent was most l i k e l y employed i n a p o s i t i o n which o f f e r e d a v a r i e t y of d i e t e t i c d u t i e s r a t h e r than a s i n g l e s p e c i a l i z a t i o n . Greater than 65% of the d i e t i t i a n s i n d i c a t e d that l e c t u r e s , addresses, conferences, seminars and workshops were the e d u c a t i o n a l methods used most f r e q u e n t l y i n t h e i r most recent c o n t i n u i n g education endeavor. P a r t i c i p a t i o n i n c o n t i n u i n g education had r e c e n t l y become a compulsory aspect of membership i n the BCDNA. Almost 95% of the respondents i n d i c a t e d that they would p a r t i c i p a t e at the same or h i g h e r l e v e l than they had done when c o n t i n u i n g education was 118 v o l u n t a r y . These d i e t i t i a n s had j o i n e d the BCDNA an average of 6.5 years ago. Nearly 87% of the respondent d i e t i t i a n s had q u a l i f i e d f o r membership in the BCDNA through completion of a d i e t e t i c i n t e r n s h i p . Respondents.were asked to r e f l e c t on statements r e g a r d i n g t h e i r p e r s o n a l b e l i e f s about p a r t i c i p a t i o n i n c o n t i n u i n g e d u c a t i o n . D i e t i t i a n s r e p o r t e d that t h e i r peers appeared t o be committed to c o n t i n u i n g t h e i r education over t h e i r e n t i r e p r o f e s s i o n a l l i v e s . Almost 95% of the respondents f e l t that they, along with a l l other d i e t i t i a n s , should continue t h e i r l e a r n i n g . Respondents b e l i e v e d that the op p o r t u n i t y to update and r e f r e s h t h e i r knowledge was the s i n g l e most important consequence or r e s u l t of t h e i r p a r t i c i p a t i o n i n c o n t i n u i n g e d u c a t i o n . D i e t i t i a n s b e l i e v e d that t h e i r p r o f e s s i o n a l a s s o c i a t i o n (BCDNA) and the l e a d e r s of t h e i r p r o f e s s i o n a l o r g a n i z a t i o n s play a very strong r o l e i n shaping t h e i r i n t e n t i o n s to p a r t i c i p a t e i n c o n t i n u i n g e d u c a t i o n . Among the r e l a t i o n s h i p s s t u d i e d between past p a r t i c i p a t i o n i n c o n t i n u i n g education and the v a r i o u s socioeconomic v a r i a b l e s , two were found to be s i g n i f i c a n t . Older d i e t i t i a n s and those who had been employed the lo n g e s t , p a r t i c i p a t e d more o f t e n than those d i e t i t i a n s who were younger, more recent graduates. T h i s f i n d i n g may be of l i t t l e p r a c t i c a l s i g n i f i c a n c e however s i n c e only 7 of the 190 respondents i n t h i s survey r e p o r t e d that they had not p a r t i c i p a t e d i n c o n t i n u i n g education i n the l a s t f i v e 119 years. Of the three determinants of i n t e n t i o n s to p a r t i c i p a t e i n c o n t i n u i n g education only the s u b j e c t i v e s o c i a l normative (SSN) f a c t o r was found using the Pearson product-moment s t a t i s t i c to be r e l a t e d to past p a r t i c i p a t i o n . The r value of .1611 was s i g n i f i c a n t at the .05 l e v e l . T h i s r e s e a r c h a p p l i e d the F i s h b e i n model to examine the r e l a t i o n s h i p s between past p a r t i c i p a t i o n and the f u t u r e i n t e n t i o n s of p r o f e s s i o n a l d i e t i t i a n s to p a r t i c i p a t e i n c o n t i n u i n g e ducation. I f , i n f a c t , the model has u t i l i t y , then i t has p o t e n t i a l a p p l i c a t i o n by program planners to s o r t a t t e n d e r s from n o n p a r t i c i p a n t s . In a d d i t i o n , i t was hoped that the a p p l i c a t i o n of t h i s model would improve the understanding of why d i e t i t i a n s engage i n c o n t i n u i n g education a c t i v i t i e s . The f i r s t h ypothesis sought a st r o n g and p o s i t i v e c o r r e l a t i o n between the s e l f - r e p o r t of past p a r t i c i p a t i o n and the i n t e n t i o n s of d i e t i t i a n s to p a r t i c i p a t e i n a c t i v i t i e s of continued l e a r n i n g . The r e s u l t i n g combined c o r r e l a t i o n was low (r= .1682, p=0.0) and accounted f o r 3% of the v a r i a t i o n i n past p a r t i c i p a t i o n . Based on the f i n d i n g s from t h i s research the f i r s t h y p o t hesis was r e j e c t e d . The s u b j e c t i v e s o c i a l normative (SSN) b e l i e f f a c t o r was the only one of the determinants of i n t e n t i o n to be s i g n i f i c a n t l y r e l a t e d to past p a r t i c i p a t i o n (r= .1611, p=0.05). A number of i n v e s t i g a t i o n s i n a d u l t education and h e a l t h p r o f e s s i o n a l c o n t i n u i n g education have suggested that some socioeconomic c h a r a c t e r i s t i c s may be r e l a t e d to p a r t i c i p a t i o n . 120 F i s h b e i n ' s conceptual framework argues a g a i n s t these su g g e s t i o n s . Since high c o r r e l a t i o n s between p a r t i c i p a t i o n and such f a c t o r s cannot be c o n s i s t e n t l y demonstrated, F i s h b e i n proposed that socioeconomic v a r i a b l e s i n f l u e n c e p a r t i c i p a t i o n i n d i r e c t l y , through t h e i r i n f l u e n c e on the a t t i t u d i n a l and normative aspects of i n t e n t i o n to p a r t i c i p a t e , which i s d e f i n e d as the immediate antecedent of p a r t i c i p a t i o n . A c c o r d i n g l y , i t was hypothesized that none of the socioeconomic v a r i a b l e s would be s i g n i f i c a n t l y r e l a t e d to past p a r t i c i p a t i o n . Only two of the socioeconomic v a r i a b l e s were s i g n i f i c a n t l y r e l a t e d to past p a r t i c i p a t i o n . Based on the low c o r r e l a t i o n s the second hypothesis was accepted. In order to explore F i s h b e i n ' s c o n t e n t i o n that the socioeconomic v a r i a b l e s would i n f l u e n c e the a t t i t u d i n a l and normative aspects of i n t e n t i o n to p a r t i c i p a t e , r a t h e r than d i r e c t l y a f f e c t p a r t i c i p a t i o n , a t h i r d research h y p o t h e s i s was c o n s t r u c t e d . The t h i r d h y p othesis s t i p u l a t e d that there would be s t a t i s t i c a l l y s i g n i f i c a n t and p o s i t i v e r e l a t i o n s h i p s between the determinants of i n t e n t i o n to p a r t i c i p a t e and the socioeconomic v a r i a b l e s . The s u b j e c t i v e s o c i a l normative (SSN) b e l i e f score was the only f a c t o r to c o r r e l a t e s i g n i f i c a n t l y with j u s t two of the socioeconomic c h a r a c t e r i s t i c s . Place of employment (r = - . l 5 , p=0.05) and education (r=-.24, p=0.00l) demonstrated low, s i g n i f i c a n t and negative c o r r e l a t i o n s . Those d i e t i t i a n s with education beyond the b a s i c b a c c a l a u r e a t e degree r e q u i r e d f o r the p r a c t i c e of d i e t e t i c s d i d not p e r c e i v e the e x p e c t a t i o n s of r e f e r e n t s as important with r e s p e c t to t h e i r 121 pe r s o n a l p a r t i c i p a t i o n i n c o n t i n u i n g education as d i d those with l e s s e d u c a t i o n . Based on the f i n d i n g that only two out of ten of the socioeconomic f a c t o r s were r e l a t e d to the determinants of i n t e n t i o n to p a r t i c i p a t e i n c o n t i n u i n g education, the t h i r d r e s e a r c h h ypothesis was r e j e c t e d . The f o u r t h hypothesis sought to make c l e a r the r e l a t i o n s h i p s between the determinants of i n t e n t i o n to p a r t i c i p a t e , the socioeconomic f a c t o r s and past p a r t i c i p a t i o n as r e p o r t e d by respondent d i e t i t i a n s . I t was p o s t u l a t e d that the a t t i t u d i n a l and normative b e l i e f f a c t o r s would s i n g l y , or i n combination, be more h i g h l y r e l a t e d to past p a r t i c i p a t i o n than any of the socioeconomic v a r i a b l e s . The r e s u l t s of the m u l t i p l e c o r r e l a t i o n a n a l y ses were such that n e i t h e r the determinants of i n t e n t i o n nor the socioeconomic v a r i a b l e s emerged as p a r t i c u l a r l y s t r o n g i n d i c a t o r s of past p a r t i c i p a t i o n of d i e t i t i a n s i n c o n t i n u i n g e d u c a t i o n . A c c o r d i n g l y , the f o u r t h hypothesis was r e j e c t e d . A l l of the f a c t o r s c o u l d only c u m u l a t i v e l y account f o r approximately seven percent of the v a r i a t i o n i n the past p a r t i c i p a t i o n v a r i a b l e . The s u b j e c t i v e s o c i a l normative b e l i e f (SSN) f a c t o r emerged o v e r a l l as the s i n g l e best p r e d i c t o r of past p a r t i c i p a t i o n a ccounting, however, f o r only about 3% of the t o t a l v a r i a n c e i n past p a r t i c i p a t i o n . 122 L i m i t a t i o n s The p o p u l a t i o n used i n t h i s study was l i m i t e d to those female BCDNA member d i e t i t i a n s working on a f u l l - or part-time b a s i s whose m a i l i n g addresses were i n the pr o v i n c e of B r i t i s h Columbia. G e n e r a l i z a t i o n beyond these boundaries must be made with c a u t i o n . Since a random sample was not s e l e c t e d there i s no b a s i s f o r g e n e r a l i z a t i o n . Future attempts should be made to assess the extent and i n t e n t i o n s of a random sample of these h e a l t h p r o f e s s i o n a l s . The survey q u e s t i o n n a i r e requested s e l f - r e p o r t data, thus a l l of the f i n d i n g s are subj e c t to the respondents' a b i l i t i e s to r e c a l l t h e i r p a r t i c i p a t i o n a c t i v i t i e s and t h e i r p e r c e p t i o n of the i n f o r m a t i o n requested i n each s e c t i o n of the q u e s t i o n n a i r e . Respondents were asked to r e c a l l the extent of t h e i r c o n t i n u i n g education a c t i v i t i e s over the pre v i o u s f i v e year p e r i o d . C o r r o b o r a t i o n was a v a i l a b l e to each of them by v i r t u e of p o i n t accumulation i n f o r m a t i o n that was re p o r t e d a n n u a l l y to the a s s o c i a t i o n . The assumption was of course that t h i s i n f o r m a t i o n had been r e c e i v e d by a l l those who were t a k i n g p a r t i n the s e r v i c e . T h i s r e s e a r c h instrument based on development c a r r i e d out at the U n i v e r s i t y of I l l i n o i s was r e c e i v e d from Dr. A. Grotelueschen. Two s u c c e s s i v e attempts to secure r e l i a b i l i t y and v a l i d i t y data from t h i s source were u n s u c c e s s f u l . Since an instrument f o r which sound r e l i a b i l i t y and v a l i d i t y data were not a v a i l a b l e was used i n t h i s r e s e a r c h the f i n d i n g s from t h i s study must be c o n s i d e r e d with t h i s l i m i t a t i o n i n mind. 123 The o v e r a l l response rate i n t h i s survey was c a l c u l a t e d based on the assumption that the q u e s t i o n n a i r e s mailed out had been r e c e i v e d by each of the 281 d i e t i t i a n s . E r r o r s of measurement that are normally a s s o c i a t e d with survey r e s e a r c h are assumed to have o c c u r r e d i n each p a r t of the q u e s t i o n n a i r e used i n . t h i s study. I m p l i c a t i o n s Nearly a l l of the p r o f e s s i o n a l d i e t i t i a n s surveyed i n t h i s r e s e a r c h had p a r t i c i p a t e d to some extent i n c o n t i n u i n g education over the l a s t f i v e y e a r s . As a group they b e l i e v e d that the s i n g l e most impending consequence or r e s u l t of t h e i r p a r t i c i p a t i o n i n c o n t i n u i n g education was the o p p o r t u n i t y to keep up to date with and to r e f r e s h t h e i r knowledge i n t h e i r f i e l d . T h e i r p r o f e s s i o n a l a s s o c i a t i o n , the BCDNA, a n d i t s l e a d e r s shaped more s t r o n g l y than anyone e l s e the b e l i e f s of these p r o f e s s i o n a l s r e g a r d i n g t h e i r p a r t i c i p a t i o n i n c o n t i n u i n g e d u c a t i o n . In many ways these f i n d i n g s are encouraging s i n c e they provide evidence re g a r d i n g the strong p r o f e s s e d commitment of t h i s group of p r o f e s s i o n a l d i e t i t i a n s to l i f e l o n g l e a r n i n g . The r o l e of the p r o f e s s i o n a l a s s o c i a t i o n i n p r o v i d i n g c o n t i n u i n g education o p p o r t u n i t i e s i s s t r o n g . In matters r e l a t e d to c o n t i n u a l l y updating t h e i r i n f o r m a t i o n d i e t i t i a n s look to t h e i r p r o f e s s i o n a l a s s o c i a t i o n . These p r o f e s s i o n a l s appear to pl a c e some importance on the p e r c e p t i o n s of others r e g a r d i n g t h e i r personal' c o n t i n u i n g education requirements. Based on the 124 p e r c e p t i o n s of respondents r e g a r d i n g the r o l e of the p r o f e s s i o n a l a s s o c i a t i o n i n shaping t h e i r i n t e n t i o n s to p a r t i c i p a t e i n c o n t i n u i n g education the BCDNA should continue i n i t s e f f o r t s to maintain the a c t i v e involvement of i t s members i n c o n t i n u i n g e d u c a t i o n . A major i m p l i c a t i o n from t h i s r e s e a r c h i n v o l v e s the ensuing r e s p o n s i b i l i t y of the p r o f e s s i o n a l a s s o c i a t i o n to continue i n i t s p r o v i s i o n of info r m a t i o n r e g a r d i n g c o n t i n u i n g e d u c a t i o n . Tremendous o p p o r t u n i t i e s l i e i n t h i s area s i n c e d i e t i t i a n s u n e q u i v o c a l l y view the r o l e of the p r o f e s s i o n a l o r g a n i z a t i o n as extremely important to t h e i r own p a r t i c i p a t i o n . Presumably the BCDNA c o u l d be c h a l l e n g e d with the f i n d i n g that so few of i t s members had re p o r t e d involvement with some of the newer e d u c a t i o n a l methods. R i s i n g c o s t s a s s o c i a t e d with program pl a n n i n g and program implementation may be o f f s e t by the a s s o c i a t i o n ' s endorsement of more economical e d u c a t i o n a l methods which may pro v i d e e d u c a t i o n a l o p p o r t u n i t y to l a r g e r numbers at l e a s t c o s t . T h i s study has provided strong evidence to support the involvement of the m a j o r i t y of p r o f e s s i o n a l d i e t i t i a n s i n c o n t i n u i n g e d u c a t i o n . The nature of that involvement remains as one area where f u t u r e program p l a n n i n g c o u l d e f f e c t p o s i t i v e change. The p r o f e s s i o n a l a s s o c i a t i o n stands to s u b s t a n t i a l l y i n c r e a s e the involvement of i t s membership i n a •wide range of l e a r n i n g a c t i v i t i e s . The b e n e f i t s to each i n d i v i d u a l d i e t i t i a n are s i g n i f i c a n t s i n c e she might then be i n a p o s i t i o n to s e l e c t the e d u c a t i o n a l method which best matches her l e a r n i n g s t y l e 1 25 pref e r e n c e or s i t u a t i o n a l needs. T h i s r e s e a r c h has demonstrated that d i e t i t i a n s are i n t e r e s t e d i n those c o n t i n u i n g education a c t i v i t i e s which update or r e f r e s h t h e i r knowledge as w e l l as those t h a t provide them with s k i l l s to serve t h e i r c l i e n t s b e t t e r . These p e r c e i v e d consequences have great relevance to program p l a n n e r s . I t would seem imperative to determine i f d i e t i t i a n p a r t i c i p a t i o n i n c o n t i n u i n g education r e s u l t s i n improved n u t r i t i o n a l care or b e t t e r job performance. In a d d i t i o n , i t would be important to determine i f improvements can be observed and whether such change i s temporary or permanent. T h i s study has demonstrated that d i e t i t i a n s are committed to c o n t i n u i n g t h e i r e d u c a t i o n . The a t t i t u d i n a l and normative b e l i e f f a c t o r s measured by the research instrument p r o v i d e d d e s c r i p t i v e i n f o r m a t i o n r e g a r d i n g the i n t e n t i o n s of d i e t i t i a n s r e g a r d i n g p a r t i c i p a t i o n i n c o n t i n u i n g e d u c a t i o n . While i t was d i s a p p o i n t i n g that the i n t e n t i o n to p a r t i c i p a t e v a r i a b l e d i d not c o r r e l a t e i n a high s i g n i f i c a n t f a s h i o n with past p a r t i c i p a t i o n , the c o r r e l a t e s obtained i n t h i s study with past p a r t i c i p a t i o n and the socioeconomic v a r i a b l e s were not stronger than those obtained when the determinants of i n t e n t i o n s were regressed with past p a r t i c i p a t i o n . Although the p r e d i c t i o n of p a r t i c i p a t i o n has not been enhanced through a p p l i c a t i o n of t h i s model i n t h i s r e s e a r c h , the general understanding of why d i e t i t i a n s p a r t i c i p a t e i n c o n t i n u i n g education has been improved. L o g i c a l l y the instrument i s next best used to i n v e s t i g a t e some a c t u a l p a r t i c i p a t i o n behaviour of these and other h e a l t h 1 26 p r o f e s s i o n a l s , to f u r t h e r t e s t i t s p r e d i c t i v e u t i l i t y . The f i n d i n g s i n t h i s study i d e n t i f y a c h a l l e n g e f o r c o n t i n u i n g education program p l a n n e r s to be both c r e a t i v e and r e s o u r c e f u l . Future r e s e a r c h p o t e n t i a l l i e s i n the area of s e c u r i n g r e l i a b i l i t y and v a l i d i t y i n f o r m a t i o n f o r the instrument used i n t h i s r e s e a r c h . In a d d i t i o n , i n f o r m a t i o n r e g a r d i n g the the i n t e n t i o n s of other groups of h e a l t h p r o f e s s i o n a l s to p a r t i c i p a t e i n c o n t i n u i n g education would be of v a l u e . 127 REFERENCES Adolph, T., & Whaley, R. F. A t t i t u d e s toward a d u l t e d u c a t i o n . Adult Education, 1967, £7, 152-159. Ajzen, I. A t t i t u d i n a l vs. normative messages: An i n v e s t i g a t i o n of the d i f f e r e n t i a l e f f e c t s of p e r s u a s i v e communications on behaviour. Sociometry, 1971, 34, 263-280. Ajzen, I., & F i s h b e i n , M. The p r e d i c t i o n of b e h a v i o u r a l i n t e n t i o n s i n a choice s i t u a t i o n . J o u r n a l of Experimental  S o c i a l Psychology 1969, 5, 400-416. Ajzen, I., & F i s h b e i n , M. The p r e d i c t i o n of behaviour from a t t i t u d i n a l and ' normative v a r i a b l e s . J o u r n a l of  Experimental S o c i a l Psychology 1970, 6, 466-487. Ajzen, I., & F i s h b e i n , M. A t t i t u d e s and normative b e l i e f s as f a c t o r s i n f l u e n c i n g b e h a v i o u r a l i n t e n t i o n s . J o u r n a l of  P e r s o n a l i t y and S o c i a l Psychology 1972, 2\_, 1-9. Ajzen, I., & F i s h b e i n , M. A t t i t u d e s and normative v a r i a b l e s as p r e d i c t o r s of s p e c i f i c behaviours. J o u r n a l of P e r s o n a l i t y  and S o c i a l Psychology 1973, 21_, 41-57. A l l p o r t , G. W. A t t i t u d e s . In C. Murchison (Ed.), Handbook of  Soc i a l Psychology. Worchester, Mass.: C l a r k U n i v e r s i t y Press, 1935. American D i e t e t i c A s s o c i a t i o n . Goals of the l i f e t i m e education of the d i e t i t i a n . J o u r n a l of the American D i e t e t i c  A s s o c i a t i o n 1969, 5_4, 9 1-93. Awty, M., & Balk, T. Dental p r a c t i t i o n e r s ' a t t i t u d e s to postgraduate education i n the South East Thames r e g i o n . B r i t i s h Dental J o u r n a l , 1975, 139, (3), 111-112. Barlow, D. J , & Chesney, A. P. Nurses want to keep up to date. J o u r n a l of Continuing Education i n Nursing 1977, 8 (6)., 15-21. Bauer, J . C , & Bush, R. G. D e n t i s t s ' a t t i t u d e s toward c o n t i n u i n g d e n t a l e d u c a t i o n : Nontopic f a c t o r s of demand fo r cou r s e s . J o u r n a l of Dental Education 1978, £2 (11), 623-626. Beamer, E. G. Co n t i n u i n g e d u c a t i o n : A p r o f e s s i o n a l requirement. J o u r n a l of Accountancy, 1972, 133 (1), 33-39. B e l l , F., & Rix, P. A t t i t u d e s of nurses toward l i f e l o n g l e a r n i n g : One h o s p i t a l examines the i s s u e s . J o u r n a l of  Co n t i n u i n g Education i n Nursing 1979, j_0 (1), 15. 1 28 Berg, H. M. Factors d i f f e r e n t i a t i n g participant and  nonparticipant nurses in continuing education. Unpublished doctoral d i s s e r t a t i o n , Columbia University, 1 9 7 3 . Bernardi, V. W. A comparison of selected variables associated  with p a r t i c i p a t i o n in pharmacy continuing education  programs. Unpublished doctoral d i s s e r t a t i o n , University of Connecticut, 1 9 7 4 . Bernardi, V. W. , & McCook, W. M. Analysis of pharmacy student attitudes toward continuing education: A cross-sectional study. American Journal of Pharmaceutical Educat ion, 1 9 7 7 , 41 ( 3 ) , 2 6 9 - 2 7 2 . Bevis, M.E. The continuing learning a c t i v i t i e s of neophyte nurses. Adult Education 1 9 7 5 , 2 5 , 1 6 9 - 1 9 1 . Boissoneau, R. Point of view: The importance of continuing education for d i e t e t i c s . Journal of the American Dietetic  Association 1 9 7 7 , 7J_, 4 9 - 5 0 . Boshier, R. A conceptual and methodological perspective  concerning research on p a r t i c i p a t i o n in adult education. Speech to the Graduate Colloquium, Department of Secondary and Adult Education. N. I l l i n o i s University, Dekalb, I l l i n o i s , March 17, 1 9 7 8 . B r i t i s h Columbia Dietetic Association. Guidelines and  continuing education for members of BCDNA. 1 9 7 5 . B r i t i s h Columbia D i e t i t i a n s ' and N u t r i t i o n i s t s ' Association (BCDNA). Minutes of a special meeting to endorse mandatory continuing education for member d i e t i t i a n s and continuation of the CE program, November 12, 1 9 8 0 . Broski, D. C., & Upp, S. C. What a l l i e d health professionals want fromContinuing education programs: A study of fiv e d i s c i p l i n e s . Journal of A l l i e d Health, 1 9 7 9 , 8, 2 4 - 2 8 . Brunner, E. de S., et a l . An overview of adult education  research. Chicago: Adult Education Association of the U. S. A., 1 9 5 9 . Buchanan, D.- -Professional attitudes to continuing education in England. Convergence, 1 9 7 0 , 3 ( 4 ) , 5 1 - 5 5 . Bush, T. A., & Lewis, C. W. Continuing education for nurses: Perceptions and performances. Journal of Continuing  Education in Nursing 1 9 7 8 , 9 ( 2 ) , 1 0 - 1 3 . Cafferata, G. L., Goldberg, H. J. Roghmann, K., & Fox, R. Continuing education: Attitudes, interests, and experiences of p r a c t i c i n g dentists. Journal of Dental Education 1975, 3 9 ( 1 2 ) , 7 9 3 - 8 0 0 . 1 2 9 Campbell, D. T. Social attitudes and other acquired behavioural dis p o s i t i o n s . In S. Koch (Ed.), Psychology: A study of a science (Vol. 6 ) . New York: McGraw-Hill, 1 9 6 3 . Canadian Di e t e t i c Association. Minutes of the Annual Convention, June 1 9 7 4 . Castle,CH. and Storey, P.B. Physician's needs and interests in continuing medical education. Journal of the American  Medical Association, 1 9 6 8 , 2 0 6 , 6 1 1 - 6 1 4 . Carp, A., Peterson, R., & Roelfs, P. Learning interests and experiences of adult Americans. In K. P. Cross, J . R. Valley & Associates (Eds.), Planning non-traditional  programs: An analysis of the issues for post-secondary  education. San Francisco: Jossey-Bass, 1 9 7 4 . Chein, I. Behavior theory and the behaviour of attitudes: Some c r i t i c a l comments. Psychology Review, 1 9 4 8 , 5 5 , 1 7 5 - 1 8 8 . Cohen, L. A. S i l v e r s i n , J. B., Kress, G. C , J r . , & Yacavone, J . A. Correlates of dentists' attitudes toward continuing education in team. Journal of Dental Education 1 9 7 7 , 4J_ (11 ) , 6 7 7 - 6 8 3 . Cowan, A. Continuing education: A survey of the attitudes of the dental profession in Ireland. Journal of Medical  Science, 1 9 7 6 , 1 4 5 ( 3 ) , 6 9 - 8 3 . Curran, C. L. Factors a f f e c t i n g p a r t i c i p a t i o n in continuing education a c t i v i t i e s and i d e n t i f i e d learning needs of registered nurses. Journal of Continuing Education in  Nursing 1 9 7 7 , 8 ( 4 ) , 1 7 - 2 2 . Dao, M. N. S. C. The orientations toward nonparticipation in  adult education. Unpublished doctoral d i s s e r t a t i o n , University of Chicago, 1 9 7 5 . Deane, S. R. Who seeks adult education and why? Adult  Education 1 9 5 0 , J _ , 1 8 - 2 0 . DeFleur, M. L., & Westie, F. R. Attitude as a s c i e n t i f i c concept. Soc i a l Forces, 1 9 6 3 , _42, 1 7 - 3 1 . DeVries, D. L., & Ajzen, I. The relationship of attitudes and normative b e l i e f s to cheating in college. Journal of  Social Psychology, 1 9 7 1 , 8 3 , 1 9 9 - 2 0 7 . Dickinson, G. D., & Blunt, A. Survey research. In H. B. Long & R. Hiemstra (Eds.), Research in adult education. San Francisco: Jossey-Bass, 1 9 8 0 . Donaldson, B. Extending educational opportunities for d i e t i t i a n s : An experimental approach. The Journal of the 130 American D i e t e t i c Association , 1 9 6 8 , 5_3, 3 2 9 . Doob, L. W. The behaviour of attitudes. Psychology Review, 1 9 4 7 , 5 4 , 1 3 5 - 1 5 6 . Dulany, D. E. Hypotheses and habits in verbal "operant conditioning". Journal of Abnormal Social Psychology, 1 9 6 1 , 6 3 , 2 5 1 - 2 6 3 . Dulany, D. E. Awareness, rules and propositional control: A confrontation with S-R behaviour theory. In D. Horton & T. Dixon (Eds.), Verbal behaviour and S-R behaviour theory Englewood C l i f f s , N. J . : Prentice-Hall, 1 9 6 8 . Dunlap, M. S. Continuing education programs in nursing: An exploration. Journal of Nursing Educat ion, 1 9 7 3 , Y2 ( 1 ) , 4 - 1 1 . Fishbein, M. Attitude and prediction of behaviour. In M. Fishbein (Ed.), Readings in attitude theory and measurement . New York: Wiley, 1 9 6 7 . Fishbein, M., & Ajzen, I. Be l i e f , attitude, intention and  behaviour: An introduction to theory and research. Don M i l l s , Ont.: Addison-Wesley, 1 9 7 5 . Fishbein, M., Landy, E., & Hatch, G. Some determinants of an individual's esteem for his least preferred co-worker. Human Relations, 1 9 6 9 , 2_2, 1 7 3 - 1 8 8 . Fruin, M. J., & Bart, W. M. Hiera r c h i c a l structure of selected behaviours of d i e t i t i a n s on the job. Journal of  the American Di e t e t i c Association 1 9 7 8 , 7 3 , 6 3 5 - 6 3 9 . Green, B. F. Attitude measurement. In G. Lindzey (Ed.), Handbook of soc i a l psychology (Vol. I ) . Reading, Mass.: Addison-Wesley, 1 9 5 4 . G r i f f i n , G. Thoughts and directions from the 1 9 6 5 - 1 9 6 6 survey of postgraduate education. American Journal of Cardiology, 1 9 6 7 , J_9 , 3 2 0 - 3 2 5 . Gross, S. M. Demographic study of the relationship of continuing pharmaceudical education to selected a t t i t u d i n a l — a n d competence—related c r i t e r i a . American  Journal of Pharmaceutical Education, 1 9 7 6 , 1 4 1 - 1 4 8 . Grotelueschen, A. D., & Caulley, D. N. A model for studying determinants of intention to pa r t i c i p a t e in continuing professional education. Adult Education 1 9 7 7 , 28_ ( 1 ) , 2 2 -3 7 . Gutman, L. The problem of attitude and opinion measurement. In S. A. Stouffer, et a l . (Eds.), Measurement and 131 prediction. Princeton, N. J . : Princeton University Press, 1 9 5 0 . Hart, M. E. D i e t e t i c education—past, present and future. Journal of the American D i e t e t i c Association 1 9 7 4 , 6 4 , 6 1 2 -6 1 5 . Hesberg, T. M. , M i l l e r , P. A-., & Wharton, C. R. , J r . Patterns for l i f e l o n g learning. San Francisco, Jossey-Bass, 1 9 7 5 . H o l l i , B. L. B. An analysis of the nature and the extent of  continuing professional learning of registered d i e t i t i a n s  in a metropolitan area. Unpublished doctoral d i s s e r t a t i o n , University of Northern I l l i n o i s , 1 9 8 1 . Houle, C. Lengthened l i n e . Perspectives of B i o l o g i c a l Medicine , 1 9 6 7 , Autumn, 1 7 . Houle, C. Continuing learning in the" professions. San Francisco: Jossey-Bass, 1 9 8 0 . ' Hozid, J . Role of continuing education in dental obsolescence. Journal of the American D i e t e t i c Association 1 9 6 9 , 7 8 , 1 2 9 9 - 2 3 0 3 . Johnstone, J. W. C , & Rivera, R. J. Volunteers for learning Chicago: Aldine Publishers Co., 1 9 6 5 . Kerlinger, F. N. Foundations of behavioural research:  Educational and psychological inquiry. New York: Holt, Rinehart & Winston, 1 9 7 9 . Kotzan, J. A., & Jowdy, A. W. D i f f e r e n t i a l attitudes toward an adult education program for pharmacists. Adult  Education 1 9 7 0 , 2J_ ( 1 ) , 2 0 - 2 8 . Krathwohl, D. R., Bloom, B. S. & Masia, B. B. Taxonomy of  educational objectives (Handbook I I : A f f e c t i v e Domain). New York: David McKay Co., Inc., 1 9 6 4 . Krowka, M. J., & Peck, 0 . C. Continuing medical education as viewed by medical students. Journal of Medical Education, 1 9 7 9 , 54 ( 1 ) , 5 3 - 5 4 . Kubat, J. Correlates of professional obsolescence. Journal of  Continuing Education in Nursing Part I, 1 9 7 5 , 6 ( 6 ) , 2 2 - 2 9 ; Part II, 1 9 7 6 , 7 ( 1 ) , 1 8 - 2 2 . Larocco, S. L., & P o l i t , D. F. A study of nurse's attitudes toward mandatory continuing education for relicensure. Journal of Continuing Education in Nursing 1 9 7 8 , 9 , 2 5 - 3 5 . Lauffer, A. The Practice of Continuing Education in the Human 1 32 S e r v i c e s . New-York: McGraw H i l l , 1977. Lemburger, M. A., & McCormick, W. C. C o n t i n u i n g education as a l i f e l o n g p r o c e s s . American J o u r n a l of Pharmacy Education , 1976, 40, 170-173. L i k e r t , R. A. A technique f o r the measurement of a t t i t u d e s . A r c h i v e s of Psychology, 1932, June (140). Matthews, A. E., & Schumacher, S. A survey of r e g i s t e r e d nurses' conceptions of and p a r t i c i p a t i o n f a c t o r s i n p r o f e s s i o n a l c o n t i n u i n g e d u c a t i o n . J o u r n a l of C o n t i n u i n g  E d u c a t i o n i n Nursing, 1 979, ]_0 (1), 21-27. McGuire, W. J . The nature of a t t i t u d e s and a t t i t u d e change. In G. Lindzey & E. Aronson (Eds.), Handbook of Soc i a l  Psychology (2nd ed.) (Vol I I I ) . Reading, Mass.: Addison-Wesley, 1969. M i l l e r , J . , & Rea, D. How nurses p e r c e i v e mandatory c o n t i n u i n g e d u c a t i o n . J o u r n a l of C o n t i n u i n g Education i n Nursing 1977, 8 (1), 8-15. Moxley, J . H. L e g i s l a t i o n and s o c i a l p r e s s u r e s f o r c o n t i n u i n g e d u c a t i o n . J o u r n a l of American C o l l e g e of D e n t i s t s , 1969, 36, 154-164. Nakamoto, J . Continuing education i n the h e a l t h s c i e n c e s . Unpublished master's t h e s i s , U n i v e r s i t y of B r i t i s h Columbia, 1972. Osgood, C. E., S u c i , G. J . , & Tannenbaum, P. H. The  measurement of meaning. Urbana: U n i v e r s i t y of I l l i n o i s P ress, 1957. Parochka, J . N. B e l i e f s and i n t e n t i o n s to p a r t i c i p a t e i n  cont i n u i n g p r o f e s s i o n a l educat i o n : A study of non- p a r t i c i p a n t nurses i n Rockford, I l l i n o i s . Unpublished d o c t o r a l d i s s e r t a t i o n , U n i v e r s i t y of Northern I l l i n o i s , 1981 . P h y s i c i a n o p i n i o n s about c o n t i n u i n g education programs. C a l i f o r n i a Medicine, 1969, 111, 132-139. P r i c e , E.M. Learning Needs of R e g i s t e r e d Nurses. New York: Teacher's C o l l e g e Press, Columbia U n i v e r s i t y , 1967. Randolph, K. B a s e l i n e s and r e s p o n s i b i l i t i e s i n c o n t i n u i n g e d u c a t i o n a l e f f o r t s . J o u r n a l of American C o l l e g e of  D e n t i s t s , 1963, 3_0, 283-288. Seaman, D. F., & Schroeder, W. L. The r e l a t i o n s h i p ' between extent of educative behaviour by a d u l t s and t h e i r a t t i t u d e s toward c o n t i n u i n g education. A d u l t Educat ion 1970, 20 (2), 133 99-105. Schwartz, S. H. , & T e s s l e r , R. C. A t e s t of a model f o r reducing measured a t t i t u d e - b e h a v i o u r d i s c r e p a n c i e s . J o u r n a l of P e r s o n a l i t y and S o c i a l sycholoqy, 1972, 24, 225-236. Seymour, R. J . , C o n n e l l y , T., & Gardner, D. C o n t i n u i n g e d u c a t i o n : An a t t i t u d i n a l survey of p h y s i c a l t h e r a p i s t s . P h y s i c a l Therapy, 1979, 59 (4), 399-402. Smornyski, H. W. , & Parochka, J . P r o v i d i n g c o n t i n u i n g education o p p o r t u n i t i e s i n the a l l i e d h e a l t h p r o f e s s i o n s . J o u r n a l of A l l i e d H e a l t h , 1979, February, 47-54. Stensland, P. G. C o n t i n u i n g p r o f e s s i o n a l e d u c a t i o n , s t r a t e g i e s f o r h e a l t h p r o f e s s i o n a l s . Soc i a l Sc ience and Medic in e , 1977, _M, 661-666. Southern, S. S. M. A t t i t u d e s , b e l i e f s , i n t e n t and s p e c i f i e d  demographic v a r i a b l e s as assessments of s e l e c t e d educators'  reasons f o r p a r t i c i p a t i o n i n graduate courses i n e d u c a t i o n . Unpublished d o c t o r a l d i s s e r t a t i o n , Texas Woman's U n i v e r s i t y , 1980. Thurstone, L. L. A t t i t u d e s can be measured. American J o u r n a l  of S o c i o l o g y , 1928. Thurstone, L. L. The measurement of s o c i a l a t t i t u d e s . J o u r n a l  of Abnormal S o c i a l Psychology, 1931, 2S, 249-269. Vanderveen, E., & Hubbard, R. M. Continuing education needs as p e r c e i v e d by d i e t e t i c p r a c t i t i o n e r s . J o u r n a l of the  American D i e t e t i c A s s o c i a t i o n 1 979, 75, 429-433. Vaughan, G. B., McCarthy, G. T., & Saegert, J . Survey of p h y s i c i a n 666666titudes and p r a c t i c e s i n Texas. Texas  Medicine, 1979, 75 (10), 64-68. Verner, C , & Newberry, J . S. The nature of a d u l t p a r t i c i p a t i o n . A d u l t Education 1958, 8, 208-222. Wendell, P. Futurism and the reform of higher e d u c a t i o n . In A. T o f f l e r (Ed.), L e a r n i n g f o r tomorrow. New York: Vantage Books, 1974. W i l l i c k , C M . H i s t o r y of D i e t e t i c s i n B r i t i s h Columbia 1926- 1980. B r i t i s h Columbia D i e t i t i a n s ' and N u t r i t i o n i s t s ' A s s o c i a t i o n , 1981. Wolczuk, P. Report on the 1976 survey of c o n t i n u i n g education needs and i n t e r e s t s of d i e t i t i a n s and n u t r i t i o n i s t s i n B r i t i s h Columbia, 1976. 134 APPENDIX A Cont i n u i n g Education G u i d e l i n e s 135 CONTINUING EDUCATION GUIDELINES 136 THE BPTTTSH COLUMBIA DIETETIC ASSOCIATION GUIDELINES (Revised June 1980) ContInuing Education for Members of B.C.D.A. Continuing Education is an essential part of the l i f e of a professional person. Each of us must see this as an opportunity to serve ourselves and others in a way that only further education can make possible. Continuing Education for the dietitian/nutritionist  is education beyond the basic preparation for the  profession. It is not a series of refresher courses, nor is i t one of personal enrichment, but instead, is the acquisition of further information which w i l l enhance the expertise of the dietitian/nutritionist. The educational background and knowledge of every dietitian/nutritionist is different, therefore dietitian/nutritionists should assess each Continuing Education event attended as to i t s ' worth as con-tinuing education for themselves, and allocate the proportion of maximum points accordingly. GENERAL INSTRUCTIONS 1. Continuing education commences a f t e r A p r i l 1, 1980.' 2. Designated one year p e r i o d - A p r i l 1 to March 31-. The average number of po i n t s earned would be 15 but these may be accumulated over the designated 5 year p e r i o d . 3. Designated f i v e year period - A p r i l 1, 1980 to March 31, 1985. Number of po i n t s that should be earned i s 75. 4. ExcesB points may not be c a r r i e d over t o the next 5 year period and only points acquired i n the pre-vious 12 months w i l l be considered. 5. The B r i t i s h Columbia D i e t e t i c A s s o c i a t i o n report forms w i l l be mailed out i n the March Newsletter w i t h a l i s t of approved events. I t i s the r e s p o n s i -b i l i t y of the member to f i l l - out t h i s form and r e t u r n  i t before A p r i l 30 f o r p o i n t s to be recorded. Mem-bers are responsible f o r requesting a d d i t i o n a l forms e i t h e r by mail or at B r i t i s h Columbia D i e t e t i c Asso-c i a t i o n meetings. 6. Members w i l l have three sources from which to l e a r n how many po i n t s w i l l be a v a i l a b l e f o r approved events a. Through the B.C.D.A. Newsletter. b. Reading the G u i d e l i n e s . c. Contact w i t h the Continuing Education committee. 7. Use of the Newsletter* a. Watch f o r announcements under the heading "Guide-l i n e s f o r Continuing Education". b. Further g u i d e l i n e m a t e r i a l i s to be appended to the o r i g i n a l . c. Lectures or addresses w h e n approved w i l l be l i s -ted together w i t h maximum p o i n t s a v a i l a b l e . d. Workshops, seminars, conferences, i n s t i t u t e s w i l l be announced (ahead when p o s s i b l e ) w i t h v maximum p o i n t s a v a i l a b l e . GENERAL INSTRUCTIONS, contd.... 7. e. To share information in order to promote ideas and contacts for continuing education subject matter. f. When an event is listed in the newsletter under the heading "Guidelines for Continuing Educa-tion" the member, when reporting, uses the t i t l e given, the date of the event, and records the hours of attendance and the points. g. When an event is not listed in the newsletter the member w i l l follow Guideline instructions under the appropriate section. h. Reports lacking sufficient information w i l l be returned for completion. i . Reports when complete and points accurately recorded are accepted i f the members does not hear from the coordinator. j . There w i l l be provision for contact in the Districts, whose duty ie w i l l be to provide the coordinator with information to f u l f i l l the obligations as outlined (c) and (d) above. 8. When reporting on continuing education forms record whole hours only. POINTS WILL NOT BE GRANTED FOR THE FOLLOWING; 1. Meetings - business, executive and committee work, and delegate reports. 2. Presentation of lectures or programs to employees (non-professional), the lay public or students. 3. Cooking demonstrations. 4. Tours. 5. Publishing cook books,. training manuals, articles and books for the lay public. 6. Courses for personal enrichment. 7. Activities listed in the individuals job descrip-tion. 139 CONTINUING EDUCATION PROCEDURE SECTION ONE General Statement? Approved events w i l l be published In the March Newsletter together with the maximum number of points available. When possible these w i l l also be published in advance. The approving body wi l l use the following c r i t e r i a to evaluate the event. 1. Applies to the f i e l d of nutrition and dietetics. 2. Extends the expertise in the professional practice of the dietitian/nutritionist in areas such as nutrition care, education, administration and research. 3. Serves to update knowledge. 4. Teaches a new s k i l l or technique related to the f i e l d . Members' Responsibility; 1. To report the actual hours in attendance. 2. To identify clearly the event by t i t l e , sponsor and date. 3. For events not listed in the newsletter, supply descriptive material that w i l l document in some detail the session, so i t can be evaluated by the approving body using the general statement as your guide. A. Lectures or Addresses that offer professional material of an educational nature which meets the c r i t e r i a outlined w i l l be considered for approval. THE POINTS WILL BE GRANTED ON THE BASIS OF ONE POINT FOR EACH HOUR 140 B. Workshops, Seminars, Conferences. InstitutesT~ Those sponsored by the British Columbia Dietetic Association, Canadian Dietetic Assocition, American Dietetic Association, a l l i e d professional material of an educational nature which meets the c r i t e r i a outlined w i l l be considered for approval. THE POINTS WILL BE GRANTED ON THE BASIS OF ONE POINT FOR EACH HOUR. When attending Continuing Education events from other disciplines i t is probable that some sections are by nature "personal enrichment" and other sections may be continuing education. It is in these instances that a member should d i f -ferentiate and claim only the applicable section of the course that she considers to be of con-tinuing education value to herself. C. Exhibits, Visiting Commercial and Educational  Exhibits. This can include food shows, exhibits of equip-ment, new product dinners, exhibits of books, etc. POINTS WILL BE GRANTED ON THE BASIS OF (A) ONE POINT PER EVENT (B) FOR A LARGE NATIONAL ASSOCIA-TION EVENT THREE POINTS. MAXIMUM POINTS PER YEAR THREE. D. Observation Study. Time spent in observing specific areas of Dieti-tian/Nutritionist practice is considered a conti-nuing education activity when the observer prac-tices in the same specialty. Member's Responsibility; 1. To state purpose of observation study. 2. To report number of hours of observation study. 3. To state name of institution, the advisor's name and date. 4. To submit a one page single spaced typed descrip-tion of the observation study that is suitable in whole or in summary form for publication in the newsletter. POINTS WILL BE GRANTED ON THE BASIS OF 4 POINTS FOR A MINIMUM OF 8 HOURS OF STUDY. SECTION TWO This section pertains to courses taken for academic credit or audit, non-academic courses, writing for publication and teaching. A. Courses - Academic and Non-Acadeaic. General Statement; Course content should apply to the the f i e l d of nutrition and dietetics and assist in improving professional competency and practice. 1. Academic courses at the graduate level may be taken for credit or audit in Canadian or foreign universities or colleges. Undergraduate courses are acceptable when the member can show evidence that they contribute to improving competency and meet the c r i t e r i a as outlined in the opening state-ment. Member's Responsibility; 1. To report the actual number of hours in attendance ; at the course. ' 2. To describe briefly the course on the report form. 3. Additional documentation is required as follows; • a) Calendar description of the course. b) State i f course taken for credit or audit. 142 A. Courses - Academic and Non-Academic. " Member's Responsibility, contd... c) If for credit, statement that the credit was obtained. d) Whether course was graduate or undergraduate. e) If undergraduate level supply supportive evi-dence that it contributes to improving compe-tency. POINTS WILL BE GRANTED ON CANADIAN DIETETIC ASSO-CIATION CREDIT HOURS, WHICH ARE DEFINED BY THE TIME DEVOTED TO FORMAL CLASS ACTIVITIES SO THAT, 1 CD.A. credit hour equals 1 hour of lecture or 2 hours laboratory or seminar time per week for one term or semester. ACADEMIC CREDIT 6 credit hours equals 16 points 3 credit hours equals 8 points 2 credit hours equals 4 points ACADEMIC AUDIT 6 credit hours equals 8 points 3 credit hours equals 4 points 2 credit hours equals 2 points 2. Non-academic courses; Suitable courses may be offered in the community night school programs, . Manpower, Hospital Labor Relations Association, or within a place of employment. Courses are acceptable when the member can show that they contribute to improving competency. Member's Responsibility; 1. To report the actual hours in attendance at the course. 2. To describe briefly the course on the re-porting form. 3. Additional documentation is required as follows: • a) A published course description and i f this is not available your summary of the course content. b) sponsor of the course. c) Name of course lecturer(s) and credentials. ; d) Supportive evidence that i t contributes to improving competency. POINTS WILL BE GRANTED AT THE RATE OF ONE POINT PER 2 HOURS OF ATTENDANCE. MINIMUM OF 6 HOURS UNLESS OTHERWISE SPECIFIED. ********** B> Writing for publication. General Statement; Articles written may be scholarly, information sharing, training manuals or books. A l l material to have been published. Member's Responsibility; 1. To submit copies of published material together with supporting documentation, i.e., name of jour-nal, t i t l e , volume, date of publication. If the material i s a book or manual, a copy should be submitted. 2. Use information below to indicate under which classification points are being requested. POINTS WILL BE GRANTED ON THE BASIS OF THE FOLLOWING LIST; A r t i c l e s Research T e c h n i c a l In fo raa t ion Sharing Author , s i n g l e s e n i o r 10 8 5 5 i* N/A co -au thor 5 3 2 c o n t r i b u t i n g ( •ore than 2) 3 3 N/A Books determined on an i n d i v i d u a l b a s i s . T r a i n i n g Manuals determined on an i n d i v i d u a l b a s i s , Book Reviews per each review 1 po in t A b s t r a c t s per three 1 point aax. 25 p t s . aax. 10 p t s . 144 C. Teaching. General Statement; This involves a teaching activity that i s not part of the member's regular employment; or for which the member does not receive remuneration. The participation may be on the teaching staff or faculty of workshops, seminars, conferences or i n s t i -tutes for the dietitian/nutritionist or related pro-fessions, which have been approved for continuing education points. It does not include teaching to students or the lay public. Member's B<?-.po^ £ib*.lity; 1. To report number of hours that material is pre-sented. 2. To provide evidence of participation. POINTS WILL BE GRANTED AS LISTED BELOW AMD ARE BASED ON TIME MATERIAL IS PRESENTED. Points per hour Participant, single 3 co 2 panelist 1 ******** SECTION THREE This section pertains to journal clubs, grand medical rounds, and individual study. A. Journal Clubs. Using the c r i t e r i a stated on the opening pages of this guideline each group wishing to form a journal club is to submit to the coordi-nator a pre-planned program. The articles dis-cussed should update knowledge or teach a new s k i l l or technique related to the f i e l d . \ Each journal club should provide for group pa r t i -! cipation, and a suggested minimum of 3 persons i and a maximum of 7. The group's activity should consist of discussions from pre-assigned topics. 1 It is suggested that a maximum of three articles per topic be discussed. The study should be in depth and concern specific and limited topics. The submission of the pre-planned program is to include: 1. The name of the journal club. 2. A l i s t of the members' names. 3. A l i s t of the professional journals from which the articles will be selected. (do not use abbreviations.) Member's Responsibilities; 1. when reporting - state the journal club name - state topic heading - state the number of hours at-tended per each topic. 2. to elect one member to submit: a) pre-planned program each September b) after each meeting submit a report on the topic covered. Each topic to be accompanied by a l i s t of articles discussed indicating source, i.e., name of journal, month and year. POINTS WILL BE GRANTED ON THE BASIS OF ONE POINT FOR EACH HOUR OF PARTICIPATION B. Grand Medical Rounds. Rounds that present nutri-tion material or additional material that w i l l enable the dietitian/nutritionist to increase her understanding of nutritional care are con-sidered a continuing education activity. Rounds attended as part of the member's job obligation are not eligible for continuing education points. Member's Responsibility; 1. To report a descriptive t i t l e and the name of the person presenting the material. 2. To state the name of the hospital. 3. To submit the number of hours in attendance. POINTS WILL BE GRANTED ON THE BASIS OF 1 POINT FOR EACH TWO HOURS OF ATTENDANCE. C. Individual Study. This embodies programs that the individual can arrange for herself, particu-larly the individual who is unable to participate \ in group sessions. Individuals should be in i touch with the coordinator during the development of the program. The approving body w i l l consider the program and indicate the maximum points that w i l l be available. The member w i l l be responsible for reporting the hours of study and pre-arranged documentation when using the report form. ADDRESS TO WHICH ALL INQUIRIES SHOULD BE MADE; Chairperson, Continuing Education Committee, B. C. Dietetic Association Ste. B100 - 1089 West Broadway, Vancouver, B. C. V6H 2V3 I M P O R T A N T PLEASE KEEP THESE GUIDELINES. WATCH FOR AND APPEND ADDITIONAL MATERIAL AS IT APPEARS IN THE NEWSLETTER. APPENDIX B Correspondence ( L e t t e r s Regarding P r o j e c t ) 150. The University of British Columbia Adult Education Department 5760 Toronto Road Vancouver, B.C. V6T 1L2 Canada 1981 03 31 Dear Colleague; In many respects d i e t i t i a n s i n t h i s province have been leaders i n pursuing continuing education to enhance t h e i r expertise in the f i e l d of n u t r i t i o n and d i e t e t i c s . I am conducting a survey of BCDA members to obtain a better understanding of the intentions of d i e t i t i a n s to p a r t i c i p a t e i n continuing education a c t i v i t i e s . Such information w i l l be valuable to the BCDA Continuing Education Committee in planning future programs for your benefit. Your assistance i n completing and returning the enclosed questionnaire by APRIL 15, 1981 w i l l be greatly appreciated. Most responses for the questionnaire require only a check ( J ) i n the appropriate space. Completion of a l l questions should take about 20 minutes. Your consent to p a r t i c i p a t e i n t h i s survey w i l l be assumed by your return of a completed questionnaire i n the enclosed stamped envelope. Many thanks f o r your co-operation and valuable assistance i n responding to this questionnaire. Your responses w i l l be completely anonymous and w i l l be used only as part of group r e s u l t s . Please return the questionnaire by APRIL 15. Sincerely, Debbie Z i b r i k , Graduate Student APPENDIX C e Test Instrument SURVEY OF DIETITIANS  INTENTIONS TO PARTICIPATE IN CONTINUING PROFESSIONAL EDUCATION Section 1 ( P i e . . . re.pond to t h . f o l l o w i n g , - e . t i o n . reo.ue.ting general i n f o r - a t i o n . Moat re.pon.ee re q u i r e only . check ( J ) i n the ap p r o p n a t . . P . c e . I n which geographic region do you work! _____ Creeter Vancouver Okenagan Vancouver Ia l a n d North Eaat F r a . e r V a l l e y North Heat Thompson V a l l e y Eaat Kootenay Weat Kootenay In what type of agency are you enployedT _ _ _ acute care general h o a p i t a l _____ extended c a r a h o a p i t a l _____ p r i v a t e h o a p i t a l c b i l d r a n ' a h o a p i t a l rehab, center educational i n a t i t u t i o n ( u n i v e r e i t y or c o l l e g e ) conminity agency/health u n i t other ,  (•pecify) How —my houra do you work aach waekt hour(a) What i a t h . higheet l . v . l of f o n a e l education you have completed? _ Bachelor'a degree H a l t e r ' a degree Doctor', degree (Ph.D., K.D.) other ( e p e c i f y ) In what year d i d you c o _ p l . t . a degree i n n u t r i t i o n / d i . t . t i c . 7 p r a c t i c a l work experience wrote CDA entrance exaa How d i d you ob t a i n aeoberehip i n the BCDA? d i e t e t i c i n t . r n a h i p Haater'a degree other _ _ _ _ _ _ _ _ _ _ _ _ ( a p e c i f y ) 7. How long have you been a member of t h * BCDA? year(a) 8. What i e your age! yeara 9. How aiany yeara have you been employed i n n u t r i t i o n / d i e t e t i c a T yeer(a) 10. How -any yeara have you been employed i n your preaent poaitionT year(a) 11. What i a your current job t i t l e t Job T i t l e '  11. (cont'd.) t l e i u i n d i c a t e what percentage (X) of your t i n e i a devoted to each of your d u t i e a t Outiea C l i n i c a l * A d m i n i a t r a t i v a _____* Reaearch * Education * Comtsunlty/Counealllng * Other * ( s p e c i f y ) ~ _ _ 100Z 12. The BCDA haa publiahed g u i d e l i n e a f o r the co n t i n u i n g education of d i e t i t i a n s . According to theee g u i d e l i n e a a c o n t i n u i n g education a c t i v i t y oust update knowledge, teach new s k i l l s or extend the e x p e r t i s e of the d i e t i t i a n outalde j ob r e l a t e d d u t i e a . How many esonths haa i t been aince you p a r t i c i p a t e d i n systematic c o n t i n u i n g p r o f e a a i o n a l education aa s p e c i f i e d i n the BCDA g u i d e l i n e s ? months cont'd.) 13. I f you have p a r t i c i p a t e d , please i n d i c a t e the method of atudy of your aosc recent a c t i v i t y ! _____ diacussion group _____ l e c t u r e s o r addreases _____ i n d i v i d u e l study _____ correspondence study _____ study with prepared tapea _____ conferencea, workshops, seminars, i n s t i t u t e s _____ educational TV other ( s p e c i f y ) 14. How many continu i n g education p o i n t s have you reported to the BCDA over the l a a t 5 year r e p o r t i n g p e r i o d , i . e . , up t o March 1980T _____ points 15. How many ( i f sny) c o n t i n u i n g education pointa have you accumulated but not submitted f o r c r e d i t to the BCDA over the l a s t 5 year r e p o r t i n g period? _____ pointa obaervation atudy academic c r e d i t or a u d i t courses non-academic courses v i s i t i n g a t e x h i b i t s w r i t i n g f o r p u b l i c a t i o n teaching j o u r n a l c l u b a grand medical rounda Th* f o l l o w i n g four q u e s t i o n * concern your b e l i e f ! about c o n t i n u i n g education. Pleaa* place a check ( / ) i n the apace that m e t c l o a e l y repreeenta your b e l i e f . 1. Do the person* l n your p r o f e s s i o n seem to be committed to c o n t i n u i n g t h e i r education over t h e i r e n t i r e p r o f e e s i o n e l l i f e ? very I I I I I I I I not at a l l committed somewhat c o m i t t e d committed 2. To what extent do you b e l i e v e t h a t peraona In your p r o f e s s i o n i h o u l d c o n t i n u * t h * i r educetlon throughout t h e i r p r o f e s s i o n a l l i f e ? . t r o n g l j ) I I I I I I 1 Jo not b e l i e v e aoderetely b e l i e v e b e l i e v e 3. Do you p e r s o n a l l y b e l i e v e you should p a r t i c i p a t e i n c o n t i n u i n g p r o f e s s i o n s ! education throughout your p r o f e e s i o n e l l i f e ? b e l i e v e moderately b e l i e v e b e l i e v e 4. To whet extent de you f e e l w i l l i n g t o act on your b e l i e f to p a r t i c i p a t e i n c o n t i n u i n g p r o f e s s i o n a l aducetion throughout your p r o f e e s i o n e l l i f e ? very | | I I I I I 1 "?< " * 1 1 . l i l l o , eomewhat w i l l i n g w i l l i n g Within the next year whet i e the X chance thet you w i l l p a r t i c i p a t e i n c o n t i n u i n g profeeaional education? Please apecify a percentage. Pleeee i n d i c e t e the method of atudy you would prefer t o uee. tank your top f i v e c h o i c e s , using I , 2, 3, e t c . , with f i r e t choice - 1. _____ d i s c u s s i o n group _ _ _ obaervetlon atudy _____ l e c t u r e s or addreasea _____ academic c r e d i t o r a u d i t i n d i v i d u a l atudy eoureea correspondence study non-academic courses atudy with prepared tap** v i a i t i n g at a x h i b i t a conference, workehop, w r i t i n g f o r p u b l i c a t i o n seminar, i n a t i t u t a _____ teaching educetional TV j o u r n a l club other _ _____ grand n o d i c a l rounds ( s p e c i f y ) Pleese estimate how many houra you Intend to devote to systematic c o n t i n u i n g profeeaional education during the next 12 months. Please spec i f y i houra I f continuing education f o r d i e t i t i a n a had not become compulsory, how would your i n t e n t i o n t o p a r t i c i p a t e i n continuing education i n the next year compare w i t h your l e v e l of p a r t i c i p a t i o n i n the peat year? I would intend t o p a r t i c i p a t e mora than I d i d I would intend t o p a r t i c i p a t e a t the same l e v e l 1 would intend to p a r t i c i p a t e l e s s thsn I d i d L O Section 3 Whether . p r o f e a a i o n a l w i l l r " ^ - . ^ t i l T ^ i ^ r r S l t ^ ^ ^ l ^ r o / p a r t i c i p a t l o n i . c o n t i n u i n g . a u c t i o n . EXAMPLEI P a r t i c i p a t i o n i n c o n t i n u i n g education I. Would ba a a o c l a l l y e t l e x i l a t l n g experience! High Value [_ | I I I J I I I "• V» l u* L i k e l y \ ** I | | | I IUnlikely In the exeaple given above the pr o f e a a i o n a l placea l i t t l e value on the consequence, however b e l i e v e a w i t h high p r o b a b i l i t y ( L i k e l y ) that p a r t i c i p a t i o n i n c o n t i n u i n g education w i l l b e ' e o c i a l l y e t i a u l a t i n g . Answer the f o l l o w i n g q uestions c o n s i d e r i n g your p s r t i c i p a t i o n i n c o n t i n u i n g e d u c a t i o n . Please i n d i c a t e the velue you piece on each consequence) n e x t , please i n d i c a t e how l i k e l y you thi n k i t would be f o r eech of theae conaequencea t o occur i f you were to p a r t i c i p a t e i n c o n t i n u i n g education a c t i v i t y . Anawer by p i e c i n g e check ( / ) on eech l i n e . PARTICIPATION IN CONTINUING EDUCATION 1. Would' incraaae ay j o b s e c u r i t y ) High Value I 1 I 1 | | I I Bo Velue L i k e l y | I I L J U n l i k e l y 2. Would use up eoiee of my apara t i m e i High V a l u . I I I I L _ J 1 1 - V * 1 " L i b e l , I I I I I 1 1 I"01""1' 3. Would challenge ay i n t e l l e c t u a l a b i l i t i e a l High Value | I 1 I I I I 1 Ho Value L i k e l y | I I I I I I I U n l i k e l y «. Would help sw refreeh -y profeaaional knowledgei High Value | I I I I I I I V a l u . L i k e l y I I I j I I I IUolU.1, J. Would increaae my p r o f e s s i o n a l v i s i b i t i t y i High Value | | I I L L i k e l y | I I L 6. Would nake ay work sore challenging) High Value | I I 1 L L i k e l y 1 I I L 7. Would e t l s x i l a t e sw i n t e l l e c t u a l l y : High Value | I I I L L i k e l y | I I L I Ho Velue J U n l i k e l y J»o Value _J | U n l l k . l y ] Ho Value | U n l i k e l y 8. Would hole, M keep up l o my f i e l d i S t c t l o n 3 (cont'd.) 13. Would a l l o w mo to intermingle e o c i a l l y w i t h my p r o f . e e l o n a l eolleegueei High Value _ _ L i k e l y 9. Would increase my High Value | L i k e l y 10. Would g i v e me » High Value | gre a t e r eens* of p r o f e s e i o n a l competence I L i k e l y \_ 11. Would i t — r o v e the High Value |__ L i k e l y l_ 12, Would remedy de High Value L__ L i k e l y L J I I L__L network of p r o f e s s i o n a l c o n t a c t a i J I L No Value U n l i k e l y No Value U n l i k e l y J I L J I L q u a l i t y of sry p r o f e e a i o n a l a e r v i c a No Value U n l i k e l y No Value U n l i k e l y i c i e n c i e a i n my p r o f e e a i o n a l t r a i n i n g : | | | I I I »<» Value I i i i i 1 u" l ikely J L No Value High Value I I I 1 I L i k e l y I I I I I I 1 I"""*1" 14. Would Improve my work s a t i s f a c t i o n ! High Value | I I I I I L L i k e l y J ! I No Value U n l i k e l y 15. Would improve my profeeaional etatuei High Value | I I I L I | | No Value L i k e l y | I 1 I I 1 1 1 Unlik-Xy 16. Would a l l o w me t o be more v e r a a t i l e i n the work I doi High Value | I I I 1 1 - No Value L i k e l y | I I I I I I l U n l i k e l y 17. Would c o n t r i b u t e t o mandatory contin u i n g education requirementai High Value I 1 I I I I I I No Value L i k e l y I I I I I I I I U n l i k e l y 18. Would a a s i a t aa i n g a i n i n g promotion! High Valua | I I I 1 I L i k e l y J I L 19. Would coat too such Jar the b e n e f i t ! gained! High Value I 1 L i k e l y 20. Would increaee the work High Valua I I L i k e l y I 1 21. Would enhance ay f u t u r e High Value I I L i k e l y | L 22. Would g i v e aa f i n a n c i a l High Valua | I L i k e l y | L load on ay co-vor k e r a i J 1 L c a r e e r proapectai I I L 1 I L g a i n a i 1 I L Section 3 (cont'd.) J No Value J U n l i k e l y J No Velue J U n l i k e l y J No Value J U n l i k e l y J No Value J U n l i k e l y J No Velue J U n l i k e l y 23. Would c o n t r i b u t e to the attainment of ay peraonal career goala: High Value L i k e l y 24. Would enable High Value L i k e l y 25. Would b e n e f i t my High Value L i k e l y 26. Would aaal a t High Value L i k e l y 27. Would ceuae High Velue L i k e l y aerva ay c l i e n t a b e t t e r ! J L_ l a p l o y e r i to develop a get behind J L J L J L new c a r e e n J L i n ay work! _ ! L J L J No Valua J U n l i k e l y No Valua J U n l i k e l y No Valua J U n l i k e l y No Value J U n l i k e l y , J No Valua J U n l i k e l y o Section 3 (conc'd.) 26. Would h . l p e. .«_in« <•» I " " ' ? " •» P'0««i»ion.l work. . i i I I I I I I No Velue High Velue [ I - I 1 1 ' 1 1 29. L i k e l y I 1 L I U n l i k e l y 30. Would increeee ay e p e c l a l i x e d e k i l l i . • < I I I I I I Ho Velue High Velue I I 1 1 1 1 1 1 L i k e l y | I 1 I 1 1 L I U n l i k e l y Would r e s u l t i n b e n e f l t e t o persons c l o s e to a e i High Velue | L j | | | | No Velue L i k e l y j I 1 1 J U n l i k e l y Section * Whether a p r o c e s s i o n a l w i l l p a r t i c i p a t e i n c o n t i n u i n g education dependa i n part on her perception of the expectations of other people end the importance placed on thoee e x p e c t a t i o n s . Typea of people who aig h t hold auch expectetione f o r you aa a profea a i o n a l are given i n each eat of items below. For each of the itema in a s e t , check ( J ) the aost appropriate blenk space. Do not answer i t e a sete i f the pereons or groups do not e x i e t i n your s i t u a t i o n . A blank i t e a i e provided e t the end of the f a r o f o r you t o w r i t e i n the name of a person or group who haa not been mentioned but who has en expectetion about your p a r t i c i p a t i o n i n c o n t i n u i n g education. Please note that c o n t i n u i n g profeaaional educetion r e f e r a to a systematic progrea of i n s t r u c t i o n en some subject a e t t e r conducted f o r p r o f e s s i o n a l a who have completed t h e i r p r o f e a a i o n a l education p r i o r to t h e i r becoming a p r a c t i c i n g p r o f e s s i o n a l . Most f r e q u e n t l y , i t i e a short-term or part-time e c t i v i t y . 1.0 My su p e r v i s o r 2.0 Most of my c l o s e p r o f e s s i o n s ! aasoclatea I t h i n k s I should continue ay education. 1. 1 doesn't cs r e whether or not I continue ay education. thinka I ahould not continue ay educetion. think I should continue my educetion. don't cs r e whether or not I continue ay educetion. 1 t h i n k I should not continue ay education. In g e n e r a l , how important i s i t to you what your eupervisor t h i n k s about you c o n t i n u i n g your educetion? , ! In general, how important i a i t to you what your cloae p r o f e s s i o n a l « " " " " think about you continu i n g your education? J Very importent Somewhat ia p o r t a n t Not at a l l important Very important Somewhat important Not at a l l i a p o r t a n t Section * (cont'd.) 1.0 L Host of my c l i e n t s ( p a t i e n t e , students) ± don't cere whether o r not I continue ay education. 'think "I ehould continue my education. In g e n e r a l , how isiportent i s I t to you what your c l i e n t * t h i n k about you c o n t i n u i n g your education? should not continue my educetion. 3.1 Very important 4.0 ± Somewhat important Not at e l l important F a c u l t y member* who t r a i n e d me profe»»ioo*lly j . l In ge n e r a l , how important i a i t t o you what the leader* i n your profeeaional a s s o c i a t i o n t h i n k about members continu i n g t h e i r educetion? Very importent 6.0 Sosewhet important Hy employer _L thinks I should continue my educetion. doesn't cere whether or not I continue my educetion. Not et e l l important t h i n k s I should not continue my educetion. 6.1 In ge n e r e l , how important i a i t to you what your employer thinka about you contin u i n g your education? t h i n k I ahould continue my education. don't care whether o r not I continue my educetion. . think I ahould not continue my educetion. 4.1 In g e n e r e l , how important i a i t to you what f a c u l t y members who t r a i n e d you p r o f e s s i o n a l l y think sbout you c o n t i n u i n g your education? Very important 3.0 Somewhat important The leedere i n my p r o f e e a i o n a l a a a o c i a t i o n Not at e l l importent Very important 7.0 thinks I should continue my educetion. Somewhat important My spouse Not et a l l important doesn't care whether or not I continue my education. thinka I ahould not continue my education. 7.1 In ge n e r e l . how importent i e i t to you what your apouae t h i n k * ebout you continuing your educetion? t h i n k member* should continue t h e i r education. don't care whether or not member* continue t h e i r education think members ahould not continue t h e i r education. Very important Somewhat important Not at a l l important a.o Hy p r o f e e s i o n e l a e e o c i e t i o n I 1 _—ll.-;;v.-wh«thlr or t h i n k a p r o l e e s l o n s . . i h o u l d continue c h o i r education S . l t h e i r education! Very important Soeawhat Important Not et * U importent 9.0 clunks I should continue ny educe t i o n • doesn't care whether or not 1 continue ay educetion. t h i n k s I should not continue ny educetion. i n ».w 1-P.runt U ^ g ^ c o n t i n u i n g your educetionl Very importent Somewhet important Not at a l l important P U O . cue » » » « — vm- ~«. m.m^. Debbie Z i b r i k , e/o Adult Education Dept., 5760 Toronto Roed, U n i v e r a i t y of B r i t i s h Columbia, Vancouver, B.C. / V6R U 7 RESPONDENT INFORMATION FORM , •trSEiZ* Set ! ^ c i M d ^ „ ' T l c o 0 „ , i ^ i n n „ d _T i f • W ™ « P " > W o r _ . » * « . - , . « , u n d . r m n d . i n , n . * , ^ 1. High*st level of formal education you hava composted? Araociate d — I I 1 [ I Bach*ror*i decree 2 [ ) M - t a r - i d - n * II I Doctor'! d -—al r fcO. MO.JO) 4 I I Oorac S I 1 lipcclly) 2 . You r eg*? y e a -3. You r e n ? Mate i l I Fanea 21 I 4 . Currant maittet status? Star* I I 1 eurriad 21 I 5 . Ill married) Is your spouse currently employed et least half-t ime outsida of t h * home? v w I I I No 21 1 6 . Spouse's highest level o f formal education com-pleted? Sams level as mins 11 I H^ohar lovol than n»m 2 1 I Loww levai rhen Han* 21 1 7 . A r * y o u a parent? v « I I I No 2 1 1 8. Ill yes) D o any chi ldren undar co i l tga ag* l i r a w i th you at home? v * . I I I No 2 1 ] 8 . Your professional occupat ion? Ill retired, indicate pre-retirement occupation.! Accountant 11 I Ajihilaas ................. 2 1 1 Ctortvi—n 21 ] CMntln 4 1 I OwUtion 6 1 I tnetaear • ( 1 L — y i 7 ( 1 Nona II 1 Optometriat • • > • . * • • > « • • • > • . S I 1 Ptn/srcJan/lliaeenn 11 I I Ftiyoicel Tharaprjt 12 I I Social Work* 1* I I Teochor loUnv/-c<-d) 16 I I Volar inarian 16 I I Oeaer I t I 1 10 You r total years in professional occupat ion? 11 . Current professional work activities? <Gi— job tithe and duties. If retired, give title end duties prior to retirement) 12 . For how many yaars ha»e you performed the kinds of duties you are presently performing? 13 . You r primary employment srnietion? Sow amounou , [ j osoncy or institution . »bve . 2 1 I . 2 1 I 14. In what state are you employed? . 16. Time sines you participated in lystemst ic continuing professional education < i_ „ part-time or shon t o r -study)? Within the Ion yaor 1- 2 y * a n 2 - 6yaora Saars than 6 yoors • I I I • 21 I • 2 I I .4 I I . 6 I I 18. Ill participated) Pleas* indicant t h * method of study of your most recant part ic ipat ion. op I I I fvoning or otf-campus course 2 1 I Study on my own % | J Corrospotufenoo study a I I Contaronca.worturtopor—colai* B l I Educational TV g r | Other 7 | j Ivtcify) 17. A re you required to undergo periodic rehcensuro es e professional? . 1 1 I . 2 1 I 18 . Ill yes) Does raliufisur* require participation in cont inuing education? . 1 1 ) . 2 1 I Ofnc* for Ora Study of Corrtlnoi— Profco-ooel Id—ouuii UnrnrsKy of ieu>ok at •—• , ; 164 INTENTION TO PARTICIPATE IN CONTINUING PROFESSIONAL EDUCATION Fur cadi of the following queitions, pleue check U) the blank ipace that best reflects your opinion. Your re—onus will be kept cmfidesr-xL Thank you for your assistance. ' 1. Do the persons in your profession seem to be committed to continuing their education over their entire professional life? ') j Very Quite Somewhat Hardly Not at all committed committed committed committed committed 2. To what extent do you believe that persons in your profession should continue their education throughout their professional life? Very strongly Strongly Moderately Hardly Do not believe believe believe believe believe 3. Do you personally believe that you should participate in continuing professional education throughout your professional life? Very strongly Strongly Moderately Hardly Do not believe believe believe believe believe \ 4. / To what extent do you feel willing to act on your belief to participate in continuing professional education throughout your W professional life? Very Quite Somewhat Hardly Not at all i»\/r willing willing willing willing willing N 5. Withi y n the next twelve months, what b the probability that you will participate in some form of continuing professional education? Low probability (Less than 25% chance) 1 [ ) Fair probability (25% - 49% chance) 2 j j Good probability (50% - 74% chance) 3 j j High probability (At least 75% chance) 4 j j 6. Briefly indicate the topic(s) or subject matter(s), if any, that you are likely to pursue during the next year. 7. Please indicate the method or methods of study that you are most likely to use. fCnec* off that apply J Discussion group [ ) Cwrespondence study [ 1 Evening cr off-campus course j j Conference, workshop or meeting [ ) Study on my own I j Educational TV [ j Other I ) g. Please estimate how many hours you expect to devote to systematic continuing professional education within the next twelve months. Zerohours 1[ 1 51-75hours 4 | ] 1-25hours . . . . 2 [ j 76-IOOhoun 5 | j 26-50 hours 3[ j More than 100 hours . . 6 ( ) 9. How does your intention to participate in the next year compare with your level of actual participation in the past year? I intend to participate more than I did 1 { ] I intend to participate at the same level 2 [ ] I intend to participate less than I did 3 [ j l CopyrtfrilCmT by Aran D. ENTER LAST FOU* DIGITS OF SOCIAL SECURITY NO. EXPECTATIONS OF OTHERS ABOUT MY PARTICIPATION IN CONTINUING PROFESSIONAL EDUCATION Whether a profeoioriai w i l l participate m txmUnuing education depends In part on his/her perception of the expectations of other people and the importance placed on those e-pecut ions . Types o f people who might hold such expectations for y o u as a professional art given in each art o f items below. F o r each o f the item* in a set,. c o * - * (-A tire most Jupproprrxt* blank »pac9. Do not answer i tem s e u i f the persona o r groups do not exist in your situation. A. h&vak i t em ta provided at the end o f the form for you to write in the name of a person or group who has not been mentioned but who has an expectation about your participation in continuing education. Please note that continuing professional education refers to a systematic prograin o f instruction on some subject matter conducted for profetsioriais who have completed their professional education prior to their becoming a practicing professional. Host frequently, it is a short-term or part-time activity. 1.0 M y supervisor 1.1 thinks I should continue my education. doesn 1 care whether or not I continue m y education. In general, how important is it to y o u what your supervisor thinks about you continuing your education? thinks 1 should not continue my education. Very important Somewhat important No t at all important 2.0 Most o f my close p rofe - r i c_U aasocUtas think I should continue my education. d o n t care whether or not I continue my education. think I should not continue my education. 2.1 In general, how important is it to you what your close professional aasociates think about you continuing your education? Very important Somewhat important Not at all important 3.0 Most o f my clients (patients, students) think I should continue my education. d o n t care whether o r not I continue my education. think 1 should not continue my education. 3.1 In general, how important is it to y o u what your clients think about you continuing your education? Very important Somewhat important Not at all important Faculty members who trained me professionsUy think I should continue my education. d o n t care whether or not I continue my education. In genera), how important is it to you what faculty members who trained you professionally think about y o u continuing your education? think I should not continue my education. Very important 8o mew hat important Not at all important 166 5.0 The leaders in my professional association think member* should continue their education. don't care whether or not menibert continue thrir etiuc*tikxB. think members should not continue their education. 5.1 In Dvneral, how important is it to you what the teaders in your professicmal tuMoeiMtion think s£xwt members continuing their education? Very important Somewhat important Not at all important 6.0 My employer thinks! should continue my education. doesn't care whether or not 1 continue my education. thinks I should not continue my education. 6.1 In general, how important is it to you what your employer thinks about you continuing your education? Very important Somewhat important Not at all important 7.0 My S I W U M think11 should continue roy education. doesnt care whether or not I continue my education. thinks I should not continue my education. 7.1 In general, how important is it to you what your spouse thinks about you continuing your education? Very important Somewhat important Not at all important 8.0 My profea__*al certification board thinks professionats doeant care should continue whether or not professionals their education. continue their education. thinks professionals should not continue their education. 6.1 In general, how important is it to you what members of your profet-ional csrtification board think about professionals continuing their education? Very important Somewhat important Not at all important 9.0 Mv thinks I should continue my education. doesn't care whether or not I continue my education. thinks I should not continue my education. 9.1 I n f r_-r_. h n w i m i w _ n t is it to V O U W h a t T O U T thinks about you continuing your education? Very important Somewhat important Not at all important Copyright © 1976 by Arden D. Ci^«4ue*chen CONSEQUENCES OF PARTICIPATING IH CONTINUING PROFESSIONAL EDUCATION Whether a professional w i l l participate i n continuing education depends l n p a r t on what he/she believes the consequences of the experience would be and on how he/ she evaluates these consequences. The following Items focus on d i f f e r e n t consequences which might result from participation l n continuing education. Please Indicate the value you place on each consequence; next please indicate how l i k e l y you think It would be for each of these consequences to occur i f you were to participate l n a continuing education a c t i v i t y . Answer by placing an X on the l i n e . 1. Would Increase try Job security: High value | | I Likely 2. Would use up a one of my spare time: High value | | 1 l _ L i k e l y | | | |_ 3. Would challenge my I n t e l l e c t u a l a b i l i t i e s : High value | | I l _ _ L i k e l y | | _ _ I I 4. Would help me refresh my professional knowledge: High value |_ | | I L i k e l y | | I I 5. Would Increase my professional v i s i b i l i t y : High value | | | I L i k e l y | |. 6. Would make my work more challenging: High value | | I I L i k e l y | | l _ _ I Ho value Unlikely No value Unlikely No value Unlikely No value Unlikely No value Unlikely Ho value Unlikely 7. Would st inulate ae I n t e l l e c t u a l l y : High value | | | Likel y | | | 8. Would help Be keep up l n ay f i e l d : High value | | | Li k e l y | | | 9. Would Increase ay network of professional contacts: High value | | | | Likel y | | I I 10. Would give ae a greater sense of professional competence: High value | | | | Li k e l y | | | | 11. Would Improve the quality of ay professional service: High value | | | | Likel y | | | I 12. Would remedy deflclenclea i n ay professional training: High value | | | | Likel y | | | J 13. Would allow ae to intermingle s o c i a l l y with High value | | | I L i k e l y | | | I 14. Would Improve ay work sa t i s f a c t i o n : High value | | | |_ Likel y | | I I. .1 I. my professional colleagues: No value 169 -3-15. Would improve my professional status: High value | | | | |_ " k e l y I I I I | . 16. Would allow me to be more v e r s a t i l e i n the work High value | | | | | Likel y | J I. 17. Would contribute to mandatory continuing education requirements: High value | | | | | " k e l y | | _ _ _ | | | _ 18. Would assist me l n gaining promotion: High value | | | |_ Likel y | | | |_ 19. Would cost too much for the benefits gained: High value | | | | |_ " k e l y | | | | |_ 20. Would Increase the work load on my co-workers: High value | | | | | Li k e l y J . J I. 21. Would enhance my future career prospects: High value | | | | |_ Likel y | | | | I. 22. Would give me f i n a n c i a l gains: High value | | Likel y | | I I. do: No value Unlikely No value Unlikely No value Unlikely No value unlikely No value Unlikely No value Unlikely No value Unlikely Ho value Unlikely 170 23. Would contribute to the attainment of my personal career goals High value | | | Likely | | | 24. Would, enable ae to serve ay clients better High value | | | Likely | |_ J . 25. Would benefit ay employer: High value | |_ Likely | |_ J. 26. Would assist me to develop a new career: High value | | | Likely | | | 27. Would cauae ae to get behind ln ay work: High value | | | Likely 28. Would help ae examine the quality of High value | | | Likely | | | 29. Would result ln benefits to persons close to ae: High value | | | Likely | | | 30. Would Increase my specialised s k i l l ! High value | | | Likely | | I ay profeaslonal work: No value Unlikely No value Unlikely No value Unlikely No value Unlikely Ho value Unlikely No value Unlikely No value Unlikely No value Unlikely Copyright © Arden D. Grotelueschen 

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