The questions and answers provide information on how the expectations in the Social Media Standards and Guidelines can be met.
A) Can you describe what “professionalism,” and “reputation of the profession” means? How does the College determine this?
A recent systematic review sought to define professionalism in the dietetics profession for the purpose of teaching nutrition and dietetics. As noted by Dart et al. (2019), professionalism is central to safe and ethical dietetic care and crucial to maintaining trust from the public in healthcare providers. As such, trust is an important part of professionalism. Conduct on social media that undermines the public’s trust and confidence in the profession may impact client access to dietetic care and client care itself.
Generally, College Standards and resources, including the Code of Ethics and other professional resources such as the
Integrated Competencies for Dietetic Education and Practice (ICDEP) inform what is considered professional.
Professionalism is contextual. Concepts of equity, diversity, inclusion and belonging (EDI-B) are relevant to how professionalism has been defined and conceptualized, historically related to the cultural norms of dominant groups. The College is committed to informed EDI-B action to minimize systemic barriers and build a more inclusive and equitable health system for all, including Indigenous peoples, immigrants, refugees, people who are racialized, people with disabilities and the 2SLGBTQIA communities.
To evaluate alleged dietitian unprofessional conduct or communication on social media and the impact on professional reputation, the College ensures that the complaints and reports process is fair, consistent, and unbiased. An EDI-B lens is applied to concepts of professionalism, including declaration of bias. Each complaint or report is handled on a case-by-case basis through a neutral, objective fact-finding process. For example, if a complaint arose about a dietitian’s alleged unprofessional conduct on social media, the complaint would be investigated based on the facts and circumstances of the case, including the performance expectations in the Social Media Standard & Guidelines using an evidence-informed approach. In addition, being a professional means practising while considering the following abilities
.
- Being reflective and committed to safe, competent, ethical practice
- Practising integrity, cultural humility, honesty, diligence, respect and treating others fairly and equitably.
- Valuing dignity and worth of all persons regardless of age, race, culture, creed, sexual orientation, gender identity and expression, body weight, ableness and/or health status
- Complying with legal requirements and professional obligations
- Applying the principles of sensitive practice and functioning in a client-centred manner
- Working within areas of personal knowledge and skills
- Maintaining a safe work environment
- Maintaining personal wellness consistent with the needs of the practice
- Using an evidence-informed approach to your work
- Acting ethically, respecting autonomy, beneficence, non-maleficence, and respect for justice.
B) What does practising dietetics on social media mean?
Dietitians should exercise reasonable professional judgement to determine if they are
practising dietetics on social media based on individual circumstances related to their specific role and practice setting. The definition of practising dietetics is quite broad and can include various practice areas and workplace settings.
As noted in the College’s definition of practising, dietetic practice can be in a paid or unpaid capacity (e.g., volunteer work) for which registrants use food and nutrition-specific knowledge, skills and judgment while engaging in:
- the assessment of nutrition related to health status and conditions for individuals, groups and populations;
- the management and delivery of nutrition therapy to treat disease;
- the management of food services systems; building the capacity of individuals and populations to promote, maintain or restore health and prevent disease through nutrition and related means; and
- the management, education or leadership that contributes to the enhancement and quality of dietetic and health services.
For greater clarity, dietetic practice includes the following activities:
- Assessing, promoting, protecting, and enhancing health and the prevention of nutrition-related diseases in populations using population health and health promotion approaches, as well as strategies focusing on the interactions among the determinants of health, food security and overall health.
- Conducting dietetic, health and evaluation research, product development, product marketing, and consumer education to develop, promote and market food and nutritional products and pharmaceuticals related to nutrition disorders or nutritional health.
- Developing or advocating for food and nutrition policy.
- Communicating food & nutrition information in any print, radio, television, video, Internet, or multi-media format.
NB: This is an excerpt from the Definition of Practising Dietetics. Please see the link for complete details.
Professional liability insurance is mandatory for all College members who practise dietetics as defined in the College’s definition. Dietitians engaging in the practice of dietetics are responsible for confirming they have coverage that meets Section 15.1,
College By-Law No. 1: General.
C) Can you elaborate on (Principle 2, Standard 2 i) “Dietitians must conduct themselves respectfully and in a professional manner that does not impact the delivery of quality dietetic services, the safety or perceived safety of others while using social media.” What is meant by safety or perceived safety? Someone might feel or perceive that they are unsafe (e.g., at danger, risk, or harm) by viewing photos, videos, posts or comments that contain disrespectful, insulting, intimidating, humiliating, or abusive language and/or content. Examples may include bullying, attacking, harassing, and making comments that may be, or are perceived to be, disparaging to others, unsubstantiated and/or defamatory, hate speech (related to race, ethnicity, religion, gender, sexual orientation, age, social class, economic status, disability, weight, or level of education), or discriminatory (e.g., racism, transphobia, sexism). Dietitians should consider various population groups they interact with, and how social media can impact initiatives relating to mental health, anti-racism, health equity, etc.
An example may include posting disparaging comments about a person who follows a specific diet (whether it is evidence-informed or not). Disparaging statements (made in jest or not) could subject a person to potential risk or harm. Dietitians have an obligation to maintain a professional presence when posting and providing advice as a dietitian, as it reflects on them and the profession.
Dietitians may consider developing strategies on how to respond to followers/clients’ comments and reflect on how their communications represent the profession and its credibility.
D) Principle 3, Standard 5 i. speaks to avoiding posting information that is “misleading, deceptive, inappropriate or harmful. Information must be supported by best available evidence7 and be consistent with the principles of equity, diversity, inclusion and belonging (EDI-B).” Can you elaborate? It may be helpful to explain this with an example. Consider how dietitians respond to client comments on social media with cultural humility*. Clients may approach their own health and wellness, food and nutrition in various ways. Dietitians may need to learn and unlearn to honour and respect client knowledge and ways of knowing.
Cultural or Indigenous ways of knowing refers to how cultures develop diverse worldviews over time. There is no single way of “knowing,” and different cultures may approach knowledge in different ways
15. There is much complexity and diversity in people’s experiences and lived realities.
By embedding EDI-B and client-centred care in practise, dietitians seek to understand, honour and recognize client approaches to their own health and wellness as legitimate and integral, particularly in the context of Indigenous clients. In responding to any social media posts, dietitians consider this complexity.
Evidence-informed practice, as noted in the ICDEP, “brings together the best available research evidence and the dietitian’s experiential knowledge, along with the client’s preferences, context, and available resources.” Evidence-informed practice places emphasis on the client – their contributions, preferences, experiences, culture and traditions, and more. It is beyond the scope of this Standard to provide detailed guidance on how dietitians implement evidence-informed practice while addressing the complex needs of their clients, however, dietitians should consider the limitations of evidence-informed practice, which may not always consider the context, traditions and ways of knowing from less dominant groups. Dietitians acknowledge systems and worldviews (e.g., Positivism, Western worldview) through which they approach their practice, recognizing the importance of all forms of knowledge, which includes cultural perspectives, and Indigenous/traditional knowledge (e.g., ways of life, healing and/or educational experiences) for client practices and an awareness of the complexity and diversity of the experiences and lived realities of clients.
Dietitians may consider the following as they work towards the process of reconciliation – naming the knowledge system (s) from which they are working when appropriate, not immediately prioritizing or privileging Western knowledge systems or worldviews and not giving feedback on practices or approaches in a way that is biased or centered only on dominant views.
*Cultural humility: “a process of self-reflection to understand personal and systemic biases and to develop and maintain respectful processes and relationships based on mutual trust. Cultural humility involves humbly acknowledging oneself as a learner when it comes to understanding another’s experience.” (First Nations Health Authority (n.d.). Retrieved from:
https://www.fnha.ca/wellness/wellness-and-the-first-nations-health-authority/cultural-safety-and-humility).
E) Can you clarify what is meant by cultural safety and cultural humility (Principle 2) via social media use? Dietitians can embed EDI-B through social media use by committing to practising in a manner that promotes cultural humility and cultural safety.
Although definitions may vary in the literature, for this document, practising cultural humility involves self-reflection, curiosity and adopting a learner’s mindset to understand the experiences of another person
12,13. Cultural humility includes empathy and respect, practicing in a client-centred manner and being open to the experiences, preferences and worldviews of clients and colleagues. It also means being aware of one’s position and privilege
13.
Culturally safe care, as defined in the ICDEP
11 is an outcome based on respectful engagement when power imbalances are recognized and addressed in the provision of dietetic care. Free of racism and other discrimination, clients, colleagues, and students should feel safe receiving and/or working with and accessing care from dietitians and dietitians should be safe and respected providing care
12, 13.
Dietitians should be aware that conduct on social media (which may include liking, sharing, and/or commenting on content) and unprofessional comments and/or behaviour can impact safety and trust for clients and the public, potentially impacting willingness to access care and/or create harm.
F) How might dietitians approach potential or actual clients who are contacting a dietitian inappropriately (repeatedly or offensively) on social media? Dietitians may consider developing their own code of conduct and/or social media policy and/or protocols/procedures for their practice
5. Standard 3, i., may help guide expectations. Dietitians may develop a strategy for how to respond to a client/potential client and what steps may occur based on the communication or behaviour (i.e., notification, blocking, etc.). A code of conduct, policy, protocol, or procedure may include how to deal with public relations issues and how negative comments will be responded to
.