Personal Attributes of Successful Interns as Perceived by Dietetic Internship Directors and Preceptors from Varying Generations

Personal attributes of students and employees are increasingly important to educators and employers. This study determined the personal attributes perceived by Dietetic Internship Directors and Preceptors from varying generations that lead to success in Dietetic Internships. Internship Directors and Preceptors throughout the United States participated in this 2012 study. A mixed methods approach was utilized. The results from a preliminary web-based survey of Preceptors and Dietetic Internship Directors local to the researchers were used to develop a list of personal attributes. The final survey provided participants the opportunity to rate 35 personal attributes. Usable data for analysis was received from 311 responders. The top ten reported personal attributes included: motivation, completion of tasks, dependability, respectful, positive attitude, flexible, listening skills, asks questions, open minded, and professional. Dietetic Internship Directors perceived flexibility (M=9.53) and punctuality (M=9.34) to lead to success significantly (p=0.017) more than Preceptors (M=9.30; M=9.04). Results showed significant differences in success-associated attributes of Interns among the primary setting, generation, and Registered Dietitian status of Directors and Preceptors. The Behavioral category of personal attributes was perceived to be more important than Communication or Interpersonal. This study suggests that some personal attributes are more highly valued by Dietetic Internship Directors and Preceptors than others. Knowledge of these attributes can help guide allied health educators in preparing future interns and employers in selecting potential employees.


INTRODUCTION
Educators agree that successful students in the medical and nursing fields display a common set of academic and personal attributes [1][2][3].Similarly, educators and administrators in the social work field agree that select personal attributes such as ethical behavior, honesty, and respectfulness are often more important for professional success than cognitive traits.These educators reported a preference for students who are self-aware and who possess the ability to recognize personal attitudes, values, strengths, and limitations [4].A previous study of Dietetic Internship (DI) Directors' perceptions indicated that there is a strong desire to know more detail than the current reference checklist about applicants' personal attributes; however, minimal current research exists regarding the personal attributes of successful dietetic interns [5].
During 2011 and 2013, only 52 and 53% respectively of undergraduate dietetics students who applied to DI Programs were matched to a DI according to the Academy of Nutrition and Dietetics (2012,2013) [6,7].This low acceptance rate concerns Didactic Program in Dietetics (DPD) Directors regarding their ability to help students improve their chances of being matched to a DI [8].The criteria for acceptance into internship programs often includes cumulative grade point average (GPA), science GPA, DPD course GPA, work experience, volunteer experience, letters of recommendation and interview skills [5].While these factors are important in selecting interns who will have potential to succeed, there is a lack of objective criteria, such as personal attributes, for the evaluation of non-academic personal attributes which are important to preceptors and future employers [1].
Preceptors in clinical, community, and foodservice settings identified motivation, professional behavior, and communication skills as attributes that are expected of interns at the beginning of a rotation [9].Literature suggests that communication, personality, positive attitude, creativity, perseverance, teamwork, planning and implementation skills, sales skills, and management skills were among the most important attributes employers prefer when selecting dietetic professionals [10][11][12].Expanded Food and Nutrition Program (EFNEP) professionals identified flexibility, respectfulness, and a positive attitude as important characteristics for building rapport with clients [13,14]; these characteristics were similar to the findings an investigation found of personality traits that are related to job success [15].Based on these findings of previous studies, the categories for personal attributes used in this research were behavioral, communication, and interpersonal [10][11][12][13][14][15][16].
Generational diversity in the workplace provides many different experiences and perspectives, yet the different needs, values, and approaches of each generation must be addressed in order for employee groups to cohesively work together and achieve organizational success.Generation has been previously defined in the literature as an identifiable group that shares birth years and significant life events at critical development stages [17].The four generations in today's workplace include Traditionalists (born 1925Traditionalists (born -1945)), Baby Boomers (1946Boomers ( -1964)), Generation X (1965)(1966)(1967)(1968)(1969)(1970)(1971)(1972)(1973)(1974)(1975)(1976)(1977)(1978)(1979)(1980)(1981), and Generation Y (1982-1999) [18].Values and personal attributes differ greatly among the four generations [17] and may cause conflicts with personal interaction and communication [19].The personal attributes of today's dietetic interns that are perceived to lead to success may therefore follow similar variations given the differences among the four generations of DI Directors and Preceptors working today.

Participants and Recruitment
Participants included DI Directors and Preceptors located in the U.S. The DI programs in Puerto Rico were not included in this study.Contact information for all DI Directors was obtained from the Academy of Nutrition and Dietetics website (www.eatright.org),where it is listed as public information [20].Approval was obtained from the Illinois State University's Institutional Review Board.Each DI Director received an invitation to participate email explaining the nature of study and its purpose.The invitation email also contained a link allowing participants to access a web-based survey created by the researchers.Informed consent was sought and obtained from all participants using the first page of the online survey, and participants had to agree to participate in order to access the survey.Since there is no national database of preceptors, the DI Directors were instructed to forward the email invitation to all preceptors of their program.The number of preceptors contacted could not be tracked.

DATA COLLECTION
Data collection was completed during the winter of 2011-2012 using a mixed methods approach [21,22].Qualitative and quantitative methods were used in the preliminary webbased survey and the final survey respectively.The preliminary survey asked open-ended questions to 19 Preceptors from a local DI in the Midwest to begin identifying specific personal attributes perceived to lead to success within three categories identified through common (or repetitive) themes in the literature [10][11][12][13][14][15] of Behavioral, Communication, and Interpersonal.
Personal attributes reported in the preliminary survey were utilized to develop the final survey.The Behavioral category of attributes included motivation, completion of tasks, dependable, respectful, positive attitude, flexible, asks questions, professional, time management, punctual, organized, independent, team player, accurate, and empathetic.Communication attributes included listening skills, professional interaction, communicates well with various education levels, provides education clearly, verbal skills, provides relevant information, writing skills, nonverbal skills, and computer skills.Open minded, cooperative, follows directions, reacts appropriately, recognizes weaknesses, eye contact, recognizes strengths, confident, passion for dietetics, humble and outgoing were listed as Interpersonal attributes.Participants of the final survey were asked to rate these personal attributes perceived to lead to success using a Likert scale ranging from 1 to 10 (1 = not important at all; 10 = most important).Additional questions included personal demographics, their role with interns, and the primary setting in which they work with interns.
Only data collected from the final survey were used for statistical analysis.The final survey was pilot tested for face and content validity using five conveniently selected DI Directors and two former DI Directors.Invitation emails for the final survey were sent to the 235 DI Directors not involved with the preliminary or pilot surveys.DI Directors were asked to provide their preceptors the opportunity to participate in the survey by forwarding the email containing the survey link.All names of participants and information gathered remained confidential throughout the data collection process.

STATISTICAL METHODS
Data analyses were completed using SPSS statistical analysis software (version 18.0 for Windows).Descriptive statistics reported participants' demographic information.Inferential statistics including independent sample t-tests and One-Way Analyses of Variance (ANOVA) were calculated to compare differences of reported personal attributes perceived to lead to success among four categories: role in working with dietetic interns (Internship Director, Preceptor), current credential status (Registered Dietitian, not a Registered Dietitian), primary setting in which the participant works with interns (Internship Director; Foodservice Management; Basic Clinical-general; Advanced Clinical-specialty, such as nutrition support team, renal, burn unit, pediatrics, etc; Community), and the generation of each participant (Traditionalist, Baby Boomer, Generation X, Generation Y).A Bonferroni Post-Hoc test was completed on all the significant differences generated from ANOVA to identify where significant differences existed within the groups.

RESULTS
A total of 338 DI Directors and Preceptors responded to the final survey which was sent to 235 DI Directors who were instructed to take the survey and share with their program's preceptors.Of the 338 surveys collected, 311 were determined to be usable.The majority of study participants were female (n=300, 96.5%).Out of the 311 participants, 40.2% (n=125) were DI Directors and 59.8% (n=186) were Preceptors.Participants were predominately Registered Dietitians (n=298, 95.8%).The primary settings in which participants reported working with interns included working solely as interns' DI Director (n=119, 38.3%), Foodservice Management (n=19, 6.1%), Basic Clinical (n=38, 12.2%), Advanced Clinical (n=81, 26.0%), and Community (n=54, 17.4%).Reported ages for all participants were placed into a generational category based on their year of birth.The majority of survey respondents were from the Baby Boomer generation (n=146, 46.9%), followed by Generation X (n=110, 35.4%),Generation Y (n=50, 16.1%) and the Traditionalist generation (n=5, 1.6%) (Table 1).

PERSONAL ATTRIBUTES
Participants were asked to rate 35 personal attributes, from the three categories of Behavioral, Communication, and Interpersonal, on a scale of 1-10 (1 = not important at all; 10 = most important).Table 2 lists the top ten personal attributes perceived to lead to success based on their mean score.The top five attributes were motivation, completion of tasks, dependability, respectful and positive attitude.

PERCEPTIONS OF PERSONAL ATTRIBUTES
DI Directors perceived flexibility and punctuality to be significantly more important attributes compared to preceptors' perception (t[309]=2.39,p=0.017; t[309]=2.46,p=0.014).Preceptors, however, reported the following attributes as significantly more important: asks questions, These results indicate that there is a difference in perceived attributes important for success between DI Directors and Preceptors (Table 3).
When comparing results from different settings, significant differences were shown among the five primary settings for the attribute independent (F[4,306]=3.34,p=0.01).A Bonferroni Post-Hoc analysis determined that participants who work in a Community (M=9.37)setting perceived the attribute, independent, as more important for dietetic interns to succeed as compared to those who work in a Basic Clinical (M=8.76)setting.There were no other significant differences in perceived attributes observed among the work settings.
Registered Dietitians (M=8.5) reported a significantly lower mean score than non-Registered Dietitians (M=9.31) for the attribute recognizes strengths (t[309]=-2.38,p=0.018).No other significant differences were identified between Registered Dietitians and non-Registered Dietitians.
Results of the One-Way ANOVA, and Bonferroni Post-Hoc tests indicated ten significant differences for attributes perceived to lead to success among the four generations currently working in the dietetics field.Motivation, completion of tasks, dependable, positive attitude, flexible, punctual, and accurate were valued more by participants from the Baby Boomer generation than those from Generation Y.The Baby Boomers and Generation X valued punctuality and reacts appropriately significantly more than Generation Y. Generation X rated follows directions significantly higher than Generation Y.

CATEGORIES OF PERSONAL ATTRIBUTES
Based on the average mean of the attributes in each category, the attributes included in the Behavioral category (M=9.28) were perceived to be more important than those in the Communication (M=9.03)and Interpersonal (M=8.66)categories.The Behavioral category included the attributes: motivation, completion, dependable, respectful, positive attitude, flexible, asks questions, professional, time management, punctual, organized, independent, team player, accurate, and empathetic.

Top 10 Personal Attributes
Research question 1 aimed to identify the top 10 overall personal attributes out of 35 perceived to lead to success by DI Directors and Preceptors.The top attributes of motivation, completion of tasks, dependability, respectful and positive attitude of this study (Table 2) are consistent with previous literature where employers of dietitians, Preceptors, and Expanded Food and Nutrition Program (EFNEP) Professionals identified characteristics of flexibility, respectfulness, teamwork, dependability, and a positive attitude as important [10][11][12][13][14]. Development of these personal attributes can help dietetics students be successful beyond the DI Program.

PERCEPTIONS OF PERSONAL ATTRIBUTES
While there was agreement on the most important attributes (Table 3), Directors tended to value selfmanagement skills of interns, while preceptors focused on patient care skills.Recognition of these perceptions and attributes may help DI Directors and their program's Selection Committee when reviewing DI applications and evaluating the input of preceptors.Notes: Personal Attributes were rated using a Likert scale ranging from 1 (not important) to 10 (most important) *Significant at the p<0.05 level There were differences among the attributes identified by those working with interns in difference practice settings, their R.D. status and generation.Identification of personal attributes perceived to lead to success in various dietetic practice areas can enhance the field of dietetics since research shows employers are beginning to focus more on personal attributes when hiring employees [2].
Differences in beliefs and values among generations can lead to communication difficulties requiring patience and understanding for all involved.Literature suggests that Baby Boomers are interested in interpersonal communication skills, seeing the big picture of an organization, and gently questioning the status quo [17,18].Generation X tends to place value on personal growth, authority, removal of outdated work materials, and aggressively questioning the status quo, while Generation Y tends to focus on sound technology skills, multitasking, participating in organizational decisions, and collaboration to accomplish goals [17,18].Diversity among the generations and in the workplace is increasing, and successful internships and workplaces require an understanding of how each generation impacts another in the workplace.

CATEGORIES OF PERSONAL ATTRIBUTES
Research Question 3 determined which category of personal attributes was perceived to be most important by Directors and Preceptors for achieving success in a DI Program.The results from DI Directors and Preceptors found attributes in the Behavioral category were perceived most important, followed by Communication, and then Interpersonal attributes.This differs from previous literature which found that employers of dietetic professionals believe communication skills, personality, and creativeness are the most important attributes when selecting dietetic professionals [11,13].These attributes would fall into the Communication and Interpersonal categories.Previous research of Preceptors' perceptions of personal attributes did identify professional behavior as one of the top three attributes [8], with communication also listed in the top three.Although the Communication category in this study was not the most important category of the attributes, it received a mean score of 9.03 on a 10-point scale, ranking close behind the Behavior category with a score of 9.28, indicating importance.

LIMITATIONS
Some of the personal attributes in this study were shown to be less important than others on a scale ranging from 1-10, but the scale was not anchored.The only identifier for the scale was direction.Therefore, it would be invalid for the researchers to attach a negative value to any of the personal attributes that appear to be less important than others.Only significant differences between the scores of personal attributes were reported due to the fact that all personal attributes may be perceived to be valuable for success in a DI.Due to the lack of standardized definitions for each personal attribute, participants may have interpreted their meanings differently.Inclusion of a list of definitions may have reduced variation in responses but was not feasible for this study and may have decreased participation due to the time spent reading and processing each definition.These limitations in the current research can be resolved by future research to further refine the identification of personal attributes that lead dietetic interns to success.

CONCLUSION
Findings of this study suggest that DI Directors and Preceptors value certain personal attributes such as motivation, dependability, and flexibility.The Academy of Nutrition and Dietetics Code of Ethics exemplify these attributes through the values of customer focus, integrity, innovation, and social responsibility [23].Literature from other health fields reports that many employers and educators are now considering personal attributes as valuable as or even more valuable than academic and technical skills in predicting success [2].Employees today work with four generations (Traditionalists, Baby Boomers, Generation X and Generation Y) and must be able to build relationships with co-workers, communicate effectively, be respectful, and honest to successfully work in any organization [17,18].DPD Directors can utilize these results by establishing classroom policies and creating assignments, which help develop the personal attributes perceived to lead to success.Classroom policies should not only focus on academic curricula but also on cultivating student character, ethical behavior, interpersonal skills, and other personal attributes [2].Knowledge of these results can also be used by DPD Directors to help screen potential DPD students who will most likely succeed in the classroom, internship and dietetics profession.The recently instituted requirement for DPD programs to set a maximum number of DPD students in programs places greater emphasis on student selection.DI Directors can request information, especially during an interview, regarding personal attributes of internship applicants to ensure that the interns selected for programs have at least begun to develop many of the attributes associated with success.If interviews are not conducted, DI Directors can assess information regarding personal attributes of applications in the applicant's personal statement and reference narratives.Preceptors can continue the process by providing experiences that will help dietetic interns further develop the personal attributes needed internship, employment and career success.Further research and its application have the potential to improve dietetics practice.
The purpose of this study was to identify personal attributes of dietetic interns perceived to lead to success in DI Programs by DI Directors and Preceptors throughout the U.S. Based on existing literature in the medical and allied health fields, the following research questions were

Table 1 . Gender, role, setting, registration status, and generation of the Internship Directors and Preceptors in a study measuring perceptions of interns' personal attributes.
empathy, listening skills, provides clear education, and eye contact.