Factors Influencing the Efficacy of the Food Service and Public Health Nutrition Practicum under the Bachelor of Science in Nutrition and Dietetics Students during the COVID-19 Pandemic in Selected Universities in Manila, Philippines

Czarina G. Rodriguez1, Trisha Ysabelle T. de Guzman1, Ciara May C. Dolfo1,

Rica Marrie S. Ganzon1, Angelica Magulldo1, Florimae E. Paimalan1, RND, MHPEd, and  Daniel G. Salunga1, RND, MSPH

 

 

 

 

1Department of Nutrition and Dietetics, College of Education

University of Santo Tomas, Manila, Philippines

 

 

 

Corresponding Author:

Czarina G. Rodriguez

czarina.rodriguez.educ@ust.edu.ph

 

 

 

 

 

 

ABSTRACT

            Online learning is already an alternative method in most cases when there is a disruption with face-to-face classes. Despite the objectives of online learning, numerous factors can influence its efficacy, usually in the field of expertise and environmental factors. This study aimed to explore the perceptions and experiences of 4th-year BS Nutrition and Dietetics students in AY 2021–2022, with regard to their online practicum. Specifically, the researchers aimed to 1) analyze the strengths and weaknesses of the online practicum; 2) assess how the seven (7) distinct factors of Time, Uncertainty, Context of Confinement and Other Difficulties, Cognitive Presence, Social Presence, Instructor Presence, and Teaching Modality were experienced in the online practicum; and 3) identify key elements required for a quality and effective online practicum experience. The data were collected using a qualitative approach using a semi-structured interview. Time management and flexibility were the most common themes of strategies and skills among student that was used when adapting to the change in teaching modality. Furthermore, instructor and social presence were emphasized as the key elements to quality and effective online learning, as not only were these considered to be the online practicum’s strengths but also one of its weaknesses to be improved.

 

Keywords: Online learning, practicum, collaborative framework

 

 

 

INTRODUCTION 

The three major courses in the program of Nutrition and Dietetics, namely clinical nutrition, public health nutrition, and foodservice in traditional settings, are designed primarily for face-to-face field experience for their practicum activities.

Online learning had already existed before the pandemic; however, it can be seen that not every field of expertise and environment appeals to this kind of learning style. The effectiveness of blended learning is complex and dependent, wherein needs, participant characteristics, contextual matters, and gathering baseline information should be analyzed and considered (Ulfa, Feni, & Dian, 2020).

Factors like differences in the rhythm, the student-instructor relationship, pedagogy, the roles of the instructor and the student, the synchronicity of online communication, the role of online evaluations, and the source of feedback should be looked into to see if there is a relationship between them and the effectiveness of online learning. A collaborative framework was proposed by Fry (2019) that, to be successful in an online environment, social, cognitive, and teaching presence are the key components to consider. These key components ensure the participant’s learning experience is diverse in this learning style.

Due to the COVID-19 pandemic, online practicum became the alternate modality of learning. The hospitals’ dietary departments, restaurants, and local government units were not to accept students for face-to-face practicum to prevent the spread of the disease. This study aimed to explore the perceptions and experiences of 4th-year BSND students with the implementation of an online practicum for AY 2021-2022. The specific objectives of the study were: 1) to analyze the strengths and weaknesses of the online practicum; 2) to determine how the seven (7) distinct factors of Time, Uncertainty, Context of Confinement and Other Difficulties, Cognitive Presence, Social Presence, Instructor Presence, and Teaching Modality were experienced in the online practicum; and 3) to identify key elements required for a quality and effective online practicum experience based on 4th-year BSND students’ perspectives.

This study can help educational agencies such as the Commission on Higher Education (CHED) determine what appropriate steps or changes to adopt for a more effective online practicum. This will also help the administration of the selected universities reinforce their policy on current practicum policies.

Theoretical framework

The differences in time, uncertainty, context of confinement and other difficulties, cognitive presence, social presence, instructor presence, and teaching modality should all be investigated to see if there is a link between online learning effectiveness and these variables. Fry (2019) presented a collaborative framework in which social, cognitive, and teaching presence are the important components to consider to be effective in an online setting. The instructional and cognitive presence guarantees that the participant’s learning experience is varied in this learning method.

 

 

 

 

Figure 1. Theoretical Framework

This theoretical framework was based on the Community of Inquiry framework (CoI) which represents a collaborative-constructivist learning experience through the development of the three interdependent elements such as the social, cognitive, and teaching presence. Social presence is for the ability of the learner to communicate and develop interpersonal relationships while cognitive is for the extent to which they can construct and confirm meaning. Lastly, teaching presence is the design, facilitation, and direction of the cognitive and social presence for a more educational and worthwhile learning outcome.

 

METHODOLOGY

Research Design  

The researchers conducted this study using a qualitative method through a semi-structured interview to understand the participants’ views, experiences, and perceptions without the participants having to limit their expression in order for the researchers to further observe and explore the given answers.

Study participants and sample size

A total of ten (10) participants from three different universities were purposively selected. Samples in qualitative research tend to be small to give a deeper case-oriented analysis. According to Robinsons (2020), in 10 in-depth qualitative interviews, most themes are already identified, which gives further support for the 10 respondents of this actual study to be significant enough to produce the needed themes to be identified.

The inclusion criteria to participate in the study include: 1) must be a 4th-year student enrolled under the program BSND and 2) have accomplished the public health nutrition and foodservice management practicum online for the 1st semester. They should also have accomplished valid informed consent before the interview and have undergone their first semester of community and food service online practicum. Prior to the interview proper, an informed consent form, along with a schedule of available time slots for the aforementioned, was sent out to the participants to determine the final number of voluntary participants as well as the time they would be available for communication.

Data collection

Development and pretesting of questionnaire

A semi-structured questionnaire was developed and pretested. The questions used for semi-structured interviews are composed of open-ended questions, wherein questions are not answerable by “yes or no”. It tackles the strengths and weaknesses of online practicum, how the seven (7) distinct factors were experienced in online practicum, and recommendations for quality and effective online practicum. The participants were asked an open-ended question to draw answers from an open-text format and gain insights from their thoughts, feelings, and behavior. The pretesting was done to check and validate if the questionnaire meets the objectives of the study before using it and conducting the actual interviews with participants. There were two (2) methods conducted for the pretesting: “expert-driven” and “respondent-driven” pretesting (SAGE Publishing, 2016). As for the expert-driven pretesting, three (3) experts in the field of nutrition and dietetics were asked and invited, specifically in food service and public health nutrition, to be validators of the interview questionnaire. This assisted in reviewing the data collection tool to be used to determine whether it is clear, unbiased, and relevant to the objectives of the study. The comments and suggestions of the validators were addressed, and revisions were made. After the revision, the questionnaire was put to respondent-questionnaire-driven pretesting, with two (2) fourth-year students invited to validate it.

Semi-structured interview

For this study, an exploratory qualitative approach was used to explore the practicum perceptions and experiences of 4th-year BS Nutrition and Dietetics (BSND) students. A semi-structured interview is a type of interview where the interviewer can ask follow-up questions during the interview proper if deemed appropriate (Given, 2008). The purpose of using this specific type of data collection is to understand perceptions and thoughts in depth (DeJonckheere & Vaughn, 2019). All the researchers participated as an interviewer, wherein the interview was conducted by two researchers per respondent via online conferencing applications, specifically Zoom and Google Meet.  Both Zoom and Google Meet are online conferencing applications that were utilized for the data collection.

Since it is the first time for the BSND to have an online practicum, this area of research has not yet been studied in depth. The figure below shows the general overview of how the seven (7) distinct factors were experienced from the resulting themes and subthemes generated from the thematic analysis. The transcript of data underwent four phases: initial coding, category development, thematic coding, and categorizing and emerging themes as a means to systematize and examine the common patterns and themes of the data transcript, allowing a data-driven analysis without preconceived themes.

Figure 2. Data Collection Procedure of the Study

Data Analysis

The data gathered were encoded in Microsoft Excel and analyzed using Inductive Thematic Analysis. In performing the inductive thematic analysis, 6 phases were undertaken, namely: (1) Familiarization with Data, wherein the researchers thoroughly read the interview transcripts and re-reading them again to fully understand each data; (2) Generation of Initial Codes, where the data collected was organized and labeled to determine if there were data that can be linked to other data; (3) Searching for Themes among Codes, in which the researchers created themes from codes to further analyze the data into an organized manner; (4) Reviewing Themes, where the created themes were checked multiple times to identify if the data were correctly linked to other data; (5) Defining and Naming Themes, wherein the researchers named and described the themes based on the context of the data that was collated per theme; and (6) Producing the Final Report, in which the final data collected that was organized in themes was presented. The validity of this thematic analysis was referenced by Braun and Clarke (2006), as it allows for systematically analyzing the data and examining the different perspectives of the participants.

Ethical Considerations

This study was conducted in accordance with existing ethical principles to ensure that the rights and well-being of the participants were maintained. The participation of all respondents was voluntary. Participants had the right to withdraw from the study at any time, as long as they notified the researchers. The data gathered from the participants was kept confidential since access was limited to the researchers and used for academic purposes only.

 

RESULTS

The majority of the respondents were 22 years old, while the oldest one was 27 years old. There were more females than males who participated in this study. Eight were female, while two were male.

There were five (5) themes established, namely, 1) Strengths and weaknesses in the online virtual practicum of PHN and FSS, 2) Initial perspectives on the uncertainties for an online PHN and FSS practicum, 3) Context of Confinement, Other Difficulties and Cognitive Presence of the BSND 4th-year students in experiencing the program, 4) Challenges on the collaboration and social presence of both community assigned and group work, and 5) Teaching modality and instructor presence with the online practicum for PHN and FSS.

 

  1. Strengths and Weaknesses of the Online Virtual Practicum of PHN and FSS

The set of questions in this given category discussed the activities the students thought would be more appropriate for a quality and effective online practicum; identifying their thoughts on what might have been the strengths and weaknesses of the curriculum program they have experienced.

1.1. Social Interaction as an important factor in Foodservice Practicum 

After completing the foodservice virtual practicum, three out of ten respondents think that the practicum was already effective. However, two out of ten respondents also contradicted it as they thought that the foodservice should not be implemented as virtual or online since there are things you cannot learn online including social interaction and cafeteria duties. Furthermore, the remaining respondents suggested having a hybrid approach (a combination of face-to-face and online) or limited face-to-face to really apply the learning they gained and to also not have purely lectures throughout the practicum. One respondent shared that:

[In terms of Foodservice [practicum], I really [suggest] more on interactive activities and simulation rather than more on the paper works as you will really feel the real-life [situations] and how they do it if simulation activities will be done. Also, it is much better if they can immerse us in different areas, to hone our networking skills like attending a foodservice conference or meeting other professionals.] (BSND 5)

1.2. Time Constraint to Activities in Public Health Nutrition Practicum

In terms of public health nutrition, the majority of the respondents suggested having at least a community visit in the barangay for data collection to have an accurate and better diagnosis, and to have more allotted time for the practicum as they think the given time for it is not enough. Also, they were bombarded with activities within a short period which lead to time constraints and producing the activity without quality while other respondents also suggested that:

[To invite people from the barangay to join in our sessions during reporting. For example, instead of just me and the Barangay Nutrition Scholar, I think it would be better if there were actually people out there in the barangay that can join in our lectures.] (BSND 3)

  1. Initial Perspectives in the Uncertainties for an Online PHN and FSS Practicum

These are the questions focused on the initial thoughts of the respondents about the practicum as set in an online environment.

2.1. Unfulfilled Sentiments on Student’s Affective Expressions to their Initial Thoughts for the Practicum Being Held Online 

When respondents were asked their thoughts on virtual practicum, 8 out of 10 respondents had unfavorable feelings about it. Some of them described it as “underwhelming”, “disappointed” and “devastated”. Some respondents stated that:

[ I think I am anxious since the skills built on me were not enough when it comes to instead of feeling the reality… [chuckles] It was slightly depressing and anxious since the experience gained is not enough rather when face-to-face.] (BSND 5)

Due to different negative emotions about the virtual practicum, respondents still bear the same thoughts even after accomplishing the courses. Six out of eight respondents who provided unfavorable comments were also more likely to believe that the virtual practicum was not worth their money as it was not fulfilling since it was held online compared to the experiences they may have experienced when it was actual.

On the contrary, four out of ten respondents claimed that it was somehow worth it as they believe that they obtained the necessary knowledge they needed from it even though it was entirely online. One respondent said:

[At first, no but once the practicum was completed, it was okay, and it is still worth it since the practicum were able to provide the needed [information]. It is the same-, same-, not totally same on the actual, the public health and foodservice, but they managed it or they delivered the [information] we needed.] (BSND 9)

  1. Context of Confinement of the BSND 4th-Year Students in Experiencing the Program

The first set of questions focused on the perspectives and experiences of the respondents in the PHN in defining the Context of confinement in their roles and responsibilities for the online practicum, As the respondents shared what they thought was the most effective in sharpening their nutrition knowledge, they also mentioned what they considered the least effective or the one that requires some improvement. Six out of ten respondents said it was the daily diary. The respondents stated that:

[I really don’t like that diary because you’re obliged to write about what you do every day. Even if what you did was worthless. You have submissions, and besides that, you still have a diary to accomplish every day. […] If it seems like you have a lot to do, then you still have to write a diary, and if you want to perfect your diary, you still need to put documentation on it.] (BSND 1)

3.1. Limited Data as a Challenge in Analyzing Information

When the respondents were asked if they encountered any problems during the assessments in PHN online practicum, the common problem they shared was that they received limited data from the barangay and some had difficulty in understanding the data provided due to its illegibility. Two out of ten respondents shared that:

[The data is very limited; for example, our practicum was last year 2021– the data that they had is only a few for the year 2020 since the pandemic happened so we worked on very limited data…]  (BSND 8)

  1. Challenges to the Collaboration and Social Presence of Both Community-Assigned and Group Work

The second set of questions focused on the communication and social presence of the members of the group and how they manage to strategize the said challenges.

4.1. Challenges in the Collaboration with the Key Person of the Barangay

Six out of ten respondents were affirmative when asked whether they have experienced any difficulty when setting up a meeting with the key persons and/or stakeholders of the barangay that they are working on. There were two primary issues observed: 1) conflict in schedule and 2) internet connection.

Four out of the six respondents that had had difficulty with setting up a meeting online with the key persons in the barangay had claimed that their primary issue was due to the conflict in time and schedule. The respondents stated that the key persons in the barangay were difficult to reach out to due to their hectic schedule and meetings were difficult to set up due to both parties having different schedules. One had explicitly stated that due to this conflict in time, some were not able to attend the agreed meeting.

 [Yes, it is a bit hard setting an appointment with them since they have a heavy workload, or if ever the meeting will push through, there will be someone who can’t attend since not everyone is available. That’s what’s happening, somewhat out of sync. It seems like there is only once when everyone is present.] (BSND 8)

Moreover, two out of the six respondents that have had difficulty with setting up a meeting online with the key persons in the barangay had stated that it was due to issues with internet connectivity, on the barangay’s part.

4.2. Brainstorming sessions, Assignation of Roles and Responsibilities, and Time Management as the Most Effective Strategy for Group Collaboration

The respondents shared different strategies that their group has done to fulfill their requirements together. Time management, designation of roles and tasks, and group meetings, to name a few. When they were asked what were the most effective among the strategies that they stated, they answered; 1) brainstorming sessions, 2) assignation of roles and responsibilities, and 3) time management.

One of the ten respondents claimed that brainstorming among the group was what had helped them the most. The respondent claimed that the strategy has helped them communicate with their group mates who were from other universities, disseminate the tasks per member of the group properly, and address any queries and concerns of the group.

[Those brainstorming sessions were very, very, very helpful because we were able to settle with our deadlines, oversee the paper as a group, we were able to ask questions with each other, so it is still not the defense for paper, we were already packing up the paper. To create a mini-defense, to create a mini-question-and-answer, every time we would check the paper.] (BSND 2)   

  1. Teaching Modality and Instructor Presence with the Online Practicum for PHN and FSS

The third set of questions focused on how the delivery content of the program was for their experience. Their insights into the knowledge, attitude, and skills needed for public health nutrition. Also, for their thoughts on how the instructor performed his/her duties in their respective online practicum and for the areas that may have needed more presence.

5.1. Virtual Practicum with Interactive Communication as an Effective Way of Learning

The teaching methodologies as described with the usage for the online functionality, such as synchronous and pre-recorded videos. Some participants had concerns about this lack of connection and as interviewed, Six out of ten respondents had positive feedback for PHN, and five out of them also stated reasons as to why they preferred synchronicity more than the pre-recorded ones. As for FSS, five out of ten of the respondents agreed that the delivery method does keep them interested, however, pointed out a few reasons as to how it can be further improved and engaging to them. Further shared the reasons as follows:  

[Not effective since the pre-recorded sessions last time were very dull.] (BSND 4)

 [Not Interesting. But the synchronous ones were okay, effective for me since I could ask questions.] (BSND 4)

In connection to how the teaching modalities were done, the students also with their experience and insights regarding the desired learning outcomes of the practicum were specified as to what specific aspects of the attitude, knowledge, and skills of the virtual practicum were developed and relevant to them. Five out of ten stated flexibility and adaptability and three for convenience.

[Flexibility and adaptability. Since the last time, we had events that needed attention like other school works. We did both, and convenient since we could’ve commuted and stayed within the community.] (BSND 4)

5.2. Instructor Presence on Direct Instruction and Facilitation

For the students’ perceptions of the instructor’s presence during the duration of the online practicum, many have responded to its subfactor which is facilitation. In the public health practicum, four out of ten for both accommodation (i.e., helpful and responsiveness) and attitude (for being kind and patient) while five on behalf of the food service with the same reasons for accommodation were stated by the respondents. Wherein most have shared the engagement part of the supervisor and how it factors in understanding and improving the difficulties they have experienced in coordination with the assigned community. The following are stated as follows:

[Mm, approachable, then approachable and they’re open to consultations. Quite confusing at times for instructions from the head person but was fast relayed to me, most provided with instructions.] (BSND 6)

On the other hand, the areas that they felt might have needed more attention from the instructor concern the sub-factor pertaining to direct instructions. This tackles how clearly and properly the instruction was disseminated to the students and how the instructor needed to be more present for relaying and understanding the details that could have lessened further queries and questions not being addressed. The following are their shared experiences:

[The synchronous sessions. I think there should be more synchronous sessions instead of just leaving us on our own.] (BSND 3)

[Like in the proper instructions from what was disseminated to them from the head [uhm] they were also confusing. So yeah, only for the proper instructions I guess.] (BSND 5)

 

DISCUSSION

In the traditional setting as with the commonly known environment for the BSND course, 4th-year students have been in line with the standard policy of clinical, foodservice, and public health nutrition with the application of theoretical and practical concepts specific to practicum programs for professional skills and competencies. However, due to the absence of experiential learning adapting to an online practicum, this study aimed to explore the perceptions and experiences which will be answered by the following objectives. For the first specific objective, the strengths identified for the online practicum were flexibility, adaptability, and convenience while the weaknesses were loss of direction related to instructor presence. These factors are correlated in both student and instructor’s involvement with the social and cognitive presence. As the result stated that students preferred synchronous sessions more than the pre-recorded ones for the reason of engagement and participation, this analyzes why the identified factors are interrelated with each other.

For the second objective, the following statements describe how the seven (7) distinct factors of Time, Uncertainty, Content of Confinement and Other Difficulties, Cognitive Presence, Social Presence, Instructor Presence, and Teaching Modality were experienced in the online practicum. Based on the researcher’s findings from the study, the BSND 4th-year students’ initial perspective on the uncertainties of the online practicum for public health nutrition and food service was heavily influenced by their preference for the traditional setting over the online setup. The participants have also indicated the different teaching modalities done in their online practicum which are utilized as combined synchronous and pre-recorded sessions. However, it was recognized that the main difference between both PHN and FSS is that the food service leaned more on the pre-recorded sessions followed by activities such as quizzes and interactive games thereafter. The majority of the respondents have stated a preference for synchronous sessions rather than pre-recorded ones. Most of the BSND 4th year students have also experienced difficulty with the social presence of the barangay they were assigned under the PHN online practicum, while in the FSS online practicum, requirements were mostly done individually, where they experienced challenges with the instructor presence in the duration of the practicum.

With this, three skills were identified as strengths of the online practicum, which were flexibility, adaptability, and convenience which were observed by the BSND 4th-year students in the duration of both PHN and FSS practicum. One study that supported the result showed that all their participants stated similar perceptions of how an online environment gives flexibility and generally self-control over their schedules. However, they also expressed the loss of direction and communication towards the instructor’s presence (Armstrong, 2011).   

Moreover, the facilitation of synchronous classes was also observed to be a strength of the online practicum, as the utilization of synchronous communication allows for building a good social presence with both the student and the instructor (Dutton et al, 2019). The study showed the positive feedback of the students with regards to online courses for which the instructor delivered high-quality instruction wherein engagement, organization, opportunities to practice real-life application skills, and feedback evaluation on the activities. Additionally, the study also exhibited that the practicum being held online had played a role in the themes of time and uncertainty on which they were experienced by the 4th year BSND students. In the context of time, time management played a crucial role in the accomplishment of the practicum, in which this stated that self-discipline was necessary for adjustment, supporting similar statements for the BSND 4th-year students (Ramos-Morcillo et al., 2020).

The third objective was the instructor’s presence. According to Fry (2018), commitment to a live setup can make the chances of online courses more successful with the incorporated virtual presence as it provides the student with a more face-to-face environment online. Thus, one of the aspects of facilitation (apart from direct instruction), appeared in the context of how the instructors provided feedback on the activities or the course questions that some respondents had commented on. Furthermore, Anderson et al. (2001), also stated that the instructor’s presence was said to overlap and associate with other presences.  In this case, it relates to how the engagement is facilitated, establishing both cognitive and social presence to achieve the desired learning outcomes (knowledge, attitude, and skills). According to Kucan et al. (2011), providing effective representations of instruction material builds the instructor’s conceptual knowledge for teaching and learning, critical to practice-based center teaching.  This suggests strengthening collaborative learning and improving innovative tools in enhancing the online environment in correlation to increasing social presence.

This study is limited to the BS Nutrition and Dietetics practicum courses in food service and public health nutrition. No comparison was made between the traditional in-person practicum and the online practicum for the courses. Moreover, the study design is an exploratory qualitative study, in which the data collected are qualitative, and the responses collected from the participants are based on their personal experiences and perspectives. In the data collection phase of the study, only the interviews for the two courses were collected due to a conflict in time.

 

CONCLUSION

This study has presented relevant data that comprehensively represented the experiences of the 4th-year BSND students with their online practicum, which may contribute to the improvement of the current program and policy of the practicum. The findings of this study also provided further supporting evidence on Fry’s Practiced-Based Teaching (PTB) Framework, in which some factors must be considered when employing a virtual mode of learning in a practiced-based course or program, to ensure its efficiency, hence, identifying these factors were essential in reinforcing the policies and programs online and blended learning be considered as options for mode of delivery for Public Health and Food Service practicum in the future.

Due to the limitations of the study, it is recommended that a comparison between face-to-face practicum and online practicum be conducted for further enrichment of the study. It is also recommended for a quantitative type of survey to follow in measuring Community of Inquiry (CoI) presence in different areas of the practicum. Moreover, investigate the instructor’s perspective and experiences in the delivery of the online practicum for both courses, to identify what practices were applied during the online practicum.  This study may also be used by future researchers for longitudinal research design, wherein it can be investigated if there is an association between preparedness to work in the field with those who underwent online learning. Moreover, it is recommended that future researchers update the research study on a comparison between the online practicum and face-to-face practicum in which they could also research if there are any improvements with the practicum policy after this study.

 

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