Study: Dietitians are credible, with or without a white coat

When you see your physician in a white coat, chances are you might think he or she is smarter, more confident and perhaps even exudes a compassionate bedside manner.

But what about dietitians? Do they need a white coat or scrubs to be perceived as credible?

New research from the University of Florida Institute of Food and Agricultural Sciences shows that patients and clients see no difference in competence when their dietitian wears a white coat.

Students in a master's program in food science and human nutrition at the UF/IFAS College of Agricultural and Life Sciences wanted to know whether wearing a white coat increased dietitians' credibility.

"Professionalism of your healthcare provider is important because it encompasses being empathetic, competent, approachable, credible, organized, effective, professional and confident," said Bobbi Langkamp-Henken, a UF/IFAS professor of food science and human nutrition and faculty advisor for the newly published, student-driven study in the journal Topics in Clinical Nutrition. "The fact that we found that perceived professionalism of a dietitian is not related to attire means that the dietitian may be seen as equally effective in professional attire or scrubs with or without a white coat."

Evidence shows an association between white coats and transmitting infections. Without having to wear white coats, dietitians can worry less about the potential of bringing home viruses such as COVID, Langkamp-Henken said.

In hospitals, dietitians have historically worn professional attire (dress shirt, dress pants) and a white coat, she said.

"Our research findings also provide great news for dietitians working in areas of the hospital where contamination of work wear may be likely," Langkamp-Henken said. "If I were practicing as a hospital dietitian in this time of COVID, I would not want to come home to my family in my hospital work clothing. Scrubs are easy to clean. Professional attire is not."

More recently, dietitians have been wearing scrubs with or without a white coat. All outfits play into the client or patient's perceptions of the dietitian's level of professionalism, whether they realize it or not, the researchers said.

A group of graduate students in the UF Master of Science-Dietetic Internship program conducted the research, under Langkamp-Henken's supervision.

The students created four videos of a dietitian entering a patient's hospital room and giving a short diet instruction.

In each video, the dietitian was wearing a different outfit: scrubs, scrubs with a white coat, professional attire and professional attire with a white coat. The 474 study participants saw the video and rated the professionalism of the dietitian. Langkamp-Henken's students then compared the professionalism scores assigned to each type of dress by study participants.

They found that attire and white coat did not influence perceived professionalism of a dietitian.

Among dietitians, dress code tends to differ based on the workplace—whether that's in a hospital, outpatient clinic, school, food service or private practice—said Farah Tadros, a graduate student who led this research.

More recently, policies regarding dress codes in hospitals have allowed dietitians to wear scrubs—whether or not they wore a white coat. In addition to this shift, the idea for discontinuing white coats continues to be discussed, especially during a time like ours with COVID-19, Tadros said.

Tadros and her classmates are part of the UF Master of Science-Dietetic Internship program, part of UF/IFAS CALS. The program prepares graduates to be credentialed as a registered dietitian nutritionist and educate clients and patients about nutrition and healthy food choices.