While the exam is a big deal, in my personal opinion, the exam isn't everything. Many RD's I've worked with, including myself, hold the opinion that while the exam serves as a gateway to weed out individuals who perhaps are suited for RD status, it also keeps many competent people from practicing. The exam is just one measure of competency, though I think many would agree, its a necessary evil in some ways.
An internship serves an intern in two ways. One is that it teaches the intern skills that cannot necessarily be assessed by the exam, such as interviewing, counseling, seeking and assessing new information and translating that information to practice, critical thinking skills, and a foundation to clinical judgement. The second is preparation for the exam in order to pass it. In my opinion, all that other stuff I listed first is the most important.
So now let me get to the point.
While gaining upper level management experience in order to get a better score on the exam is certainly a good reason to include it, I find that individuals who have experience with front line staff- whether in a job or exposure during their internship- may fair better career wise. Understanding how a dietitians decisions effect the staff that implement those decisions can go a long way in the effectiveness of the delivery. Therefore, at some point that intern or RD needs to spend time with front line staff. The attitudes I've seen in food service rotations leads me to believe it needs to be in the rotation itself.
As I've worked trayline and diet office I watched five classes of interns cycle through. For three of those I was an employee on trayline and in the diet office and for two I was an RD and served as a preceptor for a few days for some of them, and a whole rotation for another. There is a lot of anxiety surrounding the food service rotation and is frequently the least liked rotation among interns.
A kitchen is loud and moves fast, and as such the personalities and environment can be intimidating. There are ways to get hurt in a kitchen, the job is not glamorous, and the dishroom definitely isn't a first choice among anyone. But, every job in that kitchen should be of interest to the future RD and current RD. The dishroom plays a role in food safety and prevention in the spreading of germs. The cooks know way more about food palatability than most RD's and they also may have ideas on how to help with therapeutic diets. Conversely, there may be cooks who are in need of further education on proper procedures for therapeutic diets and therefore patient outcomes. Trayline participates in the actual delivery of patient food --from food safety and serving sizes to customer service. The diet office is the gatekeepers to the therapeutic diets and ordering of appropriate meals. They also serve as a link between the patients and the dietitians in many instances. Every job in that kitchen is important to the dietitian.
So I offer this: If we were to abandon teaching to the exam it would be a disservice to interns. However, using the exam as the only measure of success is also a disservice. The RD exam score has no influence on a future career, unless of course it is a failing grade. Lets focus on passing and not necessarily raising scores. Granted I was only able to read the abstract of this study but I would like to see the difference in passing vs not passing scores between the two groups, because that is ultimately the important factor, not the amount of points themselves. In this way we can find a happy medium between teaching to the exam and teaching to a successful career beyond the exam.