Using an original educational effectiveness evaluation index for the learning attainment target of the subject, we evaluated the effects on students’ perceptional changes of the participatory clinical dietetics training at the university-affiliated clinic. The content of the practical training involved the observation of nutritional support of patients attending the university-affiliated medical clinic followed by discussion of assigned cases through group work, and the development of nutritional support plans. A questionnaire consisting of 10 items related to communication skills and professional knowledge required for registered dietitians was used to assess the expected changes in their perception. The same questionnaire was used to access the changes in the perception of their importance and in their self-evaluation. These questionnaires were administered before and after the course lectures and after the nutritional guidance observation, and finally analyzed using the Friedman test. In terms of perceived importance, the following eight items showed an upward trend (all p <0.05)：appearance, attitude, interactivity, imagination, recording, listening, communication, and knowledge of food preparation and ingredients. The importance of nutritional expertise did not change (p =0.064). The students’ self-evaluation showed an upward trend for all 10 items (p <0.001). Our research suggests participatory clinical dietetics training at the university-affiliated clinic may contribute to strengthening communication and perception of the importance of expertise and to improving self-confidence.

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