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Abstract Background: Previous studies on nutrition counselling self-efficacy have assessed small groups of dietitians in focused practice areas or evaluated the effectiveness of skills training on only a few skills. This descriptive study developed a comprehensive scale to examine self-efficacy in a large, cross-sectional sample of practising dietitians when performing various counselling skills that promote dietary behaviour changes. Methods: A valid and reliable instrument was developed and administered through the Internet to survey dietitians in the USA from various areas of dietetics and with varying years of experience. Items included counselling self-efficacy, skill usage and counselling-related job characteristics. Of the 612 respondents, one group (n = 486) conducted counselling for more than 50% of their work week, and the other group (n = 126) for less than 50%. Factor analysis was used for scale development. Independent samples t-tests and chi-square tests were performed for group comparisons. Correlations and multiple regression analyses further assessed the relationships among variables. Results: The resultant unidimensional scale contained 25 items. Dietitians reported high self-efficacy scores and frequent skill usage. Those who counsel for more than 50% of their work week were more likely to work in outpatient settings and private practice, reported higher self-efficacy scores, and held longer and repeated sessions. Self-efficacy scores were positively correlated with counselling-related job characteristics. Years of counselling experience and skill usage significantly predicted self-efficacy scores. Conclusions: Dietitians perceive themselves to be highly self-efficacious in using counselling skills which may contribute positively to their professional practice. However, the relationship between counselling self-efficacy and actual performance warrants further investigation.