Examining the impact of final year radiography students on Medical Imaging services during clinical placement: a pilot study

Project Aim and research questionsThis study aims to investigate the impact of final year radiography students on Medical Imaging services during their clinical placement.The project seeks to answer the following questions:What is the impact of final year radiography students on Medical Imaging services during clinical placement?•What is the nature of radiography work for a typical final year radiography student?•What is the level of supervision provided for a typical final year radiography student?•What are the contributions of radiography students on imaging services during their final year of clinical placement?What triggered this research? Monash’s and Deakin University’s final year radiography students, along with RMIT radiography interns, are traditionally paid by the Department of Health and radiology employers to complete their final blocks of clinical placement. With the reimbursement, students and interns are regarded and supervised as employees of the workplace. As of 2022, the reimbursement offered by the Department of Health will cease. With cessation of payment, final year students will no longer be treated as employees but will revert back to student status. Rationale for the study With this change in status, clinical stakeholders are now focusing on the supervision burden required with total disregard to the ‘contributions’ final year students bring to the imaging workflow. Anecdotally, it is not uncommon for final year students to fill the gap when the staff complement is down. Study in dietetics found that at least one-third of clinical work of dietetics students were recorded as unsupervised.1 In medicine, senior students nearing graduation were found to be more readily contributing to the health service compared to the junior students who were requiring a greater supervision burden.2 There are ominous signs that some centres are beginning to drop the number of clinical placements in anticipation of the increased level of supervision required. In addition, with the sole focus on supervision burden, a number of centres are also raising the prospect of imposing placement fees on this cohort of final year students. There is therefore an urgent need to investigate and evidence the impact of radiography students on Medical Imaging workflow. This information will inform stakeholders and enable decisions to be made that are evidence based. Significance of the study A 2014 literature review shows there is minimal literature on student contributions to health services in Australia.3 Likewise, there is a paucity of literature on contribution of radiography students to the Medical Imaging workforce. In the absence of such data, clinical stakeholders are likely to continue to decrease the number of clinical placements. The diminishing number of placements is likely to affect existing students’ program progression and depending on the extent of reduction, the flow on effect may also negatively impact on the future growth of the Victoria Medical Imaging workforce.This pilot project addresses the current gap in literature and is the first such study to be undertaken for Medical Imaging in Victoria. Findings from the study will inform stakeholders of the value and contributions of final year radiography students to the clinical workflow, with corresponding implications on department hiring and staffing strategy. The findings will also highlight areas of deficiencies in clinical education, thereby enabling both employers and universities to adopt strategies to improve the quality of student clinical learning.MethodologyThis study adopts the Clinical Placement Research Framework and methodology as the 2018 Molloy et al. study on medical student contributions to the health services. 2 It is a mixed methods study using survey, activity log, observation, focus groups and semi-structured interviews to answer the research questions. Aside from students, clinical supervisors and managers will be invited to participate in this study. As in the Molloy et al.’s project, this pilot study is based on Lave and Wenger concept of community of practice.4 This Community of Practice framework is ideally suited as the framework takes into account the complex social environment and recognises practitioners and students as participants of the community of practice.The combination of quantitative and qualitative approaches is useful in providing clarification of complex issues which is not possible with a single approach.5 A quantitative approach is useful in quantifying variables such as frequency of specific radiography duties which will enable the research team to establish patterns.6 Qualitative methods focus on describing, understanding and interpreting phenomena and establishing links between complex data.7 In this instance, the qualitative data will provide an in-depth view of the social and contextual nature of clinical learning. Multiple data collection strategies allow for data triangulation and allow cross-data validity checks, thereby increasing the rigour, validity and credibility of the findings.6Outcomes of the studyUpon successful completion of the project, the study will provide the following tangible outputs:•Captures a ‘snapshot’ of final year radiography students’ clinical responsibilities;•Provides a better understanding of nature and level of supervision burden for final year radiography students; and•Depicts the contributions of final year radiography students on imaging services.The above data will provide a better understanding of the impact of radiography students on Medical Imaging services and the corresponding benefits and burdens on stakeholders. Benefits and impact of the studyThis pilot study has multiple benefits and potential impact on the following stakeholders:•Research team: This pilot study will enable the research team to fine tune its methodology and pave the way for Phase II of the study. •Victoria stakeholders: Phase II of the study will be expanded to include the major Victorian radiology centres and radiography students from two other Victorian Universities: Deakin and RMIT. The larger sample size of radiography students and the inclusion of more public and private radiology providers will provide stakeholders with greater confidence of the study findings.•Clinical stakeholders: This pilot study will inform employers of the final year student contribution to the Medical Imaging workforce, with implications on their hiring and staffing strategy for the departments. The findings will also highlight areas of deficiencies, thereby enabling both employers and universities to adopt strategies to improve the quality of student clinical learning.References1. Hughes R, Desbrow B. An evaluation of clinical dietetic student placement casemix exposure, service delivery and supervisory burden. Nutrition & Dietetics. 2010; 67(4):287-93.2. Molloy E, Lew S, Woodward-Kron R, Delany C, Dodds A, Lavercombe M, Hughson J. Medical student clinical placements as sites of learning and contribution. Melbourne: University of Melbourne; 2018. 3. Bowles K, Maloney S, Kent F, Sevenhuysen S, Molloy E, Tai J. The costs and benefits of providing undergraduate student clinical placements for a health service organisation: A rapid review. 2014 HETI and SAX Institute Report 4. Lave J, Wenger E. Situated Learning: Legitimate Peripheral Participation. Cambridge: Cambridge University Press; 1991.5. Schwalbach, E. Value and Validity in Action Research: A Guidebook for Reflective Practitioners. Lanham, Maryland: The Scarecrow Press; 2003.6. Patton, M. Q. Qualitative research and evaluation methods (4th ed.). California: Sage Publications; 2015.7. Gibbs G. Qualitative Data Analysis. Explorations with NVivo. Buckingham: Open University Press; 2011.