Universities tighten student training hours

Nursing schools are reducing the number of clinical placement hours offered to students to manage increasing demand on practical training. By Linda Belardi.

Average nursing clinical placement hours have declined over time as universities try to ease placement and resourcing problems, according to a report released by Health Workforce Australia.

While many nursing schools exceeded the required minimum by substantial amounts in the past, universities have made significant curriculum changes to drive down placement hours to the mandated amount.

One nursing program said it had undertaken substantial reform to reduce its placement hours offered in 2011 from 1100 to 820 hours. The report said there was “little doubt” this type of reform was taking place in many programs. By introducing immersive simulated learning, Edith Cowan University had also reduced its clinical placement time to the minimum.

However, a small number of universities interviewed by HWA said they anticipated accrediting bodies could push the base requirement from 800 to 1000 minimum hours with the recent introduction of national registration and accreditation.

Within universities there is an opposite move towards a clinical curriculum that assesses competencies rather than the number of contact hours. “Competency based clinical curriculum and assessment could theoretically reduce prescribed contact hours…such developments would be welcomed by universities and are thought to likely result in potentially better outcomes…,” said the report.

HWA is currently undertaking a project to map the future supply and demand of clinical placements between 2012 and 2014. The extensive report presented preliminary findings based on internal university modelling and targeted interviews conducted with senior university personnel. 36 universities provided data for courses in nursing.

While the report covers all the major health professions, in numerical terms the largest growth in student enrolments is by far planned in nursing,

The student load in Australia’s nursing schools is planned to grow to 40 000 in 2014, up by 27 per cent on 2009 student figures (31,811 equivalent full-time student load). This planned growth in numbers would create an estimated 280 000 additional clinical placement days in 2014 compared with 2009.

However the report said limits on clinical placements is a substantial constraint on growth. All universities reported concerns with the cost, complexity and difficulty in securing appropriate and enough clinical placements for nursing students.

Clinical placements were increasingly difficult to secure due to competition between schools and planned increases in student numbers will exacerbate the situation considerably, the report said.

Substantial travel and accommodation costs for students to attend clinical placements were identified as significant issues, especially for regional and rural students. One regional university calculated that in any given year their students travel a total of over 250,000 kilometres to get to their placements.

Another rural-regional university reported that the more remote the placement the less qualified the staff and the more difficult and expensive it was to recruit and train supervisors.

HWA also noted increasing pressure from industry such as private hospital groups for payment for student placements.

The public health system, especially public hospitals, is the dominant provider of student training, comprising 71 per cent of all placement days in 2009.

Universities also draw heavily on a concentrated number of clinical placement providers.
The University of Queensland reported only seven training providers for its students and the University of Canberra said its largest 10 providers delivered 98 per cent of student placement hours.

The report, “Mapping clinical placements: capturing opportunities for growth,” is available for download at the Health Workforce Australia website. Visit: www.hwa.gov.au

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