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Uni study calls placement fees a risk

488719149Plans to charge educational institutions for clinical placements could have a huge impact on the quality of the workforce, a study warns. By Erin Mayo.

The quality of education could be put at risk following plans by some health services to charge universities for clinical placements of their students.

A report by the University of Sydney warns that such fees would have a huge impact as universities and students shoulder rising costs for undertaking such courses.

Student Clinical Education in Australia: A University of Sydney Scoping Study was tabled by the university to investigate the impact such plans would have on the cost of education and the diversity and benefits of clinical practice.

“If costs are shifted, it will have a major, unexpected impact on both universities and students, and these costs will be in tens of millions of dollars,” warns the report’s lead author and director of Sydney University’s Workplace Research Centre, John Buchanan.

“The average health professional has about 1000 hours of clinical placement as part of their course, which could add up to thousands of dollars of HECS debt – it could make the cost of training a health professional expensive, Buchanan said. “More significantly, however, will be the impact on the reproduction of the health workforce in the future.

“If the number of student clinical placements drops, so will either the quality or quantity of health professionals trained. Health workforce shortfall usually results in subsequent wage pressures, as workers with scarce skills bid up the cost of their services.

“Growing demand for health professionals worldwide means that immigration is unlikely to fill the shortfall.”

Buchanan said more could be done to understand the benefit of providing clinical placements – both for students and healthcare services.

“The contribution that clinical placements make to health services is quite varied, and there is support other than direct service,” he explained. For example, some students may help with managing patient load, preparing publicity brochures, documentation of standard operating procedures, or helping to structure human resources practices.

“It can also help employers with their improvement process, and can give workplace supervisors experience and training with how they impart skills.

“Then there is the contribution to the professional development of the people supervising the students,” Buchanan continued. “These professionals are often asked questions by the students, and sometimes being asked the obvious can lead to deeper reflection on their own practice and introduce them to the latest insights and learning. The students become a transmission point for the latest information.

“To date, the integration of education with service delivery has been a defining feature of this system. If this system breaks down, is scaled back or is compromised in any way, the quality of health services is likely to be affected,” Buchanan added.

Professor Wendy Cross, chair of the Council of Deans of Nursing and Midwifery, said the current system is bursting with students completing placements, as universities have been encouraged to increase numbers.

She said that in Victoria, most universities pay $60 per head per day for clinical placements in public hospitals, a fee not usually passed on to students. Some hospitals also add administration fees and other charges on top of that.

“A large proportion of our budget is put into clinical placements. There is just no fat left in the system – and nursing schools just can’t run at a loss – no one can.

“If we continue to have the prices go up and up and up – then some universities will need to consider whether it is viable to offer nursing as a course.”

She agrees that a national approach to costing would be beneficial.

Cross said that following the federal cuts to health services, state health departments would be trying to get the money back.

“It’s almost inevitable that clinical fees will rise and whether, given that, we will now pass on some of the other changes [in the costs of higher education] to students – whether universities will want to pass on some of those clinical charges to students – is yet to be determined.”

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