Economic evaluation of simulated and traditional clinical placements in occupational therapy education

Abstract

Introduction: This economic evaluation complements results of the randomised controlled trial that established non-inferiority of the learning outcomes of a one-week simulated clinical placement (SCP) in occupational therapy qualifying degrees in comparison to an equivalent traditional clinical placement (TCP). This companion study presents detailed cost analyses of two placement alternatives and a cost-benefit study to assess the value for money of SCP. An economic evaluation of simulated versus traditional placements has not previously been conducted in Australia. Methods: Nine SCP/TCP rounds were conducted by six Australian universities. Costs were collected using studyspecific instruments. Public health sector costs were sourced from available literature. Willingness-to-pay for SCP/TCP was estimated using both a Discrete Choice Experiment and a Contingent Valuation method. These methods were employed to assess a comparative 'value' of SCP/TCP from the perspective of heads of occupational therapy departments (N = 28), who were asked to put a monetary value on the broader range of benefits associated with SCP/TCP. Results: From the universities' perspective the average cost per student ranged from AUD$460 to AUD$1511 for simulated and AUD$144 to AUD$1112 for traditional placement. From the health care sector perspective, the difference in costs favoured simulated placements for four implementations and traditional placements for five. In the Discrete Choice Experiment respondents preferred traditional rather than simulated placement and would pay additional AUD$533. The estimated monetary value of simulated placements from a contingent valuation ranged from AUD$200 to AUD$1600. Conclusions: For universities that procure TCPs predominately at public health care facilities and sustain high administrative overheads, the SCP program could be a cost-saving alternative. From a broader value-for-money perspective, respondents favoured TCP over SCP, yet placed importance on placement availability and opportunity to demonstrate competence for students during the placement. Results should be interpreted with caution and further research with larger sample sizes is required.

A mapping review of models of practice education in allied health and social care professions

“…A second significant set of limitations relates to how outcomes or effects are considered, specifically the heterogeneity of outcomes examined, the lack of use of validated measures, and limited selection of points at which effects were assessed. With the exception of the RCT by Imms et al (2018) and its associated economic evaluation (Gospodarevskaya et al, 2019), measurement in quantitative studies focused on narrow outcomes. For instance, the RCT by Sevenhuysen et al (2014) evaluated the time released for non-student activities and the volume of feedback provided to students, while Zeira and Schiff (2010) and Cleak and Smith (2012) used survey methods to assess satisfaction with the models used.…”

“…While the study by Sevenhuysen et al (2014) found no difference in educator workloads or service provision, its sample size (n ¼ 24) may not have been sufficient to detect changes. Conversely, the RCT by Imms et al (2018) was adequately powered, but the associated economic evaluation (Gospodarevskaya et al, 2019) did not examine changes in service productivity associated with the presence or absence of students.…”

“…Short, high-quality, simulated placements were found to be as effective as traditional placements of equivalent duration in terms of student attainment (Imms et al, 2018). The economic evaluation conducted by Gospodarevskaya et al (2019) concluded that simulations were more cost effective than traditional placements for healthcare providers, with the opposite being the case for universities. This evaluation also reported that students valued traditional placements ahead of simulations.…”

“…Simulated practice placements use mannequins, actors, simulated environments, video or interactive computer packages for learning. No papers considering simulation were initially included; however, the authors became aware of, and included, three papers reporting the development of a simulation framework (Chu et al, 2019), and a subsequent randomised controlled trial (Imms et al, 2018) and economic evaluation (Gospodarevskaya et al, 2019), published after the literature search. Chu et al (2019) presented a conceptual framework for simulated placements intended to structure the organisation and application of learning and simulation theory.…”

Perception of Faculty Members of Regional Medical School Toward Faculty Development Program

“…If the institute is fighting for accountability, accreditation, and implementation of the mission to achieve success, productivity, and satisfaction, much resources and time should be directed toward faculty development (15). The importance of faculty development was stressed by Harden (2009) as being equivalent to curriculum development, which is a very difficult assignment [16,17]…”