The economic cost of failure in clinical education: a multi-perspective analysis

Foo, Jonathan; Rivers, George; Ilić, Dragan; Evans, Darrell John Rhys; Walsh, Kieran; Haines, Terrence Peter; Paynter, Sophie; Morgan, Prue; Lincke, Karl; Lambrou, Haria; Nethercote, Anna; Maloney, Stephen

doi:10.1111/medu.13266

Cited by 32 publications

(27 citation statements)

References 31 publications

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“…This is only partly influenced by SES. In any case, it must be recognized that there are costs associated with failing students in a selection system (or a student may 'luck out' in a lottery system, Foo et al, 2017). Further downstream in specialty training, there is a scarcity of data around diversity with the exception of evidencing independent predictors of rural medical practice, where there is a strong positive correlation between rural background and rural clinical school exposure (Farmer, Kenny, McKinstry, & Huysmans, 2015) suggesting there needs to be greater integration of selection with policy.…”

Section: (3) Diversity and Globalisation Issuesmentioning

confidence: 99%

2018 Ottawa consensus statement: Selection and recruitment to the healthcare professions

Patterson¹,

et al. 2018

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Selection and recruitment into healthcare education and practice is a major area of endeavor for health professional educators. Key insights have emerged to guide further inquiry and influence future policy and practice since the last Ottawa consensus statement on selection (Prideaux et al., 2011). However, much remains to be done, not only in refining the science of selection, but also in considering the opportunities and challenges of translating current research understandings into established practice. This updated consensus statement is based on strong theoretical research evidence and was developed using a multi-stage process. First, a group of international researchers with expertise in selection and recruitment, assessment, curriculum, and educational theory was specially convened to critically appraise the literature and develop a draft consensus statement. Second, the group shared the draft statement with the wider community via a workshop and symposium at the 2018 Ottawa-ICME Joint Conference on the Assessment of Competence in Medicine and the Healthcare Professions, and at the Second International Conference of Selection into the Health Professions. Colleagues from diverse countries and regions actively engaged with these activities face-to-face and through social media. Finally, the statement was refined on the basis of feedback, questions and comments, sent for independent peer review, and further revised. Reflecting the state of the science at the time, the previous consensus (Prideaux et al., 2011) characterised selection as an assessment system and focussed on the quality of different selection methods. In this updated statement, we present the latest research findings on selection methods and, reflecting progression within the field, we also consider potentially more complex issues including: selection policies; methodological concerns (beyond psychometric issues); social accountability, diversity and fairness, workforce shortages in some specialities (e.g. General Practice and Psychiatry) and in certain contexts (e.g. remote and rural working, and emerging countries), globalisation issues, developments in theory, and evaluation frameworks. We conclude with a synthesis of the key issues and a series of recommendations to guide future research and practice and encourage debate between colleagues across the globe. Our findings are

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Section: (3) Diversity and Globalisation Issuesmentioning

confidence: 99%

2018 Ottawa consensus statement: Selection and recruitment to the healthcare professions

Patterson¹,

et al. 2018

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“…4 Cost evaluation represents a promising opportunity to determine the value of programmes of assessment or learning. In this issue, Foo et al 5 examined this problem by estimating what failure in health professions education costs different stakeholders, including government, students and educational institutions. We would like to extend their discussion by highlighting additional considerations for the study of cost.…”

Section: Martin G Tolsgaard 1 and David A Cookmentioning

confidence: 99%

“…11 We suspect that in many cases, cost will vary across contexts even more than other education outcomes. Foo et al 5 address the issue of context directly in an exemplary manner.…”

Section: Martin G Tolsgaard 1 and David A Cookmentioning

confidence: 99%

New roles for cost as an outcome: opportunities and challenges

Tolsgaard¹,

Cook

2017

Med Educ

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“…Characteristically, this and other Australian costing studies were undertaken from the placement providers' perspective and focussed on the degree of productivity gains/losses experienced by providers of TCP. While authors of some studies found gains in productivity (Dillon, Tomaka, Chriss, Gutierrez & Hairston, 2003;Leiken, Stern & Baines, 1983;Rodger, Stephens, Clark, Ash & Graves, 2011;Rodger et al, 2012), others estimated substantial losses (Bowles et al, 2014;Foo et al, 2017;Jones & Akehurst, 1999). Unfortunately differences in methodological frameworks prevented a meaningful comparison of the published results.…”

Section: Introductionmentioning

confidence: 99%

“…Our literature search identified publications that adopted a multi-stakeholder perspective (Haines, Kent & Keating, 2014;Lalloo & Massey, 2013), but only one specifically focussed on allied health students, albeit only those who failed their clinical education (Foo et al, 2017). None of the economic evaluations were conducted alongside an RCT or involved an SCP as one of the evaluated alternatives.…”

Section: Introductionmentioning

confidence: 99%

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

Gospodarevskaya

Carter

Imms

et al. 2019

Aus Occup Therapy J

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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.

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The economic cost of failure in clinical education: a multi-perspective analysis

Cited by 32 publications

References 31 publications

2018 Ottawa consensus statement: Selection and recruitment to the healthcare professions

2018 Ottawa consensus statement: Selection and recruitment to the healthcare professions

New roles for cost as an outcome: opportunities and challenges

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

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