Volume 79 - Fall 2001	Download

Examining the Costs and Benefits of Clinical Education by Barbara Jones, MHS, MT(ASCP) Member, Programs Approval Review Committee (PARC)

Clinical laboratory science programs, as well as other allied health educational programs, include structured clinical education experiences. Clinical education provides a means by which students become competent in clinical skills needed for the actual work setting. Allied health program directors have experienced increased difficulty in attaining and maintaining sufficient numbers of health care training sites for students. A lack of available training sites has led to program closures or a decrease in students accepted. Many health care facilities cite the costs of training students as reasons to discontinue affiliations.

The Coalition for Allied Health Leadership (CAHL) is a training program for emerging leaders in allied health education and clinical practice. This program is provided through the collaboration of the Association of Schools of Allied Health Professions (ASAHP), Health Professions Network (HPN), and the National Network of Health Career Program in Two-Year Colleges (NN2) plus the support of the Bureau of Health Professions. The CAHL training program includes the formation of project teams assigned to complete projects identified through recommendation of the National Commission on Allied Health. The CAHL Clinical Education Project group studied the costs and benefits of clinical education. The 1998 project group studied the literature and prepared a white paper of findings, which was published in Laboratory Medicine.¹ The 1999 project group continued this investigation. They developed a study to determine items to be included in a cost-benefit analysis tool and to identify costs and benefits of clinical education programs. Surveys were sent to 138 NN2 members, and 58 responded. Results of the survey were published in the Journal of Allied Health.²

Background research for both articles presented information about tangible and intangible benefits of clinical education. Research in specific allied health disciplines was reviewed. The studies showed that when student contributions to care were considered over the length of training, both quality of care and productivity remained consistent and a net monetary benefit could be realized.³ One study reported that hiring a student trained in a health care facility resulted in a $20, 000 cost savings when costs of advertising, interviewing, training, recruiting, personnel involved in processing paperwork, and overtime for covering the vacancy were all considered.⁴ Other research showed similar potential cost savings ($16, 000-$20, 000).^{5, 6}

The clinical sites in the study were primarily in independent hospitals or health care systems with preceptor-to-student ratios of 1:1-1:2. The program directors identified costs as: 1) staff time, 2) materials and supplies, 3) equipment, 4) space/facilities. The program directors identified benefits as: 1) orientation and recruitment savings, 2) increased professionalism, 3) job satisfaction, 4) work quality of staff, 5) ability to maintain and upgrade staff skills and knowledge, and 6) student assistance with clinical coverage. Results from the CAHL groups work indicated that, in few cases, were programs required to perform cost/benefit analysis.²

Allied health programs continue to be dependent upon health care facilities accepting students into clinical training programs. To enable continued collaboration for clinical education, allied health program directors should be aware of the costs and benefits incurred by the program and the health care facilities. As it becomes more difficult to attain and maintain clinical affiliations, program directors should become more aware of the benefits (tangible and intangible) and cost savings generated by students in training. They should be able to market programs to clinical affiliates by presenting the tangible (monetary) and intangible benefits of clinical education.

Providing this information will help health care facilities realize the many advantages of developing and maintaining clinical affiliations with academic programs.

References:

1. Phelan SE, Daniels MG, Hewitt L. Clinical education benefits. Lab Med. 1999; 30:714-20.
2. Jones BR, Murtaugh M, Durkin ZA, Bolden MC, Majewski T. Clinical education in two-year colleges: Cost-benefit issues. J Allied Health. 2000; 29:109-113.
3. Holland KA. Does taking students increase your waiting lists? Physiotherapy. 1997; 83: 166-172.
4. Harmening D. Benefits of a clinical affiliation. Baltimore, MD: Department of Medical and Research Technology, University of Maryland School of Medicine, DMRT and DH publishing, 1998: 1-6.
5. Snyder JR. Manpower needs in the year 2000: Medical technology education. Lab Med. 1992; 23:416-9.
6. Best ML. Lab administrators' role in retaining professionals. Lab Observer. 1990; Aug: 46-50.

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