Explaining the practicum experiences of diagnostic radiography undergraduates in Australia and Ethiopia using the theory of human relatedness.

INTRODUCTION: Practice learning is critical to the development of clinical skills; hence placements are a major component of all pre-registration radiography programmes. Nonetheless, dissatisfaction with practicum experiences is a common reason why students consider leaving such programmes. Providing effective placements which promote retention may not only require better appreciation of students' clinical reflections, but also a more fundamental understanding of the implicit criteria they use to appraise a practicum. This study applied the theory of human relatedness (THR) to the placement experiences of radiography undergraduates to identify the evaluative mechanisms which may underpin these experiences. METHODS: A critical realist investigative approach was employed to reanalyse data regarding the practicum experiences of stakeholders involved in undergraduate diagnostic radiography programmes at two universities in Australia and Ethiopia against the eight core THR concepts, namely connectedness, disconnectedness, parallelism, enmeshment, belonging, reciprocity, mutuality, and synchrony. RESULTS: The findings identified all states of relatedness and processes/social competencies of the THR within the placement experiences of these stakeholders. The degree of positive relatedness a radiography student experiences within a practicum, irrespective of the setting, may affect their clinical performance. CONCLUSION: The findings support the argument that the THR may reflect an implicit set of criteria stakeholders use to evaluate clinical encounters. Additionally, these results are congruent with earlier investigations regarding the practicum reflections of other undergraduate healthcare students. IMPLICATIONS FOR PRACTICE: To enhance student placement experiences, it is necessary to recognise the effect a student's sense of relatedness may have on their self-efficacy and proficiency, modifying pre-practicum preparation and assessment arrangements to inhibit disconnectedness and enmeshment, avoid the need for parallelism, and better cultivate connectedness, belonging, reciprocity, mutuality, and synchrony.

Insights into Diagnostic Radiography students' perception of clinical stressors.

INTRODUCTION: Clinical placements are integral components of Diagnostic Radiography (DR) university training programs, providing students with necessary and unique learning experiences. Educators' understanding of the student experience on placement is growing, and it is important for educators to be attentive to students' reactions to their learning environments and to situations identified to reduce wellbeing. This study aimed to explore DR students' perceptions of challenges experienced during clinical placements and their use of coping strategies. METHODS: Final year DR Students at the University of Sydney, were invited to participate in an online focus group. Three focus groups were conducted with a total of 13 participants. Participants were asked to narrate situations experienced while on clinical placement that reduced their emotional wellbeing, and coping strategies considered to support emotional wellbeing. An inductive thematic analysis of focus group transcripts was undertaken to identify the main discussion themes. RESULTS: Three themes were identified regarding situations considered to reduce emotional wellbeing: adapting to the 'reality' of the clinical environment, forming effective relationships, and balancing student role expectations and responsibilities of patient care. Three themes were identified about coping strategies for emotionally challenging situations: support from clinical and academic staff, peer support and personal strategies, and growing knowledge and confidence over time. CONCLUSION: Students' emotional wellbeing during experiential learning experiences is an underappreciated factor in their transformations into competent diagnostic radiographers. Academic training programs are therefore encouraged to be sensitive to the wellbeing of their trainees, and to take deliberate steps to equip students with the skills to navigate emotions and to normalise emotional responses that may be experienced in the clinical setting. IMPLICATIONS FOR PRACTICE: Students' experience of challenges in the clinical environment is largely influenced by students' abilities to deal with negative experiences, hence students' concerns require implementation of focused interventions prior to first clinical placement.

Diagnostic radiography students' perceptions of working in the clinical environment: A focus on emotional challenges.

INTRODUCTION: Diagnostic radiography (DR) students experience situations that affect their emotional wellbeing during clinical placements. This study aimed to investigate factors that contribute to students' reduced wellbeing on clinical placements, and to identify responses to situations that are considered challenging. METHODS: An online survey was employed to collect data from five cohorts in the undergraduate (UG) and graduate entry masters (GEM) DR programs (n = 461 enrolled students). Questions related to experiences with health professionals, clinical work area or patient presentations that were considered to reduce wellbeing. Data on personal reactions to challenging situations, and strategies that could better prepare students for coping were also collected. Quantitative and qualitative data were analysed using descriptive statistics and thematic analysis respectively. RESULTS: 155 completed surveys were returned (33.6% response rate). Regarding health professionals, 21.4% of participants (33/154) indicated either 'agree' or 'strongly agree' that a prior interaction with a radiographer had contributed to reduced wellbeing. The highest agreement for work area was emergency department (23/66, 34.8%). For patient presentations, 78.1% (n = 121/155) of responses related to 'patients in suffering', with differences between UG and GEM students (p = 0.027). The majority of responses to challenging situations was 'focused on the task of imaging' (n = 103/155, 66.5%), and 58.7% (n = 91/155) of participants indicated that listening to other students' personal experiences would assist them in the future. Four main themes emerged from the qualitative data: 'student role and expectations', 'emotional impact of a patient's presentation', 'interaction with radiographers' and 'personal experience'. CONCLUSION: Emotional challenges exist in the clinical environment. Experiences affecting wellbeing in the clinical setting are diverse among DR students, and students may lack preparedness to deal with them. IMPLICATIONS FOR PRACTICE: Support strategies and educational interventions are recommended in order to support students' wellbeing.