The Future of Clinical Education: Opportunities and Challenges from Allied Health Deans' Perspective.

ISSUE: There is limited information and consensus on the future of clinical education and the key factors impacting allied health (AH) clinical training. AH deans identified both opportunities and challenges impacting clinical education based on a proposed educational model. METHODS: From July 2013 to March 2014, 61 deans whose institutions were 2013 members of the Association of Schools of Allied Health Professions (ASAHP) participated in a three-round Delphi survey. Agreement on the relative importance of and the ability to impact the key factors was analyzed. Impact was evaluated for three groups: individual, collective, and both individual and collective deans. AH deans' responses were summarized and refined; individual items were accepted or rerated until agreement was achieved or study conclusion. RESULTS: Based on the deans' ratings of importance and impact, 159 key factors within 13 clinical education categories emerged as important for the future of clinical education. Agreement was achieved on 107 opportunities and 52 challenges. CONCLUSIONS: The Delphi technique generated new information where little existed specific to AH deans' perspectives on AH clinical education. This research supports the Key Factors Impacting Allied Health Clinical Education conceptual model proposed earlier and provides a foundation for AH deans to evaluate opportunities and challenges impacting AH clinical education and to design action plans based on this research.

A survey of trauma registrars: job requirements, responsibilities, recruitment, and retention.

Study purpose was to describe trauma registrar job requirements, responsibilities, and recruitment/retention practices. An online survey was used. One-third required a high school diploma; two-thirds required a college degree. Most required skills were medical terminology (66%), database management (65%), anatomy (64%), Word (63%). Data responsibilities included abstracting, entry, coding, and validating. Few employers required certification. Twenty-six percent reported problems with recruitment, and 35% with retention. Salary and lack of advancement were primary reasons for employee turnover. Certifications were less relevant than skills; the primary focus was data management. Recommendations for recruitment/retention include job flexibility, educational opportunities, and recognition as a profession.

A rural-urban comparison of allied health professionals' average hourly wage.

Nationwide, demand for allied health services is projected to grow significantly in the next several decades, and there is evidence that allied health shortages already exist in many states. Given the longstanding history of health professional shortages in rural areas, the existing and impending shortages in allied health professions may be particularly acute in these areas. To assess whether rural areas are potentially at a recruiting disadvantage because of relative wages, this report uses data from the Bureau of Labor Statistics to describe the extent to which rural-urban differentials exist in wages for eight allied health professions, focusing on professions that are both likely to be found in rural communities and have adequate data to support hourly wage estimates. Overall the data show that the national average wage of each of the eight allied health professions is higher in metropolitan than nonmetropolitan areas. On average, the unadjusted rural hourly wage is 10.3% less than the urban wage, although the extent of the difference varies by profession and by geographic area. Adjustment for the cost of living narrows the discrepancy, but does not eliminate it. It is likely that rural providers in areas with the greatest wage discrepancies find it more difficult to recruit allied health professionals, but the extent to which this is the case needs to be assessed through further research with data on workforce vacancy rates.

Impact of Enhanced Primary Care on equitable access to and economic efficiency of allied health services: a qualitative investigation.

OBJECTIVE: To evaluate new pathways to access allied health services introduced by the Enhanced Primary Care/Chronic Disease Management (EPC/CDM) initiative that may both increase or decrease equity to and efficiency in access. DESIGN: A qualitative study consisting of semi-structured in-depth interviews with a purposively selected group of allied health practitioners. PARTICIPANTS AND SETTING. Allied health practitioners in private practice in Queensland, Australia, from physiotherapy, occupational therapy, speech pathology, and exercise physiology backgrounds (n = 15). MAIN OUTCOME MEASURES. Interviews focused upon several issues including how referrals are made under the EPC/CDM initiative and what happens for patients once their five allotted sessions are expended. RESULTS. The EPC/CDM initiative appeared to address two key barriers of access to allied health services - costs to patient of access and patient awareness of benefits. However, gap payments may still be deterring economically disadvantaged patients from attending. DISCUSSION: The EPC/CDM initiative is increasing access to allied health services for people with chronic diseases. However, it is evident that this initiative may still not be meeting the needs of those most disadvantaged economically, and may lead to duplication of efforts by allied health practitioners when patients move between private and public health care sectors.

Update on the Allied Health Professions Reinvestment Act of 2004.

We are facing a crisis in health care: the ever-increasing number of patients needing care, coupled with the decreasing number of qualified staff to provide that care. This is not a vague concept that might happen to "someone else." This a very real trend that will affect us all (some sooner than later). We are in a position at this time to do something about the future of our health care, particularly the care we will need when we have finished providing care. ASET has been sending a representative to the CAHL sessions for the past seven years. CAHL is the Coalition for Allied Health Leadership, and they meet in Washington, DC, for a week in the spring, and again in the fall. In between these sessions, they network with other participants to produce projects that will develop leadership, and directly help "The Cause." "The Cause" this time around is to promote H.R.4016 and S.2491, "The Allied Health Professions Reinvestment Act." Among other things, these bills address shortages of qualified staff through a variety of educational and training programs. ASET members need to become aware of the basic information contained within these bills, and what they can do to help increase their chances of passing. We can make a difference.

The likely effects of radiologist extenders on radiology training.

Manpower shortages have led many radiologists to consider using radiologist extenders, and the American Society of Radiological Technologists and the ACR have responded by formulating the radiology assistant (RA) program. There is no doubt that the RA program is becoming a reality or that it can be a boon to radiologists and physician radiologist trainees in freeing up faculty members' time, freeing trainees from repetitive tasks, and providing limited instruction in RAs' areas of expertise. Patients will likely accept RAs and trainee physicians equally. A financial analysis of using residents and physician extenders in anesthesia suggests that residents may be a cheaper labor source in those institutions not at the cap for resident positions.

Reimbursement risks with radiologist extenders: there is no free lunch!

There is great allure in the concept of using qualified health care providers to assist radiologists and radiation oncologists, increasing efficiency and possibly even improving patient care delivery. However, physician services are most commonly reimbursed under a system that is resource based, and the physician work and practice expense components of reimbursement for existing procedure codes are periodically reexamined to ensure their appropriate rank in this "relative value system." Also, as new codes are developed, demonstrable physician work and practice expenses will determine the relative values for the new procedures. In both cases, the type of individual who actually performs different portions of a procedure will determine the reimbursement level. In addition, the total reimbursement must be appropriately apportioned between the physician involved and the facility where the service is delivered. This article examines some of the potential impacts on procedure coding and radiologist and radiation oncologist reimbursement schedules if physician extenders perform work previously performed by physicians. It also examines possible shifts in reimbursement from physician to facility if an extender is employed by a facility.

Health-related physical fitness knowledge of student allied health professions.

Each allied-health profession has their own particular expertise but also shares some commonalities. One such commonality should be knowledge of health-related physical fitness relating to the health and well-being of individuals. Although the benefits of health-related physical fitness have been well documented, few studies have examined the level of health-related physical fitness knowledge among allied-health professions. Therefore, the purpose of this investigation was to assess the health-related physical fitness knowledge of three allied health professions using a 40 item multiple-choice test designed to assess knowledge in five domains of health-related physical fitness. Results indicated that student athletic trainers scored significantly higher on the post-test versus pre-test. On the post-test, athletic training and physical therapy groups scored significantly higher than the nursing group. The information from this study may be valuable in aiding educators in developing appropriate curricula to better prepare students for their role as allied health professionals.