An evaluation of clinical dietetic student placement case-mix exposure, service delivery and supervisory burden

Aim: To evaluate the attributes of clinical dietetics student placement exposure to patient case-mix and supervision, types of services delivered and to estimate and compare costs and benefits of student activity and supervision while on placement. Methods: Descriptive study of three annual cohorts of student dietitians (n = 59) collecting data prospectively over a continuous 10-week clinical placement period. Data focused on student case-mix exposures and student and supervisor verified time utilisation. Descriptive analysis of data relating to student case-mix exposure, student service delivery and direct supervisory practices was performed to explore the attributes of student placement experiences. Student and supervisor time utilisation data were used to model estimates of dollar costs and benefits based on occasion of service as a measure of clinical productivity. Results: Data collected indicate that student service delivery activity increases and direct supervision decreases significantly as time on placement increases. The minimum occasion of service exposure required to achieve supervisor assessment of entry-level competency was 47 occasion of service (mean 165.8 occasion of service) and the maximum 306 occasion of service. Over one-third of all occasion of service provided by students was not directly supervised. Cost-benefit estimates indicate that a student needs to be over 80% as time efficient throughout the placement as a new graduate to offset the costs of direct student supervision. Conclusion: These data highlight the variability of student clinical placement experiences and exposure to learning opportunities and support evidence-based dialogue about resource exchange to support student placements.