A key element of education for radiography students is patients’ willingness to co-operate when a student is involved in their radiological procedures. Active participation of the student in patient care has been shown to be important for professional development of learners. The objective of this study is to determine the views of patients and associated factors influencing these views when students are incorporated into their radiological examinations.This study was conducted in 2 hospitals located in Enugu and Owerri. 100 patients were initially mapped out to be used for the study, but only 90 patients finally agreed to participate. A questionnaire structured in line with the objectives of this research was used to collect the data. There were 90 respondents, of whom, 35% were male and 64.4% were females. 35.6% were single, 58.9% were married and 5.6% were of the divorced group. 52% of the patients could differentiate a student radiographer from a radiographer while 48% will not be able to differentiate this. 52% will not be happy if a student will examine them without the supervision of a radiographer while 68.5% will not allow students examine them when a radiographer is not around. 86.7% would not request that a student should be sent out during an examination. Generally, 89.9% think it is important and students should participate in radiological examinations. There is generally a favourable acceptance of radiography students’ involvement.
TABLE OF CONTENTS
Title page i
Table of Contents vii
List of Tables viii
List of Figures ix
CHAPTER ONE: INTRODUCTION
- Background of study 1
1.1 Statement of problem 3
1.2 Objectives of study 4
1.3 Significance of study 5
1.4 Scope of study 5
1.5 Hypothesis 5
1.6 Literature review
CHAPTER TWO: THEORETICAL BACKGROUND
2.1 A patient 14
2.1.1. Classes of patients 15
2.2 Definition of Co-operation 16
2.3 Communication as a tool that determines the level of co-operation 17
2.4 History of patient teaching and learning 20
2.5 Barriers to communication 21
2.6 Goals of patient education which effective communication builds
2.7 Structure of attitudes
2.7.1 The function of attitudes
2.8 Teaching with patients
CHAPTER THREE: RESEARCH DESIGN AND METHODOLOGY
3.0 Research design 23
3.1 Target population 23
3.2 Sample size 23
3.3 Method/instrument for data collection 24
3.4 Description of the questionnaire 24
CHAPTER FOUR: DATA ANALYSIS AND PRESENTATION
4.0 Results 37
CHAPTER FIVE: DISCUSSION, SUMMARY OF FINDINGS, RECOMMENDATIONS AND LIMITATIONS OF STUDY
5.1 Summary of findings
5.3 Limitations of study
- Background of Study
In the healthcare sector, people who administer health care, clinical students inclusive, always maintain a close contact or work directly with those who receive the healthcare the people who receive the healthcare service are called patients, but for the purpose of emotional and psychological balance, ‘client’ or ‘healthcare consumer’ is the name chosen for them.1
Clinical placements are an important component in the education of students who are training in the healthcare professions. Here, they begin to witness examinations of patients thereby gaining required experience as it concerns the hospital environment.
The co-operation of patients and their consent to involve students in their care is vital to clinical education.1 A vital part of radiography students’ education is learning through interaction and direct contact with patients. An essential example of this is in contrast-administered examinations where students learn more on the patient pathology, participate and learn the intricacies involved in radiological examinations. Thus, a key element of clinical education is a patient’s willingness and comfort level with involving a student in their ecaminations.2 It can therefore be inferred that in order for students to finally become competent in the practice of radiography after graduation, real life sessions with patients are ultimate if this is to be achieved. The patient now becomes an important tool in making sure students earn that clinical experience which qualifies them as radiographers.
However, patients have their right to confidentiality.3 As a patient, he/she has a right to every consideration of privacy related to your medical care. Examination, consultations should be conducted discreetly. As long as it does not interfere with diagnostic procedures or treatments, a patient has the right to request that someone be present or not while an examination is being performed. This interferes with purpose of clinical learning of students by presenting them with real life situations. The era when radiographers/radiologists and clinical students approached patient with a sense of divine right over them are long gone. Patients now have increased awareness of their rights.3 It is therefore an ethical practice to seek for their consent and if sought, have the capacity or will to decide if students are to participate in their examinations or not. Some radiological investigations which require the administration of contrast agents are intimate. Therefore, patient privacy should be held esteem.
Being a patient also leaves one with a responsibility of responding to your caregivers.3 In order to facilitate care, a patient to help the medical personnel by following their instructions and medical orders. Clinical students might be involved in a care and the patient has the obligation of following instructions.
Although most patients accept that healthcare givers in training must develop their clinical skills, the presence of a student might add to the arousal that the medical environment already imposes on a patient.4 This can evoke negative/unacceptable behaviours from patients especially when the patient nurses the feeling that he/she has lost his/her privacy. The aggression of the patient might manifest in the form of defiance; refusal to co-operate with instructions given to them. This usually interferes with the examination and in general, adversely affects the clinical teaching environment. As it concerns student radiographers, it can be stated that continued exposure to uncooperative patients tend to manifest in the student as emotional exhaustion and lower level of psychological well-being.5
A patient’s willingness and comfort level with involving a student in the radiological examination may be affected by a number of factors. These range from their previous experience with radiography students, through understanding the role/responsibilities of the students, nature of the medical problem and the patient or student’s sex, most importantly.2,6,7,8
As it concerns sex as the most important factor, anecdotal evidence from male students have shown how difficult it is to obtain experience whenever it concerns female patients. In radiography, invasive examinations such as Hysterosalpingography(HSG) are often and inadvertently restricted to mainly female students. Female patients tend to be more apprehensive when they have male students around than female students in radiological examinations like HSG.
Nevertheless, previous studies carried out especially on medical students revealed a general acceptance of them as patients had a positive view of them, but specific details on assessing the level patients co-operate when students participate in intimate radiological examinations like Hysterosalpingography(HSG), Micturating Cystourethrography(MCUG), mammography has not been documented. Again, these studies have been carried out on Caucasians with the awareness that the values of this country are different from theirs; it becomes necessary to assess this major factor in clinical excellence within our locality.
1.1 Statement of problem
- Students mostly depend on their clinical postings in order to have practical knowledge of radiographic procedures. Therefore, a key factor determining radiography students’ excellence in the clinical setting depends largely on the cooperation of patients during investigations.
- It has been observed from past studies that patients feel uncomfortable when large number of students present in the diagnostic room, mostly when intimate radiological cases are handled. This discomfort causes a feeling of fear/anger, embarrassment and therefore, he/she holds back relevant information leading to poor quality of the radiographic procedure.2
- During most radiological examinations where privacy and comfort of the patient is at stake, for example, HSG, MCUG, mammography, the patients query the presence of students in the fluoroscopy room. Some even demand that students leave before examining them.
Therefore, in the light of all these, the big question remains, “If student radiographers do not witness these contrast examinations and learn the intricacies involved in such investigations, how then can they register themselves as professional radiographers?
1.2 Objectives of study
The major aims of this study are two-fold:
- To determine the overall views of patients towards the presence of radiography students during these contrast examinations.
- To ascertain the factors that influences these views.
- To determine which demographic feature directly affects the views of patients towards participation of students in radiological examinations.
- To determine if there is a general acceptance of radiography students within this locality as it is with medical students in developed countries of the world.
1.3 Significance of study
- This research study will determine extensively the factors that influence patient cooperation during these contrast examinations. After determining these factors and they are improved upon, it will influence positively, the view patients have and their cooperation towards involvement of radiography students in their examinations.
- Following these improvements, patient comfort during radiological examinations can be obtained. Patients will come to appreciate that they contribute to student education and this will make them willing to help with radiography education as previous studies have revealed.
- Significant improvement in student-patient relationship provides satisfaction for the patient, thereby making clinical placements worthwhile for the student radiographer.
1.4 Scope of study
This research will be carried out on all patients booked for the following radiological examinations; Hysterosalpingography (HSG), Micturating Cystourethrography (MCUG), including Mammography, in the University of Nigeria Teaching Hospital (UNTH) and Federal Medical Centre (FMC), Owerri, between January and May, 2013.
The racial distribution of patients, mainly ethnicity plays a major role in the perception of patients regarding the presence of students in the fluoroscopy room during their examinations.8
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