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Health information management student placements: the supervisor perspective // David Mangano, Kirsten Hinze, Rachael Sewell, Emma Parras, Michelle Cope, Maryann Wood and Emma Barker
David Mangano, Kirsten Hinze, Rachael Sewell, Emma Parras, Michelle Cope, Maryann Wood, Emma Barker
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Introduction
Student practical placements, or work integrated learning experiences, are an important component of any degree as it is an opportunity for the student to assimilate the theory and knowledge they have gained during the degree in a workplace setting. It is also an opportunity for the student to practice and further develop their skills and knowledge in a safe environment, with the aim to ultimately produce work ready health information management graduates. Students have an opportunity to engage with Health Information Managers (HIMs) through placement activities including health information management tasks, work shadowing, projects and clinical classification, allowing the student to begin to develop their own HIM network.
Placement programs are not possible without the ongoing support provided to universities by HIM colleagues who take on the essential role of placement supervisor. Several supervisors from both the La Trobe University (LTU) and Queensland University of Technology (QUT) health information management degrees were provided with a set of questions around benefits of placement, what works well, what could be improved and key messages for those considering becoming placement supervisors.
What are the benefits to you (and your organisation) from hosting students on placement?
Benefits to the organisation
Supervisors have identified a number of benefits to both themselves and their organisations, including the opportunity to ‘give back’ or support the universities, as it is seen as a crucial part of the ethos of the organisation. On behalf of their organisations they note that the student can be an additional resource to assist in completing work that would not have otherwise been completed and to have evidence based practice applied to workplace activities.
David Mangano, Northern Health, Victoria The right student can provide your organisation with an additional resource who enables work to be completed that otherwise may sit on the back burner due to time pressures or resource constraints. For example, students can assist with audits and general department projects. Over the journey, Northern Health health information management students have also assisted with the development of valuable resources such as manuals, training materials, procedure reviews and project communication strategies or material. The placement is also seen as a way of identifying the potential of the student to be recruited into their organisation.
Kirsten Hinze and Rachael Sewell, Gold Coast Health, Queensland Gold Coast Health consider placements as integral to developing the personal and professional capabilities required of all HIMs, including the capabilities of self-awareness, resilience and reflective practice. Health information management students bring new perspectives, skills and enthusiasm to our team. Our health information management students have quickly becoming valuable members of the team during their placements and have assisted us in achieving critical project milestones. This has included during our digital transformation project by tackling short-term projects and providing extra support for our busy staff during high activity periods.
By hosting students we have also been able to discover new talent, with the potential of recruiting future employees to our team. We also have the benefit of promoting our organisation to students as a great place to work that offers career satisfaction. With a shortage of HIMs in our workplace, this is a convenient way to recruit new staff with essential skills we need. We have made many strong connections and networks through our health information management students.
Emma Parras, UnitingCare Health, Queensland By having access to health information management students to complete the project part of the placement, UnitingCare Health (UCH) hospitals benefit from the fresh perspective that the students provide. As the students are in their final year of study, they are equipped with the right skills to enable them to deliver evidence-based projects that are of a very high standard with minimal supervision.
There is an industry-wide shortage of experienced HIMs and Clinical Coders (CCs) which has made recruiting sufficient staff to meet the demands of the Health Information Services Department extremely difficult. Although there is a significant difference in efficacy between newly qualified and experienced CCs, the benefits of hiring recent graduates and investing the time to develop their skills internally is widely accepted as a successful long-term strategy for building an experienced clinical coding team. We always try to offer positions to third year students that have been placed in our hospitals and are already orientated to our organisation. Michelle Cope, Redcliffe Hospital, Queensland Access to students for placements supports succession planning, continued service delivery, increases the opportunity to test innovations and provides a foundation for future on the job expectations.
We welcome students into the department for coding and mini project work to create new relationships and offer support within the health information management community, wherever they work following their placement, for continuous information sharing benefits.
We have a long history of contracting and permanently recruiting previous students that have worked with us on placements and view this as a recruitment strategy.
Benefits to the supervisor
As noted by the supervisors, from a personal perspective the supervisors identified being able to develop or enhance their own skills in areas such as training and supervision, mentoring students and watching them ‘grow’ during the placement period.
David Mangano From a professional development perspective, hosting a student placement can develop staff supervision and training skills while also consolidating the information you and your team know about your department and organisation. Finally, student supervision is an extremely rewarding experience. It is rewarding to witness students transition from ’students’ during the early days of placement, to ’employees’ who can operate at the level expected of new graduates.
Kirsten Hinze and Rachael Sewell Our staff also have professional development opportunities to mentor students and grow their leadership skills.
Emma Paras UCH hospital HIMs are committed to giving back to the profession, and supporting the health information management student placements is one way we can do this. It is very rewarding to see the growth in our students during the thirteen week placement, with the program designed to cement the theory they have learnt at university into real world practice.
In determining what works well with the placement, supervisors noted that the support material and resources (guides, manuals) and support during placement from the universities were an important part of making sure the placement progressed successfully. They also noted that the format of the placement programs assist in providing an overall good experience for the students. A number of supervisors emphasised the importance of making sure that the supervisor meets regularly with the student and is available to respond to queries from the student.
David Mangano LTU run an excellent student placement program, ensuring you as a supervisor have the right resources and guidance to provide a successful placement experience for both the students and agency. As an agency supervisor, it is important to understand what the university expects of you and what the students are expected to achieve on placement. Thankfully, the Supervisor’s Manual and the Student Journal provided by LTU detail this information. These resources assist to establish expectations and ultimately assist a supervisor when planning the upcoming placement. Another aspect that works well, is the support provided by the LTU academic supervisor. From experience, the academic supervisor is a great resource to answer queries or provide guidance as required, either before, during or following a placement.
From an agency supervisor’s perspective, it is best to be as prepared as possible when supervising a student. A strong understanding of the Subject Intended Learning Outcomes (SILOs) will ensure that the university, student and agency goals align. Further to this, it is beneficial to plan the student timetable with the SILOs in mind. At Northern Health, we find it advantageous to provide students with a timetable that gives them insight into their placement meetings and activities. In addition to this, we ensure students are orientated as best as possible, including a network login and access to the relevant systems required during their placement. To ensure these orientation type tasks are not forgotten, we developed a comprehensive checklist that the student and supervisor work through together on day one of placement. During the placement, I like to meet with the students regularly and discuss the day or week ahead. We also debrief at the conclusion of meetings or appointments to ensure the student understood what was discussed and the purpose of the meeting or appointment. Where possible, I attempt to tie these discussions back to the SILOs. In my opinion, spending enough time and touching base frequently with students is a key contributing factor to a successful placement. It is during these debriefs that students have an opportunity to consolidate what they have learnt and ask the questions that may assist them to mentally join the dots.
Kirsten Hinze and Rachael Sewell The benefits of exposing students to practical placements is to experience real-life business days for a HIM. The shadowing component works very well as it is an opportunity for the student to witness dayto-day activities. For example, participating in a statewide video conference to discuss the latest electronic medical record challenges from a HIM perspective. Students have the opportunity to contribute their learnings to understand the problem and trouble shoot some opportunities for solutions. Project activities provide students with a current problem that a site has limited capability to address due to lack of time or resources. Projects are a win-win for both the student and our team.
Employers want HIMs who can walk onto the job with knowledge of information management principles in a health environment, especially with an appreciation for continuous quality improvement. Data integrity is a critical concept health information management students learn pre-employment. It is critical that the student has a solid data integrity foundation to understand the importance of the correct data being associated with the correct patient. Health information management students with the knowledge of the ramifications of inaccurate data and the need for ongoing monitoring is essential.
Clear, responsive and timely communication and collaboration regarding expectations, making reasonable adjustments as necessary, and raising any concerns arising is essential to a successful placement. All partners are responsible for sharing information about the placement and this will support students’ health and well-being and enable them to fully participate within the placement and achieve their learning outcomes.
Emma Parras The students are able to contribute in a meaningful way to health information service departments as they can see that the work that they are involved in will be used by the hospital. At UCH hospitals students gain an appreciation of working as a HIM in the private sector and insight into the complexity of private sector funding models and health fund contract compliance. The program is split between coding, project and shadowing which allows for a distribution of resource required across a number of staff in the department.
Michelle Cope The placement gives supervisors the opportunity to set expectations for the work environment and start to nurture the student’s growth in what is to come. Supervisors nominate projects that add value to the service or address issues and students select topics that resonate with their areas of interest. Supervisors meet with the students as an introduction to the department and provide the plan for the duration of the placement. They are introduced to key contacts and orientated to their new environment. The objectives of the placement are reviewed and monitored throughout the placement and a calendar is provided for meetings and education.
Clinical coding placements are well structured to support the student and assist supervisors in delivering targeted feedback and advice. Students on project placements deliver a departmental presentation for feedback and advice prior to the university assessment.
Is there anything you would do differently for future student placements?
When asked what they would do differently, supervisors noted the importance of reflecting on past experience to continue to improve on the experience for the student, themselves and the organisation. They also noted that regular review is important for an overall positive placement experience. Reaffirming placement requirements prior to commencing the new placement is a key process supervisors need to undertake. Being aware of the student’s needs, their overall sense of comfort in the placement environment and understanding the balance required of the student between work, study and personal life were also identified as things supervisors should also consider. It should be noted that some of what the supervisors have identified is not so much things to do differently, but more a case of things to ensure they continue to do. David Mangano The health information management student placement program at Northern Health is well embedded within our department and has evolved over the years to be as robust as what I believe it can be. However, given the healthcare environment is constantly changing, I think it is important to regularly review and refine placement schedules. Constantly reviewing the SILOs against the placement schedule ensures you are fulfilling your obligation as a supervisor and guarantees students are provided the opportunity to learn the outcomes they are expected to achieve.
Kirsten Hinze and Rachael Sewell While previous placements have worked well, we always aim to improve each time by discussing the experience with the student and asking for feedback. Through busy day-to-day work life, there is the potential for us to not pay adequate attention to student health and well-being while on placement, including the impacts of distress for the student due to other competing priorities and study commitments. Setting up a buddy system of available support staff available for the student is important to ensure students have options for support. We also aim to ensure careful observation of patterns of attendance and meeting deadlines, identifying withdrawn or unusually quiet behaviour and employing an open and interested approach to the student’s experience.
We will aim to attend the final project presentations at QUT to observe students, as a way of celebrating our student’s success and to improve future student placements through their lessons learnt and collaboration with placement hosts from other health services.
Emma Parras It could be beneficial to agree to more than one student placement at a time. The ability for students to work together on projects and support each other, especially for the clinical coding component, could work well.
Michelle Cope It is always a challenge to dedicate enough time to guide students while meeting usual service demands, so I would encourage students to maintain open communication with supervisors and informally check in to ensure they aren’t too overwhelmed.
If there was one key message you would give to colleagues thinking about hosting students on placement, what would it be?
Placement supervisors were overwhelming in their support of hosting students and encouraging colleagues to take up the opportunity. Comments such as ‘rewarding’ and ‘just do it’ were noted. Other supervisors also noted some things to make sure you have in place prior to or as the student comes on board in the organisation.
David Mangano Do not underestimate how rewarding a student can be for you and your organisation. Students can bring new knowledge, ideas and can provide a fresh set of eyes or skills which can be valuable to your organisation. Finally, supervising students is a great way to share knowledge and give back to the profession by assisting the next generation of HIMs.
Kirsten Hinze and Rachael Sewell Consider projects that are achievable for a student – the more complex the project the less likely you and the student will find value. The right project for both parties will allow you to celebrate success and be rewarding.
In the same way that we ensure thorough on-boarding for new staff, we also ensure that the same on-boarding process applies for students so that they feel part of the team. On-boarding should include: • Welcome to the organisation, including the Director, team members and buddies for support • Recognising and valuing student contributions to the team
• Practicing inclusive and culturally responsive education and supervision • Creating a ‘safe space’ for student sharing of concerns throughout the placement • Using evidence-based and student-centred supervision practices • Working with QUT lecturers to present clear and consistent information on expectations of conduct and performance.
Emma Parras A simple yet powerful statement: Just do it. Michelle Cope Invest your time now to achieve the full benefit of succession planning for years to come.
Conclusion
Student placements are a critical part of all health information management students’ university experience and are reliant on the generosity of the supervisors in the health information management profession. A well planned and considered placement can be beneficial for the student, the supervisors and their organisation. The placement experience provides an opportunity for skill development and knowledge, growth of the student and the avenue to apply theory in a safe practical environment. Placement supervisors leave you with a couple of key messages: invest now for the future, celebrate success, be rewarded and just do it.
David Mangano BHIM (Hons) Operations Manager, Health Information Services, Northern Health 185 Cooper Street Epping VIC 3076 AUSTRALIA Tel: +61 3 8405 2023 Email: David.Mangano@nh.org.au
Kirsten Hinze BBus (HIM), GradCertHSM, CHIA Director, Clinical Informatics; Gold Coast Health Southport QLD 4215
Rachael Sewell MHlthSc (HSM), BBus (HIM) Clinical Applications Manager, Clinical Informatics; Gold Coast Health Southport QLD 4215 Emma Parras BBus (HIM) Group Health Information Manager; UnitingCare Queensland Brisbane QLD 4000
Michelle Cope GradCertHSM, BHSc (HIM) Director, Clinical Health Information Services; Redcliffe Hospital Redcliffe QLD 4020
Maryann Wood MHSc (HIM), BBus Lecturer, Queensland University of Technology Kelvin Grove QLD 4059
Emma Barker MHlthInfoMgt, BHthSC Associate Lecturer, La Trobe University La Trobe University VIC 3086
Production Schedule
ISSUE Volume 10 Number 3, 2020 Volume 11 Number 1, 2021 Volume 11 Number 2, 2021 DATE OF PUBLICATION October-November March-April June-July
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