Can simulation-based education or other education interventions replace clinical placement in medical radiation sciences? A narrative review

OBJECTIVES

In response to increasing student enrolment and workload pressures from the Covid-19 pandemic, a recent focus on health student preparation programs has been on curricula adaptations and replacement of clinical placement time with alternative education activities. The aim of the narrative review was to explore the current evidence relating to education activities in Medical Radiation Sciences (MRS) used to replace clinical placements or part of clinical placements. Medline, CINAHL and Web of Science databases were used to search for articles published between 2017 and 2022. Data from the literature was summarised into (1) planning and development of clinical replacement learning activities in MRS, (2) evaluation of clinical replacement activities, and (3) benefits and challenges of clinical replacement in MRS.

KEY FINDINGS

Planning and development of clinical replacement learning activities in MRSrequires support from a wide range of stakeholders, and evidence from activities already implemented exists. Activities largely encompass an institution-specific focus. Developed clinical replacement activities use a blended approach, with simulation-based education (SBE) as a main teaching platform. Evaluation of clinical replacement activities are largely focused on students' achievement of learning objectives relating to practical and communication skills. Emerging evidence based on small student samples shows that clinical and clinical replacement activities provide similar results in terms of learning objectives.

CONCLUSION

Benefits and challenges of clinical replacement in MRS are similar to those presented in the other health professions. The balance between quality and quantity of teaching and learning experiences for clinical skill development in MRS needs to be further investigated.

IMPLICATIONS FOR PRACTICE

To meet the dynamic challenges of the health care environment and MRS profession, a major goal in the future will be to affirm the benefit of clinical replacement activities for MRS students.

A morphometric study of the pelvi-ureteric junction and review of the pathogenesis of upper ureteric obstruction

A morphometric analysis has been made of the normal human pelvi-ureteric junction and upper ureter. There was found to be no anatomically definable pelvi-ureteric junction. Muscle bundles of renal pelvis and upper ureter run a spiral course and do not form clear-cut layers. There is a great normal variation of thickness of the renal pelvic and ureteric muscularis, as well as of the total thickness of these structures. Smaller, but sometimes still large differences, are seen between right and left pelvi-ureteric specimens of individual patients. Suggested normal ranges of thickness are: (1) Renal pelvis: total thickness 340-1300 micrometers, muscularis 270-1100 micrometer. (2) Upper ureter: total thickness 450-1000 micrometer, muscularis 240-790 micrometer. No neurones are present in the renal pelvis or upper ureter. The possible etiologies of pelvi-ureteric obstruction are discussed.

Fatal haematemesis from an aorto-oesophageal fistula of obscure aetiology: a case report

Endoscopy, aortography and laparotomy failed to demonstrate a high aorto-oesophageal fistula of obscure aetiology in a woman presenting with haematemesis. Recognition of Chiari's triad: mid-thoracic pain, sentinel arterial haemorrhage, and final exsanguination after a symptom-free interval, and therapeutic embolization as a mode of therapy, are discussed.

Analgesic nephropathy complicated by development of transitional cell carcinoma of the renal pelvis and ureter

A case is described of analgesic nephropathy with papillary necrosis, calcification, osseous metaplasia and the development of papillary transitional cell carcinoma of the renal pelvis and ureter. Seven similar cases are summarized, and the literature briefly reviewed with particular reference to aetiological factors and associated clinical findings.