Lambert Kelly, Austin Kylie, Charlton Karen, Heins Rebecca, Kennedy Meredith, Kent Katherine, Lutze Janna, Nicholls Natalie, O'Flynn Gabrielle, Probst Yasmine, Walton Karen, McMahon Anne
School of Medical Indigenous and Health Sciences, University of Wollongong, Wollongong, NSW, Australia.
Student Equity and Success, University of Wollongong, Wollongong, NSW, Australia.
Aust Health Rev. 2024 Dec;49. doi: 10.1071/AH24233.
Objective 'Placement poverty' refers to the financial burdens imposed upon students by the completion of mandatory professional placement. We aimed to identify the financial implications of mandatory professional placements on student wellbeing. Methods A cross-sectional online survey (August 2023 to January 2024) completed during students' most recent professional placement in the final year of their degree. Eligible participants were health or teaching students studying at Australian and New Zealand universities in degrees requiring mandatory professional placement. Questions included total and accommodation costs, financial support, impact of finances on placement preferences, presence of food insecurity, and implications for student wellbeing. Results Participants (n =530) were mostly health professional (65%) students (median, 25; interquartile range (IQR), 22-30 years, 95.3% domestic, 88.3% full time, 2.0% New Zealand). Health students had higher total costs (in Australian dollars) for the recent placement ($1500; IQR, 600-3453) compared to teaching students ($1200; IQR, 600-2757) (P =0.02), likely due to longer placement duration (6weeks for health students). A higher proportion of health students required financial support (P =0.0001). Placement preferences were always or sometimes (63.8%) determined by cost rather than learning opportunity. Food insecurity was experienced by most students (70.2%) (10.4% marginal, 32.1% moderate, 27.7% severe), with no difference by degree type. Thematic analysis identified themes of burnout, emotional distress, inability to focus on learning, postponing care of oneself, urgent need for financial support, unanticipated family and other circumstances, and worsened societal inequity. Conclusions Our study identified widespread financial difficulty in students undertaking placement that adversely impacted personal wellbeing. Strategies are needed to support wellbeing and ameliorate the financial burden.
目的 “实习贫困” 指的是学生完成强制性专业实习所面临的经济负担。我们旨在确定强制性专业实习对学生福祉的经济影响。方法 于2023年8月至2024年1月期间，在学生学位最后一年最近一次专业实习期间开展了一项横断面在线调查。符合条件的参与者为在澳大利亚和新西兰大学攻读需要强制性专业实习学位的健康或教育专业学生。问题包括总费用和住宿费用、经济支持、经济状况对实习偏好的影响、粮食不安全状况以及对学生福祉的影响。结果 参与者（n = 530）大多是健康专业（65%）学生（中位数25岁；四分位间距（IQR），22 - 30岁，95.3%为国内学生，88.3%为全日制学生，2.0%为新西兰学生）。与教育专业学生（1200澳元；IQR，600 - 2757）相比，健康专业学生最近一次实习的总费用（以澳元计）更高（1500澳元；IQR，600 - 3453）（P = 0.02），这可能是因为实习时间更长（健康专业学生为6周）。更高比例的健康专业学生需要经济支持（P = 0.0001）。实习偏好总是或有时（63.8%）由费用而非学习机会决定。大多数学生（70.2%）经历过粮食不安全（10.4%为边缘性，32.1%为中度，27.7%为重度），不同学位类型之间无差异。主题分析确定了倦怠、情绪困扰、无法专注于学习、推迟自我护理、迫切需要经济支持、意外的家庭和其他情况以及社会不平等加剧等主题。结论 我们的研究发现，进行实习的学生普遍存在经济困难，这对个人福祉产生了不利影响。需要采取策略来支持福祉并减轻经济负担。
