Assessment of the Challenges Faced by Private University

Radiography Students During Clinical Posting; Case Study of

Evangel University

BY

Yamah Princewill
EU/HS/RAD/18/002

Department of Radiography and Radiation science

College of Health Science
Evangel University, Akaeze

AUGUST 2023
Assessment of the Challenges Faced by Private University
Radiography Students During Clinical Posting; Case Study of
Evangel University

BY

Yamah Princewill
EU/HS/RAD/18/002

Department of Radiography and Radiation Science, College of

Health Science, Evangel University Akaeze

IN PARTIAL FULFILLMENT OF THE REQUIREMENT FOR

THE AWARD OF BACHELEOR OF SCIENCE (B.Sc) IN
RADIOGRAPHY AND RADIATION SCIENCE

SUPERVISOR: PROF. K.K. AGWU

AUGUST 2023
 APPROVAL
Name: Yamah Princewill

Reg. No: EU/HS/RAD/18/002

Degree in view: B.RAD

Title: Assessment of the Challenges Faced by Private

University Radiography Students During Clinical
Posting; Case Study of Evangel University

Examination Committee

……………………… ……………………
DR. OCHIE KALU PROF. K.K AGWU
Head of Department Supervisor

……………………..
PROF. K.K AGWU
Dean

Date of Approval 15th August, 2023

 CERTIFICATION
This is to certify that the research work with the topic: Assessment of the
Challenges Faced by Private University Radiography Students During Clinical
Posting; Case Study of Evangel University by YAMAH PRINCEWILL:
EU/HS/RAD/18/002 was carried out under my supervision in the department of
Radiography and Radiation Science, college of Health Science, Evangel University
Akaeze, Ebonyi State.

Prof. K. K. Agwu ………………………..

(Supervisor) Signature and Date

Dr. Ochie Kalu ………………………..

(Head of Department) Signature and Date

Prof. K. K. Agwu ………………………..

(Dean) Signature and Date
 ACKNOWLEDGEMENTS
My sincere gratitude goes to God Almighty, my wonderful parents; Rev. and Mrs. I.O Yamah
who supported me in all ramifications to ensure this work is a huge success. I wholeheartedly
appreciate my supervisor, Prof. K.K. AGWU whose intellectual prowess, critical and thorough
supervision, guidance and continuous support for this research made the success of the work a
reality. My profound appreciation to the Head of Department, Dr. Ochie Kalu for his
encouragement, support and efforts that made the conclusion of this work a reality. I sincerely
appreciate the efforts of my departmental lecturers, thank you for the knowledge, care and
commitment to making sure I receive the best training possible. I will not fail to acknowledge
and appreciate my siblings; Christopher, Divine and Treasure for their continuous support and
warm messages throughout the course of this study. To all my friends who supported me in one
way or the other during the course of this project work: Akachukwu, Sylvia, Peace and
Chinonyerem, I say a big hearty thank you. Finally, I appreciate my roommates for their
continuous support throughout my five years journey.
 ABSTRACT
Background: Private universities has recently started training radiography students with
Evangel University leading the way. The challenges they encounter in the clinical training
environment without a dedicated teaching hospital have not been investigated.
Objective: To identify major challenges faced by private university students during their clinical
posting using Evangel University as a case study.

Methods: Sixty-two questionnaires were distributed to all the 400 and 500 level Evangel
University radiography students to determine the range of equipment available at the various
clinical training centers, the attitude of staff towards the students and the students’ perception
towards clinical postings. The data was collected and analyzed using excel.

Results: After data analysis, the study identified the following challenges faced by the students
and they include; shortage of available modalities noted by 62(100%) students, distance of
clinical posting facilities from university noted by 35(56.5%) students, inadequate number of
staff noted by 62(100%)students and students’ level of participation noted by 11(17.7%)
students.

Conclusion: This study revealed, that 100% of students were of the opinion that clinical posting
is very educating and helps close the theory-practice gap regardless of the challenges faced. The
study recommended that a new facility for clinical posting be included, school should provide
accommodation for students close to the various hospitals for posting and finally, for all the
radiography staff and students be given proper orientation before the commencement of clinical
posting.
TABLE OF CONTENTS
APPROVAL i

CERTIFICATION ii

ACKNOWLEDGEMENTS iii

ABSTRACT iv

TABLE OF CONTENTS v

LIST OF TABLES vii

CHAPTER ONE 1

INTRODUCTION 1

1.1 BACKGROUND 1

1.2 STATEMENT OF PROBLEM 3

1.3 OBJECTIVES 3

1.3.1 General objectives: 3

1.3.2 Specific objectives: 3

1.4 JUSTIFICATION OR SIGNIFICANCE OF STUDY 3

1.5 SCOPE OF STUDY 4

CHAPTER TWO 5

LITERATURE REVIEW 5

2.1 RELEVANT CONCEPTS 5

2.1.1 CLINICAL EDUCATION 5

2.1.2 THEORY-PRACTICE GAP 5

 2.1.3 REQUIREMENTS FOR CLINICAL POSTING SITE 6

2.2 EMPIRICAL REVIEW 7

CHAPTER THREE 11

METHODOLOGY 11

3.1 RESEARCH DESIGN 11

3.2 STUDY AREA 11

3.3 TARGET POPULATION AND SAMPLE SIZE DETERMINATION 11

3.4 SELECTION CRITERIA 11

3.4.1 Inclusion criteria 11

3.4.2 Exclusion criteria 11

3.5 RESEARCH INSTRUMENTS 12

3.5.1 VALIDATION OF INSTRUMENT 12

3.6 DATA COLLECTION 12

3.7 DATA ANALYSIS 13

CHAPTER FOUR 14

RESULTS 14

CHAPTER FIVE 20

DISCUSSION AND SUMMARY OF FINDINGS, CONCLUSION AND RECOMMENDATION 20

5.1 INTRODUCTION 20

5.2 DISCUSSION OF FINDINGS 20

5.3 SUMMARY OF FINDINGS 23

5.4 LIMITATIONS OF STUDY 23

5.3 CONCLUSION 23

5.4 RECOMMENDATIONS AND FURTHER STUDY 24

REFERENCES 25

APPENDIX 27

LIST OF TABLES

TABLE 1: DISTRIBUTION OF THE DEMOGRAPHIC INFORMATION OF THE

STUDENTS..................................................................................................................................14
TABLE 2: DISTRIBUTION OF CLINICAL TRAINING CENTERS AND MODALITIES
AVAILABLE USED BY EVANGEL UNIVERSITY RADIOGRAPHY STUDENTS.........15
TABLE 3: DISTRIBUTION OF LOGISTICS DURING CLINICAL POSTING................16
TABLE 4: DISTRIBUTION OF AVAILABLE RESOURCES IN THE SITE FOR
CLINICAL POSTING................................................................................................................17
TABLE 5: DISTRIBUTION OF THE ROLE OF STAFF DURING CLINICAL POSTING
.......................................................................................................................................................18
TABLE 6: DISTRIBUTION OF STUDENTS PERCEPTION ON CLINICAL POSTING 19
 CHAPTER ONE

INTRODUCTION
1.1 BACKGROUND
Medical radiography, as a branch of diagnostic medicine, examines the human body using
imaging equipment for medical diagnosis. The training of the professional involves a five-year
university study, one-year of internship, and one year of NYSC. There are presently 28
universities offering radiography in Nigeria with 11 being private universities.

The study of radiography involves both academic knowledge and practical training in hospitals.
Training in this context is used to describe the transformation process from novice to expert
radiographer and this begins in the first year of radiography education. The theoretical
proficiency is done in the classroom while the practical training involves simulations in skill
laboratories and hospital-based practice or clinical posting. The skill laboratories entail the use of
phantom to study anatomy and positioning of patients, use of virtual radiography app.

Clinical posting is an essential requirement for the award of bachelor degree for every
radiography student. It constitutes about 50% of radiography education and it is a compulsory
component of the clinical year from 300 - 500 level of the course. To apply what is learned in the
classroom to real-world conditions, it is done in a clinical environment. During clinical posting
students are taught to use, adapt and integrate the theoretical aspect of radiography training into
the clinical environment, acquiring skills to become a proficient radiographer. Clinical posting
helps to develop students’ knowledge and clinical skill in preparation for professional practice.

Clinical placements in hospitals is not the time for reflection, theoretical teaching and learning, it
is a time to acquire clinical skills. A qualified radiographer is responsible for supervising the
student during the clinical posting in the hospitals to ensure the appropriate and necessary
clinical skill and knowledge is transferred to the students.

Before students are sent for block clinical posting it is expected that they are given a log book
and an attendance sheet. The log book is often filled after any completed examination carried out
either with or without assistance. The students are expected to be on their cooperate wears with a

1
lab coat. On the first day of the posting the students are briefed on tasks that are expected of
them before the end of the posting. The students are then taken on a tour of the radiology unit
where they see the available modalities and meet other staff. During the clinical posting the
students are expected to ask various questions to acquire as much knowledge as possible, the
students are also expected to take their posting as a job which means they must be on time, dress
properly and act professionally. Finally, the students are expected to build a good rapport with
other students and staff of the department.

Most federal universities have an affiliated teaching hospital like UNEC has UNTH, UNIBEN
has UBTH etc. but most private universities like Evangel University don’t have. Hence, the need
for establishing a memorandum of understanding(MOU) with hospitals arises. They contact
surrounding hospitals with the basic imaging equipment to establish an MOU with them to
enable the university send their students to the hospitals for their clinical postings.
A memorandum of understanding demonstrates the hospital and university's readiness to proceed
with a contract, but it is not legally enforceable, therefore either side may end the contract or
violate its provisions without incurring any repercussions.

Over the years there have been various articles and documentations on the challenges federal
university radiography students face during their clinical posting but there haven’t been any
study on the challenges of private universities radiography students because there hasn’t been
any graduate of radiography from private universities until now. Evangel university has attained
a major accreditation in radiography and has final year students.

Since Evangel University is preparing to award the first batch of radiography students from a
private university a B.RAD degree, it became crucial to note the difficulties they encountered
during their clinical posting. As a result, the need to document the challenges faced by
radiography students at private universities arose. Students from private universities encounter
difficulties during clinical placements, which reduces the quality of their training and their ability
to learn. In order to ensure the continued development of future radiography students at private
universities, it is crucial to identify the difficulties they encountered and document suggestions
on how to address them.

2
1.2 STATEMENT OF PROBLEM

Radiography training is faced with challenges in public universities particularly due to lack of
well-equipped clinical training facility (Bwanga et Al,,.(2019)). These challenges have been
documented and are being addressed. On the other hand, private universities recently started
training radiography students. The challenges private university radiography students may face
relates greatly to the absence of dedicated teaching hospitals and arrangements are made to use
public hospitals as clinical training centers, all these are envisioned to constitute some
challenges. The extent of the challenges and nature of the challenges need to be identified,
explained, documented and addressed.

1.3 OBJECTIVES
1.3.1 General objectives:
To identify major challenges faced by private university students during their clinical posting
with relevant opinions documented using Evangel University as a case study.

1.3.2 Specific objectives:

1. To identify the modalities available in various clinical posting centers used by private
universities for the training of radiography students.
2. To determine the distance clinical centers are from the university.
3. To evaluate the adequacy and attitude of radiography staff during clinical posting.
4. To identify students’ perception towards clinical posting.

1.4 JUSTIFICATION OR SIGNIFICANCE OF STUDY

The study on the challenges faced by radiography private university students is important for
several reasons. Firstly, radiography is a critical field in the healthcare industry, and it is essential
that students receive high-quality education and training to meet the demands of the profession.
However, private university students may not have access to the same resources and
opportunities as those in public universities, which can impact their ability to develop the skills
and knowledge necessary to succeed in the field. Secondly, understanding the challenges faced
by radiography private university students can help educators and policymakers develop

3
effective strategies to improve the quality of education and training that these students receive.
By identifying the specific challenges that students face, educators can tailor their teaching
methods and curricula to better meet the needs of their students. Policymakers can also use this
information to develop policies and programs that support private university students and
improve their access to resources and opportunities. Finally, the study can help raise awareness
of the challenges faced by radiography private university students and highlight the importance
of providing equal opportunities and resources to all students, regardless of their background or
financial situation. By promoting greater equity in education, we can help ensure that all students
have the chance to achieve their full potential and contribute to society in meaningful ways.

1.5 SCOPE OF STUDY

This study is centered on the challenges faced by private university students during their clinical
posting. However, focus is on the 400 and 500 level radiography students in Evangel University,
Ebonyi state as the pioneer private university to admit students into radiography program. This
study began in January 2023 and will end in July 2023.

4
 CHAPTER TWO

LITERATURE REVIEW
2.1 RELEVANT CONCEPTS
2.1.1 CLINICAL EDUCATION
Clinical education refers to the practical component of healthcare education, where students gain
hands-on experience through clinical placements in hospitals and other healthcare settings. For
radiography students, clinical education is a crucial component of their training, as it provides
them with the opportunity to apply the theoretical knowledge they have gained in the classroom
to real-world situations.

However, private university students may face challenges in accessing clinical education
opportunities. For example, private universities may have limited partnerships with hospitals and
other healthcare facilities, making it difficult for students to secure clinical placements.
Additionally, private university students may face competition from students in public
universities, who may have access to more clinical education opportunities.

The lack of access to clinical education opportunities can impact the quality of education that
radiography private university students receive. Without hands-on training, students may
struggle to develop the practical skills and knowledge necessary to succeed in the field. This can
impact their employability after graduation and hinder their ability to contribute to the healthcare
industry.

Understanding the challenges that radiography private university students face in accessing
clinical education is important in finding ways to improve their access to these opportunities.
This can include developing partnerships with hospitals and other healthcare facilities, as well as
providing financial support to help students cover the costs associated with clinical placements.
By addressing these challenges, we can help ensure that all radiography students have access to
high-quality clinical education and the opportunity to succeed in the field.

2.1.2 THEORY-PRACTICE GAP

The theory-practice gap is a concept that is relevant to the challenges faced by radiography
students in private universities, particularly in relation to the lack of access to hands-on training
5
and clinical experience. The theory-practice gap refers to the disconnect that can occur between
what students learn in the classroom and what they experience in the real world. In other words,
students may be well-versed in the theoretical aspects of radiography but may lack the practical
skills and experience needed to apply this knowledge in a clinical setting. This gap can be
particularly significant for students in private universities who may have limited access to well-
equipped radiography labs and hospitals.

The theory-practice gap can have a number of negative consequences, including reduced
confidence and competence among students, lower quality of care for patients, and decreased job
satisfaction among healthcare professionals. In order to address this gap, it is important for
educators and policymakers to develop effective strategies for bridging the divide between
theory and practice. This may include providing students with more opportunities for hands-on
training, increasing access to well-equipped radiography labs and hospitals, and promoting
greater collaboration between academic institutions and healthcare facilities. By addressing the
theory-practice gap, radiography students can receive the high-quality education and training
they need to succeed in the field, and patients can receive the best possible care.

2.1.3 REQUIREMENTS FOR CLINICAL POSTING SITE

Clinical posting sites provide students with the opportunity to gain practical experience in a real-
world healthcare setting. In order for a clinical posting site to be suitable for radiography
students, it must meet certain requirements. The following requirements for clinical posting sites
are generally recognized by radiography education programs and healthcare institutions
worldwide, and are not specific to the Radiographers Registration Board of Nigeria (RRBN) and
they include:

Availability of equipment and resources: A suitable clinical posting site must have the necessary
equipment and resources to provide students with hands-on training in radiography. This
includes x-ray machines, ultrasound equipment, and other imaging tools.

 Qualified staff: The clinical posting site must have qualified staff who can provide
students with guidance and support during their training. This includes radiographers,
radiologists, and other healthcare professionals who are experienced in the field.

6
  Adequate patient volume: A suitable clinical posting site must have an adequate number
of patients to provide students with the opportunity to gain practical experience in
radiography. This includes patients with a variety of conditions and illnesses, as well as
those from different age groups and backgrounds.

 Safety and infection control: The clinical posting site must adhere to strict safety and
infection control protocols to ensure the safety of students, staff, and patients. This
includes proper handling and disposal of hazardous materials, as well as the use of
personal protective equipment (PPE)

 Accessibility and location: The clinical posting site must be easily accessible to students,
with convenient transportation options and an appropriate location. This includes
proximity to the university and other resources, as well as access to public transportation.

By meeting these requirements, a clinical posting site can provide radiography students with the
practical experience they need to succeed in the field. It is important for universities and other
educational institutions to carefully select clinical posting sites that meet these requirements, and
to work closely with these sites to ensure that students receive the best possible training and
support.

2.2 EMPIRICAL REVIEW

It is important to critically review articles and research of various authors on challenges that
could hinder students learning during their clinical placement.

Harden and Laidlaw (2017) noted that the use of simulation can provide students with an active
learning experience closely modelled on real situations that creates a bridge between the theory
and practice.

Adegoke et Al,,. (2021) found that radiography students universities in Nigeria struggle to secure
clinical placement opportunities due to a lack of available sites and competition with other
healthcare programs. The study recommends that private universities work to establish
partnerships with healthcare organizations and develop innovative solutions to address this
challenge.

7
Challen et Al,,. (2017) noted that students say “College is the place where professionalism is
taught to us to a large extent, and clinical placement gives us an opportunity to reflect upon all of
it and compare with it…and often things are not so professional in hospitals”

Challen et Al,,. also noted that the students experience disparity regarding experience control he
stated that One student said: “I was scared when I saw a radiographer approached a patient with
a skin infection without wearing any gloves. I thought that she might catch the infection. It was
scary”.

Kumsa et Al,,. (2022) noted that ‘There is shortage of imaging equipment in our hospitals; one
machine is out of order currently and we are using only one machine. Therefore, it is difficult to
teach students as well as service provision to patients’. Another said; ‘We do have one old
machine which we cannot use to properly future practitioners, we do also have only one CT
scanner but with only one machine, we cannot accept many students at once because we always
need to attend to many patients on a daily basis therefore, it is difficult to serve all patients while
training students because we are mostly in a hurry to serve patients in order to avoid complaints’.
The student perspective was supported as below: ‘Most of the hospitals do not accept more than
two students to train on one machine because of patients’ privacy or comfort. Therefore, they
return some of us back to the university and the department tries to solve this problem by placing
us in turns every other day, this means we practice for half of the intended time allocated for
practice’

Bwanga et Al,,. (2019) noted challenges including; lack of dedicated training imaging equipment,
high student-to placement site ratio and lack of radiation monitoring badges for students were
previously reported. It was noted that these challenges need to be given urgent consideration as
part of efforts to harmonize practice through the training and development of radiography
students and educational programmes respectively.

Fowler and Wilford et Al,,. (2016), radiography students expressed concern with an increase in
the workload. This resulted in radiographers not paying attention to students’ learning needs.

Greenway et Al,,. (2019) noted that to further improve clinical skills, higher education institutes
offering radiography training should design their curricula to cater for adequate training within
the clinical skills laboratory of the university and the CP sites. Also, the use of clinical

8
instructors/tutor could serve at teacher at both sites to ensure a unified learning outcome and a
clear link between both theory and practice. More importantly, it should be agreed by all parties
that theory and practice will continue to explore mechanisms and processes by which clinical
training can be further improved and developed to bridge the practice-theory gap.

Eze et Al,,. (2020) noted that private universities in Nigeria struggle to provide adequate
supervision and mentorship for their students during clinical posting, which can lead to a lack of
feedback and support for students as they develop their skills. The study recommends that
private universities establish formal mentorship programs and provide more opportunities for
students to receive feedback and guidance from experienced practitioners.

Kumsa et Al,,. (2022) noted that students reported an inconvenience in relation to a high student-
to-placement site ratio. There exists a mismatch between number of students placed at a hospital
or imaging center and the available resources to support their learning. This is a key challenge to
teaching and learning of clinical skills as highlighted, some students said "we are encountering
many problems concerning clinical practice. Among other things, mismatch between the number
of students we have and the available placement area". Because of the high number of students,
radiography staff are not able to properly communicate and tutor the radiography students
properly. This results in lack of hands-on practice and patient interaction by most students as
there is no time and space to attend to all the students that come to the hospital for clinical
placement

Kumsa et Al,,. (2019) identified transportation as an issue for the students which has impacted
negatively on their clinical placement. It also shows that often there is lack of transportation or
elevated transportation costs beyond the means of students. It was also highlighted that the lack
of personal upkeep allowance (pocket money) had its impact on the learning activities of
Ethiopian health undergraduate students. The challenges with transportation service network and
cost impacts on the attendance of both students and clinical supervisors.

Kumsa et Al,,. (2022) noted out that, the lack of transportation or inconvenience with
transportation disrupted attendance and, in some instances, made students very anxious as they
are mostly late or absent due to cost of transportation for the round journey to clinical placement
is a challenge especially for some students when they miss the only available university

9
transport. ‘another problem relates to transportation services. We use one service in common
with all students at the college of health sciences. This service has to go to all areas in order to
drop each student; Most of the time we reach our site very late. Therefore, we could not use our
time effectively’. ‘We are encountering many problems concerning clinical practice.

SUMMARY OF REVIEW

From the empirical review it was noted that, students need to be properly taught in class before
undergoing clinical posting, there is lack of adequate training modalities in placement site which
hinders student learning. It is the duty of the radiography staff to make certain input during
clinical training to facilitate the knowledge gained by the students . There is also high student to
modality ratio, making the total number of student in a room at a time to be far higher than the
available resources. This hinders the level of experience students gain during clinical posting.
Also, in public universities staffs of the hospitals find it hard to make out time for their students
either due to the high student to staff ratio or high workload in the hospital or general negligence
by the staff. Finally, it was noted that students’ daily life affects how well they carry out their
clinical posting.

How these aforementioned challenges relate to and differ from challenges private university
students may face hasn’t been documented.

This work intends to document and address how the various challenges private university
radiography students face will affect the students during clinical posting and how it will affect
their perception to clinical posting.

10
 CHAPTER THREE

METHODOLOGY
3.1 RESEARCH DESIGN
A cross sectional design was used to assess the challenges faced by private university
radiography students. A questionnaire was used to collect quantitative data. The questionnaire
was distributed to a sample of students, it was collected and analyzed accordingly.

3.2 STUDY AREA

The total number of private universities that offer radiography is eleven; the research was carried
out at Evangel University in Ebonyi State because other private universities do not have students
in their 400 to 500 level yet.

3.3 TARGET POPULATION AND SAMPLE SIZE DETERMINATION

In the study, the target population are the 400 and 500 level radiography students in Evangel
University. All the target population was included in the sample due to the relatively small
number of students presently involved.

3.4 SELECTION CRITERIA

3.4.1 Inclusion criteria
This gives reasons why data that was used in this study was collected from a particular
population. The inclusion criteria for this study includes;

 Evangel university students

 Radiography students in their fourth and fifth years

 Students who have gone for clinical posting.

3.4.2 Exclusion criteria

Outlines reasons why data could not be collected from certain population and used in this study.

11
The exclusion criteria include;

 Non-Evangel University students

 Students who aren't in their fourth and fifth years
 Students who haven’t gone for clinical postings

3.5 RESEARCH INSTRUMENTS

 Questionnaires

The questionnaire is a 49-item self-completion questionnaire consisting of five (5) sections,

designed in line with the aim of the study, it contains questions derived from the research
objectives that will develop and generate more responses and insights into the study. The
sections include demographic information, logistics, available resources, staff input and students’
perception.

3.5.1 VALIDATION OF INSTRUMENT

The questionnaire was subjected to face and content validity by my research supervisor. Face
validity ensured that the questionnaire was subjected to review by the research supervisor to
ensure it has a good representation. Content validity ensures that all relevant aspect of the subject
to be measured are covered by subjecting it to review and receiving feedback on how each
question will measure the construct in question. The questionnaire was assessed for final
approval by my supervisor.

3.6 DATA COLLECTION

A pilot test of the questionnaire was conducted among a small group of my friends before
distribution in order to spot any potential problems. I then handed out the questionnaire to each
participant and explained to them how to fill it out. After completion, I went around to collect the
questionnaires, and after collecting the responses, the answers were checked for any consistency
issues and errors. The percentage return was 100%

I had trouble distributing to 400 level students because they were on clinical posting, so I had to
wait an extra three days for them to return to school before distributing to them.

12
3.7 DATA ANALYSIS
Data analysis adopted in the study is the qualitative data analysis. It is the interpretation,
description and exposition of the relationship between and among variables under study (Cohen
et Al,,. 2018). Data obtained from the use of questionnaire underwent thorough investigations
through qualitative descriptive analysis which was used to examine and analyze each section of
the questionnaire in relation to each specific objective. The data was analyzed using excel and
categorized using frequency tables and percentages.

13
 CHAPTER FOUR

RESULTS

A total of sixty-two questionnaires were distributed with a 100% return rate. This chapter
analyzes the results to obtain the findings of the study.

TABLE 1: AGE, LEVEL AND GENDER DISTRIBUTION OF CLINICAL STUDENTS

AT EVANGEL UNIVERSITY
LEVEL FREQUENCY PERCENTAGE
400 LEVEL 41 66%
500 LEVEL 21 34%
AGE RANGE(YEARS) FREQUENCY PERCENTAGE
18-23 14 23%
24-28 42 67%
29-34 2 3%
35-40 4 7%
GENDER
MALE 30 48%
FEMALE 32 52%
Table 1 presents the demographic data of the students which shows that 34% of the participant
were 500 level and 66% were 400 level students. Out of the respondent, majority of the student
belong to 24-28 years age range (67%) and there are more female students than male students
with 52% being female.

14
TABLE 2: RANGE OF IMAGING EQUIPMENT AND CLINICAL CENTERS
AVAILABLE TO RADIOGRAPHY STUDENTS AT EVANGEL UNIVERSITY.
MODALITIES FEDERAL NATIONAL SALT CITY
AVAILABLE TEACHING OBSTRETICS AND DIAGNOSTICS
HOSPITAL FISTULA CENTER CONSULTANTS
ABAKALIKI
CONVENTIONAL X- 62(100%) 62(100%) 62(100%)
RAY
FLUOROSCOPY 0 0 0
ULTRASOUND 62(100%) 62(100%) 0
RADIOTHERAPY 0 0 0
MAMMOGRAPHY 0 62(100%) 0
CT 0 0 62(100%)
MRI 0 0 0
WELL
FUNCTIONING
EQUIPMENTS
YES 2(3.2%) 62(100%) 62(100%)
NO 60(96.7%) 0 0
YES NO
ARE THE 40(64.5%) 22(35.5%)
MODALITIES
SUFFICIENT

Table 2 shows that Evangel University made arrangement for her radiography students to attend
posting in a federal teaching hospital (Federal Teaching Hospital Abakaliki), a national hospital
(National Obstetrics and Fistula Center Abakiliki) and a private hospital (Salt City Diagnostics
Center Abakaliki). It also shows that across the three hospitals 100% of students agree that
Federal Teaching Hospital Abakaliki has conventional x-ray and ultrasound, 100% confirms that
National Obstetrics and Fistula Center has mammography, conventional x-ray and ultrasound
and finally 100% indicates that Salt Diagnostics Consultant has CT scan and conventional x-ray.

15
Majority of the students indicated that the modalities are not sufficient. It was also deducted that
majority of the students(100%) agree that Federal Teaching Hospital Abakaliki does not have
well working equipment while National Obstetric and Fistula Center Abakaliki and Salt City
Diagnostics Consultants has well working equipment.

TABLE 3: LOGISTICS FOR CLINICAL POSTING AT EVANGEL UNIVERSITY

LOGISTICS YES NO
DISTANCE FROM
UNIVERSITY TO SITE OF
POSTING(KM)
LESS THAN 20 0 62(100%)
LESS THAN 40 0 62(100%)
LESS THAN 60 0 62(100%)
LESS THAN 100 62(100%) 0
IS DISTANCE A CHALLENGE 35(56.5%) 27(43.5%)
IS TRANSPORTATION 0 62(100%)
PROVIDED BY UNIVERSITY?
HOW DO YOU COMMUNE TO
YOUR PLACE OF POSTING?
KEKE 35(56.5%) 27(43.5%)
BIKE 15(24.2%) 47(75.8%)
WALK 12(19.4%) 50(80.6%)
ESTIMATED TRANSPORT
FARE WEEKLY(NAIRA)
500-1000 4(6.5%) 58(93.5%)
1000-1500 10(16.6%) 49(83.9%)
1500-2000 8(12.9%) 54(87.1%)
2000-2500 28(46.7%) 34(54.8%)
DOES UNIVERSITY PROVIDE 0 62(100%)
ACCOMODATION?
ESTIMATED
ACCOMODATION COST
MONTHLY(NAIRA)
15000-25000 40(64.5%) 22(35.5%)
35000-45000 22(35.5%) 40(64.5%)

16
Table 3 shows that the distance between the university and the hospitals is far (less than 100km
but greater than 60km). This distance makes it difficult for students to stay within the university
and convey to the hospital on daily basis so students result in getting accommodation close to the
hospital area and pay transport to the site of posting.

TABLE 4: AVAILABLE STAFF AND THEIR ROLE DURING CLINICAL POSTING

STAFF FEDERAL TEACHING NATIONAL SALT CITY
HOSPITAL OBSTETRICS AND DIAGNOSTICS
ABAKALIKI FISTULA CENTER CONSULTANTS
TOTAL NUMBER OF
RADIOGRAPHY STAFF
LESS THAN 5 0 62(100%) 62(100%)
5 0 0 0
LESS THAN 10 62(100%) 0 0
10 0 0 0
GREATER THAN 10 0 0 0
YES NO YES NO YES NO
ARE THE NUMBER OF 0 62(100%) 0 62(100%) 0 62(100%)
STAFF SUFFICIENT?
ARE CLINICAL STAFF 52(83.9%) 10(16.1%) 15(24.2%) 47(75.8%) 52(83.9%) 10(16.1%)
READY AND AVAILABLE?
DOES CLINICAL STAFF 12(19.4%) 12(19.4%) 50(80.6%) 50(80.6%) 12(19.4%)
50(80.6%)
GUIDE STUDENT?
DOES CLINICAL STAFF 59(95.2%) 3(4.8%) 35(56.5%) 27(43.5%) 59(95.2%) 3(4.8%)
TAKE ERROR INTO
CONSIDERATIONS AND
OFFER SOLUTIONS?
ARE STUDENTS ALLOWED 41(66.1%) 21(33.9%) 0 62(100%) 62(100%) 0
TO CARRY OUT
PROCEDURES?

Table 4 shows that 62(100%) indicated that Federal Teaching Hospital Abakaliki have less than
10 but greater than 5 radiography staff and 100% confirms that National Obstetrics and Fistula
17
Center and Salt Diagnostics Consultant have less than 5 staff. Majority agreed that this number is
not sufficient (100%). Majority also agrees that clinical staff in Federal Teaching Hospital
Abakaliki and Salt City Diagnostics are more readily available to guide students and take
students error into consideration and offer them solutions. Also, majority of students confirmed
that National Obstetrics and Fistula Center Abakaliki doesn’t allow students carry out procedures
unlike Salt Diagnostics Consultants which 100% of students confirms allow students carry out
procedure on their own (100%).

TABLE 5: DISTRIBUTION OF STUDENTS PERCEPTION ON CLINICAL POSTING

STUDENTS PERCEPTION YES NO
HAVE YOU GONE FOR 62(100%) 0
CLINICAL POSTING
HOW DO YOU ATTEND
CLINICAL POSTING
BLOCK POSTING 62(100%) 0
DAILY FROM UNIVERSITY 0 62(100%)
HAS CLINICAL POSTING 62(100%) 0
HELP CLOSE THEORY-
PRACTICE GAP
NEW PLACE FOR POSTING 52(83.9%) 10(16.1%)
WOULD YOU PREFER 45(72.6%) 17(27.4%)
SCHOOL PROVIDES
ACCCOMODATION DURING
BLOCK POSTING?
WOULD YOU PREFER A 27(43.5%) 35(56.5%)
SCHOOL BUS IS MADE
AVAILABLE TO CONVEY
STUDENTS FROM
UNIVERSITY TO POSTING
SITE DAILY?
SHOULD STAFF BE GIVEN 62(100%) 0
ORIENTATION BEFORE
POSTING?
Table 5 shows that 100% of participants agrees that clinical posting has helped close theory-
practice gap. Participants gave ideas on ways to resolve their challenges such as provision for a

18
new site for clinical posting (83.9%) be made available to resolve challenges relating to available
staff, some of these students suggest University of Nsukka Teaching Hospital(UNTH) and King
David Teaching Hospital. Students suggests that the hospital should conduct an orientation
program for the staff of the hospital for clinical training (100%). They also suggested that the
school provides accommodation for students during block clinical posting (72.6%).

19
 CHAPTER FIVE

DISCUSSION AND SUMMARY OF FINDINGS, CONCLUSION

AND RECOMMENDATION
5.1 INTRODUCTION
This chapter encompasses summary of the study, limitations, conclusions, recommendations and
future reading. The finding of this study is based on the objectives of the study which are:

1. To identify the modalities available in various clinical posting centers used by private
universities for the training of radiography students.
2. To determine the distance clinical centers are from the university.
3. To evaluate the adequacy and attitude of radiography staff during clinical posting.
4. To identify students’ perception towards clinical posting.

5.2 DISCUSSION OF FINDINGS

Using the results gotten from table 2 in previous chapter it was deducted that students are
exposed to different modalities in each of the hospital. Across the three hospitals 100% of
students agree that Federal Teaching Hospital Abakaliki has conventional x-ray and ultrasound,
100% confirms that National Obstetrics and Fistula Center has mammography, conventional x-
ray and ultrasound and finally 100% indicates that Salt Diagnostics Consultant has CT scan,
conventional x-ray. 60(96.7%) agrees that Federal Teaching Hospital Abakaliki don’t have well-
functioning equipment and 62(100%) affirm that National Obstetrics and Fistula Center and Salt
Diagnostics Consultant have well-functioning equipment. This finding correlates with Kumsa et
Al,,.(2022) who noted that there is shortage of modalities and bad functioning equipment in
clinical training centers used by public universities. The implication of this is that this challenge
is a repetitive challenge for both public and private universities it results in students’ experience
being limited and unable to fully close the theory-practice gap. Finally, in Federal Teaching
Hospital Abakaliki there will be a high student to modality ratio and this reduces the level of
experience and hands-on practice students will receive during clinical posting.

20
From table 3 in the previous chapter, it was observed that the distance between the university and
the hospitals is far (<100km but greater than 60km). This distance makes it difficult for students
to stay within the university and commute to the hospital on daily basis so students resort to
getting accommodation close to the hospital area and pay transport to the site of posting, so
clinical postings are usually block posting. 62(100%) of the students confirmed that the
university doesn’t provide accommodation or means of transport for the student. 35(56.5%) of
students use keke as means of transport, 15(24.2%) use bike and 12(19.4%)walk to the site of
posting. 28(46.7%) spend within the range of 2000-2500 for transport on weekly basis,
10(16.6%) spend between 1500-2000, 8(12.9%) spend between 1000-1500, 4(6.5%) spend 500-
1000 and finally 12(19.4%) walk so they don’t spend on transport. Students also spend huge sum
of money on accommodation with 40(64.5%) spending within the range of 15000-25000 naira on
monthly basis and 22(33.5%) spend between 35000 to 45000 naira on accommodation on a
monthly basis. This correlates with a study by Kumsa et Al,,.(2019) which stated that the cost of
transport and accommodation spent by students in public universities is very high and this affects
students attendance. This finding differ from a study by Kumsa et Al,,.(2022) which noted that
some public university has a transport service which convey students to their site of posting and
this enable the students avoid spending money for accommodation and transport. The
implication of this finding is that private university students that doesn’t have a means of
transportation provided by the school has to spend huge sum of money for transport and
accommodation and they might end up getting to their place of posting late. It also results in lack
of motivation towards clinical posting due to the inconveniences.

From the analysis shown in table 4 from the previous chapter it was deducted that majority of
participants (100%) noted that Federal Teaching Hospital Abakaliki has less than 10 radiography
staff, National Obstetrics and Fistula Center and Salt Diagnostics Consultant have less than 5
staff. It was deducted that the majority of students (83.9%) noted that clinical staff in Federal
Teaching Hospital Abakaliki and Salt City Diagnostics Consultants are more readily available to
attend to students. Majority (80.6%) of students also indicated that the staff of Federal Teaching
Hospital Abakaliki and Salt City Diagnostics Consultants guide students on what to do and what
not to do during clinical posting. Finally, it was noted by 59(95.2) students that Federal Teaching
Hospital Abakaliki and Salt City Diagnostics Consultants take students error into consideration
and offer them solutions while 35(56.5%) students indicated that staff from National Obstetrics

21
Center Abakaliki does the same. Finally, 62(100%) students confirmed that National Obstetrics
and Fistula Center Abakaliki doesn’t allow students carry out procedures unlike Salt Diagnostics
Consultants where 62(100%) students confirm that students are allowed to carry out procedure
on their own and 41(66.1%) students indicated that Federal Teaching Hospital Abakaliki allow
students carry out procedures. It correlates with Kumsa et Al,,.(2022) which deducted that there
is high student to placement ratio which results in high students to staff ratio and because of the
high number of students and small staff number, the staff are unable to properly communicate
and tutor the students. The implication of low number of radiography staff across all the
hospitals is that there is high student to staff ratio due to this, staff find it difficult to attend to all
the students during clinical posting, limiting and hindering the experience and knowledge gained
by students during this period. Also, students are more comfortable learning and carrying out
various procedures in Salt City Diagnostics and Consultants and Federal Teaching Hospital
Abakaliki than in National Obstetrics and Fistula Center Abakaliki. Hence, theory-practice gap is
reduced and more experience is gained in the former compared to the latter.

Using the data analyzed in table 5 of the previous chapter it was deducted that 100% of
participants confirms that clinical posting has helped close theory-practice gap. Students also
gave their perception on ways to resolve the challenges they encounter during clinical posting
such as; provision of a new site for clinical posting to resolve challenges relating to inadequate
number of radiography staff, some of these students suggested University of Nsukka Teaching
Hospital(UNTH) and King David Teaching Hospital. Students suggested the hospital conduct an
orientation program for the staff of the hospital and the students before the commencement of
clinical training. Majority (72.6%) also suggested that the school provides accommodation close
to the hospitals for students during block clinical posting. The students’ responses were divided
when asked if they will prefer the university makes a school bus available that will convey
students from the school to the hospital daily with majority 35(56.5%) responding with a no
while 27(43.5%) responded with a yes. The implication of this finding is that students will
actively participate in clinical posting if there are no inconveniences.

22
5.3 SUMMARY OF FINDINGS
 There are limited modalities across all three hospitals with hinders students level of
knowledge gained during clinical posting.
 The distance of the clinical posting facilities from the university is far, the university does
not provide transportation and accommodation for student and this results in students
spending huge sum of money on transport and accommodation during clinical posting.
 The students to staff ratio is high and it results in staff having difficulties tutoring
students. The staff of Federal Teaching Hospital and Salt City Diagnostics Consultants
allow students to carry out procedures on their own unlike National Obstetrics and Fistula
Center and it results in students being unable to put what they learnt in class into practice.
 Students will gain more knowledge and participate more in clinical posting if the
challenges they face are removed.

5.4 LIMITATIONS OF STUDY

The limitation encountered in the course of this study is small sample size. Sample size was
selected base on the available target population which was Evangel University only and it
included 62 participants from 400 level to 500 level. This sample size made the results not
entirely reliable and accurate.

5.3 CONCLUSION
This study has identified and described the main difficulties faced by radiography students in
private university, it provided an evidence-based understanding of the factors that dampen the
level of experience students attain during clinical training. This study has also stated ways to
assist educational experts on the best way to ensure future students does not face the same
challenges and ensure they develop interest and acquire knowledge in clinical training. Finally,
this study suggested strategies to address the challenges.

23
5.4 RECOMMENDATIONS AND FURTHER STUDY
The study recommended that a new facility for clinical posting be included, school should
provide accommodation for students close to the various hospitals for posting and finally, for all
the radiography staff and students be given proper orientation before the commencement of
clinical posting.

Future researchers should include other private universities in their study to increase their sample
size and make their work more reliable and accurate.

Research should be done on assessment of challenges faced by private university radiography

students during holiday posting to further understand and solidify the reliability of this study.

24
REFERENCES
Adegbore, A.K., Adedokun, A.A., Adegoke, J.I. et Al. Assessment of undergraduate health
students’ perception and satisfaction on training and participation in community health
outreach. J Public Health (Berl.) (2023). https://doi.org/10.1007/s10389-023-01903-7

Bhardwaj P. Types of sampling in research. J Pract, Cardiovasc Sci 2019;5:157-63.

Bwanga O, Regional M, Tullamore H, Sichone JM. Experiences of clinical supervisors

regarding the clinical training of radiography students in Zambia. South Afr Radiogr
2020;58 p(2).

Challen, V., Laanelaid, Z. & Kukkes, T. 2016. A qualitative study of perceptions of

professionalism amongst radiography students. Radiography(Lond). 2017 Sep;23, p 1-7

Cohen, L., Manion, L., & Morrison, K. (2018). Research Methods in Education (8th ed.). London:
Routledge. https://doi.org/10.4324/9781315456539

Eze, S.C., Chinedu-Eze, V.C.A., Okike, C.K. et Al. Factors influencing the use of e-learning
facilities by students in a private Higher Education Institution (HEI) in a developing
economy. Humanit Soc Sci Commun 7, 133 (2020). https://doi.org/10.1057/s41599-020-
00624-6

Fowler, P. & Wilford, B. (2016). Formative feedback in the clinical practice settings: What are
the perceptions of student radiographers? Radiography, 22 (1), 16-24

Greenway K, Butt G, Walthall H. What is a theory-practice gap? An exploration of the concept.

Nurse Educ Pract 2019;34: p 1-6.

Harden, R.M. & Laidlaw, J.M. (2017). Essential skills for a medical teacher-An introduction to
teaching and learning in medicine (2nd edition). London: Elsevier.p 41-47

Kumsa MJ, Lemu BN, Nguse TM. Lack of pocket money impacts Ethiopian undergraduate health
science students learning activities [Internet] PLoS One2020 [cited 2020 Dec
9];15(12):e0243634. Available from: https://dx.plos.org/10.1371/journal.pone.0243634.

25
M.J. Kumsa, B.N. Lemu, T.M. Nguse, D.O. Omiyi, T.N. Akudjedu. Clinical placement challenges
associated with radiography education in a low-resource setting: A qualitative
exploration of the Ethiopian landscape. Radiography 28 (2022) p 636-638

26
 APPENDIX
APPENDIX 1: QUESTIONNAIRE FOR STUDENTS

DEMOGRAPHIC INFORMATION
Choose the correct option
1. What is your level?

a. 400 LEVEL
b. 500 LEVEL

2. What is your age range?

a. 18 – 23 years
b. 23 – 28 years
c. 29 – 34 years
d. 35 – 40 years
e. Others

3. What is your gender?

a. MALE
b. FEMALE

LOGISTICS

Choose the correct option(s)

4. Where is the site for your clinical posting?

Federal Teaching Hospital Abakalikk
Salt City Diagnostics Abakaliki
National Obstetrics and Fistula Center Abakaliki

5. What is the estimated distance between your university and the clinical training institute?

a. <20
b. <40
c. <60
d. <100

27
6. Is distance a barrier?
Yes
No
7. How do you attend clinical posting?

Daily from university

8. Block posting with accommodation close to the venue

7. Is transportation provided for you by the university?

a. Yes
b. No

9. If no, how do you commute to the site of clinical posting?

a. BIKE
b. KEKE
c. CAR
d. WALK
e. OTHERS

10. What is your estimated transport fare weekly?

a. 500-1000
b. 1000-1500
c. 1500-2000
d. 2000-2500
e. Others

11. Is accommodation provided for you by the university?

a. Yes
b. No

12. What is your estimated cost of accommodation?

a. 15000-25000
b. 25000-35000
c. 35000-45000
d. Others

28
AVAILABLE RESOURCES

Choose the correct option(s)

13. Which range of equipment are available at FETHA?

a. MRI
b. CT
c. CONVENTIONAL XRAY
d. FLUROSCOPY
e. ULTRASOUND
f. RADIOTHERAPY
g. MAMMOGRAPHY

14. Which range of equipment are available at NOFIC?

a. MRI
b. CT
c. CONVENTIONAL XRAY
d. FLUROSCOPY
e. ULTRASOUND
f. RADIOTHERAPY
g. MAMMOGRAPHY

15. Which range of equipment are available at salt diagnostics?

a. MRI
b. CT
c. CONVENTIONAL XRAY
d. FLUROSCOPY
e. ULTRASOUND
f. RADIOTHERAPY
g. MAMMOGRAPHY

16. Are the modalities sufficient?

Yes
No

17. Do they have well-functioning equipment in FETHA?

a. Yes
b. No

18. Do they have well-functioning equipment in NOFIC?

29
 a. Yes
b. No

19. Do they have well-functioning equipment in salt diagnostics?

a. Yes
b. No

20. In FETHA, do they use a manual or digital processing?

a. Manual
b. Digital

21. In NOFIC, do they make use of manual or digital processing?

a. Manual
b. Digital

22. In salt diagnostics, do they make use of manual or digital processing?

a. Manual
b. Digital

23. In FETHA, what is the total number of radiography staff?

a. <5
b. 5
c. <10
d. 10
e. >10

24. In NOFIC, what is the total number of radiography staff?

a. <5
b. 5
c. <10
d. 10
e. >10

25. In salt diagnostics, what is the total number of radiography staff?

a. <5
b. 5
c. <10
d. 10
e. >10
30
 26. Should a new site for clinical posting be included?

a. Yes
b. No

27. If yes, where?

28. Which modality have you been allowed hands-on?

a. MRI
b. CT
c. CONVENTIONAL XRAY
d. FLUROSCOPY
e. ULTRASOUND
f. RADIOTHERAPY
g. MAMMOGRAPHY

STAFF INPUT

Choose the correct option

29. Are the clinical staff ready and available to assist learning in FETHA?

a. Yes
b. No

30. Do radiography staff readily guide you and your course mates during clinical posting in
FETHA?

a. Yes
b. No

31. Do clinical staff take your errors and mistake into consideration and proffer correction in
FETHA?

a. Yes
b. No

32. Are the clinical staff ready and available to assist learning in NOFIC?

a. Yes
b. No

31
 33. Do radiography staff readily guide you and your course mates during clinical posting in
NOFIC?

a. Yes
b. No

34. Do clinical staff take your errors and mistake into consideration and proffer correction in
NOFIC?

a. Yes
b. No

35. Are the clinical staff ready and available to assist learning in salt diagnostics?

a. Yes
b. No

36. Do radiography staff readily guide you and your course mates during clinical posting in
salt diagnostics?

a. Yes
b. No

37. Do clinical staff take your errors and mistake into consideration and proffer correction in
salt diagnostics?

a. Yes
b. No

STUDENT’S PERCEPTION

Choose the correct option(s) or write your opinions where necessary.

38. Have you gone for posting before?

a. Yes
b. No

39. Did you receive orientation before your clinical posting?

a. Yes
b. No

32
40. Is the duty roster made available on time?

a. Yes
b. No

41. Are you allowed to carry out any procedure?

a. Yes
b. No

42. If no, why?

43. Rate how often you are allowed to carry out procedures on your own.

a. Very often
b. Often
c. Rare
d. Very rare

44. Has clinical posting helped close the theory-practice gap for you?

a. Yes
b. No

45. Would you prefer the school provides accommodation during block clinical posting?

a. Yes
b. No

46. Would you prefer a school bus is made available to transport students from the school to
site of clinical posting and back to school daily during block clinical posting?

a. Yes
b. No

47. What is your biggest challenge during clinical posting?

a. Logistics
b. Staff input
c. Modalities available
d. Level of participation
e. Others

48. What do you suggest should be done to rectify your biggest challenge?
33
---------------------------------------------------------------------------------------------------------------------
-----

49. Has clinical posting been helpful?

a. Yes
b. No

34