Reprinted with permission of 'Radiologic Technology,' the official journal of the American Society of Radiologic Technologists, copyright 1995.
| Steven B. Dowd, Ed.D.,R T. (R), is an associate professor and director of the radiography program at the University of Alabama at Birmingham. | In November 1994, Dr.Dowd served as a visiting scholar at the University of Sydney. The visit was funded by the University of Sydney and initiated by Mr. Kench. This article, written by Dr.Dowd in collaboration with Mr. Kench, presents an overview of radiologic science education in Australia. |
| Peter Kench is a lecturer with the School of Medical Radiation Technology at the University of Sydney Faculty of Health Sciences in Lidcombe, Australia. |
Most Americans know surprisingly little about Australia. We see Australian films and tourism ads, but they usually present stereotypical images of kangaroos, the outback and characters straight out of "Crocodile Dundee." In reality, Australian society is very similar to our own.
In fact, many experiences in Australian history parallel events in U.S. history, including the conquering of frontiers, the relationship between indigenous people and the "new" settlers, the search for in appropriate federal system of government, the relationship between labor and capital and the multicultural mix of peoples.
Australia and the United States have strong economic, social and political ties. Trade between the two countries is strong,although intense trade competition exists in certain commodities. The influence of U.S. culture is visible in almost every facet of Australian society, from fast food restaurants to fashion trends.
One area where Australia differs dramatically from the United States is in providing health coverage for its citizens. Australia offers a workable national health insurance system that guarantees rationed health care for all residents, but also includes a provision for private health insurance for those who want a "higher quality" of health care. Thus, the Australian government has solved the problem of providing access to all while also giving people the option of choosing their own form of health care or practitioner.
The Australian approach toward radiologic science education also differs from that of the United States. Last fall, I visited the School of Medical Radiation Technology at the University of Sydney. For a radiologic science program to be housed within a university such as Sydney is akin to housing a radiologic science program in a Harvard or Yale in the United States. It shows that radiologic sciences have made incredible strides in Australia,moving from the technical level to the university setting in just a few years.1
This article examines the Australian system of higher education - particularly radiologic science education - and its relationship to how the profession is practiced there.
Undergraduate education in Australia is similar to that offered in the United States. The United States spends a greater amount per student, has more participation in university education and has a slightly higher graduation rate. (See Table 1.) According to Farina,2 one difference is that higher education is centralized in Australia. Almost all higher education is public, and taxes fund a majority of the cost involved.
Farina also notes that prior to 1990, there were three types of higher education institutions in Australia: the Technical and Further Education Institutions (TAFEs), the Colleges of Advanced Education (CAEs) and the universities. Health profession education was housed in the CAEs, most of which were absorbed into the university system in the early 1990s. According to Clark,3 this move was criticized by some who argued that "when the former colleges became universities their senior appointments should have been readvertised to ensure appointment of the best quality staff. Instead, most existing staff were suddenly turned into university academics."
Aldrich-Langen4 says the goal of university education in Australia is "to preserve, transmit, and extend knowledge to meet the needs of society with highly skilled professionals; and to enlighten and critically evaluate the society in which university scholars live." This is similar to the purpose of university education in the United States.
Australian universities suffer from the same dichotomy of work preparation vs. academic excellence seen in the United States. As Clark3 explains, "Like universities in other Western countries, Australian universities are also facing increased skepticism about the value of what they do and the quality of their ever-expanding,much more heterogeneous graduates. People of a right-wing political bent claim that many faculties have been taken over by 1960s radicals who are more intent on pandering to minorities and social engineering than advancing knowledge, while persons at the opposite end of the political spectrum claim Australian universities have been turned into merely degree factories, churning out vocationally oriented, intellectually unchallenged robots for business and industry."
Australian universities originally were established in the country's capital cities and modeled on the Scottish system of university education, which was more democratic than the English system. Today, Australian colleges and universities are becoming more like their U.S. counterparts, bifurcating into a two-tiered system. Universities like Sydney are becoming more heavily involved in graduate-level teaching, similar to a University of Chicago, a Harvard or a Massachusetts Institute of Technology. Dame Leonie Kramer, chancellor of the University of Sydney, even has suggested that the school turn itself into essentially a postgraduate institution.
All professional education in Australia is offered at the baccalaureate level. Thus, physicians and lawyers receive the baccalaureate degree at the end of their study (typically a five-year program after high school). Interestingly, even though Australian physicians possess no doctorate, they call themselves "doctors." Also interesting is the fact that professionals such as radiologic technologists possess a similar, if not exactly identical,academic level as physicians. This situation will change at the University of Sydney in 1997, when medicine becomes a graduate program.
Tertiary entrance rank (TER) scores are used to rank applicants to the universities. The score is calculated by student grades in college prep subjects during high school. A score of l00 is the highest possible.
In general, TER scores reflect both community standing and reputation of the faculty/profession.3 In some ways, they are the measure of the "popularity" of a professional program; the higher the TER required to enter a program, the more desirable the profession. Some professions, such as law and medicine, require high TER scores for entry. High TERs also can reflect limited space within a program. As shown in Table 2,the TERs for radiologic science at the University of Sydney are among the highest at the university. Some programs require TERs as low as 55; scores in the 60s are required for agriculture and education. Dentistry requires the highest listed TER score.
Physical therapy (called physiotherapy in Australia) is an extremely popular course, as it is in the United States. One reason is that physical therapists can practice independently and may order x-ray exams.
The low popularity of nursing, which has TER scores ranging from 50 to 65, may be due to a lack of interest or professional standing. Dahl5 notes that the image of nurses in Australia has not improved, despite advances in nursing practice, education and research. Nursing education in Australia has a number of image problems. A 1994 survey of recent graduates' perceptions of course quality in Australian universities found nursing ranked 32nd out of 35 disciplines.6 However, the low TER scores also may be a result of the large amount of space available in nursing programs.
The system of college entrance is based on course grades alone, rather than course grades plus standardized test scores. Similarly, students do not take a "registry" exam at the conclusion of their university education in the radiologic sciences. A graduate becomes an"R.T." - the term used in Australia is "qualified" - based upon a combination of graduation from an accredited program and a year's work experience. The registry exam has not been implemented in Australia for two reasons: First, if a program is accredited, it should graduate qualified practitioners; second, it is not possible for a multiple-choice test to measure clinical competence (personal communication with Simon Cowell, November 1994).
The Technical and Further Education (TAFE) system in Australia is analogous to the U.S. community college system. The object of TAFE is to "train you for a specific job or profession," whereas the university system offers "a more general and professionally-based education6 There is some overlap between the two systems. Universities typically offer the degrees and diplomas that are considered to be professional-level, but also may offer the associate diploma, which is considered to be paraprofessional and usually is offered by TAFE. The TAFE system also offers advanced certificates, trade certificates and statements of attainment.
Australia has about 250 TAFE colleges, offering courses in subject areas such as accounting, automotive mechanics, computing, food preparation and real estate. Although the system is well-regarded, the radiologic sciences consciously avoided becoming part of the TAFE system due to its paraprofessional orientation (personal communication with Ingrid Egan, November 1994).
Radiologic science professionals may pursue Ph.D. degrees at three institutions: the Royal Melbourne Institute of Technology, the University of Sydney and the University of Newcastle.7 They also may pursue other doctorates, such as the Ed.D. A number of master's degree options are available to practitioners, but many individuals seeking the Ph.D. can bypass the master's degree by completing a bachelor's with honors. Most master's and Ph.D. degrees in Australia are offered through research, meaning there is no coursework requirement,although students may attend seminars to facilitate their research. Some universities offer their doctorates through distance education, making it possible for foreign students to earn a doctorate by pursuing their research at home and traveling to the university as needed.
The University of Sydney is Australia's oldest and most prestigious university. It is located in Australia's largest city and is the second largest university in the country. Referred to by Aussies as "Sydney Uni," the school serves an enrollment of 30,343 students, 76% of whom are undergraduates. More than 7000 undergraduates are enrolled in health related studies, making it the largest academic area. The Faculty of Health Sciences are located at the Lidcombe campus, in the western suburbs of Sydney. Programs offered there include an associate diploma in diversional therapy and bachelor's degrees in nursing, rehabilitation counseling, aboriginal health, occupational therapy, physical therapy, speech pathology, orthoptics, health information management, nuclear medicine, diagnostic radiography and radiation therapy.
The 1995 Good Universities Guide ranked the University of Sydney among the top universities in all categories except "new innovative teaching."5 This exception also was reflected in a controversial ranking by the Committee for Quality Assurance in Higher Education, which placed the school only in the second tier. As a result of these rankings, research dollars for the school recently were increased. One of these grants was secured by Peter Kench of the School of Medical Radiation Technology to develop computer-assisted instruction. Overall, the school received $95,520 in1994 from the Australian Research Council, making it No. 2 in grant support in Australia.
My role at Sydney was to help the faculty in terms of publication and research. The School of Medical Radiation Technology was established at the Cumberland College of Health Sciences in 1988, when the college was part of the CAE system. At that time, a diploma of applied science was offered. Following the amalgamation of Cumberland into the University of Sydney, a bachelor of applied sciences program began in 1992.
The Sydney faculty had already done much good research, so my main role was to serve as a mentor and facilitator. Duane Akroyd, Ph.D., R.T.(R), associate professor at North Carolina State University, had visited Sydney earlier and much of his guidance already was evident in the quality of work being done by the Sydney faculty. I read and evaluated a number of research papers that I hope to see published soon in the U.S. Literature. Programs receive a portion of their funding based on their record of publication. Two interesting projects being conducted at the school are the Competency-Based Standards Project and the CAI Assessment Project.
The competency-based movement developed much later in Australia than in the United States or Britain.8 The Competency-Based Standards Project is an outgrowth of the Australian competency-based movement, designed to make the educational system more responsive to the needs of industry.9,10 I found the project refreshing, as it avoided many of the pitfalls into which the U.S. radiologic science profession fell when it implemented competency-based standards." The Australians used a qualitative methodology instead of task analyses and attempted to avoid the reductionistic approach of "behavioral objectives."
Although Baird12 has developed what appears to be a well-reasoned critique of the standards, I believe that the researchers in this project - Simon Cowell, Ingrid Egan and Marianne Rinks - have developed multiple documents that will find use in the professions and the educational setting.
Four tutorials using computer assisted instruction (CAI) were developed in 1993 by a research team at the School of Medical Radiation Technology. A government grant from the Committee for Advancement of University Teaching (CAUT) provided funding for computer software, hardware and consultancy to aid the development. During an eight-month period, the research team acquired skills to develop CAI materials using an icon-based authoring software called Authorware Professional. The CAI tutorials provided first-year undergraduate students with an additional learning resource to gain knowledge and skills in the fundamental principles of radiologic technology. They are designed to encourage student interaction by giving the user control over the content to be covered and providing individualized tutorials for the students' needs.
The tutorials take advantage of the multimedia capabilities of the computer through graphics, animation and digitized video. The tutorials contain theory, demonstration, simulation and revision components. The simulation and revision components provide students with immediate feedback based on their responses. The simulations of equipment and techniques used in clinical settings give students the opportunity to experiment in a safe environment without the threat of causing damage to equipment or risk to patients or personnel.
The CAI tutorials were evaluated in October 1993.Their learning outcomes and attitudes were compared to a more traditional didactic style of tutorial. Equivalent scores were obtained in a post-test, and students demonstrated similar attitudes toward the two styles of instruction. The CAI tutorials now are being evaluated by other Australian universities. The University of Alabama at Birmingham (UAB) also is evaluating these modules in a large overall project to evaluate a number of means of computer-assisted instruction. In 1994 the research team acquired another grant from the University of Sydney to develop new CAI materials.
In 1993, the School of Medical Radiation Technology at the University of Sydney developed tutorials using computer assisted instruction for first year undergraduate students.
One goal of my visit was to develop an exchange program between Sydney and UAB. As major academic health science centers, each institution has much to offer the other. The two schools are similar in many ways, including academic standing in the community, a recent move from a technical to a professional level of education and an increased emphasis on research through peer-reviewed grant funding. Also, educators in health professions at both universities are struggling with the proper balance of teaching and research.
Sydney and UAB have instituted an informal exchange program for faculty and are in the process of developing a formal exchange for faculty and students. We hope to develop a pipeline for information exchange and collaboration between the two institutions that will link us globally as radiologic science professionals.
Dr. Dowd would like to thank his coauthor, Peter Kench, who coordinated his visit to the University of Sydney and, along with his wife Lisa, served as a gracious host. Dr. Dowd also would like to thank everyone who helped him in his role as a visiting scholar at the University of Sydney, especially Jennifer Cox, Don McLean, Simon Cowell and Ingrid Egan, who went out of their way to introduce him to Sydney and discuss the future of the radiologic sciences in the United States and Australia.
© 1999 Faculty of Health Sciences, The University of
Sydney
This page was updated April 24, 2003
P.Kench@cchs.usyd.edu.au