Predictors of professional placement outcome: cultural background, English speaking and international student status

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Attrill, Stacie Lorraine
McAllister, Sue Margery
Lincoln, Michelle
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Placements provide opportunities for students to develop practice skills in professional settings. Learning in placements may be challenging for culturally and linguistically diverse (CALD) students, international students, or those without sufficient English proficiency for professional practice. This study investigated whether these factors, which are hypothesized to influence acculturation, predict poor placement outcome. Placement outcome data were collected for 854 students who completed 2747 placements. Placement outcome was categorized into ‘Pass’ or ‘At risk’ categories. Multilevel binomial regression analysis was used to determine whether being CALD, an international student, speaking ‘English as an additional language’, or a ‘Language other than English at home’ predicted placement outcome. In multiple multilevel analysis speaking English as an additional language and being an international student were significant predictors of ‘at risk’ placements, but other variables tested were not. Effect sizes were small indicating untested factors also influenced placement outcome. These results suggest that students’ English as an additional language or international student status influences success in placements. The extent of acculturation may explain the differences in placement outcome for the groups tested. This suggests that learning needs for placement may differ for students undertaking more acculturative adjustments. Further research is needed to understand this and to identify placement support strategies.
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (, which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
clinical education, international student placement, acculturation theory
Attrill, S., McAllister, S. and Lincoln, M., (2016). Predictors of professional placement outcome: cultural background, English speaking and international student status. Perspectives on Medical Education, 5(4): 222-230.