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Recorded performance during simulation activities in medical imaging: do students see a benefit?
  1. Cameron Moore,
  2. Clare Berry,
  3. Vicki Braithwaite,
  4. Therese Gunn,
  5. Pamela Rowntree,
  6. Deborah Starkey
  1. School of Clinical Sciences, Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia
  1. Correspondence to Cameron Moore, School of Clinical Sciences, Faculty of Health, Queensland University of Technology, GPO Box 2434, Brisbane, Queensland 4001, Australia; cameron.moore{at}

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Undergraduate students in medical imaging at Queensland University of Technology (QUT) practise imaging in a dedicated simulation environment using clinical equipment. Students work in small teams to complete specific imaging procedures using anthropomorphic phantoms as patients. The use of these facilities to undertake learning activities is invaluable in the development of technical skills and also the clinically relevant skills of teamwork, communication and efficiency. Students undertake objective structured clinical examination (OSCE) assessments each semester using these facilities as a prerequisite to clinical experience. Audiovisual recording devices were initially sought to document student performance in these OSCE assessments. Once these recording devices became available, the teaching team decided to explore whether students perceived any benefit from the opportunity to self-review and reflect on their performance. As noted by Coffey (2014 p. 87), ‘through an examination of performance, one gains an insight into practices that should be retained, those practices that need change as well as the implications of one’s practice.’1


A pilot study was undertaken with a cohort of second year undergraduate students. This study investigated the student perception of the use of the recorded performance for self-review of their radiographic ability in performing set tasks in the simulation laboratory. The practice of reviewing one’s recorded work is not a new phenomenon and was reported by Allen2 as early as 1966. Technology has advanced significantly since that time. The evaluation for this project was undertaken using a room mounted dedicated audiovisual recording device.

Information was provided to the participants via the information consent sheet.

Students participated in pairs to perform a mobile chest X-ray within the simulation laboratory. The mobile chest X-ray examination consisted of an antero-posterior erect projection on an anthropomorphic phantom on a trauma trolley. On completion of this activity, students were able to retrieve their individual recording for private review. Importantly, students were only able to access their own recordings.

At the conclusion of their individual review, study participants completed a Likert scale survey (1= not useful to 10= very useful) and commented on their perceived benefits of using recording technology for reflecting on their performance.


Twenty-eight students completed the recording, review and evaluation of the chest X-ray examination (n=28).

Students provided their perceptions of the impact of reflecting on their communication, efficiency and teamwork from the recording. In addition, technical radiographic factors were considered but not included in this report.

The results are summarised in figure 1.

Figure 1

Perceptions of how the reflective process affected communication, efficiency and teamwork during medical imaging examinations. x-axis: Perceived student benefit. y-axis: Number of student responses.

The results highlight that 89% of students (n=25) found the reflection on their communication skills to be beneficial (>7). As well, 86% of students (n=24) reported that the reflective process was valuable (>7) with regard to evaluating their efficiency, while 96% of students (n=27) perceived evaluation of teamwork to be the most advantageous of the reflective process (>7).

Sample comments provided by students about the recordings were as follows:

  • … best for overall view of the process supplemented with audio instructions would be beneficial for review for study’.

  • ‘… good to watch our patient handling skills and how we approach/talk to the patient’

  • ‘… very useful in observing efficiency, communication and technique and would like to use it again in future roleplays, especially trauma cases’.


The simulation laboratory provides medical imaging students with opportunities to explore their radiographic technique in a safe environment. The radiographic examination selected for this pilot study (the mobile chest X-ray) is a widely performed imaging procedure, often undertaken on patients in the complex and pressured environments of intensive care and emergency. Student review of their individual recorded performance for this radiographic examination was investigated as a reflective learning opportunity, not readily available outside the simulation environment.

Although the student cohort is small (n=28), the results from this pilot demonstrate that participating students identified the positive role the recorded performance played in their learning and wished to expand the use of this resource in their educational framework. Overall student perceptions of benefit were particularly strong in the areas of communication, efficiency and teamwork and meet the outcomes identified by Carter et al (2016 p. 30) that ‘student satisfaction and improvements in confidence are highly desirable educational outcomes from a pedagogical perspective.’3

Further evaluation of the use of recorded performance within the simulation environment to complement existing learning strategies is continuing. This technology-enabled approach has the potential to provide simulation enhancement for other health disciplines, increasing opportunity for student formative learning through review and self-reflection in a range of settings. The purposeful inclusion of this learning approach aligns with the views expressed by Cox et al (2017 p. 3), ‘the goal of education remains to provide learners with the strongest and most efficient means of developing their skills.’4


The positive perceived benefit reported by students in this pilot is promising. Given the availability and portability of existing and emerging recording technologies, it is anticipated that recording of simulation events with self and peer reflection will continue and contribute to the undergraduate medical imaging educational pedagogy into the future.

As noted by Huang et al (2012 p. 329), ‘simulation has become so commonplace that it is now difficult to imagine an accredited institution providing health professional training, which does not have some capacity of simulation education.’5

The experiences reported in this project are therefore likely to be replicated across a wide range of settings and health disciplines.


The authors would like to acknowledge the support, assistance and guidance of all of the QUT Medical Radiation Sciences academic, professional and technical staff, including Andrew Mclean and Christopher Aitken.



  • Contributors All listed authors (CM, CB, VB, TG, PR and DS) revised the draft and approved the final version of the report for publication and are accountable for the work. CM contributed to the interpretation of the data, drafting the work and final submission of the manuscript and communication with the journal and is the guarantor. CB contributed to the design and acquisition of data. VB contributed to the acquisition and analysis of the data. TG contributed to the design and acquisition of data and analysis. PR contributed to the interpretation of data, drafting the work and communications and critical review. DS contributed to the conception of the design, interpretation of the data and critical review.

  • Competing interests None declared.

  • Ethics approval QUT human research ethics committee (Approval No. 1500000497).

  • Provenance and peer review Not commissioned; externally peer reviewed.

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