used for other purposes, leaving the core activity essentially unfunded, and relying on volunteerism to actually happen. This is explored in a review of the literature as well as fieldwork, interviewing senior figures in both University and NHS who are in charge of teaching or funding allocations. Probably no organisation or set of individuals meant to disadvantage undergraduate teaching in the NHS. However, the large sums involved discouraged any major change of the SIFT formula, for fear of destabilizing hospital finances and therefore their primary function, to treat the sick. In the University sector, it is an accepted modus operandi to use student funding to invest in prestigious and activities in the University. An understanding of why the NHS and Universities acted as they did is attempted, by drawing on the field of behavioural economics, using concepts of mental accounting and fungibility of monetary income. As the funds were poorly accountable, and could be considered a type of windfall income, attitudes to spending it, and accounting for the spending, were markedly different to regular, earned income. This exploration of economic behaviour might touch on some of the root causes of the consequences and unintended consequences of the funding system for undergraduate medical education. Table of Contents Introduction Research Approach and Methodology Documentary Analysis Core literature Analysis Economic methodology Empirical Methods Interview Interview Methodology generating
pharmacy, medical illustration, teaching equipment, computers, audiovisual, provision of bleeps and white coats cost between SIFT and healthcare budget Additional space specifically for students; residences, locker rooms, teaching and study spaces, library, other overhead costs such as portering, cleaning Information needed on actual use of space for supporting UG teaching Agreed proportion of costs We turn to the resources that hospital Trusts were advised to consider in the costing of the clinical placement contract. Table 5.3 NHS Executive guidance for costing placement resources related to undergraduate teaching, 1995 Resource How to identify resources attributable to clinical placements How to cost the resource NHS medical staff Consultant job plans or diaries to identify teaching commitments Comparison of patient throughput with similar unit without teaching Specific costing of time supporting clinical examinations Pro rata to average salary NHS nursing staff, professions supplementary to Staff rotas , diaries to identify teaching contacts Comparison of ward costs in similar Pro rata to salary costs
8.2 Student collusion It would be reasonable to expect students to raise objections to the diversion of money that is nominally destined to support their education, towards other purposes. Their attitudes to this, however, were curiously passive. There are some possible explanations. Brown attributes this, not so much to the classic economic concept of economic asymmetry, where one side has more relevant information than the other; but to an information void, where students make choices without either relevant knowledge or understanding of their power, and use indirect or symbolic indicators of quality to make these choices. Chief amongst these are the interlinked marques of prestige, reputation and status (Brown 2013, p124). Students value their university’s prestige. This is an important component of their choice to apply to that university in the first instance, and it is in their interest to continue to support prestige-building activities. Course and course content are the most important factors influencing the decisions of all groups of students, but after that high achievers applying to the most selective universities tended to base their decisions on its prestige and academic excellence and had a greater belief in their own competence than other high-achievers. Their decisions were strongly influenced by league tables, academic reputation and the idea of challenging themselves (Sutton Trust 2012). Even when research is remote from their university experience, students understand that research achievement is beneficial to their own aspirations. For example, it is widely held that employers tend to recruit from a fairly narrow range of top-ranked (i.e. research-intensive) universities (see, for example, Milburn 2012).