From burden to benefit: a multi-site study of the impact of allied health work-based learning placements on patient care quality.
Allied health
Hospital setting
Patient care
Placement
Quality
Students
Journal
Advances in health sciences education : theory and practice
ISSN: 1573-1677
Titre abrégé: Adv Health Sci Educ Theory Pract
Pays: Netherlands
ID NLM: 9612021
Informations de publication
Date de publication:
08 2023
08 2023
Historique:
received:
01
09
2022
accepted:
05
11
2022
medline:
21
7
2023
pubmed:
20
11
2022
entrez:
19
11
2022
Statut:
ppublish
Résumé
Allied health clinical placements take place within an increasingly overstretched health care system where demand for services often exceeds availability of resources. Within this environment, student placements are often perceived as an additional burden to an already overwhelmed workforce. This study explored whether the quality of patient care was enhanced when services were re-designed using a collaborative partnership approach to more purposefully integrate students into delivery of care. Using an embedded multiple case study design, data were collected through focus groups and interviews, patient experience surveys, and secondary administrative data sources. Cases were across physiotherapy and occupational therapy in six different hospital settings. Perception of care provided by students was viewed positively by all stakeholders, including patients. Perceived health outcomes of faster improvement of health condition, improved mobility and function identified through our qualitative findings were supported by quantitative service delivery markers such as increased therapy sessions, more patients being discharged home instead of to other care facilities and reduced length of stay. Health care providers and students alike perceived improvements in service efficiencies whilst maintaining high quality care. This study has provided preliminary evidence towards improved patient care when a partnering approach is adopted whereby students are intentionally integrated into services that otherwise might not have been delivered. Furthermore, it has shifted the associated narrative from students as additional burden to students as benefit.
Identifiants
pubmed: 36401661
doi: 10.1007/s10459-022-10185-9
pii: 10.1007/s10459-022-10185-9
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
759-791Informations de copyright
© 2022. Crown.
Références
Alison, J. A., McKeough, Z. J., Johnston, K., McNamara, R. J., Spencer, L. M., & Jenkins, S. C. (2017). Australian and N ew Z ealand P ulmonary R ehabilitation G uidelines. Respirology, 22(4), 800–819.
doi: 10.1111/resp.13025
Apke, T. L., Whalen, M., & Buford, J. (2020). Effects of student physical therapists on clinical instructor productivity across settings in an academic medical center. Physical Therapy, 100(2), 209–216.
doi: 10.1093/ptj/pzz148
Australian Commission on Safety and Quality in Health Care. (2016). Hip fracture care clinical care standard. Retrieved from Sydney: https://www.safetyandquality.gov.au/publications-and-resources/resource-library/hip-fracture-clinical-care-standard
Australian Commission on Safety and Quality in Health Care. (2019). The state of patient safety and quality in Australian hospitals. Retrieved from Sydney: https://www.safetyandquality.gov.au/publications-and-resources/resource-library/state-patient-safety-and-quality-australian-hospitals-2019
Australian Institute of Health and Welfare. (2018). Australia's health 2018. Retrieved from Canberra: https://www.aihw.gov.au/reports/australias-health/australias-health-2018/contents/table-of-contents
Australian Institute of Health and Welfare. (2022). Hospital activity. Retrieved from https://www.aihw.gov.au/reports-data/myhospitals/themes/hospital-activity
Barton, R., Corban, A., Herrli-Warner, L., McClain, E., Riehle, D., & Tinner, E. (2013). Role strain in occupational therapy fieldwork educators. Work, 44(3), 317–328.
doi: 10.3233/WOR-121508
Beveridge, J., & Pentland, D. (2020). A mapping review of models of practice education in allied health and social care professions. British Journal of Occupational Therapy, 83(8), 488–513.
doi: 10.1177/0308022620904325
Billett, S. (2001). Co-participation: Affordance and engagement at work. New Directions for Adult and Continuing Education, 92, 63–72.
doi: 10.1002/ace.41
Billett, S. (2009). Realising the educational worth of integrating work experiences in higher education. Studies in Higher Education, 34(7), 827–843.
doi: 10.1080/03075070802706561
Bourne, E., Short, K., McAllister, L., & Nagarajan, S. (2019). The quantitative impact of placements on allied health time use and productivity in healthcare facilities: A systematic review with meta-analysis. Focus on Health Professional Education: A Multidisciplinary Journal, 20(2), 8–40.
doi: 10.11157/fohpe.v20i2.315
Broman, P., Tokolahi, E., Wilson, O. W., Haggie, M., Andersen, P., & Brownie, S. (2022). Patient outcomes from student-run health services: An integrative review. Journal of Multidisciplinary Healthcare, 15, 641.
doi: 10.2147/JMDH.S348411
Bureau of Health Information. (2017, 7 July 2022). Adult Admitted Patient Survey. Retrieved from https://www.bhi.nsw.gov.au/nsw_patient_survey_program/adult_admitted_patient_survey
Doherty, M., Dyer, M., Wilson, E., & Russell-Thomas, D. (2020). Rehabilitation outcomes of an occupational therapy student-run free clinic for individuals with acquired brain injury. Journal of Allied Health, 49(1), 60–66.
Engeström, Y. (1999). 23 Innovative learning in work teams: Analyzing cycles of knowledge creation. Perspectives on Activity Theory, 377.
Stroke Foundation. (2021). Clinical guidelines for stroke management. Retrieved from Melbourne: https://informme.org.au/en/Guidelines/Clinical-Guidelines-for-Stroke-Management
Hager, P. (2008). Learning and metaphors. Medical Teacher, 30(7), 679–686.
doi: 10.1080/01421590802148899
Hake, M. P., Glickman, L. B., King, B. A., & Hollman, J. H. (2015). Evaluating physical therapist students’ clinical performance in acute care: A retrospective analysis comparing student-treated and staff-treated patient outcomes after total knee arthroplasty. Journal of Physical Therapy Education, 29(2), 32–42.
doi: 10.1097/00001416-201529020-00006
Kauffman, D. M., & Mann, K. V. (2013). Teaching and learning in medical education: How theory can inform practice. Understanding Medical Education: Evidence, Theory and Practice, pp. 7–29.
Kemp, C., van Herwerden, L., Molloy, E., Kleve, S., Brimblecombe, J., Reidlinger, D., & Palermo, C. (2021). How do students offer value to organisations through work integrated learning? A qualitative study using Social Exchange Theory. Advances in Health Sciences Education, pp. 1–19.
Kleinsmann, M., & Valkenburg, R. (2008). Barriers and enablers for creating shared understanding in co-design projects. Design Studies, 29(4), 369–386.
doi: 10.1016/j.destud.2008.03.003
Lave, J., & Wenger, E. (1991). Situated learning: Legitimate peripheral participation: Cambridge University Press.
Lave, J. (1996). Teaching, as learning, in practice. Mind, Culture, and Activity, 3(3), 149–164.
doi: 10.1207/s15327884mca0303_2
McBride, L.-J., Fitzgerald, C., Costello, C., & Perkins, K. (2018). Allied health pre-entry student clinical placement capacity: Can it be sustained? Australian Health Review, 44(1), 39–46.
doi: 10.1071/AH18088
McKenzie, D. K., & Frith, P. A. (2003). The COPDX plan: Australian and New Zealand guidelines for the management of chronic obstructive pulmonary disease 2003. The Medical Journal of Australia, 178(6), S1.
Molloy, E., Lew, S., Woodward-Kron, R., Delany, C., Dodds, A., Lavercombe, M., & Hughson, J. (2018). Medical student clinical placements as sites of learning and contribution.
Moon, K., & Blackman, D. (2014). A guide to understanding social science research for natural scientists. Conservation Biology, 28(5), 1167–1177.
doi: 10.1111/cobi.12326
Morgan, D. L. (2014). Pragmatism as a paradigm for mixed methods research (pp. 25–44). SAGE Publications Inc.
Nisbet, G., McAllister, S., Morris, C., & Jennings, M. (2021). Moving beyond solutionism: Re-imagining placements through an activity systems lens. Medical Education, 55(1), 45–54.
doi: 10.1111/medu.14345
O’Leary, N., & Cantillon, P. (2020). Why shouldn’t we do that on placement if we’re doing it in the real world? Differences between undergraduate and graduate identities in speech and language therapy. Advances in Health Sciences Education, 25(4), 781–797.
doi: 10.1007/s10459-020-09955-0
O’Brien, S. R., Bulas, M., Metcalfe, A., Mix, Z., Richert, T., & Wagner, R. (2017). Meaningful functional change achieved from physical therapy provided in a student-run pro bono clinic. Journal of Allied Health, 46(3), 138–142.
Pabian, P. S., Dyson, J., & Levine, C. (2017). Physical therapist productivity using a collaborative clinical education model within an acute care setting: A longitudinal study. Journal of Physical Therapy Education, 31(2), 11–17.
doi: 10.1097/00001416-201731020-00003
Patterson, F., Doig, E., Fleming, J., Strong, J., Birch, S., Whitehead, M. (2021). Student-resourced service delivery of occupational therapy rehabilitation groups: patient, clinician and student perspectives about the ingredients for success. Disability and Rehabilitation, pp. 1–12.
Patton, M. Q. (2014). Qualitative research & evaluation methods: Integrating theory and practice: Sage publications.
Pigott, A., Patterson, F., Birch, S., Oakley, P., & Doig, E. (2022). The health service impact of an occupational therapy practice placement model: Student-resourced service delivery of groups. Focus on Health Professional Education: A Multi-Disciplinary Journal, 23(2), 21–34.
doi: 10.11157/fohpe.v23i2.525
Pirinen, A. (2016). The barriers and enablers of co-design for services. International Journal of Design, 10(3), 27–42.
Pivko, S. E., Abbruzzese, L. D., Duttaroy, P., Hansen, R. L., & Ryans, K. (2016). Effect of physical therapy students’ clinical experiences on clinician productivity. Journal of Allied Health, 45(1), 33–40.
QSR International Pty Ltd. (2018). NVIVO (Version 12).
Reising, D. L., Allen, P. N., & Hall, S. G. (2006). Student and community outcomes in service-learning: Part 2–community outcomes. Journal of Nursing Education, 45(12), 516–518.
doi: 10.3928/01484834-20061201-10
Rindflesch, A., Hake, M., Haack, R., Kleven, A., McPartlin, M., Strikwerda, J., & Hollman, J. (2018). Evaluating clinical performance of student physical therapists: A comparison of student-and staff-managed patient outcomes after hip arthroplasty. Journal of Allied Health, 47(3), 204–209.
Romig, B. D., Tucker, A. W., Hewitt, A. M., & Maillet, J. O. S. (2017). The future of clinical education: Opportunities and challenges from allied health deans’ perspective. Journal of Allied Health, 46(1), 43–56.
Rone-Adams, S., Nof, L., Hart, D. L., Sandro, C. R., & Wang, Y.-C. (2009). Investigating physiotherapy and occupational therapy students’ outcome effectiveness. International Journal of Therapy and Rehabilitation, 16(3), 167–175.
doi: 10.12968/ijtr.2009.16.3.40070
Spector, A., Alpert, H., & Karam-Hage, M. (2007). Smoking cessation delivered by medical students is helpful to homeless population. Academic Psychiatry, 31(5), 402–405.
doi: 10.1176/appi.ap.31.5.402
Steen, M. (2013). Co-design as a process of joint inquiry and imagination. Design Issues, 29(2), 16–28.
doi: 10.1162/DESI_a_00207
Stickler, K., Sabus, C., Gustafson, H., Kueser, M., Lavaveshkul, B., & Denney, L. (2016). Pro-bono service through student-run clinics: How does physical therapy measure up? Journal of Allied Health, 45(3), 207–211.
Teddlie, C., & Tashakkori, A. (2010). Overview of contemporary issues in mixed methods research. Sage Handbook of Mixed Methods in Social and Behavioral Research, 2, 1–44.
Waters, L., Lo, K., & Maloney, S. (2018). What impact do students have on clinical educators and the way they practise? Advances in Health Sciences Education, 23(3), 611–631.
doi: 10.1007/s10459-017-9785-y
Yazan, B. (2015). Three approaches to case study methods in education: Yin, Merriam, and Stake. The Qualitative Report, 20(2), 134–152.
Yin, R. K. (2013). Case study research: Design and methods (5 ed.): Sage Publications.