The quantitative impact of placements on allied health time use and productivity in healthcare facilities: a systematic review with meta-analysis

Abstract

Introduction: The current and future health needs of the population pose challenges for healthcare services, which face increased pressure for service provision, and for universities educating graduates to meet this clinical demand. One aspect influencing allied health (AH) clinician willingness to offer student placements is the perceptions of impact on patient activity levels and clinician time. This systematic review synthesises the evidence quantifying student impact on AH patient activity, clinician time and productivity. Methods: Searches of peer-reviewed literature published since 1990 were conducted in Medline, CINAHL, Scopus and EMBASE and supplemented by other sources. Selected studies reported clinician-recorded patient activity and/or time participating in services provided by nutrition and dietetics, occupational therapy, physiotherapy and speech pathology, with and without students present. Studies meeting eligibility criteria (n = 23) were rated using the McMaster Guidelines for Critical Review Form: Quantitative Studies. Effect size calculations and meta-analysis were planned if sufficient studies reported similar outcome measures. Results: Seventeen studies contributed to four meta-analyses: patient activity levels, direct clinical time, clinical billed units and direct time per patient. Pooled results were neutral or favoured increases in activity or time during student placements. Methodological variation and research quality inhibited more comprehensive analysis. Conclusions: Data showed students may have a neutral or positive effect on AH patient activity levels and clinical time. Potential factors influencing data are discussed, and the areas of focus for further research are suggested.