Experiences of a student-run clinic in primary care: a mixed-method study with students, patients and supervisors

Abstract

ObjectiveTo explore how a student-run clinic (SRC) in primary health care (PHC) was perceived by students, patients and supervisors.DesignA mixed methods study. Clinical learning environment, supervision and nurse teacher evaluation scale (CLES + T) assessed student satisfaction. Client satisfaction questionnaire-8 (CSQ-8) assessed patient satisfaction. Semi-structured interviews were conducted with supervisors.SettingGustavsberg PHC Center, Stockholm County, Sweden.SubjectsStudents in medicine, nursing, physiotherapy, occupational therapy and psychology and their patients filled in questionnaires. Supervisors in medicine, nursing and physiotherapy were interviewed.Main outcome measuresMean values and medians of CLES + T and CSQ-8 were calculated. Interviews were analyzed using content analysis.ResultsA majority of 199 out of 227 student respondents reported satisfaction with the pedagogical atmosphere and the supervisory relationship. Most of the 938 patient respondents reported satisfaction with the care given. Interviews with 35 supervisors showed that the organization of the SRC provided time and support to focus on the tutorial assignment. Also, the pedagogical role became more visible and targeted toward the student’s individual needs. However, balancing the student’s level of autonomy and the own control over care was described as a challenge. Many expressed the need for further pedagogical education.ConclusionsHigh student and patient satisfaction reported from five disciplines indicate that a SRC in PHC can be adapted for heterogeneous student groups. Supervisors experienced that the SRC facilitated and clarified their pedagogical role. Simultaneously their need for continuous pedagogical education was highlighted. The SRC model has the potential to enhance student-centered tuition in PHC.Key PointsKnowledge of student-run clinics (SRCs) as learning environments within standard primary health care (PHC) is limited.We report experiences from the perspectives of students, their patients and supervisors, representing five healthcare disciplines.Students particularly valued the pedagogical atmosphere and the supervisory relationship.Patients expressed high satisfaction with the care provided.Supervisors expressed that the structure of the SRC supported the pedagogical assignment and facilitated student-centered tuition – simultaneously the altered learning environment highlighted the need for further pedagogical education.Student-run clinics in primary health care have great potential for student-regulated learning.

The learning environment on a student ward: an observational study

“…Whilst many students continue to learn in regular clinical settings, some settings have been specially adapted to student learning [2–6]. These have been referred to in the literature as: clinical education wards; interprofessional training wards [7–10]; dedicated education units [6, 11–15]; student training wards [5]; and student-run clinics in primary care [16]. A unified term is lacking, so we use the descriptive term ‘student ward’ to encompass all clinical settings adapted specifically to students.…”

Effect of student-led health interventions on patient outcomes for those with cardiovascular disease or cardiovascular disease risk factors: a systematic review

“…Whilst the included studies lacked detailed reporting on the student intervention, there is literature that independently describes the training, supervision and resources required without clinical patient outcomes. For example, Froberg and colleagues detailed the administration, the organisation and the physical environment that students were exposed to when exploring student, patients and supervisor perceptions of participating in a student-run clinic [14]. Nevertheless, one of the included studies [32], recognised this limitation and likewise recommended that future research should investigate and report both patient and student outcomes.…”

“…This form of evaluation however can only capture the participant's reaction to the service and does not capture higher level evaluation, including the ability of the intervention to facilitate learning and behaviour change [8]. Accordingly, the results from patient satisfaction questionnaires, often suggest that overall patients are satisfied with student services [9][10][11][12][13][14] providing the lowest level of evaluation according to the Kirkpatrick model [8]. Satisfaction may also be influenced by personal factors such as the patient's ability to access healthcare [15] or communication and interpersonal skills of the students.…”

Volunteering, health and the homeless – the cost of establishing a student-run primary healthcare clinic serving the inner-city homeless in South Africa

“…The services provided by SRCs are supported by the communities they serve, although the number of patients served in such facilities is often unknown. Patients report to be satisfied with the services provided [26][27][28]. While studies have shown that SRCs are valued by both students and patients very little is known of the cost of such services or the cost impact to the healthcare system.…”