Understanding the complexity of student placement impacts on clinical educators in speech pathology and other allied health professions

Abstract

Allied health clinical educators often report challenges managing student placements in a demanding and complex health system. Impacts such as reduced clinical services or clinical educator (CE) stress have been reported. With limited empirical evidence to respond to these claims, this thesis measures and explores student impact on CE patient activity, work time use and stress levels using four studies. Initial studies quantify student impacts on CEs in healthcare settings. Study 1 systematically reviews and quantifies allied health student impact using meta-analysis. Pooled data shows neutral or increased levels of patient activity and clinical time during placements. Study 2 uses prospective data from 34 speech pathology CEs. Using linear mixed modelling, data shows no difference in patient activity or clinical time use during placements but some differences in non-clinical time. Few differences are found using variables such as student experience level. With these quantitative results contrasting with some qualitative reports of student impact, two further studies explore factors that influence CEs’ experience of student impact. Study 3 presents an interpretive description of survey responses from speech pathologists and identifies themes used to model influences on student impact: Clinician, Supervision Practices, Workplace, Student. Using qualitative comparative analysis, Study 4 explores the contribution of internal and external factors associated with no CE stress in speech pathology placements. Complex relationships between CE role demands, their control of work tasks and workplace social support are portrayed. A flexible decision tree is presented, modelling how CEs can approach planning and management of student placements within complex contexts. This suite of studies illuminates the complex nature and diverse impacts of clinical education in speech pathology and other allied health professions, and guides approaches to placement planning and research.