1 Introduction

In Australia, general practitioners (GPs) tend to be the first point of contact for patients seeking health care [1, 2]. Current challenges in primary health care include the ageing population, an increase in chronic health conditions, patients with complex and multiple issues, the prevalence of mental health concerns and inadequate Medicare billing rebates [2-5]. Overall, people living in rural and remote areas are at greater risk of poor health outcomes [4, 6, 7].

Allied health professions can alleviate some of the demand placed on GPs through interprofessional collaboration and patient care [8]. Barriers to multi-disciplinary team care include: GPs and allied health professionals are seldom co-located; practices' lack of capacity to coordinate care with other services; and limited understanding of allied health roles and competencies in health management [9-11].

Multi-disciplinary allied health student-led clinics assist students' understanding of their own profession, other professions' role and scope of practice and interprofessional teamwork [12-14]. Rural student-led allied health care hubs can improve the well-being of people and ‘are generally a ‘good fit” for student learning [15, p. 1179]. This study aimed to evaluate a multidisciplinary allied health student placement model co-located within a General Practice. This model was responsive to the health workforce shortages in rural and remote areas and provided an opportunity to prepare students for rural and remote practice and working in multi-disciplinary teams [16, 17].

2 Methods

The overall aims of this mixed methods research were to develop a model for allied health student-led clinic co-locating within a rural general practice and to evaluate the multidisciplinary allied health student placements and their outcomes. Students were recruited through the statewide university placement allocation process, except social work, whereby students were recruited through expressions of interest to individual universities. Four final year speech pathology (SP), three social work (SW) (one third year undergraduate, one final year undergraduate and one final year masters) and three occupational therapy (OT) (two third year undergraduate and one final placement masters) students completed their placements ranging between 6 and 16 weeks in an Emerald general practice, servicing MMM 4–6 regions in Queensland [18]. Students delivered services to clients by undertaking relevant professional tasks and practices, supported by discipline-specific supervision by qualified practitioners. A placement preparation curriculum, referral guidelines and checklists were created, and four education sessions for the GPs about the different allied health services were provided.

Data collection was via the online survey platform Redcap [19]. Students recorded client demographics and service provision. Clients, stakeholders and students were invited to provide feedback. Qualitative data were organised within NVivo 12.0 [20] and descriptive analysis was applied to the quantitative data using SPSS version 29.0 [21]. The qualitative data was analysed thematically [22]. Initial codes were generated and then categorised into themes and subthemes independently by two of the authors. These were then discussed and further refined through exploration and discussion with all authors [19, 22].

3 Results

3.1 Interventions

The student-led allied health clinic received 198 referrals February–July 2024. Of these, 94 clients were seen, resulting in 266 appointments. Social work students, in line with the length of their overall placement and type of service provided, had more appointments (n = 135) than OT (n = 50) and SP (n = 81). Encouragingly, students across all disciplines had clients who returned for repeat appointments (see Figure 1).

3.2 Client Satisfaction Survey Feedback

A total of 75 clients completed the client satisfaction survey offered to them at the end of their initial appointment, resulting in an 80% response rate. All respondents selected that they were likely to return to the student-led clinic, with 72 clients identifying they were very satisfied with the services (see Figure 2).

Clients were asked to consider the program's contribution to their wellbeing. Seventy-one highlighted that the student-led allied health clinic contributed to their overall wellbeing, with one selecting no and three being unsure.

4 Discussion

The research aims were to evaluate the multidisciplinary allied health student placements co-locating within a General Practice and their outcomes. Although this is a small cohort of students, the positive reception of the student-led services by key stakeholders highlighted that such clinics contribute to addressing allied health gaps in rural communities. It is recommended that allied health student-led clinics should be considered a workforce strategy to prepare students for rural and remote practice. Students on placement were supervised by qualified professionals and involved in interdisciplinary education sessions and engaged in reflective practice throughout their placement. This supported students in developing the necessary clinical skills for their discipline and rural practice [10, 15]. Students were able to see a range of clients in the clinic, highlighting that allied health student placements in rural and remote areas provide students with a valuable and diverse clinical placement [15].

Nevertheless, critique of some key stakeholders needs to be noted. An implicit assumption in the stakeholder feedback that allied health students may not be briefed in the same ways as medical students for placement suggests the need for further engagement of allied health and medical students during residencies and medical training [10]. It is imperative that allied health students are clearly communicating their competencies to minimise risk and to provide appropriate care to clients [10] and that programs, collaboration and communications are well planned and implemented [15].

Although there was an overall appreciation of the student-led clinic in offering access to allied health services for clients who previously did not have access, it reinforces the need for an innovative solution to address workforce shortages in primary health care [4]. Although students might not provide complex care services, they provided services that otherwise would not have been available under the supervision of qualified practitioners. Considering the prevalence and complexity of chronic health and mental health conditions in rural and remote areas and the absence of appropriate services when living remotely [4, 6, 7], the student-led clinics offered a valuable service. Allied health student placements reflect a commitment by universities to improve access to allied health services in rural areas and ensure that graduates are work ready for rural employment [16]. These programs need to be carefully evaluated to identify the quality of service delivery and outcomes for the community [15]. Moreover, the concern that the services provided should not replace fully qualified allied health care is valid, and appropriate health provision for rural and remote regions needs to be pursued.

Author Contributions

Taegen Pascoe: writing – review and editing, formal analysis, investigation, conceptualization, methodology, data curation, validation. Asmita Mudholkar: conceptualization, investigation, methodology, writing – review and editing, formal analysis, data curation, visualization, project administration. Stephanie Burke: conceptualization, investigation, methodology, writing – review and editing, formal analysis, data curation, validation. Kehinde Obamiro: conceptualization, investigation, methodology, writing – review and editing, formal analysis, data curation, visualization, validation. Ines Zuchowski: writing – original draft, investigation, conceptualization, methodology, writing – review and editing, formal analysis, data curation, validation.

Ethics Statement

This study protocol was reviewed and approved by the James Cook University Human Research Ethics Committee, approval number H9224.

Conflicts of Interest

The authors declare no conflicts of interest.