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Comparison of paired and single clinical placement models: a time-use analysis.

BACKGROUND
To meet rising clinical placement demand caused by increasing health student numbers, the use of paired (two students) rather than single (one student) placement models has been proposed. There is, however, limited research available to inform placement providers about the relative effects of both models on healthcare services, including patient- and non-patient-related activities and patient occasions of service.


AIMS
To investigate a key clinical question: Does clinical educator (supervisor) and student time use differ during paired placements compared with single placements? Also to examine the satisfaction levels of clinical educators (CEs) and students with paired and single clinical placement models.


METHODS & PROCEDURES
Queensland Health speech and language therapists (N = 44) and speech and language therapy students (N = 32) involved in paired or single clinical placements were recruited for this study. CEs and students completed time-use surveys for 3 days after the midpoint of placements; CEs also completed surveys for 3 matched days during a non-placement period 3 weeks or more following placements for comparative purposes. CEs and students additionally completed a satisfaction survey at the end of placements. Paired and single CE and student groups were compared for differences in their time-use and satisfaction levels using non-parametric statistics.


OUTCOMES & RESULTS
The placement model did not impact on occasions of service provided by CEs (p = 0.931) or students (p = 0.776). It also had no effect on the percentage of time CEs or students engaged in patient-related activities (p = 0.577; 0.291) and non-patient-related activities (p = 0.559; 0.177). On clinical placement days, CEs spent a median 10 minutes longer at work regardless of whether or not it was a paired or single placement, compared with non-placement days (p = 0.107). CEs and students who had been involved in a paired placement reported the same high levels of placement satisfaction (various measures) as those who had been involved in a single placement.


CONCLUSIONS & IMPLICATIONS
The paired-placement model has the potential to increase student placement offers without negatively impacting on clinical service provision including occasions of service, patient or non-patient-related activities, or overall CE time spent at work.