Methodological quality of service learning studies in rehabilitation professions: A systematic review

Service-learning (SL) has been widely implemented and grown as a pedagogy in the rehabilitation professions. However, assessment on the quality of evidence for the effectiveness of SL related to student learning outcomes and the scope of SL activities related to the occupation of work in the rehabilitation professions is not available.

This systematic review was to evaluate the rigor of the methodological quality of SL studies and the scope of SL activities related to the occupation of work in the rehabilitation professions.

We performed a systematic on-line electronic literature search of nine bibliographic databases available through the university library system to identify peer-reviewed journal articles on SL provided by the tri-alliance of rehabilitation professional students, with the primary or secondary outcome on the evaluation of student SL experiences. Twenty-two SL articles using experimental design between 1995 and 2016 were extracted as they qualified for the methodological appraisal. Appraisal of each article was performed independently by four investigators using the Effective Public Health Practice Project Quality Assessment Tool for Quantitative Studies.

In six of the 22 SL studies (27%), service provided by the rehabilitation professional students was related to the occupation of work (i.e., assessment, prevention of illness, injury, and disability, and intervention). There was a significant increase in the number (and percent) of SL studies related to the occupation of work compared to that of a previous systematic review (0%, P = 0.03, Fisher's exact test). Results from the evaluation of the methodological quality of these 22 reviewed articles revealed that all received a global rating score of weak. The low methodological quality rating of the reviewed articles was mainly attributed to not controlling for confounders (22 articles), non-blinding (21), and using outcome measures which did not have evidence to support their validity (14). Inability to control for confounders was related to weak research design as more than 77% of the reviewed articles used quasi-experimental designs without a control group. Non-blinding was related to the self-report nature of the outcome measures.

A significant increase in the number of SL studies related to the occupation of work was found, which may provide an indirect indication on an increase in the capacity to provide (work) rehabilitation services. However, selected studies demonstrated high risk of bias which limited firm conclusions to be drawn on reported findings from SL in the tri-alliance of rehabilitation professions curricula.