The Effect of Aged-Care Rural Clinical Placements on Health Student Self-Efficacy: A Mixed-Methods Evaluation

The objective of this study was to determine the effect of rural clinical placements on allied health students' perceived self-efficacy in service delivery, as part of a larger evaluation of facilitated student placements in Northern New South Wales residential aged-care homes.

A mixed-methods design was employed. Allied health students from a variety of universities undertook at least five-week clinical placements in two rural residential aged-care homes via a programme designed and coordinated by the University Centre for Rural Health in partnership with the Aged Care Residential facility. Quantitative data were collected using a modified Self-Efficacy in Clinical Performance Scale, pre and post-placement. Semi-structured interviews were conducted post-placement. Self-efficacy scores were compared using the Wilcoxon Signed-Rank test, and the effect size was calculated. Reflexive thematic analysis was conducted to identify themes from interview transcripts.

Twenty-five students completed the surveys, and 12 interviews were included in this study. There was a statistically significant increase, post-placement compared to pre-placement, in total self-efficacy in clinical performance scores, as well as in subscale scores. The subscales related to assessment, diagnosis, and planning and implementation. Two themes were identified from the qualitative interviews: (1) heightened confidence, independence, and work readiness; and (2) confidence and enthusiasm for interprofessional work.

Our findings provide beginning evidence that a well-resourced and focused programme of clinical placements can improve allied health student self-efficacy and may stimulate greater enthusiasm for working in the rural aged-care sector.