MENTAL WELLBEING OF ALLIED HEALTH STUDENTS IN CLINICAL TRAINING: A SCOPING REVIEW

Background: Increasing number of clinicians experience psychological consequences attributed to poor qualities of work environment. Healthcare students are subjected to the same environment during clinical training. While a lot is known about the effect of workplace clinical training on the mental wellbeing of medical and nursing students, not much is known about its effect on allied health professions (AHP) students, including physiotherapy clinical students. Understanding the effect of clinical training to mental wellbeing of AHP students and the contributory factors may help guide wellbeing initiatives developed by institutions and facilitate reflection from the clinical education community.

Purpose: This scoping review aimed to understand how AHP student mental wellbeing is affected by clinical training and map current recommendations to improve practice.

Methods: Guided by the Arksey and O’Malley framework, a search was conducted in major databases and supplemented with snowball sampling and personal reference lists. Included papers discussed effects of workplace clinical training on mental wellbeing and focused on entry-level programs. Excluded articles focused on non-AHP health disciplines, years without clinical training, or post-registration programs only.

Results: Twelve studies were included from 927 records screened. The search resulted to studies mostly originating from high income countries (n=11, 91.67%) and from a minority of AHP (Dietitians, OT, PT, Radiographers, SLP, and Paramedics). A preference for cross-sectional descriptive study design using questionnaire (n=8, 66.67%) was also noted. Ten studies used negative terms to describe mental wellbeing, such as stress, burnout, anxiety, and fatigue, while only two used mental wellbeing or wellbeing. The majority found increased stress and adverse psychological consequences in AHP students undergoing clinical training. Changes in compassion satisfaction and emotional intelligence were also noted in three studies. These effects were found to be influenced by interactions with supervisors and staff as well as the quality of supervision provided, emotional burden of the caring professions, the dual workload as students and healthcare providers, demands of transitioning from classroom to clinic, and the burden of training on personal conditions. Recommendations focused on acknowledging and identifying effects of clinical training on mental wellbeing of students, providing support and preventive training for students, increasing awareness of influence of supervisors and empowering them to provide support and signposting, and creating a more inclusive, supportive, and participative learning environment in the workplace.

Conclusion(s): AHP students in the workplace experience adverse effects on wellbeing due to the social environment and workload associated with training. Strategies to assist and empower students are needed. Educators, supervisors and institutions should also be equipped to provide wellbeing support. Further research is needed to evaluate effectiveness of interventions and explore positive effects on mental wellbeing, especially from low- and middle-income countries.

Implications: This review is the first to map effects of clinical training on mental wellbeing of allied health students and associated factors from the literature. This study also provides recommendations to improve wellbeing practices in clinical placements.

Funding, acknowledgements: The author was supported by the University of the Philippines Faculty, REPS and Administrative Staff Development Program.

Keywords: mental wellbeing, clinical training, allied health professions

Topic: Education

Did this work require ethics approval? No

Institution: N/A

Committee: N/A

Reason: Ethics approval was not required because the research project did not involve new data collection.