Student-Led Clinic Shows Functional Gains in Disadvantaged Community

An observational pre-post cohort study found that adults receiving non-urgent musculoskeletal physiotherapy from a student-led clinic in a socially disadvantaged community experienced a statistically significant improvement in patient-specific function. The change was measured among 56 participants who consented to the patient-reported outcome analysis at the Logan Healthcare Centre service in 2023. Their mean score on the Patient-Specific Functional Scale increased by 2.0 points between the initial and final clinic visits, with a 95% confidence interval of 1.4 to 2.5 and P < 0.001.

Pain and health-related quality of life did not show statistically significant changes during the same evaluation. The study focused on adults referred with Category 3, or non-urgent, musculoskeletal conditions. Care was delivered by final-year physiotherapy students under the supervision of registered physiotherapists.

Researchers assessed pain using the Numeric Pain Rating Scale, function using the Patient-Specific Functional Scale and health-related quality of life using the World Health Organization Quality of Life-BREF. Linear mixed-effects models were used to examine changes between initial and final clinic visits, while routinely collected data described service activity. Among the participants included in the outcome analysis, the median age was 54 years and the median symptom duration was 36 months.

Patient-specific function improved significantly, but the analysis did not detect statistically significant changes in pain or quality of life. At discharge, participants reported a median self-perceived improvement of 75% and a median confidence to self-manage of 95%. These figures were recorded separately from the initial-to-final scale changes, and the study does not establish that the student-led model itself produced the functional improvement.

As an observational pre-post cohort study without a comparison group, the findings show changes over time but cannot determine how much of that change was attributable to student delivery rather than other aspects of care, natural variation or other factors. Service records showed that the clinic assessed 577 referrals from the waiting list during the 2023 evaluation, including 141 Category 3 musculoskeletal referrals. It delivered 539 new patient consultations, 2,301 review consultations and 861 group treatment occasions while operating with 2.0 full-time equivalent physiotherapists supervising 60 physiotherapy students.

The outcome sample was substantially smaller than the number of referrals assessed or consultations delivered, so the functional results describe the participants who consented to the patient-reported outcome analysis rather than the entire service population. The service figures nevertheless demonstrate the scope of clinical activity and supervision during the evaluation period. Overall, the study suggests that a supervised student-led musculoskeletal physiotherapy service can deliver patient care and provide an opportunity for functional improvement in a community experiencing social disadvantage.

The authors described the model as potentially valuable for healthcare delivery and workforce development, but the evidence presented is limited by its observational design, the small outcome-analysis group and the lack of a control service.

Subject of Research: Patient-reported outcomes and service activity at a supervised student-led musculoskeletal physiotherapy clinic serving a socially disadvantaged community.

Article Title: Patient-reported outcomes and service evaluation of a student-led musculoskeletal physiotherapy clinic in a socially disadvantaged community: an observational cohort study

Article References: Hams, A., Parnwell, L., Louwen, C., Collings, T., Bisset, L., Gordon, S., & Jones, T. (2026). Patient-reported outcomes and service evaluation of a student-led musculoskeletal physiotherapy clinic in a socially disadvantaged community: an observational cohort study. BMC Health Services Research. https://doi.org/10.1186/s12913-026-15637-1

Image Credits: AI Generated

DOI: 10.1186/s12913-026-15637-1

Keywords: student-led physiotherapy, musculoskeletal care, patient-reported outcomes, functional improvement, self-management, health service evaluation, social disadvantage, clinical education, observational cohort study, Patient-reported, outcomes, service