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

Student-led physiotherapy services provide care delivered by physiotherapy students under the supervision of registered physiotherapists. These models may improve access to physiotherapy services, increase healthcare capacity and support workforce development, particularly in communities experiencing social disadvantage. This study evaluated a musculoskeletal student-led physiotherapy service by examining patient-reported outcomes and service activity. This observational pre-post cohort study included adults referred to the Logan Healthcare Centre musculoskeletal physiotherapy service with Category 3 (non-urgent) musculoskeletal conditions. Participants received physiotherapy care delivered by final-year physiotherapy students under the supervision of registered physiotherapists. Pain, function and health-related quality of life were assessed using the Numeric Pain Rating Scale, Patient-Specific Functional Scale and World Health Organization Quality of Life-BREF, respectively. Changes between the initial and final clinic visits were examined using linear mixed-effects models. Service activity was described using routinely collected data, including occasions of service and workforce utilisation. During the 2023 evaluation period, the service assessed 577 referrals from the waiting list, including 141 Category 3 musculoskeletal referrals. Of these, 56 participants consented to patient-reported outcome analysis. Participants had a median age of 54 years and a median symptom duration of 36 months. Patient-specific function significantly improved from the initial to the final clinic visit (mean change + 2.0, 95% CI 1.4 to 2.5, P < 0.001). No statistically significant changes were observed for 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%. The service 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. This study suggests that a musculoskeletal student-led physiotherapy service can support significant improvements in patient-specific function while delivering substantial service activity. Student-led physiotherapy services may offer a valuable model for supporting healthcare delivery and workforce development. particularly in communities experiencing social disadvantage.