Quality, Quantity, Scope, and Trends for Research on Student-Run Clinics in the United States: A Scoping Review of the Existing Literature.

Abstract

Purpose: This study characterizes the quality, quantity, scope, and trends for literature on student-run clinics (SRCs) in the United States.

Method: Following PRISMA guidelines, the authors searched PubMed, Embase, Ovid MEDLINE, Web of Science, and SCOPUS for publications concerning SRCs in the United States involving MD and DO students for all years up to March 1, 2024, and every publication from the Journal of Student Run Clinics and Free Clinic Research Collective. The authors used inductive analysis to identify literature themes and performed a standardized methodological quality assessment for research articles.

Results: Of 7,584 results, the search identified 503 publications, including 278 primary research (55%), 14 reviews (3%), and 211 nonresearch (42%) (e.g., viewpoint articles). Most research was cross-sectional (160 of 292 [55%]) and of low methodological quality (195 of 282 [69%]; 10 studies excluded from quality assessment). Volunteer outcomes were most studied (n = 97), with volunteer satisfaction (n = 62) being the most studied topic. Patient clinical (n = 42) and behavioral (n = 21) outcomes were studied less. Of the 278 primary research articles, 237 (85%) concerned individual clinics and 91 (33%) were produced by 10 institutions. Underrepresented topics include ethics, policy, social work, community participatory research, and national studies of SRCs.

Conclusions: Despite the rapid growth of SRCs and publications describing them, quality research is lacking, and patient outcome data are limited. The literature has high representation bias, where existing evidence disproportionately describes a small subset of institutions. Most SRCs have not published empiric data and most research is nongeneralizable to other SRCs, limiting the overall understanding of these clinics. These findings underscore clear priorities for developing the knowledge base for this rapidly growing component of the U.S. safety net health care system.