Abstract
BackgroundThere is an ongoing debate about the impact of studying medicine in rural vs. metropolitan campuses on student assessment outcomes. The UNSW Medicine Rural Clinical School has five main campuses; Albury-Wodonga, Coffs Harbour, Griffith, Port Macquarie and Wagga Wagga. Historical data of student assessment outcomes at these campuses raised concerns regarding potential biases in assessment undertaken, as well as the availability and quality of learning resources. The current study aims to identify the extent to which the location of examination (rural versus metropolitan) has an impact on student marks in OSCEs.MethodsAssessment data was employed for this study from 275 medical students who sat their final examinations in Years 3 and 6 of the undergraduate Medicine program at UNSW in 2018. The data consists of matched student assessment results from the Year 3 (Y3) MCQ examination and OSCE, and from the Year 6 (Y6) MCQ, OSCE and management viva examinations. The analysis used Univariate Analysis of Variance and linear regression models to identify the impact of site of learning and site of examination on assessment outcomes.ResultsThe results demonstrate that neither site of learning nor site of examination had any significant impact on OSCE or Management Viva assessment outcomes while potential confounders are controlled.ConclusionIt is suggested that some of the supposed disadvantages inherent at rural campuses are effectively mitigated by perceived advantages; more intensive interaction with patients, the general and medical communities at those sites, as well as effective e-learning resources and moderation of assessment grades.
Highlights
There is an ongoing debate about the impact of studying medicine in rural vs. metropolitan campuses on student assessment outcomes
Data consist of matched student assessment results from the Year 3 (Y3) Multiple Choice Questions (MCQ) examination and Objective Structured Clinical Examination (OSCE), as well as from the Year 6 (Y6) MCQ, OSCE and management viva examinations
The only impact on Y6 MCQ results was of the Y3 MCQ results (Table 2)
Summary
There is an ongoing debate about the impact of studying medicine in rural vs. metropolitan campuses on student assessment outcomes. Many medical schools in Australia, New Zealand, Canada and elsewhere have developed rural clinical schools where students live and study in these rural communities for a significant length of time during their medical training (for example: [1, 8,9,10]).enhancing medical students’ experience in rural placements has become an important objective for these schools. With this in mind, there is evidence suggesting that the clinical learning experience of students in rural. Possible explanations for such impact of rural clinical experiences might be related to the nature of rural settings, whereby students are most commonly engaged in more intimate clinical settings learning in smaller groups which foster greater personal interactions with clinicians and the community, and experiencing a lower ratio of medical students to available patients [13,14,15]
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