Australian Rural Clinical School Research Articles

Assessing medical student satisfaction with rural placement: The Australian Rural Clinical School Support Survey.

Australia has a doctor shortage in rural settings, and rural placements for medical students have an important role in increasing the likelihood of students staying in rural settings throughout their careers. However, to date there is limited research regarding medical student perceptions of rural placement quality. We aimed to determine factors that impact the overall medical student experience during rural placements. Cross-sectional survey. Rural/remote clinical schools across Australia. Medical students on rural/remote clinical placements for at least 6 months. To assess factors impacting student experience on rural placements, we conducted a cross-sectional survey, known as the Australian Rural Clinical School Support Survey (ARCSSS) which was completed online by medical students across Australia. Demographic data were collected in addition to responses regarding academic teaching, extracurricular activities, and support services. Multiple choice and Likert scale questions were utilised. A total of 107 responses to our survey were analysed. The majority of participants were female (66.4%), and in their middle years of clinical education (55.1%). Overall, respondents showed high levels of satisfaction with clinical school supervisors, and clinical education. A high proportion of respondents indicated minimal accessibility of health and other support services. While a large proportion of participants indicated satisfaction with the rural placements, it was demonstrated that students were generally dissatisfied with school wellness activities and extracurricular activities. Financial insecurity was noted. The findings from our survey indicate there are numerous areas in which rural placements have been effective for medical students, and others in which improvement is needed. Furthermore, more research is required to better develop well-being initiatives that are effective in improving overall experience.

Contemporary Australian socio-cultural factors and their influence on medical student rural career intent.

ObjectiveTo understand how contemporary socio‐cultural factors may impact medical students' rural career intent.DesignCross‐sectional study using data from the national Federation of Rural Australian Medical Educators survey.Participants/settingMedical students across 18 Australian universities who completed a full academic year of clinical training in rural areas in 2019.Main outcome measure(s)Preferred location of practice post‐training reported to be either: (i) a major city; (ii) a regional area or large town; or (iii) a small rural location.ResultsIn total, 626 students completed the survey (70.1% response rate). A small rural location was the most preferred location of practice after graduation for 28.3% of the students (95% CI 21.6–36.0). Four socio‐cultural factors were positively associated with a preference for a rural career location: poor health status of rural people, motor vehicle traffic congestion in cities, rural generalist training opportunities in the state and the Royal Flying Doctor Service. Other socio‐cultural factors, including specialists’ under‐employment, Medicare freeze effect on doctors' income, bullying/sexual harassment in hospitals, climate change/natural disasters or recognised rural health personalities did not influence the investigated outcome.ConclusionsOur findings indicate a novel association between contemporary socio‐cultural factors and rural career intention in a cohort of Australian rural clinical school students. These findings advocate for further consideration of research exploring socio‐cultural factors shaping rural career intent and workforce outcomes.

Impact of the COVID-19 pandemic on medical student placements in rural Queensland: A survey study.

ObjectiveThe COVID‐19 pandemic has adversely impacted medical students' learning experiences. Students in one Australian Rural Clinical School were surveyed to investigate the impact of disruptions to clinical placements and satisfaction with educational changes implemented as a result of the pandemic.DesignCross‐sectional survey.SettingThe University of Queensland Rural Clinical School.MethodsStudents undertaking one or two years of study at the participating Rural Clinical School in November 2020.Main outcome measureA 20‐item anonymised survey with questions on personal health and safety, quality of clinical training experience, response to changes in learning and student environment, and progression to completion of the medical degree.ResultsThe survey was completed by 124 students (76% response rate). Students were satisfied with the changes made to their learning to accommodate the disruptions to health service delivery and placements. Final year students were more satisfied with their learning experiences compared to their third‐year counterparts.ConclusionsThe Rural Clinical School implemented a range of academic and psychological support strategies which appear to have helped with mitigating mental health concerns experienced by students completing rural placements, who are already prone to experiencing social isolation. Strengthening communication between the academic and health service sectors can improve the quality of learning for medical students on placements.

Are Australian rural clinical school students' career choices influenced by perceived opinions of primary care? Evidence from the national Federation of Rural Australian Medical Educators survey.

To investigate whether perceived opinions of primary care are associated with student career preferences after graduation among a rural clinical school cohort and whether the preferred location of practice moderates these relationships. Cross-sectional study using data from the national Federation of Rural Australian Medical Educators survey. Medical students across 18 Australian universities who completed a clinical year in a rural setting in 2019. Career preference in primary care after graduation. The survey was completed by 624 students (response rate=69.9%). A preference for primary care was reported by 35.5% (95% CI: 29.4-42.0) of students and was more likely among those age 30+years, with a rural background, or preferring to practise rurally after graduation. Students reported that primary care was more commonly respected by medical academics (66.8%) than peers (24.0%) or junior/hospital doctors (24.0%). In adjusted analysis, none of the perceived opinions were associated with student career preferences. However, among students aiming to work in small rural locations, a career in primary care was associated with more frequent reports that peers had poor opinions of primary care (P=.004). Rural clinical school students perceive negative opinions of primary care, particularly among peers and junior/hospital doctors. Students aiming to work in small towns after graduation are more likely to report negative opinions among their peers, suggesting they may be more attuned to negative attitudes. This points to the need for a community of practice of like-minded peers and clinicians to preserve the career interest of these students.

Flinders University rural medical school student program outcomes.

The impact of Australian Government Rural Clinical School (RCS) programs onthe geographical maldistribution ofthe Australian medical workforce isimportant to report. This data linkage study compared graduates of the Flinders University medical program who have undergone training in a metropolitan tertiary hospital (Flinders Medical Centre, Adelaide) with those who participated in the Parallel Rural Community Curriculum (PRCC) RCS Program based in rural towns of South Australia between 1999 and 2012. Australian Health Practitioners Authority data were used to determine their location of practice in 2017. In 2017, more than one-third (36.8%) ofPRCC graduates were working in non-metropolitan Modified Monash (MM) 2-7, compared with 20.7% of city campus graduates (odds ratio 2.2; 95% confidence interval: 1.6, 3.0; P <0.001). The difference was even more evident when comparing smaller rural centres inMM 3-7 and MM 5-7. The study demonstrates the strong correlation between the Flinders University RCS Program in South Australia and long-term rural medical workforce outcomes.

Determining the feasibility and effectiveness of brief online mindfulness training for rural medical students: a pilot study

BackgroundWe sought to determine the feasibility and effectiveness of a mindfulness training program, delivered online to medical students at a Rural Clinical School.MethodsAn 8-week online training program was delivered to penultimate-year medical students at an Australian Rural Clinical School during 2016. Using a mixed methods approach, we measured the frequency and duration of participants’ mindfulness meditation practice, and assessed changes in their perceived stress, self-compassion and compassion levels, as well as personal and professional attitudes and behaviours.ResultsForty-seven participants were recruited to the study. 50% of participants were practising mindfulness meditation at least weekly by the end of the 8-week program, and 32% reported practising at least weekly 4 months following completion of the intervention. There was a statistically significant reduction in participants’ perceived stress levels and a significant increase in self-compassion at 4-month follow-up. Participants reported insights about the personal and professional impact of mindfulness meditation training as well as barriers to practice.ConclusionsThe results provide preliminary evidence that online training in mindfulness meditation can be associated with reduced stress and increased self-compassion in rural medical students. More rigorous research is required to establish concrete measures of feasibility of a mindfulness meditation program.

The Australian Rural Clinical School (RCS) program supports rural medical workforce: evidence from a cross-sectional study of 12 RCSs.

Many strategies have been implemented to address the shortage of medical practitioners in rural areas. One such strategy, the Rural Clinical School Program supporting 18 rural clinical schools (RCSs), represents a substantial financial investment by the Australian Government. This is the first collaborative RCS study summarising the rural work outcomes of multiple RCSs. The aim of this study was to combine data from all RCSs' 2011 graduating classes to determine the association between rural location of practice in 2017 and (i) extended rural clinical placement during medical school (at least 12 months training in a rural area) and (ii) having a rural background. All medical schools funded under the RCS Program were contacted by email about participation in this study. De-identified data were supplied for domestic students about their gender, origin (rural background defined as having lived in an Australian Standard Geographic Classification-Remoteness Area (ASGC-RA) 2-5 area for at least 5 years since beginning primary school) and participation in extended rural clinical placement (attended an RCS for at least 1 year of their clinical training). The postcode of their practice location according to the publicly available Australian Health Practitioner Regulation Agency (AHPRA) register was collected (February to August 2017) and classified into rural and metropolitan areas using the ASGC 2006 and the more recent Modified Monash Model (MMM). The main outcome measure was whether graduates were working in a 'rural' area (ASGC categories RA2-5 or MMM categories 3-7) or 'metropolitan' area. Pearson's χ2 test was used to detect differences in gender, rural background and extended placement at an RCS between rural and metropolitan practice locations. Binary logistic regression was used to determine odds of rural practice and 95% confidence intervals (CIs) were calculated. Although data were received from 14 universities, two universities had not started collecting origin data at this point so were excluded from the analysis. The proportion of students with a rural background had a range of 12.3-76.6% and the proportion who had participated in extended RCS placement had a range of 13.7-74.6%. Almost 17% (16.6%) had a principal practice postcode in a rural area (according to ASGC), range 5.8-55.6%, and 8.3% had a principal practice postcode in rural areas (according to MMM 3-7), range 4.5-29.9%. After controlling for rural background, it was found that students who attended an RCS were 1.5 times more likely to be in rural practice (95%CI 1.2-2.1, p=0.004) using ASGC criteria. Using the MMM 3-7 criteria, students who participated in extended RCS placement were 2.6 times as likely to be practising in a rural location (95%CI 1.8-3.8, p<0.001) after controlling for rural background. Regardless of geographic classification system &#40;ASGC, MMM&#41; used for location of practice and of student background (metropolitan or rural), those students with an extended RCS had an increased chance of working rurally. Based on the combined data from three-quarters (12/16) of the Australian medical schools who had a graduating class in 2011, this suggests that the RCS initiative as a whole is having a significant positive effect on the regional medical workforce at 5 years post-graduation.

Block versus longitudinal integrated clerkships: students' views of rural clinical supervision.

Medical students undertaking longitudinal integrated clerkships (LICs) train in multiple disciplines concurrently, compared with students in block rotations who typically address one medical discipline at a time. Current research suggests that LICs afford students increased access to patients and continuity of clinical supervision. However, these factors are less of an issue in rural placements where there are fewer learners. The aim of this study was to compare rural LIC and rural block rotation students' reported experiences of clinical supervision. De-identified data from the 2015 version of the Australian national rural clinical schools (RCSs) exit survey was used to compare students in LICs with those in block rotations in relation to how they evaluate their clinical supervisors and how they rate their own clinical competence. Multivariate general linear modelling showed no association between placement type (LIC versus Block) and reported clinical supervision. The single independent predictor of positive perception of clinical supervisors was choosing an RCS as a first preference. There was also no association between placement type (LIC versus Block) and self-rated clinical competence. Instead, the clinical supervision score and male gender predicted more positive self-ratings of clinical competence. The quality of clinical supervision in block placements and LIC programmes in rural Australian settings was reported by students as equivalent.

Thoughtful questions in the history as new pedagogy for teaching patient centred care: A pilot study in an Australian Rural Clinical School (RCS).

Abstract Introduction: The taking of the patient medical history is at the heart of the doctor patient relationship. It is often critical for a diagnosis and also plays an important part in ongoing clinical care of the patient. However, with the move away from assessment by “long case” to the Objective Structured Clinical Examination (OSCE), medical students spend less time with patients and when they do take a history it is done in a didactic checklist manner. This learning is contrary to the needs of the now more health literate patient. Methods: By an iterative process we developed a program of teaching medical history at the bedside of real patients that focussed on listening to what the patient said as opposed to the traditional history checklist. By anonymous online survey we sought feedback from the students on this way of teaching. Results: Over the three years of this program (from 2013) 76 of the 85 students responded to the survey (89% response rate). Students were mostly receptive to the ideas of following up on clues and information that patients gave them and then presenting this information in a more interesting way to peers. However, there was less enthusiasm, for taking the history in a more casual but patient centred way Conclusion: This program was feasible and welcomed by the students. The major limitations were that students were frustrated by not being taught examinable OSCE cases and that the time commitment by the clinician was onerous.

What is an appropriate social scenario for staff and students at an Australian Rural Clinical School? A survey of fourth and fifth year medical student and #8217;s resident in rural Tasmania.

Introduction: The degree of comfort that medical students have in different social settings with staff and faculty has not been documented. Methods: We undertook in 2012 a survey of 53, 4th and 5th year medical students at the University of Tasmanian Rural Clinical School to determine the incidence of previous inappropriate social invitations/interactions and perceptions of comfort to five different hypothetical social scenarios of different appropriateness. Results: Two students had received what they considered to be an inappropriate invitation. Most students were comfortable with communal public social situations. However, in an overt date scenario eight students were either completely at ease with or comfortable. 18 students although uncomfortable with this scenario would still attend and only 14 students would decline the invitation. Conclusion: There needs to be increased awareness that certain social interactions between health professionals when there is significant difference in hierarchy may not always be appropriate.

Measuring organisational-level Aboriginal cultural climate to tailor cultural safety strategies

Australian medical schools have taken on a social accountability mandate to provide culturally safe contexts in order to encourage Aboriginal and Torres Strait Islander people to engage in medical education and to ensure that present and future clinicians provide health services that contribute to improving the health outcomes of Aboriginal and Torres Strait Islander peoples. Many programs have sought to improve cultural safety through training at an individual level; however, it is well recognised that learners tend to internalise the patterns of behaviour to which they are commonly exposed. This project aimed to measure and reflect on the cultural climate of an Australian rural clinical school (RCS) as a whole and the collective attitudes of three different professional groups: clinicians, clinical academics and professional staff. The project then drew on Mezirow's Transformative Learning theory to design strategies to build on the cultural safety of the organisation. Clinicians, academic and professional staff at an Australian RCS were invited to participate in an online survey expressing their views on Aboriginal health using part of a previously validated tool. Survey response rate was 63%. All three groups saw Aboriginal health as a social priority. All groups recognised the fundamental role of community control in Aboriginal health; however, clinical academics were considerably more likely to disagree that the Western medical model suited the health needs of Aboriginal people. Clinicians were more likely to perceive that they treated Aboriginal patients the same as other patients. There was only weak evidence of future commitments to Aboriginal health. Importantly, clinicians, academics and professional staff demonstrated differences in their cultural safety profile which indicated the need for a tailored approach to cultural safety learning in the future. Through tailored approaches to cross-cultural training opportunities we are likely to ensure participants are able to engage with the material and reflect upon implications of a challenging cultural climate on the health and wellbeing outcomes of Aboriginal people.

Outcomes of Australian rural clinical schools: a decade of success building the rural medical workforce through the education and training continuum

The establishment of the rural clinical schools funded through the Commonwealth Department of Health and Ageing (now Department of Health) Rural Clinical Training and Support program over a decade ago has been a significant policy initiative in Australian rural health. This article explores the impacts of this policy initiative and presents the wide range of educational innovations contextualised to each rural community they serve. This article reviews the achievements of the Australian rural clinical and regional medical schools (RCS/RMS) through semi-structured interviews with the program directors or other key informants. The questions and responses were analysed according to the funding parameters to ascertain the numbers of students, types of student placements and range of activities undertaken by each university program. Sixteen university medical schools have established 18 rural programs, creating an extensive national network of RCS and RMS in every state and territory. The findings reveal extensive positive impacts on rural and regional communities, curriculum innovation in medical education programs and community engagement activities. Teaching facilities, information technology, video-conferencing and student accommodation have brought new infrastructure to small rural towns. Rural clinicians are thriving on new opportunities for education and research. Clinicians continue to deliver clinical services and some have taken on formal academic positions, reducing professional isolation, improving the quality of care and their job satisfaction. This strategy has created many new clinical academics in rural areas, which has retained and expanded the clinical workforce. A total of 1224 students are provided with high-quality learning experiences for long-term clinical placements. These placements consist of a year or more in primary care, community and hospital settings across hundreds of rural and remote areas. Many programs offer longitudinal integrated clerkships; others offer block rotations in general practice and specialist clinics. Nine universities established programs prior to 2004, and these well-established programs are finding graduates who are returning to rural practice. Universities are required to have 25% of the students from a rural background. University admission policies have changed to encourage more applications from rural students. This aspect of the policy implements the extensive research evidence that rural-origin students are more likely to become rural practitioners. Additional capacity for research in RCS has influenced the rural health agenda in fields including epidemiology, population health, Aboriginal health, aged care, mental health and suicide prevention, farming families and climate change. There are strong research partnerships with rural workforce agencies, research centres for early career researchers and PhD students. The RCS policy initiative has vastly increased opportunities for medical students to have long-term clinical placements in rural health services. Over a decade since the policy has been implemented, graduates are being attracted to rural practice because they have positive learning experiences, good infrastructure and support within rural areas. The study shows the RCS initiative sets the stage for a sustainable future Australian rural medical workforce now requiring the development of a seamless rural clinical training pipeline linking undergraduate and postgraduate medical education.

Additional years of Australian Rural Clinical School undergraduate training is associated with rural practice

BackgroundTo understand the influence of the number of years spent at an Australian rural clinical school (RCS) on graduate current, preferred current and intended location for rural workforce practice.MethodsRetrospective online survey of medical graduates who spent 1–3 years of their undergraduate training in the University of New South Wales (UNSW) Rural Clinical School. Associations with factors (gender, rural versus non-rural entry, conscription versus non-conscript and number of years of RCS attendance) influencing current, preferred current and intended locations were assessed using χ2 test. Factors that were considered significant at P < 0.1 were entered into a logistic regression model for further analysis.Results214 graduates responded to the online survey. Graduates with three years of previous RCS training were more likely to indicate rural areas as their preferred current work location, than their colleagues who spent one year at an RCS campus (OR = 3.0, 95% CI = 1.2-7.4, P = 0.015). Also RCS graduates that spent three years at an RCS were more likely to intend to take up rural medical practice after completion of training compared to the graduates with one year of rural placement (OR = 5.1, 95% CI = 1.8-14.2, P = 0.002). Non-rural medicine entry graduates who spent three years at rural campuses were more likely to take up rural practice compared to those who spent just one year at a rural campus (OR = 8.4, 95% CI = 2.1-33.5, P = 0.002).ConclusionsIncreasing the length of time beyond a year at an Australian RCS campus for undergraduate medical students is associated with current work location, preferred current work location and intended work location in a rural area. Spending three years in a RCS significantly increases the likelihood of rural career intentions of non-rural students.

A decade of Australian Rural Clinical School graduates - where are they and why?

The Australian Rural Clinical School (RCS) initiative has been addressing the rural medical workforce shortage at the medical education level for over a decade. A major expectation of this initiative is that it will improve rural medical workforce recruitment and subsequent retention through a rurally based undergraduate clinical training experience. The longitudinal nature of these workforce initiatives means that definitive evidence of its impact on the shortage of rural doctors is yet to be provided; however, to date cross-sectional studies are accumulating a measure of efficacy for these initiatives by monitoring early career factors such as internship location choice and speciality choice of RCS graduates. This article reports on a study in one RCS that is monitoring the impact of rural undergraduate clinical training on trends in workforce participation patterns of its graduates as long as 9 years in the workforce. Career location and speciality choice are reported as well as perspectives on early career intentions and the reality of making career and life decisions as a doctor in the medical workforce. A longitudinal mixed methods sequential explanatory design employed a quantitative data collection phase followed by a qualitative phase with the merging of data sources during the interpretation and analysis. In 2007 a database was established that maintained the contact details of all former graduates since 2002. Every 2 years graduates are invited to participate in a survey and provide an update on the influences on their current career intentions/decisions. The qualitative sample was recruited through a survey question asking for interest in participating in an interview. The whole-sample survey results showed that out of a 64% (N = 115) response rate, 40% of respondents were currently working in non-urban locations. The majority (<n = 51, 53%) had been out in the workforce for 5 to 7 years and general practice was the most frequent speciality choice. Out of 29 interviewees, just over half (n = 16, 55%) were currently working in non-urban locations and primarily in general practice. The majority (n = 17, 58%) had been out in the workforce for 5 to 6 years. Overall they perceived that the primary drivers influencing their early career/life decisions were personal/family reasons and speciality training requirements. The study highlighted what is obvious but often overlooked in recruitment strategies for medical students and prevocational doctors: the significance of the inevitable life decisions that frequently take precedence over career intentions. A decade on there is strong endorsement for the positive influence that rural undergraduate clinical training has on promoting rural career intentions. However the fulfilment of these intentions is at risk when competing with concurrent personal/life choices and while based in an urban training environment. Provision of a continuum of postgraduate training opportunities in rural and regional settings that include a rural focus for specialties such as surgery, anaesthetics and obstetrics could: (1) satisfy speciality training requirements; (2) focus life decisions in a rural environment; and (3) keep rural career intentions viable and congruent with other life goals. The overriding message is: the longer the exposure to training in the rural context, the greater the impact on interest in future rural practice and, particularly, the greater the likelihood that important life decisions will also be made in the rural context.

Rural origin plus a rural clinical school placement is a significant predictor of medical students' intentions to practice rurally: a multi-university study

Health workforce shortages are a major problem in rural areas. Australian medical schools have implemented a number of rural education and training interventions aimed at increasing medical graduates' willingness to work in rural areas. These initiatives include recruiting students from rural backgrounds, delivering training in rural areas, and providing all students with some rural exposure during their medical training. However there is little evidence regarding the impact of rural exposure versus rural origin on workforce outcomes. The aim of this study is to identify and assess factors affecting preference for future rural practice among medical students participating in the Australian Rural Clinical Schools (RCS) Program. Questionnaires were distributed to 166 medical students who had completed their RCS term in 2006; 125 (75%) responded. Medical students were asked about their preferred location and specialty for future practice, their beliefs about rural work and life, and the impact of the RCS experience on their future rural training and practice preferences. Almost half the students (47%; n=58) self-reported a 'rural background'. Significantly, students from rural backgrounds were 10 times more likely to prefer to work in rural areas when compared with other students (p<0.001). For those preferring general practice, 80% (n=24) wished to do so rurally. Eighty-five per cent (n=105) of students agreed that their RCS experience increased their interest in rural training and practice with 62% (n=75) of students indicating a preference for rural internship/basic training after their RCS experience. A substantial percentage (86%; n=108) agreed they would consider rural practice after their RCS experience. This baseline study provides significant evidence to support rural medical recruitment and retention through education and training, with important insights into the factors affecting preference for future rural practice. By far the most significant predictor of rural practice intention is recruitment of students with a rural background who also undertake an RCS placement. This research also demonstrates significant demand for post-graduate rural training places, including specialty places, as RCS graduates become junior doctors and vocational trainees.

Growing rural doctors as teachers: A rural community of medical education practice

This reflective work considered the journey of rural doctors from diverse backgrounds as teachers and academics during the establishment and rapid expansion of an Australian rural clinical school. The observed social and academic processes are analysed in the context of social learning theory. The extent to which the theoretical social processes match observations during a period of transformational change indicates how social learning processes contributed to the outcome. Ten areas of thematic teacher concerns were identified during teachers’ professional development and the strategies used to address these declared. Despite the concurrent evolution of both the overall organisation (teacher environment) and teachers’ task (curriculum approach), a community of rural educational practice (CREP) formed and thrived. It adopted a culture of sharing experiences which enabled ongoing knowledge brokering, engaged experts and transformed members. Critical reflection resulting from engagement in mutual activity and a supporting culture of enablement driven by senior leadership was central to success.A generic framework for building a successful CREP includes, leadership that ‘enables’ its members to flourish, a rural academic identity with a ‘Community of Practice’ governance, internal benchmarking by members to measure and refine practice, critical reflection ‘in’ and ‘on’ academic practice, vertical and horizontal mentoring.

The Value of a Rural Medicine Rotation on Encouraging Students Toward a Rural Career: Clear Benefits From the RUSC Program

Background: The Australian government has addressed rural medical workforce shortages through strategies such as the Rural Undergraduate Support and Co-ordination program, based on the premise that increased exposure to rural medicine within the curricula will contribute to more students adopting a rural career. Purpose: This article reports on how an Australian Rural Clinical School is meeting the aims of this initiative. Methods: Year 3 students (n = 463) from 10 eight-week rural rotations in 2005–2006 evaluated the content and value of rural lectures/workshops and a 6-week rural clinical placement. Results: The aggregate results suggest overall favourable evaluation of the various components of this rotation. Conclusions: A rural rotation can encourage students' interest in and understanding of rural medicine. The longitudinal nature and ongoing evaluation of this program may in time provide more conclusive evidence for this. Challenges such as increasing student numbers, decreasing clinical placements, and logistically complicated programs remain. Research toward alternatives to a “real-life” rural experience may be needed.

Reported reasons of medical students for choosing a clinical longitudinal integrated clerkship in an Australian rural clinical school

With the expectation that students educated in a rural setting will be likely to return to practise in a rural area after graduation, the Rural Clinical School of Western Australia (RCSWA) focuses on long-term placements in rural areas during students' clinical training. to identify why students chose to come to RCSWA. each of the 10 rural and remote sites in the RCSWA office. All students in 2006 and 2007 attending the RCSWA who were available for the mid-year evaluation interviews participated (n = 98). A qualitative thematic analysis of individual interviews was undertaken and emerging themes were compared, with the 2006 data used as a basis to consider the data from 2007. Three major reasons for coming to RCSWA were identified, with most students giving more than one reason. Over 80% of the students reported that they expected to receive broader and better clinical and academic learning opportunities in the rural setting. Three-quarters of the students chose the RCS in order to have the chance to have a year experiencing rural life. One-third of the students came for personal development and increased life experience. The reasons for coming were often multidimensional. Students also articulated reasons for not coming which they considered prior to accepting the position in the RCSWA. In addition, they gave examples of why their decision to come had been a good one, in terms of opportunities for clinical learning and their other identified reasons. Students reported they perceived an academic year spent in a rural area to be so overwhelmingly positive that they were prepared to give up everything the city has to offer and go to a different, often challenging environment in order to participate.

The Rural Clinical School Tracking Project: More IS better – Confirming factors that influence early career entry into the rural medical workforce

Introduction: This longitudinal tracking project by the University of Queensland Rural Clinical School (UQRCS) provides data on the early career pathways of alumni since its inception in 2002. Specifically we report on; (1) perceptions of the UQRCS regarding its influence on current career choice, (2) current speciality choices, and (3) factors that influenced these choices.Methods: A retrospective web-based survey of all graduates who undertook clinical Year 3, Year 4 or Years 3 & 4 at UQRCS from 2002 to 2006. Associations with demographics, Year(s) at UQRCS, current workplace and speciality choice were assessed.Results: Response rate was 69%, (N = 180). Alumni who spent two years (Years 3 & 4) at UQRCS reported significantly higher degrees of encouragement to pursue a rural career. Alumni currently working in a non-urban location had spent two years at UQRCS and were significantly higher in desire to remain rural. ‘Time spent at the UQRCS’ contributed most to interest in a rural career. General practice and emergency medicine were most preferred specialities.Conclusions: Findings confirm that a longer rural clinical experience is more effective in eventual choice of workplace location and future interest in a rural career. This corroborates the positive impact of Australian rural clinical schools toward rural medical workforce improvement.

Will Australian rural clinical schools be an effective workforce strategy? Early indications of their positive effect on intern choice and rural career interest

Will Australian rural clinical schools be an effective workforce strategy? Early indications of their positive effect on intern choice and rural career interest