Clinical Placement Experiences Research Articles

Exploring clinical facilitation and student learning on undergraduate nursing placements through a community of practice lens: A qualitative study

Background: High-quality clinical placement experiences are important for preparing undergraduate student nurses for practice. Clinical facilitation and support significantly impact student placement experiences and their development of skills, knowledge, and attitudes in the healthcare setting. Aim: This research aimed to explore university-employed clinical facilitators’ perspectives on providing quality clinical facilitation and student learning on placement. Design: An exploratory, descriptive research design was used to examine the perspectives of n = 10 university-employed clinical facilitators working in regional New South Wales, Australia (March 2020-December 2021). Methods: Semi-structured interviews were used to explore the experiences of a purposeful sample of university-employed clinical facilitators. Data was thematically analysed using Miles et al.'s (2014) qualitative data analysis framework. Results: Five key themes were identified 1) relationships at the core of quality, 2) a culture of commitment to student learning, 3) connection to the curriculum, 4) examining the model, and 5) empowering growth and development. Clinical facilitators perceive their role as misunderstood, undervalued, and isolating and that they require further preparation and ongoing professional development to provide quality facilitation. Building rapport and relationships with staff and students was at the core of quality clinical facilitation. Conclusions: The clinical facilitator role has an important function in preparing student nurses for practice and needs further recognition and continued professional development. Education providers and healthcare organisations need to examine strategies to provide inclusive and supportive work environments, building communities of practice for clinical facilitators and stakeholders to share their experiences and knowledge, promoting individual and group learning, thus improving the student placement experience and fostering the professional identity of clinical facilitators.

Maximising your clinical placement experience.

Final-year student Aghogho Wanogho offers advice, for those starting out on their nursing journey, on making the most of the learning opportunities while on placement.

Insights from the Field: A Phenomenological Study of Radiography Students' Computed Tomography Clinical Placement Experiences

Introduction: While there are studies that explore the overall experiences of radiography students during clinical placements, there is a lack of research specifically focusing on the experiences of students in the context of computed tomography (CT). Therefore, this study aimed to understand the experiences of radiography students during their clinical placements in CT imaging at a tertiary institution in Harare, Zimbabwe.
 Methods: A qualitative descriptive phenomenological study design employing one-on-one interviews with 15 undergraduate students was conducted. The interview data was managed in Nvivo 12, and the analysis was based on Giorgi’s structured way of analyzing phenomenological data.
 Results: The findings show that student's experience during CT clinical placements was diverse and distinct compared to their other placements. Four themes emerged from the interview data that summarised their experiences i. Nervousness ii. Limited CT clinical exposure iii. Theory to Practice Conversion, and iv. Interpersonal skills. Initially, they felt nervous, but later they found the placements to be interesting and challenging. Some students were able to apply their theoretical knowledge to practical situations. Students also had an opportunity to improve their interpersonal skills. However, students also faced challenges such as equipment breakdowns and a shortage of consumables. These affected the student's ability to acquire the necessary clinical skills within the given timeframe.
 Conclusion: Given the limitations in accessing CT practical experience, innovative strategies such as software simulation-based training, particularly virtual reality CT simulation, are suggested to enhance students' preparedness.

Physiotherapy students' perspectives of a blended learning approach through the COVID-19 pandemic years

The Waikato Institute of Technology launched an innovative approach in 2019 to deliver a Bachelor of Physiotherapy degree. The programme utilised a blended-block learning andragogy of face-to-face (block-week) and online learning. At the end of the first 4-year cycle, it seemed pertinent to understand the students’ perspective of this approach, while recognising possible effects of the COVID-19 pandemic. An online questionnaire was distributed to a sample of students (n = 70), with 44% completing the survey. Preference to continue with block-week learning was split: 32.2% of students wished to continue with the current approach, 32.2% preferred to discontinue and return to traditional campus teaching, and 35.6% were unsure. Those students who preferred to discontinue predominantly originated or moved to the Hamilton region for study. Students who preferred block-blended learning were often from a population that the programme was meant to serve, living in rural areas and/or having significant family/community responsibilities, meaning they were unable to move to the institute and would struggle to access the course in any other manner. To reduce fatigue and improve satisfaction, students also suggested mixing content delivery every week, engaging in 2–3 days of face-to-face sessions and 2 3 days online, moving away from block-learning yet retaining blended-learning. Most students believed the course was well positioned to manage the effects of COVID-19; however, they recognised practical skills learning and access to clinical placement experience was reduced. Future research could focus on exploring the benefits and barriers of online learning developed for physiotherapy-specific content.

Implementation of a Blended-Learning Perioperative Nursing Education Program in Canada.

Governmental COVID-19 mandates in Ontario, Canada, resulted in a backlog of perioperative procedures. Organization leaders were required to expand services after the pandemic; however, the ongoing nursing shortage and college-based structure of perioperative education programs complicated their response. In 2021, we developed an in-house perioperative education program using a blended-learning theory comprising online modules and videos, skills laboratory sessions, and clinical placement experiences. Nurses were required to apply for the program and remain employed at the facility for two years. Program evaluations showed that the novice nurses felt confident when beginning clinical experiences and preceptors believed the nurses were prepared for practice. Sixteen of 19 participants successfully completed the program, which helped resolve the staffing shortage. Novice nurses may benefit from a shadowing experience before applying for this type of program. Leaders in nonperioperative specialties should consider an in-house education program to help meet staffing needs in their areas.

Exploring the sociocultural experiences of student veterinary nurses in the clinical learning environment through the lens of situated learning theory.

Student veterinary nurses (SVNs) complete significant time in clinical placements and this training can have a positive or negative impact on the development of professional skills and identity. A cross-sectional design, using semi-structured interviews, explored 12 SVNs' experiences of clinical placements. Interpretative phenomenological analysis was used to explore each individual participant's experience, prior to the identification of themes across participants' experiences. Most students reported a sense of belonging within the practice team, which fostered engagement. Clinical supervisors were considered key role models and vital support for student progress. Students reported conflict between the demands of the practice and the requirements of their student status. Some poor interpersonal interactions led to reduced confidence. The results may not reflect experiences of the diversity of student demographics, such as those students with protected characteristics, as described in the Equality Act 2010, who may encounter specific workplace challenges. To ensure parity and positive experiences, accredited educational institutes can plan regular engagement with student feedback and support of the training practice. Training practice teams can ensure they are meeting the student's needs and fostering a positive learning environment by adhering to the RCVS Framework for Veterinary Nurse Education and Training, which will, in turn, benefit the whole team. Clinical supervisors can play a convening role in increasing belonging and participation within the clinical learning environment.

GP trainees as teachers: a rapid review of the barriers, facilitators and outcomes

ABSTRACT Background There is a workforce crisis in General Practice (GP) within the United Kingdom (UK). High-quality clinical placement experiences in GP influence medical students’ interest and likelihood to enter this speciality. GP trainees often express a desire to teach, yet teaching does not feature significantly within their current practice. This study aims to explore outcomes, barriers, and facilitators of GP trainees teaching medical students through a rapid review of published literature. Methods MEDLINE, EMBASE, PsychINFO, Web of Science were searched for articles relating to GP trainees teaching. Studies conducted in the UK and Australia, between January 2000 and October 2022 were included. The Medical Education Research Study Quality Index and the Critical Appraisal Skills Programme checklist were used to assess quality. Results Twenty-seven publications, 11 qualitative, six quantitative, three mixed-methods and seven opinion pieces, were identified. Many studies have methodological limitations. Empirical studies show that there are benefits of near-peer teaching, but these are limited by trainees’ capacity and capability to teach, and GPs' confidence in trainees’ teaching. The culture within the practice influenced whether trainees were seen solely as learners or also as teachers for students. Discussion When GP trainees teach there are positive outcomes for medical students and trainees. Teaching was considered an activity that trainees did in ‘addition to’ rather than ‘part’ of’ their training. Appropriate teaching opportunities, and relevant training, were key to trainees’ competence and confidence in teaching. Resources and recognition and a strong teaching culture are needed to support GP trainees to teach.

Clinical Placement Experience, Supervision, and Nursing Career Aspirations of Undergraduate Nursing Students in Sarawak, Malaysia

This study aimed to explore nursing students' perceptions of the clinical learning environment and mentorship during their clinical placement in hospitals and how these factors relate to their intention to work as a nurse upon graduation. A survey was conducted among nursing students who had completed at least 12 months of clinical practice in hospitals located in Kuching, Sarawak, between January 2022 and February 2023. Data were analysed using percentages, frequencies, mean, standard deviation, t-test, Pearson's correlation, ANOVA, and regression analysis. Our findings revealed a significant correlation between the sociodemographic characteristic such as age of students and year of study towards clinical learning experience. Student perceived ward as good learning environment, clinical teacher teaching expertise, and clinical teacher ability to integrate between knowledge and practice rated the most satisfying element in students’ clinical experience. Our study established a significant correlation between student age, year of study, and their clinical learning experiences. Students found the ward environment, clinical teacher expertise, and knowledge-to-practice integration to be highly satisfying elements in their clinical education.

Aesthetic Expression as a Means to Nurture "Self" in a Basic Nursing Care Practicum.

Nursing students develop their professional "self" through clinical placement experiences. Aesthetic expression can be used as a means to reflect students' personal knowing and to convey self as nurtured during their clinical journey. In a postconference session of the Basic Nursing Care Practicum course, six students were asked to draw pictures reflecting their clinical experience and then share their stories. It appeared that nursing students learned the meaning of nursing and caring, and through these meanings, their actual self as nurses was also developed.

Modifiable factors contributing to belongingness of undergraduate nursing students in the clinical learning environment: An exploratory study

BackgroundBelongingness has been tied to positive personal and educational outcomes in undergraduate nursing students in the clinical learning environment, but there is limited literature on specific factors that promote these important feelings of acceptance and value alignment. ObjectivesThis study aimed to assess demographic characteristics, program/clinical structure factors, and modifiable clinical setting factors that may impact feelings of belongingness in U.S. undergraduate nursing students in the clinical learning environment. DesignA cross-sectional survey design was used to assess the relationship between demographics, program/clinical structure factors, and modifiable clinical setting factors and levels of belongingness using the U.S. version of the Belongingness Scale – Clinical Placement Experience. SettingA national study was conducted via the National Student Nurses Association database from December 2022 to January 2023. Participants759 volunteer undergraduate nursing students in the U.S. who had completed at least one clinical course. MethodsAn online survey was disseminated to assess demographic factors, program/clinical structure factors, students’ perceptions on the frequency of occurrence and perceived value of modifiable clinical setting factors (including clinical format, clinical site, relationship and interpersonal, and miscellaneous factors), and to measure levels of belongingness experienced. ResultsBivariate analyses revealed one statistically significant program/clinical structure factor (p <.001) and 10 statistically significant modifiable clinical setting factors (p <.001) that contribute to belongingness. The findings also support the use of the U.S. version of the BES-CPE as a reliable and valid instrument. ConclusionsResults demonstrate the importance of fostering belongingness in undergraduate nursing students in the clinical learning environment and, for the first time, extrapolate qualitative findings from the literature into the identification of factors that contribute to these critical feelings of inclusion. There are immediate implications for nursing educators and a rich foundation for future intervention research is proposed.

Factors Influencing Postgraduate Student Midwives Clinical Experience

Postgraduate student midwives are a unique cohort of students with many factors influencing their clinical placement experience. As registered general nurses, they return to being a student to undertake a Higher Diploma in Midwifery programme. A qualitative study was undertaken to identify supports and challenges encountered by postgraduate student midwives during their clinical placement in an Irish maternity hospital. By creating an awareness of the factors which influence postgraduate student midwives clinical experience, an environment can be promoted where students feel valued, supported and work with midwives who are understanding of the students’ needs and keen to share their knowledge.

Midwifery students’ experiences of their clinical internship placement during the COVID-19 pandemic in Ireland: A qualitative descriptive study

ObjectiveTo explore the impact of the COVID-19 global pandemic on midwifery students’ experiences of clinical internship placement in the final year of their midwifery programme. DesignA qualitative descriptive study was conducted following ethical approval. Four online focus groups were facilitated. Setting and participantsTo prepare for autonomous practice, BSc Midwifery students in the Republic of Ireland (RoI) undertake a 36-week internship in the final year of their programme. Midwifery students (n = 15), from one Higher Education Institute (HEI), who were undertaking internship across two clinical practice sites volunteered to participate in the study. FindingsFour overarching themes were identified: Fear and uncertainty of internship in the context of a pandemic, Consequences of COVID-19 within the clinical environment, Student supports, Opportunities and challenges during internship. Working within a health care environment dominated by the presence of COVID-19 had significant consequences for the students and their provision of care for women and families. Students were challenged with managing increased responsibility within the context of COVID-19 practice requirements and restrictions. Students balanced their need to progress to autonomous practice, whilst acknowledging their needs as learners. COVID-19 also brought unexpected benefits, which included enhancing students’ ability to develop relationships with women in their care, and students described a sense of belonging within the midwifery team. Key conclusions and implications for practiceMidwifery students identified internship, during the COVID-19 pandemic as challenging and stressful. However, students also portrayed a sense of pride in their achievements. Support structures assisted students to cope during this period which included peer support, protective reflective time (PRT) in the HEI and support from clinical placement coordinators in midwifery (CPC-Midwifery) within clinical placements sites. It is essential that these support structures continue within midwifery educational programmes. Promoting peer support in a more formal support structure may need consideration. These support structures need to be protected and enhanced during unprecedented times, such as the COVID-19 pandemic.

Impostor phenomenon traits in radiography students: Findings from a UK pilot survey

IntroductionImpostor Phenomenon (IP) includes feelings of being a fraud, which can be associated with high anxiety levels. Research suggests healthcare students on clinical placement report high levels of anxiety. This study aimed to explore radiography students' (diagnostic and therapeutic) IP traits within the United Kingdom (UK). MethodsThe pilot study used a mixed-method online survey, applying the Clance Impostor Phenomenon Scale (CIPS). Internal student recruitment used the university virtual learning environment (VLE), and external UK recruitment used social media with a convenience sampling method. The survey included demographic questions (gender, age, year of study, course). The statistical analysis used the Kruskal-Wallis test for the quantitative responses and content analysis of the qualitative responses. ResultsThe survey received n = 92 responses; 77% were found to have frequent or intense IP traits. No significant differences were identified by age (p = 0.46) or radiography programme (diagnostic or therapeutic) (p = 1.00). The year of study demonstrated a significant difference (p = 0.01), with second-year students scoring a higher CIPS score (78.56) than first and third years (72.41 and 66.17, respectively). There was also a significant difference between males and females surveyed (p = 0.001). The thematic analysis highlighted that the clinical placement environment, prior IP knowledge, feelings of not belonging, and being an older/mature student increased IP feelings. ConclusionBoth therapeutic and diagnostic students returned a high CIPS score >70, demonstrating that IP traits were present in the sample of survey responses. Although being an older/mature student was a subtheme in qualitative responses, the quantitative data displayed no statistical difference amongst the CIPS scores by age. A significant difference between males and females surveyed (p = 0.001) and year of study (p = 0.01) was found with second years students scoring higher (mean CIPS score of 75.56) than first and third-year students (72.41 and 66.17, respectively). The qualitative responses further suggested as clinical placement experiences increased, feelings of IP decreased. Implications for practiceEducational intervention methods such as workshops may assist radiography students in identifying and coping with IP traits before their first clinical placement.

Evaluating Allied Health Clinical Placement Performance: Protocol for a Modified Delphi Study.

University-affiliated student-led health care services have emerged in response to the challenges faced by universities in securing quality clinical placements for health care students. Evidence of the health care benefits and challenges of student-led health care services is growing, while evidence of clinical placement performance remains variable and not generalizable. Though there have been previous attempts to develop a framework for evaluation of clinical placement performance, concerns have been raised about the applicability of these frameworks across the various placement settings. Additionally, the perspectives of all key stakeholders on the critical areas of clinical placement performance have yet to be considered. This study's objective is to gather information on areas of measurement related to student learning outcomes, experience of placement, and costs of placement and then develop consensus on which of those areas need to be included in a framework for evaluation of clinical placement performance within the context of student-led health care services. The aim of this paper is to outline a protocol for a modified Delphi study designed to gain consensus on what is important to measure when evaluating an allied health clinical placement. We will recruit up to 30 experts to a heterogeneous expert panel in a modified Delphi study. Experts will consist of those with firsthand experience either coordinating, supervising, or undertaking clinical placement. Purposive sampling will be used to ensure maximum variation in expert panel member characteristics. Experts' opinions will be sought on measuring student learning outcomes, student experience, and cost of clinical placement, and other areas of clinical placement performance that are considered important. Three rounds will be conducted to establish consensus on what is important to measure when evaluating clinical placement. Each round is anticipated to yield both quantitative data (eg, percentage of agreement) and qualitative data (eg, free-text responses). In each round, quantitative data will be analyzed descriptively and used to determine consensus, which will be defined as ≥70% agreement. Qualitative responses will be analyzed thematically and used to inform the subsequent round. Findings of each round will be presented, both consensus data and qualitative responses in each subsequent round, to inform expert panel members and to elicit further rankings on areas of measurement yet to achieve consensus. Data analysis is currently underway, with a planned publication in 2024. The modified Delphi approach, supported by existing research and its ability to gain consensus through multiround expert engagement, provides an appropriate methodology to inform the development of a framework for the evaluation of clinical placement performance in allied health service. DERR1-10.2196/44020.

Competencies Associated With Australian and New Zealand Podiatrists’ Perceptions of Their Preparedness for Graduate Clinical Practice

Podiatry training institutions are responsible for preparing future podiatrists to be competent and safe practitioners. This follow-up study investigated podiatrists’ self-reported preparedness to practice through their ratings of various competencies. An online retrospective survey comprising closed and open-ended questions was distributed to registered and practising podiatrists in Australia and New Zealand. Of the 74 podiatrists who completed the survey, 75.7% felt “prepared” for clinical practice at graduation, with preparedness univariately associated with being female (p = .042), overall perception of clinical competence (p = .004), preparedness for clinical placement as a student (p &lt; .001), theoretical knowledge (p &lt; .001), manual skills (p = .002), and clinical competence standards (p &lt; .001). Multivariable analysis identified preparedness for student clinical placement (OR = 8.95, 95%CI 1.92 – 41.76) and overall theoretical knowledge (OR = 19.29, 95%CI 3.76 – 99.13) being significantly associated with perceived preparedness for practice. Age, qualification, and graduation year were not associated with perceived preparedness. Positive clinical placement experiences enhanced their perceived preparedness, while limited clinical exposure hindered preparedness, potentially resulting in a probable theory-practice gap, and lowered professional self-efficacy. While generally feeling prepared to practice as podiatrists at graduation, they identified the need for additional hands-on learning with early patient exposure in diverse settings during their training, which should improve self-efficacy.

Clinical placement education during the coronavirus disease 2019 pandemic shapes new nurses: A qualitative study

BackgroundMany newly qualified nurses experience transition challenges because they feel unprepared for the reality of the nursing profession owing to the theory-practice gap. Transition challenges amongst newly qualified nurses have profound consequences for the nursing profession and patient care. A detailed and nuanced understanding of the complexity in transition-related challenges during extraordinary conditions like the coronavirus disease 2019 pandemic is needed for newly qualified nurses to remain in the nursing profession. ObjectiveThis study explored the experience of newly qualified nurses entering the nursing profession who had their clinical placement education missed, shortened, or substituted since they had to serve as health care assistants during the coronavirus disease 2019 pandemic. DesignAn exploratory and descriptive study design was used. SettingsWorkplaces for newly qualified nurses. ParticipantsA purposive sample of 10 newly qualified Norwegian nurses working in various clinical placement nursing settings were included. MethodsData were collected in April and May 2022 via individual interviews conducted via Zoom. Thematic analysis was applied to identify themes. Triangulation was employed to ensure trustworthiness. FindingsThree major themes emerged: relational aspects of nursing, practical aspects of nursing, and inadequacies in the pedagogical plan of teaching and learning. The themes indicate that the limited or suspended clinical placement education during the pandemic affected the competence of newly qualified nurses. ConclusionsDuring the coronavirus disease 2019 pandemic, clinical placement education for student nurses was limited or suspended owing to safety concerns. The short clinical placement durations affected the competence of newly qualified nurses, as they lacked exposure to real-world patient care scenarios as in non-pandemic times. Furthermore, our findings indicate that newly qualified nurses’ clinical placement experiences provide important knowledge and insight for educators in terms of education and support for future student nurses going into situations with short clinical placement hours. The conclusion highlights the implications of the findings and recommendations and the need for further support and education for newly qualified nurses after the pandemic. Study registration detailsThe study was approved by the Norwegian Social Data Service (project number 396247). The registration date was 2021–11–04. Tweetable abstractTransition-related challenges became more prominent during the coronavirus disease 2019 pandemic than during non-pandemic times.

Students' perceptions of a UK physiotherapy student-led clinic.

Student-led clinics (SLCs) are a mode of delivery whereby students take responsibility for the delivery of a health service or intervention. SLCs for physiotherapy have a wide range of uses, including enhancement of learning, replacement of clinical placement hours and serving population and community needs. Evidence is emerging globally as to the outcomes of SLCs in physiotherapy, but little exists in the United Kingdom (UK) context. The purpose of this study was to explore student perceptions of running, leading and participating in a UK physiotherapy student-led neurological rehabilitation clinic. A qualitative design using a focus group. Four themes were identified relating to students' perceptions of SLCs associated with the learning environment, self-development, enhanced clinical skill development and reflections on experience at the SLC. The findings of this study suggest that physiotherapy SLCs in a UK context can contribute positively to student experience and skill development, particularly in relation to the learning environment, development of clinical skills, leadership and autonomy. Some aspects related to, for example, student induction and preparation could be further developed. Further research should explore if these findings are applicable in other countries where SLCs are less established. Further research in the UK and globally related to SLC models in different courses and across varying stages is required. Exploration of the SLC as a viable form of clinical placement experience is also warranted.

The implementation and evaluation of a mentoring program for Bachelor of Midwifery students in the clinical practice environment

AimTo describe the implementation and evaluation of a midwife/midwifery student-mentoring program in one Local Health District in Sydney NSW Australia. BackgroundEvidence suggests well designed and supported midwife/midwifery student mentorship programs can make a difference to the clinical placement experiences and attrition rates of midwifery students. DesignIn the evaluation of the mentoring program, we used surveys, focus groups and individual interviews. MethodsEighty-six participants, including midwife mentors, midwifery students, non-mentor midwives and midwifery managers participated in the evaluation. Quantitative data were analysed using descriptive statistics and qualitative data, content analysis. ResultsThe mentoring program increased midwives’ mentoring skills and was beneficial to their professional growth and leadership skills. Students reported positive outcomes including someone to talk to, emotional support and a sense of belonging. Mentoring programs require structure, mentor training, organisational support and transparency. ConclusionThe mentoring program provided benefits to both midwifery mentors and students and demonstrated the value of a structured and supported mentoring program for midwifery students.

Nursing Students` Experiences with Clinical Placement During the COVID-19 Pandemic After the Online Education: A Qualitative Study

Objective: Due to the coronavirus, clinical placement opportunities for nursing students have been reorganized, and their education has transitioned to online education. To examine the clinical placement experiences of nursing students following their online education during the COVID-19 pandemic.Material and Methods: A qualitative method with a phenomenological approach. A total of 111 eligible nursing students from the 2nd, 3rd, and 4th who had online nursing education and clinical placements during the COVID-19 pandemic were recruited. Thematic analysis was used with NVivo 20 program. Results: There themes emerged from the data: 1) The impact of COVID-19 on nursing students; 2) Perceived online education during COVID-19;3) Clinical experiences during COVID-19.Conclusion: The significance of clinical placement experiences has been highlighted because of the negative impacts of the lack of clinical practice on nursing students' learning processes.

What have the Romans ever done for us?

The only privilege of being the Editor in Chief of a journal is that I get the opportunity to write an editorial for every edition. I can say, within reason, what I like, without peer review, censor or editing by anyone else. This being my last editorial for the journal that is probably even more true. So, as I sat contemplating the blank screen to write this editorial, my tongue decided it was once again time to explore the tooth that was causing me some discomfort, where a chip had come off making it extremely sensitive. My experience of managing this dental problem brought my mind to the RHMT funding for rural health workforce training and that is when the title of this paper came to the front of my mind. Yes, for those of you from my generation, I am referencing the classic scene from Monty Python's, Life of Brian. As John Cleese, playing the part of Reg goes on to say “apart from sanitation, the medicine, education, wine, public order, irrigation, roads, a fresh water system and public health, what have the Romans ever done for us?” What has that got to with the Australian rural health care. Well at times I feel like I am Reg in the Life of Brian. I struggle to see what the Romans, in the form of the RHMT funded Rural Clinical Schools, University Departments of Rural Health and Dental Training Expanding Rural Placement Programs have done for us. If I go back to my tooth. I live in a regional city, Bendigo, with both a Rural Clinical School (Monash), a University Department of Rural Health (La Trobe University) and a Dental School, solely based in Bendigo. Yet, when I saw the dentist and it was determined that I need my tooth assessed for suitability of a crown (it might need root canal work), my options were to wait a long time for an appointment with the Endodontist who comes to Bendigo from Melbourne, or travel to Melbourne to see them at their practice. In the latter case, I could get an appointment within a week, in the former, more than a month wait with ongoing pain. So, despite all the RHMT funding and rural health workforce training here in Bendigo, if I wanted a reasonably quick resolution of my tooth pain, I needed to go to Melbourne. Fortunately, I have the advantage of a good income and flexible employment, which allowed me to do that, with no financial penalty. Unfortunately, the vast majority of our rural communities do not have that privilege. So, at an individual level, I feel like Reg. Apart from “on average, graduates who had the most rural clinical placement experience are now working more in regional, rural and remote Australia” (1 p213) and “the RHMT program, has a direct economic benefit to the communities and regions with economic analyses demonstrating a positive multiplier effect of around 2 i.e. for every spent under the RHMT program another dollar is generated in the local economy” (1 p 236), I wonder what has the RHMT programme done for us. Despite these assertions, we do not have any good quality evidence anywhere that the approach we are taking is actually addressing the problems of recruiting and retaining a rural and remote health workforce. Where are the data that the workforce shortage in a city or town is less after an RCS or UDRH was established than before, or that towns without RCS's and UDRHs have more workforce shortages and worse health outcomes than communities with them. In the most recent review, that I am aware of,2 identified that 34 papers focused on health workforce retention interventions for rural and remote areas. They conclude that most of the studies were of low quality, that about only one-third applied appropriate statistical analysis to the date, less than half adjusted for key potential confounders, and many had no comparator groups.2 In no other contexts of health care would that be considered a solid literature base to make any conclusions on, yet it does not deter the authors from asserting “Policy makers seeking rural retention in the medium and longer term would be prudent to strengthen rural training pathways and limit the use of strongly coercive interventions.”2 So, my plea to the few people who read these editorials is can we please stop pretending that the RHMT programme has had a major impact on the health and health workforce of rural and remote Australia and spent the time and intellectual effort to actually determine if this approach is working because I am not seeing what the RHMT programme has done for my tooth.