Student perceptions of rural placement – Australia to Aberystwyth

Medical Journal of Australia, 2009

Australian Journal of General Practice

Australian Health Review, 2015

Objective. A major challenge for medical schools is the provision of clinical skills training for increasing student numbers. This case study describes the expansion of the clinical school network at The University of Queensland (UQ). The purpose of the study was to investigate consistency in medical education standards across a regional clinical teaching network, as measured by academic performance. Methods. A retrospective analysis of academic records for UQ medical students (n = 1514) completing clinical rotations (2009-2012) was performed using analysis of covariance (ANCOVA) for comparisons between clinical school cohorts and linear mixed-effects modelling (LEM) to assess predictors of academic performance. Results. In all, 13 036 individual clinical rotations were completed between 2009 and 2012. ANCOVA found no significant differences in rotation grades between the clinical schools except that Rural Clinical School (RCS) cohorts achieved marginally higher results than non-RCSs in the general practice rotation (5.22 vs 5.10-5.18; P = 0.03) and on the final clinical examination (objective structured clinical examination; 5.27 vs 5.01-5.09; P < 0.01). LEM indicated that the strongest predictor of academic performance on clinical rotations was academic performance in the preclinical years of medical school (b = 0.38; 95% confidence interval 0.35-0.41; P < 0.001). Conclusions. The decentralised UQ clinical schools deliver a consistent standard of clinical training for medical students in all core clinical rotations across a range of urban, regional and rural clinical settings. Further research is required to monitor the costs versus benefits of regionalised clinical schools for students, local communities and regional healthcare services. What is known about the topic? To help meet the demand of increasing numbers of students, Australian medical schools locate clinical training outside the traditional tertiary hospitals. However the viability of maintaining teaching standards across regional and rural locations is uncertain. What does this paper add? Maintaining teaching standards outside established urban teaching hospitals and across a diverse range of urban, regional and rural clinical settings is viable. What are the implications for practitioners? Decentralised clinical teaching networks provide consistent quality of clinical placements while diversifying exposure to different patient populations and clinical environments. These important outcomes may not only alleviate the strain on clinical teaching resources, but also help address the maldistribution of doctors in Australia.

Rural and remote health

Medical students have been attending rural clinical schools (RCSs) since 2001. Although there have been generally positive single institution reports, there has been no multi-institution study using a common survey instrument. The experiences of medical students who attended a number of RCSs during 2006 were evaluated using a rural-specific questionnaire. Questionnaires were distributed to 166 medical students who had completed one year at the RCS of six participating universities across Australia, including the Universities of New South Wales, Melbourne, Tasmania, Adelaide, and Sydney, and the Australian National University, of whom 125 responded (75.3%). Students were asked to rate their level of agreement on 29 items concerning their overall RCS experience, skills development and clinical supervision experience. The majority of respondents (n = 107, 86%) stated they would go to the RCS again if they had their time over and almost two-thirds (n = 77, 64%) stated they would spend m...

Rural and remote health

The Rural Clinical School of Western Australia (RCSWA) provides 25% of Western Australia&#39;s medical students in their first full clinical year with a longitudinal integrated clerkship in rural and remote areas. They live and work in 10 different sites in groups of 3 to 10 members. This study aimed to discover if students at the smaller sites were disadvantaged by the reduced number of student colleagues, and also by a smaller population catchment area potentially providing a smaller number of clinical presentations. Data were collected from 2003 until 2007 from a variety of sources including annual comparisons of end of year results, annual mid-year interviews of all students and staff, and the Dundee Ready Education Environment Measure (DREEM) Survey. There was no difference in end of year results between smaller sites and larger sites and both had slightly higher marks (and statistically significantly better) than their metropolitan colleagues. Mid-year interviews were shown to...

MedEdPublish, 2019

This article was migrated. The article was marked as recommended. Many medical programmes around the world seek to provide experiences for their students in rural and remote health, community and primary care, with a view to encouraging future doctors to practice in under resourced and under-doctored areas of the world. New schools (and satellites of existing schools) have been established in rural and remote areas with a view to recruiting students from those areas who will go on to practice there. In these new schools, and in more traditional programmes, the primary curriculum models in use are either short placements in selected areas (including overseas electives) or immersive longitudinal clerkships, typically in a primary/community setting. A wealth of evidence exists of the success of these approaches, however, for many schools, the curriculum is more fixed and there are limited opportunities for introducing what can be seen as more radical change. In this paper, we describe ...

Rural and remote health

As in many developed nations, there is a shortage in the rural medical workforce in Australia. Research indicates that a strong relationship exists between rural educational exposure and an increased interest in pursuing a rural career or selecting a rural internship. Accordingly, in 2000 the Australian Commonwealth Government established the Rural Clinical Schools (RCS) program. Under this program, 25% of parent medical schools&#39; Commonwealth Supported Place (CSP) medical students must spend at least 1 year of their clinical medical education in a rural setting. Research indicates that positive experiences are of vital importance in determining future rural practice. Arguably, if students are conscripted to a RCS, they may view their overall experience negatively. Thus, the development and sustainability of an adequate future rural medical workforce depends on medical schools understanding and fostering the factors that encourage voluntary student recruitment to the RCSs. The ai...

Rural and remote health

The University of Adelaide and the University of South Australia established the Spencer Gulf Rural Health School (SGRHS) as a joint venture to facilitate rural health professional education and research. Annually a cohort of medical students from the University of Adelaide volunteer and are placed in various SGRHS &#39;learning centres&#39; throughout rural South Australia for the 5th year of their medical training. This article addresses the issues encountered in one of these &#39;learning centres&#39; in Port Lincoln, rural South Australia. The challenge was to integrate five students into a general medical practice and the local hospital and to provide high quality medical education for the academic year. Medical practice, student and university requirements were identified and a range of strategies implemented to address these. To date, four groups of medical students have successfully completed their rural academic year in Port Lincoln since 2003. The local systems have evolve...