Abstract：
INTRODUCTION:Flinders University in Australia has had a rural longitudinal integrated clerkship for selected medical students, the Parallel Rural Community Curriculum, since 1997. The Northern Ontario School of Medicine (NOSM) in Canada introduced a similar clerkship for all NOSM students in 2007. An external evaluation of both programs was conducted in 2006 and 2008, respectively. The aim of this article was to analyse the similarities in and differences between these two rural programs and determine key factors that could inform others interested in creating similar programs. METHODS:The evaluation took the form of a cross-sectional descriptive study conducted in each school using focus group and individual interviews, involving students, faculty, preceptors, health service managers and community representatives. Interviews were analysed for emerging themes based on a grounded theory approach, and common themes were tabulated and validated. The themes for the two sites were compared and contrasted to assess similarities and differences. RESULTS:Individual interviews were conducted with 87 people at Flinders and 39 at NOSM; focus groups included 45 students at Flinders and 7 at NOSM. All participants felt that the programs produce confident and skilled students. The educational value of the programs was expressed in terms of continuity of care, longitudinal exposure, development of relationships, mentoring, team work, and participatory learning. Common concerns related to issues of standardisation, ensuring exposure to all specialist disciplines, communication, support for students and preceptors, isolation, dealing with personal issues, and the process of site selection. CONCLUSIONS:The rural longitudinal integrated clerkship approach to teaching the core clinical components of the undergraduate medical curriculum has a positive impact on both students and clinicians, as demonstrated in two different sites on two continents. Five key factors emerged that may inform development of similar programs in other institutions: (1) invest in careful site selection matching local epidemiology with curricular goals; (2) create collegiate faculty development that facilitates peer to peer relationships between rural and urban faculty; (3) integrate IT systems with the health system to create hardware synergies; (4) manage student expectations regarding isolation and expected site differences; and (5) build strong local postgraduate training that reinforces the values and workforce benefits of the undergraduate program.
journal_name
Rural Remote Healthjournal_title
Rural and remote healthauthors
Couper I,Worley PS,Strasser Rsubject
Has Abstractpub_date
2011-01-01 00:00:00pages
1665issue
2issn
1445-6354pii
1665journal_volume
11pub_type
杂志文章abstract：INTRODUCTION:In Italy the course to become a general practitioner (GP) lasts 3 years and includes both theoretical and practical study. Different from the theoretical part, until recently the practical activity has not been assessed at all. The Emilia Romagna Regional Health Authority has developed a special program ca...
journal_title：Rural and remote health
pub_type： 杂志文章
doi：
更新日期：2016-07-01 00:00:00
abstract：INTRODUCTION:Breastfeeding provides health benefits to infants and mothers, yet many women decide against breastfeeding. This study examined differences in the prevalence of breastfeeding among national, urban, rural, and Appalachian regions of the USA. METHODS:Secondary data analysis of the US 2007 National Survey of...
journal_title：Rural and remote health
pub_type： 杂志文章
doi：
更新日期：2011-01-01 00:00:00
abstract：INTRODUCTION:Reacting to demand and supply pressures, European healthcare systems are undergoing significant structural changes to the organisation and delivery of out of hours care. Such pressures are of particular concern to rural practice. Although patient satisfaction with out of hours care has been extensively stu...
journal_title：Rural and remote health
pub_type： 杂志文章
doi：
更新日期：2004-07-01 00:00:00
abstract：CONTEXT:In post-war Japan, a number of factors lead to a general shortage of physicians by the 1950s, which became acute in rural areas and has continued until recent times. ISSUE:Teamwork among national, prefectural, municipal governments and public medical schools has addressed this shortage of physicians. The natio...
journal_title：Rural and remote health
pub_type： 杂志文章
doi：
更新日期：2010-04-01 00:00:00
abstract：INTRODUCTION:Atrial fibrillation (AF) is a major risk factor for ischaemic stroke and a common presentation in general practice. Scoring systems to guide antithrombotic treatment have been available since 1996, with the CHA2DS2-VASC in current use; however, little is known about adherence to guidelines in rural general...
journal_title：Rural and remote health
pub_type： 杂志文章
doi：10.22605/RRH4342
更新日期：2019-03-01 00:00:00
abstract：INTRODUCTION:Hokianga Hospital is a small rural hospital in the far north of New Zealand serving a predominantly Maori population of 6500. The hospital, an integral part of a comprehensive primary healthcare service, provides continuous acute in-hospital and emergency care. Point-of-care (POC) biochemistry has been ava...
journal_title：Rural and remote health
pub_type： 杂志文章
doi：10.22605/RRH4934
更新日期：2019-04-01 00:00:00
abstract：INTRODUCTION:The aim of this project was to identify if there is a link between what nursing students learn in simulated clinical laboratory sessions and what they experience during their clinical placements. Clinical laboratories are commonly used to assist students to develop clinical nursing skills through simulatio...
journal_title：Rural and remote health
pub_type： 杂志文章
doi：
更新日期：2010-04-01 00:00:00
abstract：INTRODUCTION:In the perspectives of implementation of policy, the top-down and bottom-up perspectives of policy-making dominate the discourse. However, service delivery and therefore the experience of the policy by the citizen ultimately depend on the civil servant at the front line to implement the policy. Lipsky name...
journal_title：Rural and remote health
pub_type： 杂志文章
doi：
更新日期：2016-01-01 00:00:00
abstract：CONTEXT:Hypothyroidism is a significant cause of pericardial effusion. However, large pericardial effusions due to hypothyroidism are extremely rare. Hormone replacement therapy is the cornerstone of treatment for hypothyroidism and regular follow-up of patients after initiation of the therapy is indicated. Herein, the...
journal_title：Rural and remote health
pub_type： 杂志文章
doi：10.22605/RRH4384
更新日期：2018-05-01 00:00:00
abstract：INTRODUCTION:In Nepal, a number of private sector medical schools have opened recently; although sufficient numbers of doctors are graduating there continues to be a doctor shortage in rural areas. This article analysed the rural doctor shortage in Nepal and reviewed the international literature for strategies that may...
journal_title：Rural and remote health
pub_type： 杂志文章
doi：
更新日期：2010-07-01 00:00:00
abstract：INTRODUCTION:Soon-to-be graduate nurses who choose to begin their career in rural hospital settings face not only the challenge of learning to do rural nursing, but also how to navigate the complex personal and professional relationships that characterize the close knit community of rural hospital teams. Since every en...
journal_title：Rural and remote health
pub_type： 杂志文章
doi：
更新日期：2010-10-01 00:00:00
abstract：INTRODUCTION:Farmers and farm workers have higher than expected rates of suicide and undetermined deaths in UK studies, and some rural areas of Scotland have higher than average male suicide rates. Firearm access seems to be an influencing factor in England and Wales. Type of farming, and farming social networks may al...
journal_title：Rural and remote health
pub_type： 杂志文章
doi：
更新日期：2006-01-01 00:00:00
abstract：INTRODUCTION:Iran has a major land mine injury problem in its border areas. Mine injuries have a high mortality and morbidity, and the injuries generally occur in remote areas. Iran has a well developed system of rural health workers and clinics, covering most border areas. These have mainly had prevention, immunizatio...
journal_title：Rural and remote health
pub_type： 杂志文章
doi：
更新日期：2008-10-01 00:00:00
abstract：INTRODUCTION:Chronic conditions are a growing healthcare concern. People living in rural regions are particularly affected because many barriers exist to accessing services and supports. Peer support for chronic condition self-management, where people living with chronic conditions learn about how to care for themselve...
journal_title：Rural and remote health
pub_type： 杂志文章,评审
doi：
更新日期：2016-01-01 00:00:00
abstract：CONTEXT:The World Health Organization's World report on disability calls upon all nations to 'remove the barriers which prevent [people with disabilities] from participating in their communities; getting a quality education, finding decent work, and having their voices heard' (p. 5). People with communication disabilit...
journal_title：Rural and remote health
pub_type： 杂志文章
doi：
更新日期：2015-07-01 00:00:00
abstract：INTRODUCTION:Decreasing physical activity levels, particularly among youth, continue to be a prominent health concern in Canada, and youth living in rural areas may encounter unique facilitators and barriers to physical activity. In addition, current research suggests that overweight and obesity rates are higher for yo...
journal_title：Rural and remote health
pub_type： 杂志文章
doi：
更新日期：2012-01-01 00:00:00
abstract：INTRODUCTION:There has been no research exploring the financial impact on the live renal donor in terms of testing, hospitalisation and surgery for kidney removal (known as nephrectomy). The only mention of financial issues in relation to live renal transplantation is the recipients' concerns in relation to monetary pa...
journal_title：Rural and remote health
pub_type： 杂志文章
doi：
更新日期：2012-01-01 00:00:00
abstract：INTRODUCTION:Following a percutaneous coronary intervention (PCI), emphasis is placed on healthy lifestyle modification by means of secondary prevention. The literature suggests Australians have difficulty within the period following a PCI, particularly the rural cohort. Despite having a higher incidence of cardiac dis...
journal_title：Rural and remote health
pub_type：
doi：10.22605/RRH4854
更新日期：2019-05-01 00:00:00
abstract：:Since the first case of the current pandemic (H1N1) 2009 virus reported to WHO on 24 April 2009 on the American continent, the virus has spread in 160 countries and territories. By mid-2009, there were 135,000 cases and 816 deaths recorded. Pandemic preparedness is not advanced in most developing countries. Effective ...
journal_title：Rural and remote health
pub_type： 杂志文章
doi：
更新日期：2009-07-01 00:00:00
abstract：INTRODUCTION:There is growing evidence that in rural areas cancer mortality is higher and referral occurs later, indicating different patterns of care. In Scotland services to rural areas have been organized through 'managed clinical networks'. In some cases, these organizational networks have been structured so that t...
journal_title：Rural and remote health
pub_type： 杂志文章
doi：
更新日期：2008-10-01 00:00:00
abstract：INTRODUCTION:High prevalence rates of obesity, particularly among those residing in US rural areas, and associated physical and psychosocial health consequences, direct attention to the need for effective prevention programs. The current study describes an initial step in developing a school-based obesity prevention pr...
journal_title：Rural and remote health
pub_type： 杂志文章
doi：
更新日期：2009-10-01 00:00:00
abstract：CONTEXT:This article describes the development and evaluation of a tool to prioritize physiotherapy referrals in a remote, under-serviced region in Canada's eastern Arctic. The Baffin Region of Nunavut is home to approximately 16 000 people dispersed across 12 communities accessible only by air. Physiotherapists are ba...
journal_title：Rural and remote health
pub_type： 杂志文章
doi：
更新日期：2010-04-01 00:00:00
abstract：INTRODUCTION:For many women, and particularly rural women, birthing locally and within their own community is important for personal, social and/or cultural reasons. If concerns about the woman or her baby mean transfer to a secondary or tertiary facility is necessary, this can be disruptive and stressful, especially i...
journal_title：Rural and remote health
pub_type： 杂志文章,多中心研究
doi：
更新日期：2011-01-01 00:00:00
abstract：INTRODUCTION:Access to health care as near to where people live as possible is desirable. However, not enough medical graduates choose to work in rural and regional areas, especially in general practice. The career decisions of recent medical graduates are known to be affected by a variety of professional, societal and...
journal_title：Rural and remote health
pub_type： 杂志文章
doi：10.22605/RRH4247
更新日期：2017-12-01 00:00:00
abstract：INTRODUCTION:In mid-July 2010 flash flooding in Pakistan destroyed the basic water, environmental sanitation and livelihood infrastructures in 82 districts. Two months later, the local press of Swat (northern Pakistan) reported that several residents of Marghazar town became ill and were hospitalized after drinking con...
journal_title：Rural and remote health
pub_type： 杂志文章
doi：
更新日期：2012-01-01 00:00:00
abstract：INTRODUCTON:Disaster preparedness of the community is an essential disaster-mitigation strategy to protect human life and to prevent injuries and property damage. This study aimed to assess the knowledge of disaster, and the disaster preparedness of community members in Aceh, Indonesia. METHODS:A community-based descr...
journal_title：Rural and remote health
pub_type： 杂志文章
doi：
更新日期：2016-10-01 00:00:00
abstract：INTRODUCTION:Although some characteristics of physicians are known to be associated with their recruitment in rural and remote areas, the factors that predict mobility of physicians, and in particular, their mobility to rural and distant areas are largely unknown. METHODS:Flows of all physicians (n=4268) among municip...
journal_title：Rural and remote health
pub_type： 杂志文章
doi：
更新日期：2012-01-01 00:00:00
abstract：INTRODUCTION:Skin infections including scabies and impetigo have a high burden and cause significant morbidity in remote Aboriginal communities in Australia. Nevertheless, there is limited knowledge about community, healthcare practitioner and service provider perspectives on skin infections and treatment preferences. ...
journal_title：Rural and remote health
pub_type： 杂志文章
doi：10.22605/RRH5227
更新日期：2019-09-01 00:00:00
abstract：CONTEXT:Exposure of undergraduate medical students to general practice and community healthcare services is common practice in the international medical curricula. Nevertheless, proponents of the hospital and biotechnology based paradigm, which is still dominant within the medical academic environment, question both th...
journal_title：Rural and remote health
pub_type： 杂志文章
doi：
更新日期：2013-01-01 00:00:00
abstract：CONTEXT:Finding providers to work in the hospitals and clinics in the small towns of the USA is a significant struggle. In the traditional model, the primary care doctor sees patients in the inpatient setting in addition to a clinic practice. In the usual hospitalist model, providers specialize to work only in the inpa...
journal_title：Rural and remote health
pub_type： 杂志文章
doi：10.22605/RRH4419
更新日期：2018-08-01 00:00:00
