Abstract：
INTRODUCTION:Rural health workforce issues are a priority area for the Australian Government and substantial funding has been provided for rural education programs to address health workforce disparities across Australia's rural and remote communities. The Australian Government established a Rural Health Strategy in 2001 and as a result there are now 14 rural clinical schools in Australia. The 2008 Urbis Report highlighted the lack of research on rural programs and workforce outcomes, essential to ensuring that educational efforts, resources and funding are being concentrated appropriately. This study examined the Australian National University (ANU) Medical School's 4 year rural program to identify the impact of elective and compulsory program components on student intentions to practice in a rural and remote location post-graduation. The study also explores factors that affect student decisions to apply for year-long rural placements. METHODS; ANU Medical School's graduating cohort of 2008 fourth year medical students completed an anonymous and voluntary online survey questionnaire. Survey sections included student demographics, compulsory and elective components of the ANU rural program, and an overall evaluation of the ANU rural curriculum. The survey contained a mixture of forced-answer questions and open-ended commentary. Quantitative data were analyzed for descriptive and frequency statistics using EpiInfo V3.5.1 (http://wwwn.cdc.gov/epiinfo/). Qualitative data were reviewed and consistent themes among responses extracted. RESULTS:In total, 40 students from a cohort of 88 (45%) responded, with 26 respondents (65%) indicating that at medical school commencement they considered working in a rural or remote area. At the end of their medical education, 33 respondents (82%) indicated their intention to spend some time in their careers working in a rural or remote area. Students from non-rural backgrounds had greater positive change in their intentions to practice rurally as a direct effect of ANU rural programs when compared with students from rural backgrounds. More than 70% of students believed the amount of rural focus in the curriculum was correct, 75% believed that they will be better medical practitioners because of the program, and 85% found the curriculum was delivered effectively. Students who undertook elective rural programs such as a year-long rural placement were more likely to have future rural career intentions when compared with students undertaking compulsory rural components. Compulsory components, however, had a strong influence on students applying for elective programs. Regarding application for the year-long rural placement, students reported clinical exposure was the most encouraging factor, and time away from family and friends, and lack of spousal and family support were the most discouraging factors. CONCLUSION:Rural programs at the ANU, and medical school exposure to rural health experiences is important in influencing students' perceptions of a career in rural and remote health. This study provides evidence that both compulsory and elective components contribute to a successful holistic rural program which nurtures the rural interest of all students. Overall, students at the ANU medical school were satisfied with the rural curriculum. The results confirm that there is difficulty in recruiting students with family commitments into year-long rural placement programs, despite incentives. Those students who select long-term rural study for reasons other than an interest in a career in rural health end the program with positive rural intentions.
journal_name
Rural Remote Healthjournal_title
Rural and remote healthauthors
Lee YH,Barnard A,Owen Csubject
Has Abstractpub_date
2011-01-01 00:00:00pages
1602issue
2issn
1445-6354pii
1602journal_volume
11pub_type
杂志文章abstract：INTRODUCTION:One approach to facilitating student interactions with patient pathways at Keele University School of Medicine, England, is the placement of medical students for 25% of their clinical placement time in general practices. The largest component is a 15-week 'student attachment' in primary care during the fin...
journal_title：Rural and remote health
pub_type： 杂志文章
doi：
更新日期：2016-04-01 00:00:00
abstract：INTRODUCTION:Internationally, musculoskeletal conditions are a major morbidity issue for Indigenous populations and the social and economic burden imposed by musculoskeletal complaints is significant. However, little is known about the prevalence and associated pain and impairment of musculoskeletal conditions among ru...
journal_title：Rural and remote health
pub_type： 杂志文章
doi：
更新日期：2004-07-01 00:00:00
abstract：:Traditionally dental plaque, calculus and stains have been removed by scaling and polishing manually with hand instruments such as curettes, chisels, hoes and scalers. However, ultrasonic scaling is becoming the preferred method of initial periodontal treatment and maintenance, due to improved patient and operator com...
journal_title：Rural and remote health
pub_type： 杂志文章
doi：
更新日期：2012-10-01 00:00:00
abstract：INTRODUCTION:The community care philosophy in Australia has led to a number of older people remaining in their own homes, dependant on others for the majority of their care needs. A small number of older people being cared for by a family member or friend will move into residential aged care facilities for full-time ca...
journal_title：Rural and remote health
pub_type： 杂志文章
doi：
更新日期：2008-07-01 00:00:00
abstract：CONTEXT:Entry to practice medical programs (graduate- and undergraduate-entry) in Australia are under considerable pressure to provide clinical training as a result of increased student numbers. At the same time modern medical curricula require the development of active placements in expanded settings to achieve gradua...
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:Time spent in remote medicine as an undergraduate is influential in career choice in Australia and Northern America. However, its influence is not known in smaller countries, where recruitment into rural medicine is also problematic. Differences across countries mean work is required to explore determinant...
journal_title：Rural and remote health
pub_type： 杂志文章
doi：
更新日期：2008-07-01 00:00:00
abstract：INTRODUCTION: Marginalization is a significant issue in Mexico, involving a lack of access to health services with differential impacts on Indigenous, rural and urban populations. The objective of this study was to understand Mexico’s public health problem across three population areas, Indigenous, rur...
journal_title：Rural and remote health
pub_type： 杂志文章
doi：10.22605/RRH3948
更新日期：2017-12-01 00:00:00
abstract：INTRODUCTION:This study considered the views and experiences of 85 rural women, most of whom gave birth in two regional South Australian hospitals. METHOD:This descriptive survey used a validated questionnaire, modified for use in rural South Australia, which included open-ended questions to invite further comment. Wo...
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:Suicide remains an important public health issue in Australia, responsible for around 2500 deaths each year. Although suicide only accounts for around 1.7% of total mortality in Australia per year, 75% of suicide deaths are in males. This article reviews the factors contributing to suicide in older rural m...
journal_title：Rural and remote health
pub_type： 杂志文章,评审
doi：10.22605/RRH4020
更新日期：2017-10-01 00:00:00
abstract：INTRODUCTION:Nurses in rural settings are often the first to assess and interpret the patient's clinical presentations. Therefore, an understanding of how nurses experience decision-making is important in terms of educational preparation, resource allocation to rural areas, institutional cultures, and patient outcomes....
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: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：INTRODUCTION:Health professions students interested in future rural practice locations spend a week learning about and investigating all aspects of small town personal, professional and community life. This augments the mainly clinical experience provided by clinical rotations they complete as part of their professiona...
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 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：INTRODUCTON:The key parameter for rural clinical schools (RCSs) is to provide at least 1 year of clinical training in rural areas for 25% of Australian Commonwealth supported medical students with the intent to influence future rural medical workforce outcomes. The objective of this study was to describe the associatio...
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:North American rural residents have higher rates of chronic disease and they report being ill more frequently compared to their urban counterparts. We recently studied health-related quality in residents living in the isolated, rural community of Bella Coola, Canada. OBJECTIVE:To assess health-related qua...
journal_title：Rural and remote health
pub_type： 杂志文章
doi：
更新日期：2006-04-01 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：INTRODUCTION:The WHO has estimated that 1% of the world's population need a wheelchair, but few have access. Access to wheelchairs for most of the South African poor population is through accessing rehabilitation services at public health facilities. This study explored access to wheelchair services from the perspectiv...
journal_title：Rural and remote health
pub_type： 杂志文章
doi：10.22605/RRH5855
更新日期：2021-01-01 00:00:00
abstract：INTRODUCTION:Health worker shortages and maldistribution have important implications for the capacity of health systems. Ghana has one of the highest physician emigration rates in the world, and over 75% of those who remain work in Ghana's two largest cities. The aim of this study was to investigate the contribution of...
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: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：INTRODUCTION:Much of regional Australia continues to face challenges in recruitment and retention of medical practitioners, despite the apparently successful rural medical education initiatives funded by the Commonwealth Government. International fee-paying (IFP) medical students are a significant component of Australi...
journal_title：Rural and remote health
pub_type： 杂志文章
doi：10.22605/RRH4292
更新日期：2017-07-01 00:00:00
abstract：:The provision of health services to rural and remote communities has been the source of much concern and debate in recent times. One aspect of this is the universal problem of insufficient medical practitioners in rural areas and the associated issues of recruitment and retention. Rural communities can play an importa...
journal_title：Rural and remote health
pub_type： 杂志文章
doi：
更新日期：2004-04-01 00:00:00
abstract：INTRODUCTION:The views of health managers and physicians working in non-metropolitan areas of Western Australia (WA) were sought about which telehealth services are most needed. METHOD:Chief executives and nurse managers of rural hospitals were sent a simple, open-ended questionnaire and asked to consider the current ...
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: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: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:Road traffic crashes constitute a considerable public health burden and represent the eighth leading cause of death and tenth leading cause of disability adjusted life years (DALYs) globally. However, very little is known about the extent, causes and impact of crashes in low- and middle-income countries in...
journal_title：Rural and remote health
pub_type： 杂志文章
doi：
更新日期：2015-07-01 00:00:00
abstract：:There are trends towards centralising hospital care within the NHS, for many excellent reasons. Yet this has a disproportionate impact upon those patients who live at a distance from their hospital, and this impact has not been well reported or researched, but studies have demonstrated that the utilisation of services...
journal_title：Rural and remote health
pub_type： 杂志文章
doi：
更新日期：2005-04-01 00:00:00
abstract：CONTEXT:People living in rural and remote areas have been found to suffer higher rates of mental illness and psychological distress than their urban counterparts. However, rural and remote Australians also suffer from a lack of specialist mental health services. Mental health consumers are concerned about the lack of a...
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:Mondana Clinic is a small rural clinic located in the Napo river region of the Amazon basin in Ecuador. Since its opening in 1997 the clinic has grown to be the primary health care facility for approximately 3000 individuals. METHODS:A retrospective study was performed tabulating the ambulatory diagnosis,...
journal_title：Rural and remote health
pub_type： 杂志文章
doi：
更新日期：2001-01-01 00:00:00
abstract：INTRODUCTION:Portions of Montgomery County, Virginia, are designated a Medically Underserved Area with a large portion of this population experiencing limited access to healthcare services. In September 2008, the Federal Bureau of Primary Care awarded the authors a planning grant to assess community need in Montgomery ...
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:The traditional view of paramedic practice is one of provision of emergency care and transport within community or industrial settings. With greater integration of emergency services with the overall health system, this role is changing. Paramedics, especially in rural areas, are now working more closely w...
journal_title：Rural and remote health
pub_type： 杂志文章,评审
doi：
更新日期：2014-01-01 00:00:00
