Clinical medical education in rural and underserved areas and eventual practice outcomes: A systematic review and meta-analysis

Guilbault, Ryan; Vinson, Joseph

doi:10.4103/efh.efh_226_16

Cited by 21 publications

(17 citation statements)

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“…A few institutions in underserved areas prioritised the admission of students from small municipalities in the region, aiming to increase retention of physicians . This strategy was shown to be efficient in other countries and could be added to the system of social quotas of public universities located in areas lacking doctors . The implementation of rural clinical schools could be another strategy to guarantee rural practice learning experiences and improve the quality of health care in smaller municipalities …”

Section: Discussionmentioning

confidence: 99%

“…The characteristics of curricula are also important to ensure social commitment and the development of professionals with the necessary competence to respond to the health care needs . Although most health problems can be managed in primary care settings, most medical schools prioritise a model of hospital training in large urban centres . The organisation of the labour market is an additional factor to consider, given that the structure of the service network, employment opportunities, working conditions, social status and qualification opportunities increase the possibility of attracting and retaining professionals …”

Section: Introductionmentioning

confidence: 99%

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Medical school expansion policies: educational access and physician distribution

et al. 2019

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Introduction Many countries are employing strategies intended to reduce maldistribution of health workers and inequities. The purpose of this study was to analyse the impact of expansion policies of medical schools on regional inequalities in the distribution of undergraduate class sizes, and the capacity to attract and retain doctors and to expand health facilities. Methods We conducted a descriptive analysis to compare the distribution of undergraduate places in 2007 and 2016 to determine the impact of targeted expansion policies on inequalities in access to medical education in Brazil. A group of municipalities with new medical schools (n = 54) and a control group without medical schools (n = 408) were compared to analyse impacts of expansion in the health sector. We compared the increase in the number of physicians per 1000 inhabitants and health establishments per inhabitants between 2007 and 2016 based on these two groups. We also analysed the relationship between geographic distance from the state capital and capacity to attract physicians. Results There was a decrease in the regional inequalities of undergraduate places in medical schools; the greatest increase in the places per 1000 inhabitants was in municipalities of between 50 000 and 100 000 inhabitants. Municipalities with new medical schools showed an increase in physicians per 1000 inhabitants and in health establishments per inhabitant ratio, demonstrating the potential to attract and retain doctors, as well as strengthening the health infrastructure. Municipalities more distant from state capitals showed a greater increase in physician : inhabitant ratio. Discussion Countries with health workforce shortages and inequalities in their distribution might consider public financing and regulation policies for expansion of medical schools as a strategy to attract and retain professionals. Early results in Brazil showed that such strategies could strengthen service networks in deprived areas, supporting implementation of Universal Healthcare Coverage.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Medical school expansion policies: educational access and physician distribution

et al. 2019

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“…Likewise, comparative effectiveness research is exceptionally rare; a need for research and evaluation methodologies that provide clarity on the most effective strategies for achieving specified social mission outcomes is expressed in the literature. 14,15,23…”

Section: Rigorous Research Needed To Assess the Role Of Social Missio...mentioning

confidence: 99%

Advancing Social Mission Research: A Call to Action

Erikson

Ziemann

2021

Academic Medicine

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Social mission efforts in health professions education are designed to advance health equity and address the health disparities of the society in which they exist. While there is growing evidence that social mission–related interventions are associated with intended outcomes such as practice in underserved communities, student diversity, and students graduating with skills and knowledge that prepare them to address societal needs, critical evidence gaps remain that limit the possibility of generalizing findings and using social mission strategically to advance health equity. At a time when COVID-19 has been laying bare health disparities related to systemic racism and maldistribution of resources, understanding how health professions training can produce the workforce needed to advance health equity becomes even more imperative. Yet, data and methods limitations are hindering progress in this critical research. The authors present an overview of the social mission research landscape; their review of the research led them to conclude that more rigorous research and data collection are needed to determine the link between social mission activities in health professions education and advances in health equity. To accelerate understanding of how health professions education and training can advance health equity, the authors propose a social mission research road map that includes (1) creating a social mission research community by consolidating stakeholders, (2) building a solid foundation for the research through development of a consensus-driven logic framework and research agenda, and (3) laying out the data and methodological needs that are imperative to strengthening the social mission evidence base and identifying opportunities to address these needs. Core to achieving these milestones is leadership from an organizing body that can serve as a hub for social mission research and engage stakeholder groups in building the evidence base for social mission strategies that will ultimately advance health equity.

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“…15 In those areas alone, there is a shortage of about 14 000 primary care physicians. 16 Rural and urban areas are the most commonly affected by the maldistribution of primary care physicians. 16,17 Socioeconomic Factors.…”

Section: Access To Health Carementioning

confidence: 99%

“…16 Rural and urban areas are the most commonly affected by the maldistribution of primary care physicians. 16,17 Socioeconomic Factors. Socioeconomic status (SES), which is commonly defined by lower education achievement, substandard income attainment, low occupational status, or all of the above, has directly been linked to health status.…”

Section: Access To Health Carementioning

confidence: 99%

Medically Underserved Populations: The Athletic Trainer's Role

Wetherington

Pecha

2020

Athletic Training Education Journal

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Context Health care cost continues to rise; the US continues to spend dramatically more money than other developed nations per individual without increased health outcomes. More individuals are finding it harder to get access to a health care provider, especially those in medically underserved areas and populations. Objective To increase the knowledge of the athletic training educator about medically underserved populations and the roles athletic trainers (ATs) play as leaders in health care delivery. Background Current and future physician shortages are known and are only going to increase as more than one-third of current primary care physicians are expected to retire in the next 10 years. Forty percent of the population lives in areas that are medically underserved and designated by the government as areas of professional medical shortage; patients in these areas are primarily served by primary care physicians. Synthesis As with access to physicians, access to ATs has been shown to be based upon socioeconomic status and presents more challenges for the medically underserved. Early access to health care providers has shown to be important in adolescents, as negative health behaviors can carry into adulthood, leading to poorer health-related outcomes throughout life. Recommendation(s) To ensure that athletic training educational programs include opportunities to provide service to the medically underserved, education on social determinates of health, and the means by which ATs can fill critical holes in providing care for these patients. More research is needed to validate ATs' roles in providing quality health care. Additionally, more research is needed around how AT education can help meet patient needs. Conclusion(s) As the athletic training profession continues to evolve and responds to the growing demands of the complex health care system, access to an AT may provide a vital bridge to overall health care for patients within medically underserved populations.

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Clinical medical education in rural and underserved areas and eventual practice outcomes: A systematic review and meta-analysis

Abstract: These estimates may help guide medical school administrators and policymakers to expand underserved clinical training programs to help relieve some of the problems associated with access to medical care among underserved populations.

Cited by 21 publications

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Medical school expansion policies: educational access and physician distribution

Medical school expansion policies: educational access and physician distribution

Advancing Social Mission Research: A Call to Action

Medically Underserved Populations: The Athletic Trainer's Role

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