Social network analysis of rural medical networks after medical school immersion in a rural clinical school

Abstract

Background The impact of new medical graduates on the social dimensions of the rural medical workforce is yet to be examined. Social Network Analysis (SNA) is able to visualize and measure these dimensions. We apply this method to examine the workforce characteristics of graduates from a representative Australian Rural Clinical School. Methods Participants were medical graduates of the Rural Clinical School of Western Australia (RCSWA) from the 2001–2014 cohorts, identified as being in rural work in 2017 by the Australian Health Practitioner Regulation Agency. SNA was used to examine the relationships between site of origin and of work destination. Data were entered into UCInet 6 as tied pairs, and visualized using Netdraw. UCINet statistics relating to node centrality were obtained from the node editor. Results SNA measures showed that the 124 of 709 graduates in rural practice were distributed around Australia, and that their practice was strongly focused on the North, with a clear centre in the remote Western Australian town of Broome. Women were strongly recruited, and were widely distributed. Conclusions RCSWA appears to be a “weak tie” according to SNA theory: the School attracts graduates to rural nodes where they had only passing prior contact. The multiple activities that comprise the social capital of the most attractive, remote, node demonstrate the clear workforce effects of being a “bridge, broker and boundary spanner” in SNA terms, and add new understanding about recruiting to the rural workforce.

Approaches Used to Describe, Measure, and Analyze Place of Practice in Dentistry, Medical, Nursing, and Allied Health Rural Graduate Workforce Research in Australia: A Systematic Scoping Review

“…Other studies identified that graduates who had participated in a rural clinical school (RCS) during their training, were more likely to undertake rural and remote work in years following graduation [15,30,31,36,38,42,47,48,52,57,[59][60][61]. However, it was identified that this rural work was not always sustained [42] and that graduates had limited prior contact with the rural areas in which they were working [50]. Other models of rural training included a partnership between a university and a health service to deliver a rural training program, with research finding that graduates who had participated in the program were more likely to remain local for an internship, as well as following an internship [44].…”

The pathway to more rural doctors: the role of universities

“…For example, the Rural Clinical School of Western Australia distributes rural medical workforce in a clearly geographically patterned way, with Broome acting as a bridge to the remote north of Australia. 40 In Victoria, those selected from a specific region and having greater than one year of rural training in that region had a 17.4 times increased chance of working in that same rural region compared with urban background students who had completed fewer than 12 weeks of training in the region. 25 In rural communities, students make an authentic contribution to the clinical care of patients.…”

Intention mutability and translation of rural intention into actual rural medical practice

“…This argument is suggested by social network analysis of RCSWA graduate work choices, which showed a strong social patterning of graduate rural work choices. Choices were not ordered by the usual factors of location to capital city, size of town, affluence of town or availability of specialist resources, 21 but appeared rather to relate to social aspects of the work location 22 …”