Strengthening training in rural practice in Germany: new approach for undergraduate medical curriculum towards sustaining rural health care

Holst, Jens; Normann, Oliver; Herrmann, Markus

doi:10.22605/rrh3563

Cited by 9 publications

(6 citation statements)

References 27 publications

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“…Thirty-six studies reported on the relationship between undergraduate training in underserved areas and eventual practice location [50,51,56,57,63,71,74,75,80,86,87,91,92,110,[112][113][114][115][116][117][118][119][120][121][122][123][124] or intentions to practice in underserved areas [52,81,93,[123][124][125][126][127][128][129][130]. This included training at medical education institutions in an underserved location (usually rural) [91,128], shorter opportunities for medical students to participate in clerkships, internships, externships, or placements in any such practice setting (e.g., hospital, family practice) for any duration [50-52, 56, 57, 63, 71, 75, 80, 81, 86, 87, 92, 110, 112-116, 118-121, 125, 127, 129, 130], and combinations of clinical placements with specific non-clinical curricula [50,57,...…”

Section: Undergraduate Training Experiences In Underserved Areasmentioning

confidence: 99%

“…Notably, the duration of rural undergraduate training varied across studies, ranging from 6 weeks to more than 1 year, with some reporting that associations with eventual practice in underserved locations were stronger the longer the duration of the placement [86,87]. The majority of studies reporting on the effect of rural undergraduate training on intentions to practice described positive outcomes [53,81,122,123,[127][128][129][130]]. An American cross-sectional study indicated that students placed in underserved locations had greater odds of reporting intention to work in such communities at graduation (OR 9.40, 95% CI 4.66-19.96) [52].…”

Section: Undergraduate Training Experiences In Underserved Areasmentioning

confidence: 99%

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Medical education interventions influencing physician distribution into underserved communities: a scoping review

et al. 2022

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Background and objective Physician maldistribution is a global problem that hinders patients’ abilities to access healthcare services. Medical education presents an opportunity to influence physicians towards meeting the healthcare needs of underserved communities when establishing their practice. Understanding the impact of educational interventions designed to offset physician maldistribution is crucial to informing health human resource strategies aimed at ensuring that the disposition of the physician workforce best serves the diverse needs of all patients and communities. Methods A scoping review was conducted using a six-stage framework to help map current evidence on educational interventions designed to influence physicians’ decisions or intention to establish practice in underserved areas. A search strategy was developed and used to conduct database searches. Data were synthesized according to the types of interventions and the location in the medical education professional development trajectory, that influence physician intention or decision for rural and underserved practice locations. Results There were 130 articles included in the review, categorized according to four categories: preferential admissions criteria, undergraduate training in underserved areas, postgraduate training in underserved areas, and financial incentives. A fifth category was constructed to reflect initiatives comprised of various combinations of these four interventions. Most studies demonstrated a positive impact on practice location, suggesting that selecting students from underserved or rural areas, requiring them to attend rural campuses, and/or participate in rural clerkships or rotations are influential in distributing physicians in underserved or rural locations. However, these studies may be confounded by various factors including rural origin, pre-existing interest in rural practice, and lifestyle. Articles also had various limitations including self-selection bias, and a lack of standard definition for underservedness. Conclusions Various educational interventions can influence physician practice location: preferential admissions criteria, rural experiences during undergraduate and postgraduate medical training, and financial incentives. Educators and policymakers should consider the social identity, preferences, and motivations of aspiring physicians as they have considerable impact on the effectiveness of education initiatives designed to influence physician distribution in underserved locations.

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Section: Undergraduate Training Experiences In Underserved Areasmentioning

confidence: 99%

Section: Undergraduate Training Experiences In Underserved Areasmentioning

confidence: 99%

Medical education interventions influencing physician distribution into underserved communities: a scoping review

et al. 2022

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“…Three evidence reviews demonstrated the connection between rural exposure during undergraduate medical training, and the increase in the number of medical graduates working in rural settings. Interventions noted have included attending a rural campus or spending time in a rural area to practice in non-metropolitan areas [ 41 ], short rural assignments to complete medical training in geographically remote medical schools, rural internships [ 42 ] and intensive rural health programmes [ 43 ]. One review by Guilbault and Vinson found that clinical training in rural underserved areas increased the likelihood to practice in primary care in underserved areas by about four times [ 44 ].…”

Section: Resultsmentioning

confidence: 99%

What are the impacts of setting up new medical schools? A narrative review

et al. 2022

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Background The growth of the UK’s population together with an aging society with increasingly complex health and social care needs has placed a greater demand on statutory care services. In view of this emerging landscape, the UK Government has sought to increase its medically trained workforce in order to better respond to the demands placed on the health service. Five universities were announced as homes to new medical schools offering undergraduate places to boost the numbers of doctors training in England. The aim of this narrative review was to explore how new medical schools could improve the health outcomes of the local population and evaluate the potential contribution it may make to the local economy, workforce and to research and innovation. Methods A narrative review was undertaken using a systematic approach for the search literature strategy. The articles were evaluated by undertaking a critical assessment evaluating the fitness of a paper for review according to results, methods used to test the hypothesis, conclusions and impact and limitations. Thematic analysis was employed to organise and summarise the findings across a heterogeneous body of literature included in the review. The analysis was developed in an inductive manner and there were not any predefined themes to guide data extraction and analysis. Results Thirty-six articles were selected for inclusion for this narrative review. The review identified six key themes: influence of prior rural exposure, medical school environment and rural enrichment programmes, workforce, health outcomes of local populations, social accountability, economic contribution of medical schools to communities and impact on rural research. Conclusions The studies included found a wealth of information on a wide-range of topics on the expansion of undergraduate education and its implications on the future medical workforce. It was shown that medical schools can have a positive effect on the health, social, economic and research activity of a region, but this literature tended to be heterogeneous in focus without consideration of the inter-connections between the wider societal and economic impacts arising from long-term sustainable change being brought to a region.

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“…Estes achados são compatíveis com os de outros trabalhos. (39) Tabela 2 -Motivadores atuais entre alunos para trabalhar fora de um grande centro urbano. Quando questionados sobre motivadores que os levariam a preferir trabalhar em grandes centros urbanos (ver Tabela 3), as principais motivações citadas são as relacionadas a aspectos profissionais, em especial o pertencimento a um "serviço especializado" e "de referência", facilidade de acesso para encaminhar pacientes a colegas, acesso facilitado a exames e trabalho em ambiente hospitalar.…”

Section: Motivadores Para Trabalho Fora Ou Em Um Grande Centro Urbanounclassified

Avaliação do internato médico rural em Medicina de Família e Comunidade da Universidade de Caxias do Sul: reflexões para a educação médica e políticas de saúde

Targa

Camargo

2022

Semin. Cienc. Biol. Saude

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A educação médica passou por transformações constantes ao longo da História e no Brasil assume características específicas. Recentemente, entre outros aspectos, têm-se debatido sobre a importância da variedade de cenários de ensino e de uma abordagem integral e generalista para o desenho de um perfil de egresso mais próximo às necessidades de saúde da população. Este estudo apresenta uma avaliação qualitativa e quantitativa da experiência de acadêmicos de Medicina, professores e profissionais de saúde envolvidos no internato médico rural em Medicina de Família e Comunidade da Universidade de Caxias do Sul, estado do Rio Grande do Sul, Brasil. Perfis dos participantes, motivadores de estágio, influências sobre opções de trabalho futuro, impacto nas equipes de saúde e aspectos positivos e negativos da experiência são apresentados e discutidos à luz da literatura internacional no tema. O internato rural aparece como uma experiência positiva na formação médica, com potencial agregador qualitativo para os envolvidos e influência na opção futura de trabalho, ajudando a reduzir a defasagem de recursos humanos em áreas rurais. O diálogo entre as comunidades, equipes de saúde, universidade e gestores locais é essencial para a superação dos desafios cotidianos e para a manutenção das atividades, assim como o suporte institucional aos alunos e qualificação do corpo docente. Sugestões de futuras linhas de pesquisa na área são apresentadas.

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Strengthening training in rural practice in Germany: new approach for undergraduate medical curriculum towards sustaining rural health care

Cited by 9 publications

References 27 publications

Medical education interventions influencing physician distribution into underserved communities: a scoping review

Medical education interventions influencing physician distribution into underserved communities: a scoping review

What are the impacts of setting up new medical schools? A narrative review

Avaliação do internato médico rural em Medicina de Família e Comunidade da Universidade de Caxias do Sul: reflexões para a educação médica e políticas de saúde

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