The John Flynn Placement Program: Evidence for repeated rural exposure for medical students

Young, Louise; Kent, Lachlan; Walters, Lucie

doi:10.1111/j.1440-1584.2011.01201.x

Cited by 27 publications

(52 citation statements)

References 8 publications

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“…The quality screening process led to 40 studies being classified as ‘moderate’ and therefore were well reported but the study designs could have been better by applying; larger sample sizes, achieving higher consent/participant rates, reducing risk of selection and recall bias, multi-site programs, applying control groups, or being multi-strategy comparison programs [12, 35–73]. …”

Section: Methodsmentioning

confidence: 99%

The impact of rural outreach programs on medical students’ future rural intentions and working locations: a systematic review

2018

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BackgroundSignificant investment has been undertaken by many countries into ‘Rural Clinical Training Placement Schemes’ for medical students in order to deal with shortages of trained health care professionals in rural and remote locations. This systematic review examines the evidence base of rural educational programs within medical education and focusses on workforce intentions and employment outcomes. The study provides a detailed description of the methodological characteristics of the literature, thematic workforce outcomes and key related factors are identified, study quality is assessed, and the findings are compared within an international context.MethodsA systematic review looking at international literature of rural placement programs within medical education between January 2005 to January 2017 from databases including; Medline, Embase, NursingOVID, PubMed and Cochrane. The study adopted the PRISMA protocol. A quality assessment of the literature was conducted based on the Health Gains Notation Framework.ResultsSixty two papers met the inclusion criteria. The review identified three program classifications; Rural Clinical Placement Programs, Rural Clinical Placement Programs combined with a rural health educational curriculum component and Rural Clinical School Programs. The studies included were from Australia, United States, Canada, New Zealand, Thailand and Africa.Questionnaires and tracking or medical registry databases were the most commonly reported research tools and the majority were volunteer programs. Most studies identified potential rural predictors/confounders, however a number did not apply control groups and most programs were based on a single site. There was a clear discrepancy in the ideal rural clinical placement length. Outcomes themes were identified related to rural workforce outcomes. Most studies reported that an organised, well-funded, rural placement or rural clinical school program produced positive associations with increased rural intentions and actual graduate rural employment.ConclusionsFuture research should focus on large scale methodologically rigorous multi-site rural program studies, with longitudinal follow up of graduates working locations. Studies should apply pre-and post-intervention surveys to measure change in attitudes and control for predictive confounders, control groups should be applied; and in-depth qualitative research should be considered to explore the specific factors of programs that are associated with encouraging rural employment.Electronic supplementary materialThe online version of this article (10.1186/s12909-018-1287-y) contains supplementary material, which is available to authorized users.

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Section: Methodsmentioning

confidence: 99%

The impact of rural outreach programs on medical students’ future rural intentions and working locations: a systematic review

2018

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“…15 It demonstrates that the vast majority (90%) of students found their UDRH placement satisfying and that placement satisfaction is associated with changes in students' future practice intentions. It is encouraging that, on average, students who were less inclined or equivocal about rural practice before placement showed an increase in rural practice intention score afterwards.…”

Section: Discussionmentioning

confidence: 99%

Health professional students' rural placement satisfaction and rural practice intentions: A national cross‐sectional survey

Smith

Sutton

Pit

et al. 2017

Australian J Rural Health

101

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Objective: The aim of this study was to profile students undertaking placements at University Departments of Rural Health (UDRHs) and investigate factors affecting students' satisfaction and intention to enter rural practice. Design: Cross-sectional survey comprising 21 core questions used by all UDRHs. Setting: Eleven UDRHs across Australia that support students' placements in regional, rural and remote locations. Participants: Medical, nursing and allied health students who participated in UDRH placements between July 2014 and November 2015 and completed the questionnaire. Main outcome measures: Key dependent variables were placement satisfaction and rural practice intention. Descriptive variables were age, gender, Aboriginal or Torres Strait Islander (ATSI) background, location of placement, healthcare discipline, year of study and type and length of placement. Results: A total of 3328 students responded. The sample was predominantly female (79%), the mean age was 26.0 years and 1.8% identified as ATSI. Most placements (69%) were >2 but ≤12 weeks, 80% were in Modified Monash 3, 4 or 5 geographical locations. Public hospitals and community health made up 63% of placements. Students satisfied with their placement had 2.33 higher odds of rural practice intention. Those satisfied with Indigenous cultural training, workplace supervision, access to education resources and accommodation had higher odds of overall satisfaction and post-placement rural practice intention. Conclusions: The majority of students were highly satisfied with their placement and the support provided by rural clinicians and the UDRHs. UDRHs are well placed to provide health professional students with highly satisfactory placements that foster rural practice intention.

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“…Of 21 different programs (described in 26 papers), 15 were primary care courses added to the conventional curriculum. [49][50][51][52][53][55][56][57][58][59][63][64][65][66][68][69][70][71][72] The remaining six programs were special curricula or medical schools focusing on primary care and/or rural health. 47,48,54,[60][61][62] , Contrary to the studies on clerkships, the most frequently studied outcomes of longitudinal programs were career choices after graduation (n=15).…”

Section: Impact Of Interventions On Primary Care Specialty Choicementioning

confidence: 99%

Impact of Interventions to Increase the Proportion of Medical Students Choosing a Primary Care Career: A Systematic Review

et al. 2015

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BACKGROUND: Increasing the attractiveness of primary care careers is a key step in addressing the growing shortage of primary care physicians. The purpose of this review was to (1) identify interventions aimed at increasing the proportion of undergraduate medical students choosing a primary care specialty, (2) describe the characteristics of these interventions, (3) assess the quality of the studies, and (4) compare the findings to those of a previous literature review within a global context. METHODS: We searched MEDLINE, EMBASE, ERIC, CINAHL, PsycINFO, The Cochrane Library, and Dissertations & Theses A&I for articles published between 1993 and February 20, 2015. We included quantitative and qualitative studies reporting on primary care specialty choice outcomes of interventions in the undergraduate medical curriculum, without geographic restrictions. Data extracted included study characteristics, intervention details, and relevant outcomes. Studies were assessed for quality and strength of findings using a five-point scale. RESULTS: The review included 72 articles reporting on 66 different interventions. Longitudinal programs were the only intervention consistently associated with an increased proportion of students choosing primary care. Successful interventions were characterized by diverse teaching formats, student selection, and good-quality teaching. Study quality had not improved since recommendations were published in 1995. Many studies used cross-sectional designs and non-validated surveys, did not include control groups, and were not based on a theory or conceptual framework. DISCUSSION: Our review supports the value of longitudinal, multifaceted, primary care programs to increase the proportion of students choosing primary care specialties. Isolated modules or clerkships did not appear to be effective. Our results are in line with the conclusions from previous reviews and add an international perspective, but the evidence is limited by the overall low methodological quality of the included studies. Future research should use more rigorous evaluation methods and include long-term outcomes.

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The John Flynn Placement Program: Evidence for repeated rural exposure for medical students

Abstract: Longitudinal experiences, such as the JFPP, are positively influencing intention to enter the rural workforce but the impact of urban centric vocational training might be negating this impact.

Cited by 27 publications

References 8 publications

The impact of rural outreach programs on medical students’ future rural intentions and working locations: a systematic review

The impact of rural outreach programs on medical students’ future rural intentions and working locations: a systematic review

Health professional students' rural placement satisfaction and rural practice intentions: A national cross‐sectional survey

Impact of Interventions to Increase the Proportion of Medical Students Choosing a Primary Care Career: A Systematic Review

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