Undergraduate education in rural primary health care: evaluation of a first-year field attachment programme

Abstract

In an effort to evaluate the first part of the rural field attachment programme at the University of Zimbabwe Medical School, a self-assessment questionnaire was administered to the first-year students. Assessment criteria were derived from the stated aims of the school's new undergraduate medical curriculum. The results indicate that students view the programme as relevant and of value of their training as future doctors, even though they were dissatisfied with aspects of the programme. There was some evidence that more emphasis should be placed on the limitations on what doctors can do to solve the health problems of rural Zimbabweans. Contrary to previous opinions of some individuals, students whose homes are in rural areas benefited from the programme and found it of value. Better orientation and selection of supervisors would benefit the programme. Recommendations for field attachment programmes are made based on the findings.

Early practical experience and the social responsiveness of clinical education: systematic review

“…Some of the evidence concerned students' socialisation to their role as a clinical learner and future health professional. Two comparative studies found no association between early experience and the outcomes examined,22 26 although six descriptive studies found positive effects,14 15 17 19 27 28 including becoming more mature, acclimatising to professional settings, and identifying with doctor role models. Looking back on their education, graduates felt that early experience had reduced the stress they experienced when they first met patients during clerkships 27…”

“…Early experience made students more confident in their knowledge, taught them things “that could not be learned from books,”14 20 24 25 27 brought diseases to life, and made medical science more comprehensible 13 17 20 29. It provided a framework to explain clinical practice, showed students how professionals viewed their interactions with patients, and helped develop “clinical ways of thinking.”17 It also taught students how people live, how their living conditions affect their health, and how important it is that health services are readily accessible to them 14 30 31. It helped them appreciate the impact of illness18 28 30 and strengthened their knowledge of healthcare delivery systems,14 16 32 health professional roles and responsibilities, and the importance of good interprofessional communication and multidisciplinary working 18 19 30 31.…”

“…It provided a framework to explain clinical practice, showed students how professionals viewed their interactions with patients, and helped develop “clinical ways of thinking.”17 It also taught students how people live, how their living conditions affect their health, and how important it is that health services are readily accessible to them 14 30 31. It helped them appreciate the impact of illness18 28 30 and strengthened their knowledge of healthcare delivery systems,14 16 32 health professional roles and responsibilities, and the importance of good interprofessional communication and multidisciplinary working 18 19 30 31. It helped students learn biomedical sciences,19 behavioural and social sciences, and the ethical dimension of patient care 18 23…”

The impact of an early_exposure program on medical students’ interest in and knowledge of rural medical practices: a questionnaire survey

“…Evidence has suggested that early experience in rural exposure programs can have a positive influence on students’ preferences for and attitudes toward working in rural medical practices [ 13 , 14 ], as well as their perceptions of rural primary care [ 15 ]. However, the duration of these exposure programs is generally over 75 hours, and the impact of a one-day exposure program on freshman students’ interest in rural practice remains uncertain [ 16 ].…”

Remote and rural placements occurring during early medical training as a multidimensional place-based medical education experience

“…The RRCP was modelled after similar rural elective placements at other institutions, such as Dartmouth in the 1970s, and Morehouse School of Medicine and Eastern Virginia Medical School in the 1980s (Johnson and Haughton, 1975;Blumenthal et al, 1983;Berger and Schaffer, 1986;Lynch et al, 2001). Such experience have shown to be effective for nurturing positive attitudes towards rural medicine (Riley et al, 1992;Vaz and Gona, 1992); Grant et al, 1997;Lynch et al, 2001), and the intent to base future practice in rural communities (Moores et al, 1998;Williamson et al, 2003;Peach et al, 2004).The inclusion of the placements is also supported by studies showing that community placements can improve students" social responsibility towards the community they subsequently practice within (Reeves, 2000).…”