What factors in rural and remote extended clinical placements may contribute to preparedness for practice from the perspective of students and clinicians?

Daly, Michele; Perkins, David; Kumar, Koshila; Roberts, Chris; Moore, Malcolm A

doi:10.3109/0142159x.2013.820274

Cited by 49 publications

(100 citation statements)

References 45 publications

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“…Our findings mirror those of our colleagues (Daly, Perkins, Kumar, Roberts, & Moore, 2013;Jamar, Newbury, & Mills, 2014;Walters et al, 2012) in that graduates of a program incorporating an LIC possess good communication and clinical skills, and are more ready for the role of a doctor, having gained clinical experience though 'acting up' that closely approximates this. Rural students gain confidence and procedural skill, perhaps to a greater extent than their metro-trained counterparts (Rowe, Campbell, & Hargrave, 2014).…”

Section: Discussioncontrasting

confidence: 40%

Effectiveness of a rural longitudinal integrated clerkship in preparing medical students for internship

2015

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Background: We interviewed graduates from the first two cohorts of a postgraduate medical program that had a senior year longitudinal integrated clerkship (LIC) in a practice setting in rural New South Wales, Australia to determine how well their training prepared them to be junior doctors (3-4 years after graduation), and what aspects of that training they thought were particularly useful. Methods: In-depth interviews. Results: Fourteen junior doctors were interviewed. Participants reported feeling well prepared in ability to develop close relationships with clinical supervisors, good clinical and procedural skills, ability to work autonomously and work in teams, knowledge of health systems, ability to ensure self-care, and professionalism. Consensus view was that a rural placement was an excellent way to learn medicine for a variety of reasons including relationships with clinicians, less competition for access to patients, and opportunities to extend their clinical skills and act up to intern level. Conclusion: The advantages we found in the training these junior doctors received which prepared them well for internship were integral both to the longitudinal, unstructured placement, and to the fact that it was carried out in a rural area. The two aspects of these placements appear to act synergistically, reinforcing the learning experience.

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Section: Discussioncontrasting

confidence: 40%

Effectiveness of a rural longitudinal integrated clerkship in preparing medical students for internship

2015

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“…The value of community service for their development is consistent with studies elsewhere (Benson et al 2015;Daly et al 2013). However, only a few recognised that learning in this area is a journey of continuous improvement, a core principle of cultural competency (Cross et al 1989;Gorringe, et al 2008).…”

Section: Self-reflection and Continuous Improvement -The Basis For Ensupporting

confidence: 69%

Serving an Indigenous community: Exploring the cultural competence of medical students in a rural setting

et al. 2017

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Since 2013, medical students from the International Medical University (IMU) in Malaysia have been providing primary healthcare services, under the supervision of faculty members, to the indigenous people living in Kampung Sebir. The project has allowed the students to learn experientially within a rural setting. This study aims to examine the cultural competence of IMU medical students through an examination of their perspective of the indigenous people who they serve and the role of this community service in their personal and professional development. Students who participated in the project were required to complete a questionnaire after each community engagement activity to help them reflect on the above areas. We analysed the responses of students from January to December 2015 using a thematic analysis approach to identify overarching themes in the students’ responses. Students had differing perceptions of culture and worldviews when compared to the indigenous people. However, they lacked the self-reflection skills necessary to understand how such differences can affect their relationship with the indigenous people. Because of this, the basis of their engagement with the indigenous community (as demonstrated by their views of community service) is focused on their agenda of promoting health from a student’s perspective rather than connecting and building relationships first. Students also lacked the appreciation that building cultural competency is a continuous process. The results show that the medical students have a developing cultural competence. The project in Kampung Sebir is an experiential learning platform of great value to provide insights into and develop the cultural competency of participating students. This study also reflects on the project itself, and how the relationship with stakeholders, the competence and diversity of academic staff, and the support of the university can contribute toward training in cultural competence.

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“…There are a number of ways in which the nature of learning in clinical placements can influence preparedness for practice (Westerman et al 2013;Tokuda et al 2010). For example, early clinical exposure allows medical students to 'actup' as junior doctors and may ease their transition to internship (Brennan et al 2010;Hauer et al 2012;Daly et al 2013a); At the same time failure to be prepared for practice can have negative consequences. For example, insufficient preparedness is a significant contributor to stress and ultimately burnout in the early junior doctor years (Brennan et al 2010;Willcock et al 2004).…”

Section: Theoretical Frameworkmentioning

confidence: 99%

Social learning in a longitudinal integrated clinical placement

Roberts

Daly

Held

et al. 2016

Adv in Health Sci Educ

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Recent research has demonstrated that longitudinal integrated placements (LICs) are an alternative mode of clinical education to traditional placements. Extended student engagement in community settings provide the advantages of educational continuity as well as increased service provision in underserved areas. Developing and maintaining LICs require a differing approach to student learning than that for traditional placements. There has been little theoretically informed empirical research that has offered explanations of which are the important factors that promote student learning in LICs and the relationships between those factors. We explored the relationship between student learning, student perceptions of preparedness for practice and student engagement, in the context of a rural LIC. We used a sequential qualitative design employing thematic, comparative and relational analysis of data from student interviews (n = 18) to understand possible processes and mechanisms of student learning in the LIC. Through the theoretical lens of social learning systems, we identified two major themes; connectivity and preparedness for practice. Connectivity described engagement and relationship building by students, across formal and informal learning experiences, interprofessional interactions, social interactions with colleagues, interaction with patients outside of the clinical setting, and the extent of -016-9740-3 integration in the wider community. Preparedness for practice, reflected students' perceptions of having sufficient depth in clinical skills, personal and professional development, cultural awareness and understanding of the health system, to work in that system. A comparative analysis compared the nature and variation of learning across students. In a relational analysis, there was a positive association between connectivity and preparedness for practice. Connectivity is a powerful enabler of students' agentic engagement, collaboration, and learning within an LIC. It is related to student perceptions of preparedness for practice. These findings provide insight for institutions wishing to develop similar programmes, by encouraging health professional educators to consider all of the potential elements of the placements, which most promote connectivity.Adv in Health Sci Educ (2017) 22:1011-1029 DOI 10.1007/s10459

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What factors in rural and remote extended clinical placements may contribute to preparedness for practice from the perspective of students and clinicians?

Cited by 49 publications

References 45 publications

Effectiveness of a rural longitudinal integrated clerkship in preparing medical students for internship

Effectiveness of a rural longitudinal integrated clerkship in preparing medical students for internship

Serving an Indigenous community: Exploring the cultural competence of medical students in a rural setting

Social learning in a longitudinal integrated clinical placement

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