Rural Health - Research Publications

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Author: DEWITT TALBOT, DAWN × End date: 2009 × Start date: 2002 × Type: Journal Article ×

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    Longitudinal Integrated Clerkships for Medical Students: An Innovation Adopted by Medical Schools in Australia, Canada, South Africa, and the United States
    Norris, TE ; Schaad, DC ; DeWitt, D ; Ogur, B ; Hunt, D (LIPPINCOTT WILLIAMS & WILKINS, 2009-07)
    PURPOSE: Integrated clinical clerkships represent a relatively new and innovative approach to medical education that uses continuity as an organizing principle, thus increasing patient-centeredness and learner-centeredness. Medical schools are offering longitudinal integrated clinical clerkships in increasing numbers. This report collates the experiences of medical schools that use longitudinal integrated clerkships for medical student education in order to establish a clearer characterization of these experiences and summarize outcome data, when possible. METHOD: The authors sent an e-mail survey with open text responses to 17 medical schools with known longitudinal integrated clerkships. RESULTS: Sixteen schools in four countries on three continents responded to the survey. Fifteen institutions have active longitudinal integrated clerkships in place. Two programs began before 1995, but the others are newer. More than 2,700 students completed longitudinal integrated clerkships in these schools. The median clerkship length is 40 weeks, and in 15 of the schools, the core clinical content was in medicine, surgery, pediatrics, and obstetrics-gynecology. Eleven schools reported supportive student responses to the programs. No differences were noted in nationally normed exam scores between program participants and those in the traditional clerkships. Limited outcomes data suggest that students who participate in these programs are more likely to enter primary care careers. CONCLUSIONS: This study documents the increasing use of longitudinal integrated clerkships and provides initial insights for institutions that may wish to develop similar clinical programs. Further study will be needed to assess the long-term impact of these programs on medical education and workforce initiatives.
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    Medical students' reported barriers to training at a Rural Clinical School.
    Jones, GI ; DeWitt, DE ; Elliott, SL (Wiley, 2005-10)
    OBJECTIVE: To understand and address students' concerns about attending one of the new Commonwealth-funded Rural Clinical Schools. DESIGN: Analysis of students' reported reasons for clinical school selection from 2003 to 2004. SETTING: The School of Medicine and the Rural Clinical School, University of Melbourne. PARTICIPANTS: Data were obtained from de-identified preference documents submitted by the medical student cohort assigned to the University of Melbourne clinical schools to begin in July, 2004. RESULTS: Thirteen categories of student concerns (social) were identified from written student preference documents. CONCLUSIONS: Evaluation of the students' concerns about social dislocation if they were assigned to a rural clinical school has provided important information about perceived barriers to rural training. These issues must be systematically addressed at the school, university and community level.
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    Developing a conceptual understanding of rural health practice.
    Bourke, L ; Sheridan, C ; Russell, U ; Jones, G ; DeWitt, D ; Liaw, S-T (Wiley, 2004-10)
    OBJECTIVE: This study presents a set of concepts underpinning rural practice that could assist teaching health and medical students. OUTCOME: Five concepts, important in distinguishing rural health practice, are presented and discussed. These are rural-urban health differentials, access, confidentiality, cultural safety and team practice. Together these concepts impact the ways in which rural health professionals provide care, due to fewer services, greater distances, smaller populations, less choice of services and smaller workforce. CONCLUSION: These concepts introduce students to some of the positive and negative aspects of rural practice, as well as opportunities for rural practitioners to have a diverse practice, to become involved in all aspects of health and to initiate change. They provide an understanding of rurality from which health students can learn from their practical experiences during rural placements.