Evidence for the acceptability and academic success of an innovative remote and rural extended placement

Abstract

Introduction: Time spent in remote medicine as an undergraduate is influential in career choice in Australia and Northern America. However, its influence is not known in smaller countries, where recruitment into rural medicine is also problematic. Differences across countries mean work is required to explore determinants of success of remote and rural undergraduate training locally. The objectives of this pilot study were to identify why 4th year medical students chose an extended remote and rural option within a degree program which includes a short compulsory period of remote and rural practice. Because this was a novel option the study also looks at the academic performance of the first cohort of students to ensure quality control of teaching and learning.

Methods: This was a mixed methods (questionnaire, focus group, assessment data) pilot study exploring student views and performance outcomes in 4th year medical undergraduate students (n = 14), University of Aberdeen, who completed an innovative, one-year remote and rural placement.

Results: Fourteen students took part in the pilot. Questionnaire data indicated they viewed remote and rural medicine positively. This interest was maintained over the placement. Most had no definite career plans, but did have a slight preference towards general practice. Focus group data indicated four main themes relating to the decision to select the remote and rural placement: (1) teaching reputation; (2) to experience remote and rural medicine; (3) a change from Aberdeen; and (4) lifestyle factors. Assessment data indicated that student performances at the end of the year placement were consistent with their 3rd year performance on all assessments: OSCEs (p = 0.79), written exams (p = 0.10; p = 0.49), special study module/ Ethics (p = 0.10) and year mark averages (p = 0.48).

Discussion: The results indicate that the extended remote and rural placement was a valuable and academically successful experience for the students. Important outcomes include that: the students who chose to undertake the remote and rural option did not suffer academically; and the cohort maintained their enthusiasm for long-term remote and rural practice. This pilot study represents only the short-term results of a remote and rural extended option offered by one university medical school. We plan further follow up on these students and their successors to look at both short- and long-term outcomes in terms of post selection and choosing to live and work within rural communities.