Rural physicians' skills enrichment program: a cohort control study of retention in Alberta

Abstract

Objective: The Rural Physician Action Plan of Alberta introduced an enrichment program in 2001 to improve physician access to skills training. The objective of this study was to evaluate this program and measure retention compared with matched controls over 5 years.

Design: Longitudinal, matched, case control study and program evaluation.

Setting: Rural communities in Alberta, Canada.

Participants: Rural physicians.

Interventions: Thirty-one rural physicians self-selected their personal skills training program and listed three goals they wished to attain. They were matched by age, specialty, years in practice and size of community with rural physicians who did not participate in a skills training or upgrading program.

Main outcome measures: Goal attainment for subject physicians, use of skills at 5 years and comparison of rural retention of physicians at 5 years.

Results: Thirty-two of thirty-five physicians classified their goal attainment to be as expected or greater, and all were using their new skills at 5 years. Of the matched physicians, 29 training participants remained in rural practice at 5 years compared with only 22 of 29 matched control: relative risk 1.31, confidence interval 1.06-1.62 P < 0.05.

Conclusions: The enrichment program provides focused, valued skills training for rural physicians and long-term benefits to rural communities.