The Parallel Rural Community Curriculum: an integrated clinical curriculum based in rural general practice (original) (raw)
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Ruralising the Undergraduate Medical Curriculum Through Consultation with Key Stake Holders
Australian Journal of Rural Health, 1996
This paper describes the approach taken at the University of Queensland to broaden the scope of curriculum design to involve rural general practitioners, medical students and rural health care consumers. A form of nominal group process in serial telephone teleconferences was used, with a group of rural general practitioners, to develop and pilot curriculum content, learning strategies and assessment methods. kIedica2 students assisted in the evaluation of the curriculum and representatives of rural organisations were consulted about the value of hosting medical students in rural communities. The three groups made significant contributions to the project. The results will be trialed for the entire year 6 cohort (240 students) in 1995 and will form the basis of the planned rural practice term in the new graduate course.
MEDICC Review, 2008
Introduction Medical schools today are being challenged to educate doctors who are willing and able to practice in areas of poverty and workforce need. In many countries, there is a shortage of doctors practicing in rural and remote communities. There is evidence that locating undergraduate medical education in rural areas increases the likelihood that graduates will choose to practice in underserved areas. Through its Parallel Rural Community Curriculum (PRCC), Flinders University School of Medicine (FUSM) now enables over 25% of its students to undertake an entire clinical year based in small rural communities supervised principally by rural family physicians. Objective The PRCC was conceived to provide a high quality educational intervention that would result in an increased number of students choosing to practice in rural and remote Australia. It was also designed to test the hypothesis that small rural and remote practices were capable of facilitating a full year of medical training at a standard comparable to that provided at a major tertiary hospital. Intervention Starting with eight students in four towns in 1997, the PRCC now places 30 students across 18 towns in rural Australia. The students simultaneously learn the disciplines of medicine, surgery, pediatrics, obstetrics and gynecology, psychiatry, and family medicine. At the end of the year, all Flinders students, regardless of training location, take the same comprehensive exam. Outcomes PRCC students improved their academic performance in comparison to their tertiary trained peers. This improvement has been consistent over the ten years studied. Seventy percent of the PRCC students have chosen to practice in rural locations, compared to 18 percent of tertiary-trained students. Over twelve years, the program has proved to be sustainable in a private practice environment with a workforce shortage. Conclusions Evaluation of the PRCC indicates that a rural community-based clinical education can provide a high quality academic experience for students as well as a sustainable solution to rural medical workforce maldistribution.
A student view of the difference between general practice and rural and remote medicine
Rural and remote health
Shortages in the Australian medical workforce have been a concern for the rural sector and government alike for many years. The Commonwealth Department of Health and Aged Care has implemented the Government's Regional Health Strategy to secure a rural education and training network which, it is hoped, will increase the availability and viability of rural health services in the long term. The University of Western Australia's Rural Clinical School was established in 2002 and has delivered a one-year clinical course to a total of 81 students at eight rural and remote sites throughout Western Australia. To identify student perceptions of rural general practice and whether they perceived any differences from city general practice. All available students in 2005 participated in a mid-year semi-structured interview with an evaluator. This article reports the findings relating to the question: 'In your experience so far, do you think there is a specialty that could be called ru...
A multi-university evaluation of the rural clinical school experience of Australian medical students
Rural and remote health
Medical students have been attending rural clinical schools (RCSs) since 2001. Although there have been generally positive single institution reports, there has been no multi-institution study using a common survey instrument. The experiences of medical students who attended a number of RCSs during 2006 were evaluated using a rural-specific questionnaire. Questionnaires were distributed to 166 medical students who had completed one year at the RCS of six participating universities across Australia, including the Universities of New South Wales, Melbourne, Tasmania, Adelaide, and Sydney, and the Australian National University, of whom 125 responded (75.3%). Students were asked to rate their level of agreement on 29 items concerning their overall RCS experience, skills development and clinical supervision experience. The majority of respondents (n = 107, 86%) stated they would go to the RCS again if they had their time over and almost two-thirds (n = 77, 64%) stated they would spend m...
Rural and remote health
The establishment of the rural clinical schools funded through the Commonwealth Department of Health and Ageing (now Department of Health) Rural Clinical Training and Support program over a decade ago has been a significant policy initiative in Australian rural health. This article explores the impacts of this policy initiative and presents the wide range of educational innovations contextualised to each rural community they serve. This article reviews the achievements of the Australian rural clinical and regional medical schools (RCS/RMS) through semi-structured interviews with the program directors or other key informants. The questions and responses were analysed according to the funding parameters to ascertain the numbers of students, types of student placements and range of activities undertaken by each university program. Sixteen university medical schools have established 18 rural programs, creating an extensive national network of RCS and RMS in every state and territory. Th...
Challenges to rural medical education: a student perspective
Australian Journal of Rural Health, 2002
The health care needs of rural communities are different from those of urban ones, presenting many quite different challenges for the rural practitioner. Rural medical services primarily revolve around the general practitioner, but
Rural and Remote Health
Introduction: Despite an increase in the number of undergraduate training positions, Australia faces a critical shortage of medical practitioners in regional, rural and remote communities. Extended rural clinical placements have shown great utility in undergraduate medical curricula, increasing training capacity and providing comparable educational outcomes while promoting rural medicine as a career. The Prevocational Integrated Extended Rural Clinical Experience (PIERCE) was developed to increase the training capacity of the Queensland Rural Generalist Pathway (QRGP) and strengthen trainee commitment to rural practice by offering an authentic, extended 15-week rural term that provided an integrated experience in anaesthetics, obstetrics and gynaecology, and paediatrics, while meeting the requirements for satisfactory completion of prevocational rural generalist training. This study sought to evaluate whether trainees believed PIERCE and/or traditional regional hospital specialty placements achieved their learning objectives and to identify elements of the placements that contributed to, or were a barrier to, their realisation. Methods: This translational qualitative study explored the experiences and perceptions of QRGP trainees who undertook a PIERCE placement in three Queensland rural hospitals (Mareeba, Proserpine and Stanthorpe) in 2015, with a matched cohort of trainees who undertook regional hospital placements in anaesthetics, obstetrics and gynaecology, and paediatrics at a regional referral hospital (Cairns, Mackay and Toowoomba base hospitals). The study used a realist evaluation framework that investigates What works, for whom, in what circumstances, in what respects and why? Results: PIERCE provided an enjoyable and valued rural training experience that promoted trainee engagement with, and contribution to, a rural community of practice, reinforcing their commitment to a career in rural medicine. However, QRGP trainees did not accept that PIERCE could be a substitute for regional hospital experience in anaesthetics, obstetrics and gynaecology, and paediatrics. Rather, trainees thought PIERCE and regional hospital placements offered complementary experiences. PIERCE offered integrated, hands-on rural clinical experience in which trainees had more autonomy and responsibility. Regional hospital placements offered more traditional caseload learning experiences based on observation and the handing down of knowledge and skills by hospital-based supervisors. Conclusion: Both PIERCE and regional hospital placements provided opportunities and threats to the attainment of the curriculum objectives of the Australian Curriculum Framework for Junior Doctors, the Australian College of Rural and Remote Medicine and the Royal Australian College of General Practitioners Fellowship in Advanced Rural General Practice curricula. PIERCE trainees enjoyed the opportunity to experience rural medicine in a community setting, a broad caseload, hands-on proficiency, continuity of care and an authentic role as a valued member of the clinical team. This was reinforced by closer and more consistent clinical and educational interactions with their supervisors, and learning experiences that address key weaknesses identified in current hospital-based prevocational training. Successful achievement of prevocational curriculum objectives is contingent on strategic alignment of the curricula with supportive learning mechanisms focused by the learning context on the desired outcome, rural practice. This study adds weight to the growing consensus that rural community-based placements such as PIERCE are desirable components of prevocational training.
BMC medical education, 2005
Earlier studies have successfully demonstrated that medical students can achieve success in core clinical rotations with long term attachments in small groups to rural general / family practices. In this study, three students from a class of 226 volunteered for this 1-year pilot program, conducted by the University of Queensland in 2004, for medical students in the 3rd year of a 4-year graduate entry medical course. Each student was based with a private solo general practitioner in a different rural town between 170 and 270 km from the nearest teaching hospital. Each was in a relatively isolated rural setting, rated 5 or 6 on the RRMA scale (Rural, Remote, Metropolitan Classification: capital city = 1, other metropolitan = 2, large regional city = 3, most remote community = 7). The rural towns had populations respectively of 500, 2000 and 10,000. One practice also had a General Practice registrar. Only one of the locations had doctors in the same town but outside the teaching practi...