A systematic literature review of undergraduate clinical placements in underserved areas (original) (raw)

Context-The delivery of undergraduate clinical education in under-served areas is increasing in various contexts across the world in response to local workforce needs. A collective understanding of the impact of these placements is lacking. Previous reviews often take a positivist approach by looking only at outcome measures. This review addresses the question: What are the strengths and weaknesses for medical students and supervisors of community placements in under-served areas? Methods-A systematic literature review was carried out by database searching, citation searching, pearl growing, reference list checking, and use of own literature. The databases included MEDLINE, EMBASE, PsycINFO, Web of Science, and ERIC. Search terms used were combinations and variations of four key concepts exploring GP primary care, medical students, placements, and location characteristics. The papers were analysed using a textual narrative synthesis. Findings-The initial search identified 4923 results. After removal of duplicates and screening of titles and abstracts, 185 met the inclusion criteria. These full articles were obtained and were assessed for their relevance to the research question, fifty-four were then included in the final review. Four main categories were identified: student performance, student perceptions, career pathways, and supervisor experiences. Conclusions-This review reflects the emergent qualitative data, as well as quantitative data used to assess initiatives. Under-served area placements have produced many beneficial implications for students, supervisors, and the community. There is a growing amount of evidence regarding rural, under-served areas but little in relation to inner-city, deprived areas, and none in the UK.