Rural Remote Health
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Rural Remote Health · Jul 2015
ReviewDeterminants of an urban origin student choosing rural practice: a scoping review.
The shortage of physicians in rural and remote communities is an ongoing problem. Many studies have shown that the rural background of a student (ie rural origin) is a primary factor in recruiting physicians for practice in rural communities. Scoping reviews are primarily done to gauge the extent of literature on the research question at hand, typically with an intent that future research in that area is a constructive addition to pre-existing knowledge. This scoping review focuses on factors that predispose urban-origin students to choose a carrier in rural medicine. ⋯ Urban-origin students may choose rural practice because of market forces as well as financial incentives. The participation in undergraduate and postgraduate rural training is reported to positively alter the attitude of urban-origin students. A small subset of these students has a predetermined mindset to practice rurally at the time of matriculation. Obstacles for choosing a rural carrier include, but are not limited to lack of job and education opportunities for spouses/partners, lack of recreational and educational opportunities for children, and obscure opportunities for continuing medical education.
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Rural Remote Health · Jul 2015
Multicenter StudyWhen a LIC came to town: the impact of longitudinal integrated clerkships on a rural community of healthcare practice.
Two small rural towns in Australia, where medical practitioners provide primary care to the population, including emergency, anaesthetic and obstetric services, were early adopters of an innovative year-long integrated clerkship (clinical placement) designed to foster medical student skill attainment and a commitment to underserved rural communities. Primary care vocational trainees had previously trained in the region. Engaging with the university to participate in the clerkship initiative for undergraduate medical education offered the local healthcare service an opportunity to really integrate education with service. This study sought perspectives from a multidisciplinary group of stakeholders on the impact of the longitudinal integrated clerkship (LIC) on the healthcare community. ⋯ There was significant clinical exposure, skill and teaching capacity in these previously unrecognised rural placements but realising the potential of the health service needs careful management to sustain this resource. Early engagement and initial enthusiasm have produced many positive outcomes for the healthcare community, but this alone is not sufficient to sustain an increasing role for rural primary care in medical education. The study identified issues that need addressing for sustainability, namely validation, time and costs. Strategies to address these are key to continuation of LICs in small rural communities.
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Rural Remote Health · Jul 2015
Using cultural immersion as the platform for teaching Aboriginal and Torres Strait Islander health in an undergraduate medical curriculum.
In 2011 Bond University was looking for innovative ways to meet the professional standards and guidelines in Aboriginal and Torres Strait Islander health in its Bachelor of Medicine, Bachelor of Surgery (MBBS) curriculum. In 2012 Bond piloted a compulsory cultural immersion program for all first year students, which is now a usual part of the MBBS program. ⋯ The use of immersion in the early part of a cultural awareness program for medical students provides an extremely valuable platform from which to launch more detailed information about the history of Aboriginal and Torres Strait Islander Australia and its impact on the current health status of Aboriginal and Torres Strait Islander Australians. Doing this in a safe, supportive cross-cultural environment with highly skilled facilitators is essential. Key to success is strong leadership, commitment and support from Faculty level, a structured educational program and educating all staff and students about its importance throughout the journey.
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Rural Remote Health · Jul 2015
ReviewSuccesses, challenges and needs regarding rural health medical education in continental Central America: a literature review and narrative synthesis.
Central American countries, like many others, face a shortage of rural health physicians. Most medical schools in this region are located in urban areas and focus on tertiary care training rather than on community health or primary care, which are better suited for rural practice. However, many countries require young physicians to do community service in rural communities to address healthcare provider shortages. This study aimed to: (a) synthesize what is known about the current state of medical education preparing physicians for rural practice in this region, and (b) identify common needs, challenges and opportunities for improving medical education in this area. ⋯ Expertise in rural medicine and training exists in continental Central America. However, there are numerous challenges to improving medical education to meet the needs of rural communities. Overcoming these challenges will require creative solutions, new partnerships, and evaluation and dissemination of successful educational programs. There is a great need for further research on this topic.
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Rural Remote Health · Jul 2015
Using a participatory action research framework to listen to Aboriginal and Torres Strait Islander people in Australia about pandemic influenza.
This article describes the use and effectiveness of the participatory action research (PAR) framework to better understand community members' perceptions and risks of pandemic influenza. In 2009, the H1N1 influenza pandemic affected Indigenous populations more than non-Indigenous populations in Oceania and the Americas. Higher prevalence of comorbidities (diabetes, obesity, asthma and chronic obstructive pulmonary disease) as well as pregnancy in Indigenous communities may have contributed to the higher risks of severe disease. Social disparity, institutionalised racism within health services and differences in access to culturally safe health services have also been reported as contributors to disadvantage and delayed appropriate treatment. ⋯ The most effective responses of this project were embedded in pre-existing relationships with individuals within organisations that had been established over a long period of time between Aboriginal medical services and investigators; however, research relationships established specifically for the purposes of the project were less successful because of changes in personnel and organisational support. The participatory approach used in this study has the potential to be applied to vulnerable populations in other countries.