Perceptions of UK medical students on rural clinical placements

Jenny A. Deaville, John Wynn-Jones, Richard B. Hays, Peter J. Coventry, Robert K. McKinley, Jane Randall-Smith

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Abstract

INTRODUCTION: Rural clinical placements are now commonly used to both promote awareness of rural health careers and expand clinical placement networks in Australia, North America and elsewhere. However in the United Kingdom (UK) there is no clear workforce or health education policy that encourages rural background student recruitment, rural clinical placements, rural oriented curricula or rural health education infrastructure, because deprivation and poor health status are regarded as urban phenomena. The question for one new medical school in regional/rural UK is: can increasing the utilisation of rural primary care practices both resolve teaching capacity constraints and offer students valuable learning opportunities about rural health? This article reports an exploration of students' views on the value of rural clinical placements in a new curriculum designed to address regional deprivation and workforce needs. METHODS: Medical students in Year 1 and Year 3 of a regional medical school were invited to attend focus group discussions that explored their understanding of rural health and life and the attractions of and barriers to expanding rural clinical placements. The Year 1 students were in the new curriculum and therefore more likely to be allocated a rural clinical placement in their more senior years. The discussions were audio-recorded, transcribed and thematically analysed. RESULTS: Themes that emerged were: what is rural? how different is rural from urban?; differences in rural and urban learning, logistic issues, and choosing a rural placement. Student perceptions in both groups were rather negative about rural placements. Rural practices were thought to provide a narrow range of patient contact and learning opportunities, and rural life was thought to be unattractive, especially out of formal placement hours. Even relatively small distances from friends and social outlets were regarded as barriers. Year 1 students were more positive about the possibility of a rural placement, although they knew at admission that the school would be expanding into rural communities and may therefore have been more open to the concept. CONCLUSION: Ruralization of health professional education in the UK faces substantial challenges. More may need to be done to increase recruitment of rural-interested students, foster rural career interest during courses, recruit rural role models, develop rural curricula and establish the infrastructure to support rural clinical placements. These initiatives will require greater political will and some investment by education, heath and community development agencies.

Original languageEnglish
Pages (from-to)1165
Number of pages1
JournalRural and Remote Health
Volume9
Issue number2
Publication statusPublished - Apr 2009
Externally publishedYes

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Medical Students
medical student
Rural Health
Students
Curriculum
Health Education
student
curriculum
Learning
Medical Schools
deprivation
health promotion
health
career
school
infrastructure
learning
Social Distance
Social Planning
Professional Education

Cite this

Deaville, J. A., Wynn-Jones, J., Hays, R. B., Coventry, P. J., McKinley, R. K., & Randall-Smith, J. (2009). Perceptions of UK medical students on rural clinical placements. Rural and Remote Health, 9(2), 1165.
Deaville, Jenny A. ; Wynn-Jones, John ; Hays, Richard B. ; Coventry, Peter J. ; McKinley, Robert K. ; Randall-Smith, Jane. / Perceptions of UK medical students on rural clinical placements. In: Rural and Remote Health. 2009 ; Vol. 9, No. 2. pp. 1165.
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abstract = "INTRODUCTION: Rural clinical placements are now commonly used to both promote awareness of rural health careers and expand clinical placement networks in Australia, North America and elsewhere. However in the United Kingdom (UK) there is no clear workforce or health education policy that encourages rural background student recruitment, rural clinical placements, rural oriented curricula or rural health education infrastructure, because deprivation and poor health status are regarded as urban phenomena. The question for one new medical school in regional/rural UK is: can increasing the utilisation of rural primary care practices both resolve teaching capacity constraints and offer students valuable learning opportunities about rural health? This article reports an exploration of students' views on the value of rural clinical placements in a new curriculum designed to address regional deprivation and workforce needs. METHODS: Medical students in Year 1 and Year 3 of a regional medical school were invited to attend focus group discussions that explored their understanding of rural health and life and the attractions of and barriers to expanding rural clinical placements. The Year 1 students were in the new curriculum and therefore more likely to be allocated a rural clinical placement in their more senior years. The discussions were audio-recorded, transcribed and thematically analysed. RESULTS: Themes that emerged were: what is rural? how different is rural from urban?; differences in rural and urban learning, logistic issues, and choosing a rural placement. Student perceptions in both groups were rather negative about rural placements. Rural practices were thought to provide a narrow range of patient contact and learning opportunities, and rural life was thought to be unattractive, especially out of formal placement hours. Even relatively small distances from friends and social outlets were regarded as barriers. Year 1 students were more positive about the possibility of a rural placement, although they knew at admission that the school would be expanding into rural communities and may therefore have been more open to the concept. CONCLUSION: Ruralization of health professional education in the UK faces substantial challenges. More may need to be done to increase recruitment of rural-interested students, foster rural career interest during courses, recruit rural role models, develop rural curricula and establish the infrastructure to support rural clinical placements. These initiatives will require greater political will and some investment by education, heath and community development agencies.",
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Deaville, JA, Wynn-Jones, J, Hays, RB, Coventry, PJ, McKinley, RK & Randall-Smith, J 2009, 'Perceptions of UK medical students on rural clinical placements' Rural and Remote Health, vol. 9, no. 2, pp. 1165.

Perceptions of UK medical students on rural clinical placements. / Deaville, Jenny A.; Wynn-Jones, John; Hays, Richard B.; Coventry, Peter J.; McKinley, Robert K.; Randall-Smith, Jane.

In: Rural and Remote Health, Vol. 9, No. 2, 04.2009, p. 1165.

Research output: Contribution to journalArticleResearchpeer-review

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Deaville JA, Wynn-Jones J, Hays RB, Coventry PJ, McKinley RK, Randall-Smith J. Perceptions of UK medical students on rural clinical placements. Rural and Remote Health. 2009 Apr;9(2):1165.