농촌지역학생을 선발하면 농촌지역으로 갈까?

Does recruitment lead to retention? Rural Clinical School training experiences and subsequent intern choices.

Eley D1, Baker P.

o 배경

¡ Australian Rural Clinical Schools은 2000년~2001년에 전국적으로 설립되었고 의과대학생들이 호주 전역에 걸쳐서 hospitals, general practice surgeries, community medical centres 등의 네트워크를 통해서 임상 수련을 받을 수 있게 하려는 목적이 있었음.

¡ UQ의 RCS는 2002년 설립되었으며, 학생은 Central/Southern/Rural division에서 실습을 할 수 있음. 세 division에서 Training은 사실상 동등함. RCD에 대한 체계적 평가는 프로그램의 지속적 발전 뿐만 아니라 Commonwealth funding을 지속적으로 받기 위한 기전(mechanism)으로서 중요함. 또한 학생들의 인식은 교육 향상과 학생 모집을 지원하는 측면에서 중요한 의미가 있음.

¡ 4학년 학생들에게 졸업시 설문조사(Exit Survey)를 시행하였으며 medical graduate retention 차원에서 학생들의 인턴 선택을 분석하였음.

¡ RCS에서 긍정적인 교육 경험을 심어주는 것은 인턴 선택시에 농촌 지역을 선호하는 양상으로 나타날 것을 기대할 수 있음. 본 연구는 한 학년의 코호트를 대상으로 농촌에서의 교육 경험이 junior medical personnel로서 농촌 병원에 recruitment하는 것과 어떤 연관이 있는가 보고자 하였음.

 

o 방법

¡ 4학년 학생들을 대상으로 63문항으로 된 설문 실시

 

o 결과

¡ 의학 교육 전반에 대해서 만족도가 매우 높은 편이었으나, 이러한 결과와 internship 선택 사이에는 불일치가 있었음. 이는 미래의 근무 환경, 그리고 전문성 지원(professional support)에 대한 부정적인 인식이 원인인 것으로 나타났음.

 

o 결론

¡ 긍정적인 농촌 학습 경험을 심어주고 양질의 의학교육을 제공하는 것이 농촌 의료에 대한 흥미를 높이는 것으로 나타났으며, 그 지역에서 진로를 추구하고자 하는 의사도 높이는 것으로 나타났음. 

¡ 그러나 이러한 양질의 교육이 곧바로 농촌 지역 인턴십으로 나타나지는 않았음. 따라서 만약 농촌 의료인력을 확충하려는 목적을 달성하기 위해서는 진료 환경에 대한 지원(supportive clinical workplace environment)와 연계되어야 할 필요가 있음.

 

(출처 : http://dynamic.architecture.com.au/i-cms?page=1.13262.156.3145.11745.13869.14011.14024)

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Rural Remote Health. 2006 Jan-Mar;6(1):511. Epub 2006 Feb 3.

Does recruitment lead to retention? Rural Clinical School training experiences and subsequent intern choices.

Eley D1, Baker P.

Author information

Abstract

INTRODUCTION:

The Australian Rural Clinical Schools, established nationally in 2000-2001, have provided an opportunity for medical students to undertake their clinical training across a network of hospitals, general practice surgeries and community medical centres in locations throughout Australia. The Rural Clinical School at the University of Queensland was established in 2002, as the Rural Clinical Division (RCD) of the School of Medicine, which provides a four-year graduate MB BS program. Students may elect to train in their 3rd and/or 4th year in one of three clinicaldivisions, namely Central, Southern (both based in Brisbane) or Rural which comprises teaching sites in south west Queensland and central Queensland region. Training must be of an equivalent nature throughout these three divisions, because students all sit the same examinations. Rigorous evaluation of the RCD teaching program underpins the goals of continuing improvement of both education and resources, and is also a key component of the reporting mechanisms linked to ongoing Commonwealth funding. Students' perception of their medical education at the RCD is the major focus of such evaluations in order to assist both educational improvement and required student recruitment. With this in mind, a questionnaire, the 'Year 4 Exit Survey' was developed to evaluate medical student perceptions of their 4th year experience at the RCD. Coupled to this was an analysis of internship choices to evaluate the important related issue of medical graduate retention. Objective: The increasing popularity of the RCD has prompted further investigation into the intern placement choice by these students. The provision of a positive medical education experience in aRural Clinical School might be expected to influence this intern choice to favour a rural location. This preliminary report provides the results of the evaluations by one cohort of year 4 students and explores the relationship between rural undergraduate medical training experiences and subsequentrecruitment and retention of junior medical personnel within local rural hospitals.

METHODS:

The Year 4 Exit Survey contained 63 questions and was a combination of open-ended and forced answer items. The survey was divided into the following sections: demographics, career interests, experience of rural living, interest in rural medical practice, perceptions of ruralcommunities, perceptions of the RCD, rating of their medical training, the impact of the RCD on their desire to practice medicine in a rural area, their opinions on the most and least valuable study experiences at either site and their suggestions on how that experience might be improved. A final question asked them their choice of internship location and the reasons why they were or were not staying at their present RCD site.

RESULTS:

Overall there was a high degree of student satisfaction with all aspects of their medical education. However there was a discrepancy between these findings and subsequent internship choices. Reasons for this discrepancy were associated with the students' adverse perceptions of their future workforce environment and professional support.

CONCLUSIONS:

Provision of positive rural training experiences and quality medical education has been shown to increase interest in rural medicine and encourage a desire to pursue a medical career in a rural area. However a quality undergraduate rural medical education does not guarantee immediate transition to rural internship. If the ultimate goal of improving the rural medical workforce is to be achieved, the present high levels ofrecruitment by the Rural Clinical Schools and their provision of a positive rural training experience must be matched by a supportive clinical workplace environment. Studies are needed to look more closely at the transition period between medical graduate and intern.

PMID:

 

19469660

 

[PubMed - indexed for MEDLINE] 

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