How rural immersion training influences rural work orientation of medical students: Theory building through realist evaluation. (2nd December 2021)

• Record Type: Journal Article
• Authors: Bingham, Amie; O'Sullivan, Belinda; Couch, Danielle; Cresser, Samuel; McGrail, Matthew; Major, Laura
• Is Part Of: Medical teacher. Volume 43:Number 12(2021)
• Page Start: 1398
• Page End: 1405
• Publication Date: 2021-12-02
• Subjects: Undergraduate -- Medicine -- General Learning Outcomes -- Medical Education Research -- Evaluation; Medical education -- Periodicals; 610.711
• DOI: 10.1080/0142159X.2021.1948520
• Languages: English
• ISSNs: 0142-159X

Abstract

Abstract: Aim: To develop theory about how contexts and mechanisms interact to contribute to openness to future rural practice by medical students undertaking immersive rural training. Methods: A realist evaluation based on RAMESES II protocol. We interviewed 23 students exploring Contexts (C) which were external (place-based) and internal (the student's characteristics), Mechanisms (M) (that drive a response) and Outcomes (O) (openness to rural work). Results: 'Openness to rural work' related to: a desire to live rurally, work in rural medicine, or consider this as a possibility. This was triggered by responses to experience in rural places of an aspirational, intellectual and emotional nature (mechanisms). Students most affected were those with a strong motivation to help others and who value teamwork. Students with clearly envisaged career paths suited to metropolitan areas, or those retaining/prioritising strong social and community ties in metropolitan areas were less likely to commit to future rural work. Conclusion: Our theory indicates multi-level stimuli activates openness. Implications are that rural immersion programs could select students with an orientation towards teamwork, without pre-set professional ideation, and with a strong commitment to helping others. Experiencing rural immersion will trigger aspirational, intellectual and emotional responses leading to rural work openness for such students.