scholarly journals Rural exposure during medical education and student preference for future practice location - a case of Botswana

2016 ◽  
Vol 8 (1) ◽  
Author(s):  
Tonya Arscott-Mills ◽  
Poloko Kebaabetswe ◽  
Gothusang Tawana ◽  
Deogratias O. Mbuka ◽  
Orabile Makgabana-Dintwa ◽  
...  
Keyword(s):  
Family Medicine ◽  
Student Perceptions ◽  
Rural Areas ◽  
Structured Interview ◽  
Rural Practice ◽  
Public Institution ◽  
Practice Location ◽  
Rural Training ◽  
The Impact ◽  
Future Practice

Background: Botswana’s medical school graduated its first class in 2014. Given the importance of attracting doctors to rural areas the school incorporated rural exposure throughout its curriculum. Aim: This study explored the impact of rural training on students’ attitudes towards rural practice.Setting: The University of Botswana family medicine rural training sites, Maun and Mahalapye.Methods: The study used a mixed-methods design. After rural family medicine rotations, third- and fifth-year students were invited to complete a questionnaire and semi-structured interview. Data were analysed using descriptive statistics and thematic analysis.Results: The thirty-six participants’ age averaged 23 years and 48.6% were male. Thirtythree desired urban practice in a public institution or university. Rural training did not influence preferred future practice location. Most desired specialty training outside Botswana but planned to practice in Botswana. Professional stagnation, isolation, poorly functioning health facilities, dysfunctional referral systems, and perceived lack of learning opportunities were barriers to rural practice. Lack of recreation and poor infrastructure were personal barriers. Many appreciated the diversity of practice and supportive staff seen in rural practice. Several considered monetary compensation as an enticement for rural practice. Only those with a rural background perceived proximity to family as an incentive to rural practice.Conclusion: The majority of those interviewed plan to practice in urban Botswana, however, they did identify factors that, if addressed, may increase rural practice in the future. Establishing systems to facilitate professional development, strengthening specialists support, and deploying doctors near their home towns are strategies that may improve retention of doctors in rural areas.Keyords: rural health, student perceptions

scholarly journals An Exploratory Study of a Novel Approach to Improve Readiness for a Rural Family Medicine Residency

PRiMER ◽  
2021 ◽  
Vol 5 ◽  
Author(s):  
Dwight Smith ◽  
Nellie Wirsing ◽  
Joyce C. Hollander-Rodriguez ◽  
Tracy Bumsted ◽  
Eric Wiser ◽  
...  
Keyword(s):  
Family Medicine ◽  
Medical School ◽  
Rural Areas ◽  
Exploratory Study ◽  
Rural Practice ◽  
Family Medicine Residency ◽  
Novel Approach ◽  
Field Notes ◽  
Curricular Elements ◽  
Rural Training

Background and Objectives: Transitioning from medical school to residency is challenging, especially in rural training programs where a comprehensive scope of practice is needed to address rural health disparities. Oregon Health & Science University partnered with Cascades East Family Medicine Residency in Klamath Falls, Oregon to create an integrated fourth-year medical student experience (Oregon Family medicine Integrated Rural Student Training (Oregon FIRST). Participants may then enter this residency to complete their training with the intention to practice in rural underresourced settings.  Methods: In this exploratory study, we conducted key informant interviews with 9 of ten Oregon FIRST participants to determine how Oregon FIRST contributed both to their readiness for residency training and their choice to practice in rural underserved locations. Interviews were conducted between June 10, 2020 and July 8, 2020. We analyzed field notes taken during interviews for emergent themes using classical content analysis. Results: Emergent themes included logistical ease, relationship development, key curricular elements, and commitment to rural practice. Overwhelmingly, Oregon FIRST participants reported the experience had many challenging and demanding components because they served as subinterns for their entire fourth year of medical school, but this prepared them very well for internship. When asked if they would choose to enroll in Oregon FIRST again, given what they now know about physician training and patient care, all nine (100%) said they would. Conclusions: This study demonstrated that Oregon FIRST students felt better prepared for the rigors of residency and are committed to practicing in rural areas. 

scholarly journals Factors perceived to influence rural career choice of urban background family physicians: a qualitative analysis

2019 ◽  
Author(s):  
Olga Szafran ◽  
Douglas Myhre ◽  
Jacqueline Torti ◽  
Shirley Schipper
Keyword(s):  
Family Medicine ◽  
Career Choice ◽  
Rural Areas ◽  
Role Models ◽  
Rural Practice ◽  
Training Experience ◽  
Urban Background ◽  
Practice Location ◽  
Telephone Interviews ◽  
Physician Role

Background: Urban background physicians are the main source of physician supply for rural areas across Canada. The purpose of this study was to describe factors that influence rural career choice and practice location of urban background family medicine graduates. Methods:  We conducted a qualitative, descriptive study employing telephone interviews with 9 urban background family medicine graduates. Those who completed residency training between 2006 and 2011 and were in rural practice, but who had an urban upbringing were asked about: when the decision for rural practice was made; factors that influenced rural career choice; and factors that influenced choice of a particular rural location.  Emerging themes were identified through content analysis of interview data.  Results:  We identified four themes as factors influencing rural career choice - variety/broad scope of rural practice, rural lifestyle, personal relationships, and positive rural experience/physician role models.  We also identified factors in four theme areas as influencing the choice of a particular rural practice location - having lived in the rural community, spousal influence, personal lifestyle, and comfort with practice expectations.  Conclusion:  Decisions for rural career choice and rural practice location by urban background family medicine graduates are based on clinical practice considerations, training experience, as well as personal and lifestyle factors.

scholarly journals It is time for rural training in family medicine in Brazil!

2018 ◽  
Vol 13 (40) ◽  
pp. 1-4
Author(s):  
Magda Moura Almeida ◽  
Mayara Floss ◽  
Leonardo Vieira Targa ◽  
John Wynn-Jones ◽  
Alan Bruce Chater
Keyword(s):  
Family Medicine ◽  
Low Income ◽  
Rural Areas ◽  
Human Resources For Health ◽  
Health Indicators ◽  
Health Needs ◽  
Rural And Remote ◽  
Barriers To Access ◽  
The Social ◽  
Rural Training

The gap between health needs and the training of human resources for health is much more evident in rural areas. In Brazil, a country of continental dimensions, these differences become more challenging. The diversity of geographical and administrative barriers to access makes the health indicators of rural and remote populations worse than those of the urban population. Family Medicine could address the social determinants of health through the provision of human services and play an important role in low-income rural residents’ health status. This essay is an urgent call for the debate on models for projecting heath workforce supply and requirements for rural areas in Brazil.

scholarly journals Prescribers’ perspectives on including reason for use information on prescriptions and medication labels: a qualitative thematic analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Colin Whaley ◽  
Ashley Bancsi ◽  
Joanne Man-Wai Ho ◽  
Catherine M. Burns ◽  
Kelly Grindrod
Keyword(s):  
Patient Adherence ◽  
Interprofessional Collaboration ◽  
Qualitative Interviews ◽  
Structured Interview ◽  
Qualitative Thematic Analysis ◽  
Interview Guide ◽  
Trained Interviewer ◽  
Circle Of Care ◽  
The Impact ◽  
Future Practice

Abstract Background The indication for prescribing a particular medication, or its reason for use (RFU) is a crucial piece of information for all those involved in the circle of care. Research has shown that sharing RFU information with physicians, pharmacists and patients improves patient safety and patient adherence, however RFU is rarely added on prescriptions by prescribers or on medication labels for patients to reference. Methods Qualitative interviews were conducted with 20 prescribers in Southern Ontario, Canada, to learn prescribers’ current attitudes on the addition of RFU on prescriptions and medication labels. A trained interviewer used a semi-structured interview guide for each interview. The interviews explored how the sharing of RFU information would impact prescribers’ workflows and practices. Interviews were recorded, transcribed and thematically coded. Results The analysis yielded four main themes: Current Practice, Future Practice, Changing Culture, and Collaboration. Most of the prescribers interviewed do not currently add RFU to prescriptions. Prescribers were open to sharing RFU with colleagues via a regional database but wanted the ability to provide context for the prescribed medication within the system. Many prescribers were wary of the impact of adding RFU on their workflow but felt it could save time by avoiding clarifying questions from pharmacists. Increased interprofessional collaboration, increased patient understanding of prescribed medications, avoiding guesswork when determining indications and decreased misinterpretation regarding RFU were cited by most prescribers as benefits to including RFU information. Conclusions Prescribers were generally open to sharing RFU and clearly identified the benefits to pharmacists and patients if added. Critically, they also identified benefits to their own practices. These results can be used to guide the implementation of future initiatives to promote the sharing of RFU in healthcare teams.

scholarly journals When Walmart leaves small towns : vulnerability, food insecurity and community resilience

2021 ◽  
Author(s):  
◽  
Yanu Endar Prasetyo
Keyword(s):  
Food Insecurity ◽  
Rural Areas ◽  
Community Resilience ◽  
Structured Interview ◽  
Small Towns ◽  
Vulnerable Groups ◽  
Future Research ◽  
Assistance Program ◽  
The Impact ◽  
The Town

Walmart store closures, especially in rural areas, seem to be continuing since the company is moving forward in serving its urban customers and investing heavily in its digital features and markets. If this scenario happens, then many townspeople in a rural area will lose their only Walmart store, which has been part of the town for decades. There are many studies on the impact of Walmart's entry and presence in towns. However, investigating the effects of Walmart when they leave small towns is still rare. For this reason, this study is focused on addressing the impact of Walmart store closures in small towns in Missouri. The purpose of this study is to identify factors affecting the residents' perception of and response toward the impact of Walmart's store closure in Rural Areas. Our conceptual framework is designed to assess household vulnerability and incorporate food insecurity factors to capture how vulnerability and resilience in rural communities change because of the closure of a Walmart store. This approach may help us better understand the linkages between community vulnerability and community resilience. Using a mixed-method design, we explored the residents' perceptions, opinions, and experiences regarding the closing of Walmart. Data from both the qualitative phase (observation, semi-structured interview, group discussion, and document analysis) and quantitative phase (community-based drop-off and pick-up surveys) of this study then mixed in the final analysis to provide a more detailed and complete description of the effect of Walmart store closures in rural Missouri. We found that people were overwhelmingly disappointed and angry when Walmart closed in their area in 2017. Most residents said they felt disappointed (46 percent) and angry (41 percent) about Walmart's decision. There was a change in households' attitudes and shopping habits after Walmart left these towns, including a significant decline (54.9 percent) in shopping frequency among residents who often shop at Walmart. Not having Wal sense of losing pride in being part of the town. When Caruthersville and Piedmont still had Walmart in town, it became the center of community for the surrounding towns and the entire county. The number of households that fall into vulnerability categories (very lowvulnerable, low-vulnerable, vulnerable, and very vulnerable) is calculated and obtained from Categorical Principal Component Analysis (CATPCA). The data showed that most households fell into a vulnerable (39.8 percent) and low-vulnerable situation (34.6 percent) after Walmart left and were able to cope with this stressor. Households in the neighboring towns (Patterson, Williamsville, and Greenville) that were 10-15 miles from Piedmont also had a high percentage of vulnerable groups (47.6 percent) and very vulnerable households (6.5 percent). Based on this study, the Walmart store's closure in Piedmont had a bigger impact on both the households within the host town and their neighboring towns. Our findings also confirmed that many residents in these areas rely on government assistance programs, especially SNAP (Supplemental Nutritional Assistance Program), the most extensive federal nutrition program in the U.S. About 43.7 percent of households in Caruthersville, 25.5 percent of households in Piedmont, and 24.4 percent of households in the neighboring town are SNAP recipients. These findings further prove that SNAP recipients and community food bank/pantry users were more sensitive to Walmart's store closure. While SNAP benefits provided valuable support to many households, the retail mobility -- increased proximity to small retailers and decreased proximity to many large ones (Walmart) -- would negatively affect townspeople. This study suggests that Policymakers and public health experts need to work closely to ensure healthier and more equitable food systems since small retailers may provide limited access to fresh and healthy foods. Future research can also evaluate the impact of existing small retailers - that authorized for SNAPof the rural community.

scholarly journals Retention in rural speech and language therapy: The impact of rural tertiary education in Australia

2021 ◽  
pp. 1-14
Author(s):  
Michelle Smith-Tamaray ◽  
Sarah Verdon ◽  
Laura Hoffman
Keyword(s):  
Rural Areas ◽  
Online Survey ◽  
Health Workers ◽  
Tertiary Education ◽  
Rural Practice ◽  
Speech And Language ◽  
Language Therapy ◽  
Speech And Language Therapy ◽  
Recruitment And Retention ◽  
The Impact

BACKGROUND: Recruitment and retention of skilled health workers into rural areas is a major challenge to achieving equity in health between rural and urban populations. OBJECTIVE: This study explored the impact of rurally-based tertiary education in promoting the recruitment and retention of speech and language therapists (SLTs) in non-metropolitan areas and intention to remain in the profession. METHODS: Participants in this cohort study were 133 graduates from a rurally-based speech and language therapy course in Australia who completed the course between 1998 and 2018. Data were collected via an online survey. Data were analysed using inferential statistics, ArcGIS mapping software and content analysis in NVivo. RESULTS: 65.0% of the graduates practiced in rural or remote areas with just 21.1% practicing in major cities. Most participants’ ideal work location was in a rural area. Benefits of rural practice included seeing a mixed caseload, living near family, work/life balance and loving their location. Challenges of rural practice included limited opportunities for specialist caseloads and career progression. In total, 93.2% of the rural graduates intended to remain in the speech and language therapy profession for the next 5 years. CONCLUSIONS: This study indicates that SLTs who are trained in rural areas with a focus on servicing rural populations are highly likely to enter and remain in rural practice, consistent with the rural pipeline model.

Toward Identifying the Unique Characteristics of Social Work Practice in Rural Areas: From the Voices of Practitioners

2000 ◽  
Vol 6 (1) ◽  
pp. 19-35 ◽  
Author(s):  
Joanne Gumpert ◽  
Joan E. Saltman ◽  
Donna Sauer-Jones
Keyword(s):  
Social Work ◽  
Cultural Values ◽  
Rural Areas ◽  
Work Practice ◽  
Social Work Practice ◽  
Rural Practice ◽  
Small Communities ◽  
Rural And Urban ◽  
Self Help Groups ◽  
The Impact

Although literature has identified cultural values, environmental factors, and specific problems unique to social work practice in rural and small communities, research efforts focused on identification of the differences between rural and urban practice have found little variation. This article presents a new dimension. The findings from a survey of rural practitioners provide a closer look at practice within the rural context. Findings confirm several characteristics found in the literature: direct and indirect practice with multiple client systems, and extensive interface with community based systems of self help groups and natural helpers. The impact of two factors, the influence of rural cultural norms and values and lack of resources, appears to suggest avenues for further study in order to uncover the unique qualities of rural practice. Implications are drawn for social work education.

General Dentist Characteristics Associated With Rural Practice Location

2020 ◽  
Author(s):  
Susan C McKernan ◽  
Raymond A Kuthy ◽  
Golnaz Kavand
Keyword(s):  
Rural Areas ◽  
Urban Areas ◽  
Tracking System ◽  
Study Data ◽  
Individual Characteristics ◽  
Rural Practice ◽  
Outcome Variable ◽  
Practice Location ◽  
General Dentists ◽  
General Dentist

Purpose: To examine whether there is a difference in the likelihood that a general dentist practices in a rural location based on individual characteristics, including dental school attended, birth state, practice arrangement, sex, and age. Methods: All private practice, general dentists in Iowa were included in this study. Data were extracted from the year 2010 version of the Iowa Dentist Tracking System, which monitors practice patterns of active dentists. Rurality of primary office location, categorized using Rural-Urban Commuting Area (RUCA) codes, served as the outcome variable. Chi-square tests and multivariable logistic regression were used to explain associations between rural practice location and dentist characteristics. Findings: Fifteen percent of the state’s population resided in isolated small rural towns, but only 8% of general dentists practiced here. Approximately 17% of dentists in isolated small rural towns were age 40 or younger, compared to 32% of dentists in urban areas. Among male dentists, those who were born in Iowa (P = .002), were older (P = .020), and graduated from dental schools other than the University of Iowa (P = .009) were more likely to practice in rural areas than were their counterparts. Conversely, among female dentists, solo practice (P = .016) was the only variable significantly associated with rural practice location. Conclusions: The dentist workforce in rural areas of Iowa is dominated by older males who were born in Iowa. As this generation retires and increasing numbers of women enter the profession, state policy makers and planners will need to monitor changing trends in the rural workforce.

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