Tuning medical education for rural-ready practice: designing and resourcing optimally.

In an effort to bring doctors back to the bush the Australian government has resourced a number of rural clinical schools (RCS). At the RCS in the University of Western Australia students were allocated in small groups to rural sites for the entire fifth year of a six-year course, sitting the same final examinations as city students. Key factors guiding the successful outcome were the resourcing and implementation of the infrastructure and teaching and learning pedagogy. In designing support, the disconnection of students from their city colleagues was anticipated as an issue, as was the pedagogical indoctrination of the teachers. The curriculum implementation was adapted in this light. The role of the Web in teaching and learning, and their status as 'student colleagues' and independent learners were pivotal aspects. As students settled at their site, their confidence grew and their anxiety over urban disconnection dissipated. By benchmarking themselves using Web-based formative assessments and in formative 'objective structured clinical examinations' staged for them by the RCS, the students received ongoing feedback on their progress. This model of embedding students in rural centres for an extended period with rural practitioners as teachers was successfully implemented at multiple sites geographically vastly separate.