Poole Phillippa, Bagg Warwick, O'Connor Barbara, Dare Anna, McKimm Judy, Meredith Kay, Shulruf Boaz, Reid Papaarangi
Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.
Rural Remote Health. 2010 Jan-Mar;10(1):1254. Epub 2010 Mar 1.
Medical schools in Australasia are using a range of initiatives to increase the number of graduates working outside major centres. This article describes the design, implementation and selected outcomes of the University of Auckland's regional-rural program, Pūkawakawa. The program is based on a 'hub and spoke' model located in Northland, New Zealand, an area of 150,000 people with a high proportion of Māori and relative social deprivation.
A 27 week curriculum for 20 volunteer year 5 students was developed in collaboration with stakeholders. The curriculum had three main attachments: integrated care and general practice; women and children's health; and secondary care. These were designed to promote better continuity with patients and supervisors, and a greater likelihood of a rural career. Funding for Pūkawakawa came from existing government grants with a contribution from the Northland District Health Board. A mixed-methods evaluation of the first year was conducted.
Staff and students reported high levels of satisfaction with the program and students performed at an academic level similar to their standard-program counterparts. Early reservations related to the experience of supervisors with assessment standards, and the resourcing required to maintain academic equivalence across sites. It is too soon to detect whether students' career aspirations are altered as a result of Pūkawakawa. Areas for future study include student preparedness for later stages of training, career destination, how students learn in this environment and the benefits to the Northland region more broadly.
澳大拉西亚地区的医学院正在采取一系列举措，以增加在主要中心以外地区工作的毕业生数量。本文介绍了奥克兰大学的地区-农村项目“普卡瓦卡瓦”的设计、实施情况及部分成果。该项目基于一种“中心辐射”模式，位于新西兰的北地地区，该地区有15万人口，毛利人比例较高，且社会相对贫困。
与利益相关者合作，为20名自愿参加的五年级学生制定了为期27周的课程。该课程有三个主要实习方向：综合护理与全科医疗；妇女和儿童健康；以及二级医疗护理。这些实习方向旨在促进与患者和导师之间更好的连续性，并增加学生从事农村医疗工作的可能性。“普卡瓦卡瓦”项目的资金来自政府现有拨款以及北地地区卫生委员会的一笔捐款。对该项目第一年进行了混合方法评估。
教职员工和学生对该项目满意度较高，学生的学业表现与标准课程的同龄人相似。早期出现的一些问题涉及导师对评估标准的经验，以及在各实习地点维持学业等效性所需的资源。现在判断“普卡瓦卡瓦”项目是否改变了学生的职业抱负还为时过早。未来的研究领域包括学生对培训后期阶段的准备情况、职业去向、学生在这种环境中的学习方式以及对北地地区更广泛的益处。
