Taylor Jennifer D, Goletz Sarah E
Indiana University School of Medicine, Indianapolis, Indiana, USA.
Rural Remote Health. 2016 Jul-Aug;16(3):3934. Epub 2016 Sep 14.
In the USA, area health education centers (AHECs) work to recruit and educate students to serve in medically underserved communities, primary care, and rural settings. One important aspect of their work is connecting students with rural clinical experiences. Within these experiences, AHECs incorporate a community health/socioeconomic experience within the family medicine clerkship that may not be as prevalent in the standard family medicine clerkship experiences. The purpose of the study was to assess the relationship between AHEC-sponsored family medicine clerkships with a self-reported intent to practice in a rural setting upon graduation.
The study compared third-year medical students with the Indiana University School of Medicine, which participated in AHEC-sponsored family medicine clerkships to the standard family medicine clerkship. Following the 4-week clerkship, students were asked to report their intent to work in a rural setting using a five-point Likert scale. A χ2 test was used to determine the association of AHEC sponsorship, clerkship site location (rural/urban) and intent to practice in a rural setting.
The study consisted of 587 students. There was a statistically significant association between self-reported intent and rural clerkship site, χ2 (1, =587)=6.542, =0.01. Furthermore, 21.6% (=25) of students with a rural clerkship experience reported a greater intent compared to 12.3% (=58) of students with non-rural clerkship experience.
The study confirmed a significantly positive association between participation in medical clerkship experiences in a rural primary care setting and the intent to practice in a rural setting upon graduation. The results also support the potential value-added benefits through academic-community partnerships with AHECs, family medical and other primary care specialty clerkship programs may perhaps succeed in increasing student interest in pursuing a practice serving in rural communities upon graduation.
在美国，地区健康教育中心（AHEC）致力于招募和培养学生，使其服务于医疗服务欠缺的社区、基层医疗及农村地区。其工作的一个重要方面是为学生提供农村临床实习机会。在这些实习经历中，AHEC在家庭医学实习中融入了社区健康/社会经济体验，而这在标准的家庭医学实习经历中可能并不常见。本研究的目的是评估由AHEC赞助的家庭医学实习与毕业后自我报告的在农村地区执业意向之间的关系。
本研究将印第安纳大学医学院参与AHEC赞助的家庭医学实习的三年级医学生与参加标准家庭医学实习的学生进行了比较。在为期4周的实习结束后，要求学生使用五点李克特量表报告他们在农村地区工作的意向。采用χ2检验来确定AHEC赞助、实习地点（农村/城市）与在农村地区执业意向之间的关联。
该研究共纳入587名学生。自我报告的意向与农村实习地点之间存在统计学上的显著关联，χ2（1，=587）=6.542，P = =0.01。此外，有农村实习经历的学生中有21.6%（=25）表示有更强的意向，而没有农村实习经历的学生中这一比例为12.3%（=58）。
该研究证实，在农村基层医疗环境中参与医学实习经历与毕业后在农村地区执业的意向之间存在显著的正相关。研究结果还支持了通过与AHEC、家庭医学及其他基层医疗专业实习项目建立学术 - 社区伙伴关系可能带来的潜在附加值，这些项目或许能够成功提高学生毕业后从事农村社区医疗服务的兴趣。
