Department of Nursing and Health Sciences, Fulda University of Applied Sciences, Leipziger Strasse 123, D-36037 Fulda, Germany.
Int J Environ Res Public Health. 2020 Sep 3;17(17):6423. doi: 10.3390/ijerph17176423.
Ensuring nationwide access to medical care challenges health systems worldwide. Rural exposure during undergraduate medical training is promising as a means for overcoming the shortage of physicians outside urban areas, but the effectiveness is widely unknown. This integrative review assesses the effects of rural placements during undergraduate medical training on graduates' likelihood to take up rural practice. The paper presents the results of a longitudinal review of the literature published in PubMed, Embase, Google Scholar and elsewhere on the measurable effects of rural placements and internships during medical training on the number of graduates in rural practice. The combined database and hand search identified 38 suitable primary studies with rather heterogeneous interventions, endpoints and results, mostly cross-sectional and control studies. The analysis of the existing evidence exhibited predominantly positive but rather weak correlations between rural placements during undergraduate medical training and later rural practice. Beyond the initial scope, the review underpinned rural upbringing to be the strongest predictor for rural practice. This review confirms that rural exposure during undergraduate medical training to contributes to recruitment and retention in nonurban settings. It can play a role within a broader strategy for overcoming the shortage of rural practitioners. Rural placements during medical education turned out to be particularly effective for rural-entry students. Given the increasing funding being directed towards medical schools to produce graduates that will work rurally, more robust high-quality research is needed.
确保全国范围内的医疗服务可及性是全球卫生系统面临的挑战。本科医学培训期间的农村实习经历有望成为克服城市以外地区医生短缺的一种手段，但其实效性尚不清楚。本综合评价评估了本科医学培训期间的农村实习经历对毕业生从事农村实践的可能性的影响。本文介绍了对在 PubMed、Embase、Google Scholar 及其他地方发表的文献进行纵向综述的结果，这些文献评估了医学培训期间农村实习经历对农村执业毕业生人数的可衡量影响。综合数据库和手工搜索确定了 38 项合适的初级研究，这些研究的干预措施、终点和结果相当多样化，主要是横断面和对照研究。对现有证据的分析表明，本科医学培训期间的农村实习经历与后来的农村实践之间存在主要为正相关但相关性较弱的关系。除了最初的范围之外，该综述还支持农村成长经历是农村实践的最强预测因素。该综述证实，本科医学培训期间的农村实习经历有助于在非城市环境中招聘和留住人员。它可以在克服农村医生短缺的更广泛战略中发挥作用。医学教育期间的农村实习经历对农村入学的学生尤其有效。鉴于越来越多的资金被投向医学院，以培养愿意在农村工作的毕业生，因此需要进行更多稳健的高质量研究。
