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农村和地区临床实习计划体验的定性与半定量探索

A Qualitative and Semiquantitative Exploration of the Experience of a Rural and Regional Clinical Placement Programme.

作者信息

Webster Craig S, McKillop Ann, Bennett Win, Bagg Warwick

机构信息

Centre for Medical and Health Sciences Education, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.

Department of Anaesthesiology, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.

出版信息

Med Sci Educ. 2020 Mar 17;30(2):783-789. doi: 10.1007/s40670-020-00949-6. eCollection 2020 Jun.

Abstract

In many countries, including New Zealand, recruitment of medical practitioners to rural and regional areas is a government priority, yet evidence for what determines career choice remains limited. We studied 19 newly qualified medical practitioners, all of whom had participated in a year-long undergraduate rural or regional placement (the Pūkawakawa Programme). We explored their placement experiences through focus groups and interviews and aimed to determine whether experiential differences existed between those who chose to return to a rural or regional location for early career employment (the Returners) and those who did not (the Non-Returners). Focus group and interview transcripts were a mean (range) length of 6485 (4720-7889) and 3084 (1843-4756) words, respectively, and underwent thematic analysis. We then used semiquantitative analysis to determine the relative dominance of themes and subthemes within our thematic results. Placement experiences were overwhelming positive - only four themes emerged for negative experiences, but five themes and nine subthemes emerged for positive experiences. Many curricular aspects of the placement experience were viewed as similarly positive for Returners and Non-Returners, as were social aspects with fellow students. Hence, positive experiences appear not to differentiate Returner and Non-Returner groups and so seem unlikely to be related to decisions about practice location. However, Returners reported a substantially higher proportion of positive placement experiences related to feeling part of the clinical team compared with Non-Returners (11% vs 4%, respectively) - a result consistent with Returners also reporting more positive experiences related to learning and knowledge gained and personal development.

摘要

在包括新西兰在内的许多国家,吸引医学从业者到农村和偏远地区工作是政府的一项优先任务,但关于决定职业选择因素的证据仍然有限。我们研究了19名新获得资格的医学从业者,他们都参加了为期一年的本科农村或偏远地区实习(普卡瓦卡瓦项目)。我们通过焦点小组和访谈探讨了他们的实习经历,旨在确定选择回到农村或偏远地区开始职业生涯的人(回归者)和没有这样做的人(非回归者)之间是否存在体验差异。焦点小组和访谈记录的平均(范围)长度分别为6485(4720 - 7889)和3084(1843 - 4756)个单词,并进行了主题分析。然后,我们使用半定量分析来确定主题结果中主题和子主题的相对主导地位。实习经历总体上是积极的——负面经历仅出现了四个主题,但积极经历出现了五个主题和九个子主题。实习经历的许多课程方面对回归者和非回归者来说同样积极,与同学的社交方面也是如此。因此,积极经历似乎并没有区分回归者和非回归者群体,所以似乎不太可能与执业地点的决定有关。然而,与非回归者相比,回归者报告称与感觉自己是临床团队一员相关的积极实习经历比例要高得多(分别为11%和4%)——这一结果与回归者也报告了更多与学习、获得的知识和个人发展相关的积极经历一致。

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