Three Rivers Department of Rural Health, Charles Sturt University, Wagga Wagga, NSW 2678, Australia.
Int J Environ Res Public Health. 2022 Apr 28;19(9):5363. doi: 10.3390/ijerph19095363.
Supporting the provision of clinical placement (CP) experiences in rural areas is a strategy used worldwide to promote the rural health workforce. While there is international evidence for this intervention in medicine, there is limited understanding of the influence of rural CP for nursing, midwifery, allied health, and dentistry health professions in Australia, which have received substantial federal investment. This review examined the relationship between rural CP and non-medicine health students' future rural practice intentions and workforce outcomes.
Four databases were systematically searched; papers were screened using defined criteria and appraised using the mixed-methods appraisal tool (MMAT). Findings were synthesized using a critical narrative approach.
The methodological quality of the 29 eligible studies (13 quantitative non-randomized, 10 mixed method, 4 qualitative, 2 quantitative description) was appraised. Ten high-quality studies were identified. The review found that positive CP experiences may influence intention to practice rurally amongst undecided students and serve as a reinforcing experience for those students already interested in rural practice. There were mixed findings regarding the influence of CP length. The review also found that there is currently only evidence for the short-term effects of CP on students' future practice outcomes in rural areas with focus thus far on early practice outcomes.
Those looking to use rural CP to promote the rural health workforce should focus on supporting the quality of a large number of CP experiences that are undertaken in rural areas, as there are currently differing findings on the role of rural CP length. Future studies of rural CP should consider greater use of social and educational theories to guide them.
在农村地区提供临床实习（CP）机会是全球范围内用于促进农村卫生人力队伍建设的一项策略。尽管有国际证据表明这种干预措施在医学领域有效，但对于澳大利亚的护理、助产、联合健康和牙科等卫生专业的农村 CP 对其未来农村实践意向和劳动力成果的影响，了解有限，这些专业已经获得了大量联邦投资。本综述考察了农村 CP 与非医学卫生专业学生未来农村执业意向和劳动力成果之间的关系。
系统地对四个数据库进行了搜索；使用定义的标准筛选论文，并使用混合方法评估工具（MMAT）进行评估。使用批判性叙述方法综合研究结果。
对 29 项合格研究（13 项非随机定量、10 项混合方法、4 项定性、2 项定量描述）的方法学质量进行了评估。确定了 10 项高质量的研究。综述发现，积极的 CP 体验可能会影响犹豫不决的学生从事农村执业的意向，并为那些对农村执业感兴趣的学生提供强化体验。CP 时间长短的影响存在混合的研究结果。综述还发现，目前只有 CP 对学生未来农村实践成果的短期影响的证据，迄今为止，研究重点主要集中在早期实践成果上。
那些希望利用农村 CP 来促进农村卫生人力队伍建设的人应该专注于支持在农村地区进行的大量 CP 体验的质量，因为目前对于农村 CP 时间长短的作用存在不同的研究结果。未来的农村 CP 研究应考虑更多地使用社会和教育理论来指导研究。
