College of Medicine and Dentistry, James Cook University, Townsville, Australia.
BMC Med Educ. 2022 Aug 31;22(1):652. doi: 10.1186/s12909-022-03707-x.
Rural placements are an important component of rural medical education programs seeking to develop rural practice pathways for medical students. These placements are usually domestic, but James Cook University in Australia developed an international rural placement program in the first half of the medical course that was funded through bursaries. This study explores how the international rural placement helped to shape the lives (personal development and learning) of the participants, using Transformational Learning Theory as a framework for identifying and describing the transformational elements, process and impact of the program.
Sixty-five students received a bursary for an international rural placement between 2001-2019. All were contacted by email and invited to participate in a short survey and a follow-up interview. Fifteen participants agreed and twelve were able to participate in individual semi-structured interviews which were recorded, transcribed and analysed using inductive thematic analysis.
Participants reported that the bursary provided a "once in a lifetime opportunity" to "experience eye-opening and culturally rich difference". Nonetheless, some elements of the placement experience presented disorientating dilemmas that triggered deep reflections and shifts in perceptions. The bursary recipients realised that "being open-minded" allowed them "enjoy good company". They were also able to assume "outsider view which allowed reassessment of their own country" and the "isolation experiences gingered desire to right health wrongs". The triggers and mental shifts had significant impact on the bursary recipients and fostered the development of "inspirational new horizons" based on an appreciation of the "value of rural practice" and "role-modelling for life-long learning." These findings are consistent with Transformational Learning Theory.
Participants in this study reported meaningful and strongly positive impacts from the experiences gained during an international rural clinical placement early in their course. They described transformative experiences which appear to contribute strongly to personal development. This finding supports maintaining opportunities for international experiences during rurally-oriented medical programs as these may impact longer term career choice.
农村实习是农村医学教育项目的一个重要组成部分，旨在为医学生开辟农村实践途径。这些实习通常是在国内进行的，但澳大利亚詹姆斯·库克大学在医学课程的前半部分开发了一个国际农村实习项目，该项目通过助学金资助。本研究使用转化学习理论作为框架，从个人发展和学习的角度探讨了国际农村实习如何帮助参与者（个人发展和学习）塑造生活，以确定和描述该项目的转化元素、过程和影响。
2001-2019 年间，有 65 名学生获得了国际农村实习助学金。所有学生都通过电子邮件联系，并邀请他们参加一项简短的调查和后续访谈。有 15 名参与者表示同意，其中 12 名能够参加个人半结构化访谈，访谈内容被记录、转录和使用归纳主题分析进行分析。
参与者报告说，助学金提供了“一生一次的机会”，让他们“体验大开眼界和充满文化差异的经历”。尽管如此，实习经历的某些方面还是带来了令人困惑的困境，引发了深刻的反思和观念的转变。助学金获得者意识到“思想开放”让他们“享受良好的陪伴”。他们还能够“以局外人的视角重新评估自己的国家”，并“体验到孤立的经历，激发了纠正健康不平等的愿望”。这些触发因素和心理转变对助学金获得者产生了重大影响，并培养了基于对“农村实践价值”和“终身学习榜样”的欣赏的“鼓舞人心的新视野”。这些发现与转化学习理论一致。
本研究中的参与者报告说，从课程早期的国际农村临床实习中获得的经验带来了有意义的、强烈的积极影响。他们描述了具有变革性的经历，这些经历似乎对个人发展有很大的贡献。这一发现支持在农村导向的医学项目中保持国际经验的机会，因为这些经验可能会对长期职业选择产生影响。
