Adelaide Rural Clinical School, University of Adelaide, Adelaide, South Australia, Australia.
Discipline of Rural and Remote Health, Flinders University, Adelaide, South Australia, Australia.
Aust J Rural Health. 2023 Oct;31(5):999-1007. doi: 10.1111/ajr.13035. Epub 2023 Aug 31.
To report self-perceived readiness for work as a junior doctor in a national cohort of rural clinical school students.
Cross-sectional study using a self-report questionnaire. Independent variables included 14 individual readiness items related to clinical and professional tasks, sociodemographic data and reported experience of rural clinical school (RCS) training. Participants were 668 medical students (55.3% females) completing a full academic year in rural Australia. Multivariable analysis explored factors associated with overall readiness for work as a junior doctor.
86% agreed that RCS experience prepared them to undertake the roles and responsibilities of a junior doctor. Self-ratings for specific clinical and professional tasks varied from a mean score of 5.9-8.0 out of 10, and 13 of the 14 items were associated with the outcome (p-value <0.001, except for performing spirometry). Lowest readiness scores were seen for some aspects including raising concerns about a colleague (mean score 6.1) or responding to workplace bullying (mean score 6.0). Aspects of the RCS experience that were strongly associated with overall readiness included: feeling a valued team-member (OR 9.28, 95%CI 2.43-35.39), feeling well-supported academically (OR 6.64, 95%CI 3.39-13.00), having opportunity for unsupervised but supported clinical practice (OR 4.67, 95%CI 1.45-15.00), having a rural mentor (OR 3.38, 95%CI 1.89-6.06) and having a previous health professional qualification (OR 2.7, 95%CI 1.32-5.54).
Most RCS students felt ready for work as a junior doctor. Important aspects of RCS experience are likely to include students feeling integrated within the clinical team and having opportunities for authentic clinical roles. There remains a significant challenge for medical school curricula to address professional areas where graduates felt less prepared.
报告全国农村临床学校学生队列中初级医生工作自我准备情况。
使用自我报告问卷的横断面研究。自变量包括与临床和专业任务、社会人口统计学数据以及农村临床学校(RCS)培训报告经验相关的 14 项个体准备项目。参与者是在澳大利亚农村完成一整学年学业的 668 名医学生(55.3%为女性)。多变量分析探讨了与作为初级医生工作整体准备相关的因素。
86%的人同意 RCS 经验使他们能够承担初级医生的角色和职责。对特定临床和专业任务的自我评估从 10 分制的 5.9-8.0 分不等,14 项中的 13 项与结果相关(p 值<0.001,除了肺量测定法)。一些方面的准备程度最低,包括对同事的担忧(平均得分为 6.1)或对工作场所欺凌的反应(平均得分为 6.0)。与整体准备情况密切相关的 RCS 经验方面包括:感觉自己是一个有价值的团队成员(OR 9.28,95%CI 2.43-35.39)、感觉在学术上得到很好的支持(OR 6.64,95%CI 3.39-13.00)、有机会进行无人监督但有支持的临床实践(OR 4.67,95%CI 1.45-15.00)、有农村导师(OR 3.38,95%CI 1.89-6.06)和具有以前的医疗专业资格(OR 2.7,95%CI 1.32-5.54)。
大多数 RCS 学生都觉得自己可以胜任初级医生的工作。RCS 经验的重要方面可能包括学生在临床团队中的融合感以及获得真实临床角色的机会。医学院课程仍然面临着解决毕业生准备不足的专业领域的重大挑战。