Anderson Emily, Gurney Tiana, Young Louise, O'Sullivan Belinda, McArthur Lawrie, McGrail Matthew, Hollins Aaron
College of Medicine and Dentistry, James Cook University, Townsville, Queensland, Australia.
Rural Clinical School, The University of Queensland, Rockhampton, Queensland, Australia.
Aust J Rural Health. 2024 Dec;32(6):1150-1158. doi: 10.1111/ajr.13182. Epub 2024 Aug 29.
Globally, most doctors train and work in metropolitan areas but a key strategy for developing the rural health workforce is expanding rural training. The aim of this study was to describe the scope and quality of learning along with skill acquisition of GP trainees based in regional, rural, and remote settings.
Regional, rural and remote settings in Queensland Australia excluding Brisbane.
Thirty-seven general practice trainees who had undertaken their first community placement were recruited from regional, rural and remote learning settings within Queensland.
Qualitative descriptive methodology based on constructionist epistemology was employed which allowed for the exploration of current GP trainees' experiences. Trainees were interviewed and data were thematically analysed as to the scope and quality of learning by the setting of training. Learning experiences were then mapped against the Dreyfus and Dreyfus model to explore skill acquisition.
In terms of the scope and quality of learning, rural and remote trainees mainly focused on the diverse and unique (sometimes challenging) experiences their setting offered compared with regionally based trainees. Mapping of the trainee comments to the Dreyfus model of skill acquisition demonstrated that regardless of setting, equivalent learning occurred by GP trainees.
This exploratory study provides evidence that rural and remote learning may provide a more diverse and challenging experience. It suggests an equivalence of quality of education and skill acquisition across settings rural, regional and remote. This suggests that the training distribution policies may not disadvantage GP trainees and the scope and quality of more remote learning may increase uptake of remote placements.
在全球范围内，大多数医生在大都市地区接受培训并工作，但发展农村卫生人力的一项关键战略是扩大农村培训。本研究的目的是描述在地区、农村和偏远地区工作的全科医生培训生的学习范围和质量以及技能获得情况。
澳大利亚昆士兰州除布里斯班以外的地区、农村和偏远地区。
从昆士兰州内的地区、农村和偏远学习环境中招募了37名完成首次社区实习的全科医生培训生。
采用基于建构主义认识论的定性描述方法，以探索当前全科医生培训生的经历。对培训生进行访谈，并根据培训环境对学习的范围和质量进行主题分析。然后将学习经历与德雷福斯模型进行对照以探索技能获得情况。
在学习范围和质量方面，与在地区工作的培训生相比，农村和偏远地区的培训生主要关注其所在环境提供的多样且独特（有时具有挑战性）的经历。将培训生的评论与德雷福斯技能获得模型进行对照表明，无论环境如何，全科医生培训生都能获得同等的学习效果。
这项探索性研究提供了证据，表明农村和偏远地区的学习可能提供更多样化且具有挑战性的经历。这表明农村、地区和偏远地区在教育质量和技能获得方面是等同的。这表明培训分配政策可能不会对全科医生培训生产生不利影响，而且更偏远地区学习的范围和质量可能会增加对偏远实习的接受度。
