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Background: With the increasing emphasis on ambulatory health care, clinical educators need to ensure that students are sufficiently prepared to maximise learning opportunities during placements in ambulatory settings., Context: This study focuses on third-year medical students entering urban or rural clinical placements at an Australian graduate entry medical school., Innovation: All rural and a subset of urban students received intensive training in taking Papanicolaou (Pap) smears prior to starting the clinical placement. Training involved gynaecological teaching associates, active practice and real-time feedback. Evaluation included workshop feedback, reflection on effectiveness during the placement, and comparison of trained and untrained students' recorded clinical experience of taking Pap smears., Implications: Students given pre-placement training praised their learning experience, and on average took more Pap smears during their placement than did their untrained peers. The difference, however, did not reach statistical significance. The pre-placement teaching workshop on a difficult skill was popular and worthy of further study regarding other challenging clinical skills., (© Blackwell Publishing Ltd 2011.)

Objective: To describe effects of employing primary care doctors in hospital care and their roles in improving the quality of care and health outcomes of rural and remote patients. Design: A systematic scoping review. Setting: Peer‐reviewed publications were sourced from 3 online journal databases (PUBMED, SCOPUS and Web of Science). Participants: All study designs from peer‐reviewed journals that discussed effects of employing primary care doctors in hospital care Interventions: employing primary care doctors in hospital care. Main outcome measures: Positive and negative consequences of employing primary care doctors in hospital care, and the roles of primary care doctors in improving the quality of care and health outcomes. Results: A total of 12 articles met the inclusion and exclusion criteria. Positive outcomes included improved access to specialised treatment, improved continuity of care, reduced waiting list and admission rates, improved skills, competence and confidence of primary care doctors, and increased satisfaction from both health providers and patients/families. Negative consequences reported included increased prescriptions and poorly documented history and physical examinations. Conclusion: Employing primary care doctors in hospital care can fill the gaps in the delivery of acute care, emergency medicine and maternity care. Primary care doctors bring advanced clinical skills and a patient‐centred approach to the hospital care. They also improve the quality of referrals leading to freed‐up clinical capacity of tertiary hospitals to treat more serious conditions. The provision of acute or emergency care and secondary care in rural and remote areas should be directed towards patient‐oriented not provider‐oriented policies. [ABSTRACT FROM AUTHOR]

Context Longitudinal integrated clerkships ( LICs) represent a model of the structural redesign of clinical education that is growing in the USA, Canada, Australia and South Africa. By contrast with time-limited traditional block rotations, medical students in LICs provide comprehensive care of patients and populations in continuing learning relationships over time and across disciplines and venues. The evidence base for LICs reveals transformational professional and workforce outcomes derived from a number of small institution-specific studies. Objectives This study is the first from an international collaborative formed to study the processes and outcomes of LICs across multiple institutions in different countries. It aims to establish a baseline reference typology to inform further research in this field. Methods Data on all LIC and LIC-like programmes known to the members of the international Consortium of Longitudinal Integrated Clerkships were collected using a survey tool developed through a Delphi process and subsequently analysed. Data were collected from 54 programmes, 44 medical schools, seven countries and over 15 000 student-years of LIC-like curricula. Results Wide variation in programme length, student numbers, health care settings and principal supervision was found. Three distinct typological programme clusters were identified and named according to programme length and discipline coverage: Comprehensive LICs; Blended LICs, and LIC-like Amalgamative Clerkships. Two major approaches emerged in terms of the sizes of communities and types of clinical supervision. These referred to programmes based in smaller communities with mainly family physicians or general practitioners as clinical supervisors, and those in more urban settings in which subspecialists were more prevalent. Conclusions Three distinct LIC clusters are classified. These provide a foundational reference point for future studies on the processes and outcomes of LICs. The study also exemplifies a collaborative approach to medical education research that focuses on typology rather than on individual programme or context. [ABSTRACT FROM AUTHOR]

The article focuses on a study approved by the Australian National University (ANU) Human Research Ethics Committee, which compared assessment outcomes for medical students assigned in a Commomwealth-funded rural stream longitudinal clinical placement in Australia. The study utilized the data on the results of examinations taken by students from urban and rural students. The anxiety of rural supervisors over the result of these examinations are included in this study.