Background: The medical internship as a way of exposing young doctors to training in a rural context is regarded as a useful tool to recruit and retain doctors in rural areas. Norwegian health authorities tested an arrangement of early sign-up for medical internships in the Finnmark County in Norway. Objective: To report on the effects of the early sign-up for medical internship. Design: This study compares the choice of workplace after internship among physicians who signed up early with those candidates assigned to the raffle model of internship in the study area, and in a comparison area experiencing similar recruitment and retention problems. Results: The proportion of interns who signed up early that still worked as physicians in the study area by April 2014 (29%) was twice as high as among the regular interns (15%) and interns in the comparison area (14%). Among the 59 interns who signed up early still working in the study area in April 2014, 33% had grown up in this area. However, the greatest benefits were for the most densely populated municipalities in the study area. Conclusions: The early sign-up model had a net contribution of proving additional physicians in the study area.

Varighet av fastlegeavtaler 2045 -9

ObjectiveThe aim of this study is to identify and analyse rural general practice patients’ experiences of hazards and harm that comprise adverse events, and their strategies for coping with them.DesignInterview study using systematic text condensation and coping strategy theory in an abductive analysis process.SettingNine rural general practice clinics in Norway.ParticipantsTwenty participants, aged 21–79 years, all presenting with recent onset of somatic and/or psychiatric complaints.ResultsParticipating rural general practice patients described their experiences of a variety of hazards and harms. Their three most discussed cognitive and behavioural coping strategies were: (1) to accept the events; (2) to confront them and (3) to engage in planful problem-solving. While the participants demonstrated a tendency toward accepting hazards and harm that their regular general practitioner created, they were often willing to confront those that locum (ie, substitute) general practitioners created. Participants used planful problem-solving in situations they deemed hazardous, such as breaches of confidentiality or not being taken seriously, as well as during potential/actual emergencies.ConclusionsPatients at rural general practice clinics actively identify and respond to hazards and harm, applying three coping strategies. Thus, patients themselves may serve as an important safety barrier against hazards and harm; their potential contributions to improving patient safety must be appreciated accordingly and reflected in future research as well as in everyday clinical practice.

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BackgroundEnsuring a sufficient nursing workforce, with respect to both number and relevant professional competencies, is crucial in rural Arctic regions in Norway. This study examines the continuing education (CE) of nurses who graduated from a decentralized nursing programme between 1994 and 2011.ObjectiveThis study aims to measure the extent to which the decentralized nursing education (DNE) in question has served as a basis for CE that is adapted to current and future community health care service needs in rural Arctic regions in northern Norway. More specifically, the study aims to investigate the frequency and scope of CE courses among the graduates of a DNE, the choice of study model and the degree of employment with respect to the relevant CE.DesignThis study is a quantitative survey providing descriptive statistics.ResultsThe primary finding in this study is that 56% of the participants had engaged in CE and that they were employed in positions related to their education. The majority of students with decentralized bachelor's degrees engaged in CE that was part time and/or decentralized.ConclusionsMore than half of the population in this study had completed CE despite no mandatory obligation in order to maintain licensure. Furthermore, 31% of the participants had completed more than one CE programme. The findings show that the participants preferred CE organized as part time and or decentralized studies.