Does a socially-accountable curriculum transform health professional students into competent, work-ready graduates? A cross-sectional study of three medical schools across three countries

Woolley, Torres; Clithero-Eridon, Amy; Elsanousi, Salwa; Othman, Abu-Bakr

doi:10.1080/0142159x.2019.1646417

Cited by 25 publications

(20 citation statements)

References 27 publications

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“…Compared with learners in HICs, learners in LMIC were less likely to have rural practice intentions at entry, but more likely at exit, suggesting that the power of these levers to strengthen the rural health workforce in LMICs might be even greater than in HICs (where the majority of studies to date have taken place). This is confirmed by other work coming from our partner schools in the Philippines (14) and Sudan (16). Further exploration of the cultural expectations of service and triangulation with placement experiences across settings may help to explore how these intentions change over the period of training and how strengthening the role of primary care within health systems could synergistically provide pathways and support for emerging health professionals.…”

Section: Discussionsupporting

confidence: 73%

“…In addition, given the many factors associated with choice of practice location, strong rural intent may not always result in later rural practice. Although early studies from some schools are encouraging (16), longitudinal studies with longer follow-up periods are important, especially given implications for future funding for rural initiatives (29). Furthermore, this study focused on learners' background characteristics and rural practice intent.…”

Section: Discussionmentioning

confidence: 99%

“…Data to inform this analysis come from document review of publicly available sources and websites, supplemented by direct communication between authors; all embedded experts in health professional education in their own contexts. To further the trustworthiness of our results we also triangulated findings with those from complementary research from within the THEnet community, to understand the factors contributing to these strong drivers (14,16).…”

Section: Methodsmentioning

confidence: 99%

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Training a Fit-For-Purpose Rural Health Workforce for Low- and Middle-Income Countries (LMICs): How Do Drivers and Enablers of Rural Practice Intention Differ Between Learners From LMICs and High Income Countries?

Johnston

Guingona

Elsanousi

et al. 2020

Front. Public Health

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Equity in health outcomes for rural and remote populations in low-and middle-income countries (LMICs) is limited by a range of socioeconomic , cultural and environmental determinants of health. Health professional education that is sensitive to local population needs and that attends to all elements of the rural pathway is vital to increase the proportion of the health workforce that practices in underserved rural and remote areas. The Training for Health Equity Network (THEnet) is a community-of-practice of 13 health professional education institutions with a focus on delivering socially accountable education to produce a fit-for-purpose health workforce. The THEnet Graduate Outcome Study is an international prospective cohort study with more than 6,000 learners from nine health professional schools in seven countries (including four LMICs; the Philippines, Sudan, South Africa and Nepal). Surveys of learners are administered at entry to and exit from medical school, and at years 1, 4, 7, and 10 thereafter. The association of learners' intention to practice in rural and other underserved areas, and a range of individual and institutional level variables at two time points-entry to and exit from the medical program, are examined and compared between country income settings. These findings are then triangulated with a sociocultural exploration of the structural relationships between educational and health service delivery ministries in each setting, status of postgraduate training for primary care, and current policy settings. This analysis confirmed the association of rural background with intention to practice in rural areas at both entry and exit. Intention to work abroad was greater for learners at entry, with a Johnston et al. Rural Health Workforce for LMICs significant shift to an intention to work in-country for learners with entry and exit data. Learners at exit were more likely to intend a career in generalist disciplines than those at entry however lack of health policy and unclear career pathways limits the effectiveness of educational strategies in LMICs. This multinational study of learners from medical schools with a social accountability mandate confirms that it is possible to produce a health workforce with a strong intent to practice in rural areas through attention to all aspects of the rural pathway.

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Section: Discussionsupporting

confidence: 73%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Training a Fit-For-Purpose Rural Health Workforce for Low- and Middle-Income Countries (LMICs): How Do Drivers and Enablers of Rural Practice Intention Differ Between Learners From LMICs and High Income Countries?

Johnston

Guingona

Elsanousi

et al. 2020

Front. Public Health

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“…Study participants included final‐year medical students, 6‐25 junior doctors early in their first postgraduate year, 3,13,14,16‐19,26‐42 junior doctors late in internship (>6 months) or in postgraduate year 2 or above 2,14,16,22,24,35,38,42‐57 (Table 1). Twenty‐one studies incorporated feedback or reports from clinical supervisors or training managers 5,7,13,14,17‐19,22,25,31,35,36,39,43,45,55,58‐61 (Table 1). Six studies followed up students longitudinally when they were part way into, or at the end of, their intern year 13,14,18,19,22,37 (Table 1).…”

Section: Resultsmentioning

confidence: 99%

Transitioning from university to postgraduate medical training: A narrative review of work readiness of medical graduates

Padley

Boyd

Jones

et al. 2021

Health Science Reports

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Context Work readiness is often described in terms of the clinical competence medical graduates bring to day 1 of internship. Despite being increasingly viewed as a key graduate outcome, work readiness has remained poorly defined. Objective This narrative review draws on the international literature to explore how different research methods provide differing insight into what constitutes work readiness of medical graduates. From this, we explored contributory factors and developed a conceptual framework to better understand work readiness. Methods Databases were searched using the terms including “ready,” “readiness,” “preparedness,” “medical graduates,” “intern,” and “junior doctor.” Information was summarized using a textual description template that included information on study setting, participants, methodologies, limitations, and key result areas (including measures/themes and study conclusions). Consensus discussions between authors led to the naming and understanding of the key themes. Results Seventy studies were included in the review. Study participants included final‐year medical students (n = 20), junior doctors early in internship (n = 24), and junior doctors late in internship or postgraduate year 2 and above (n = 23). Most studies explored work readiness through the retrospective self‐report of the students and/or junior doctor participants. Quantitative research methods elaborated on key skills‐based competencies, whereas qualitative research methods provided insight into key contextual and individual characteristics that contributed to preparedness. Conclusions Different research methods provided insight into competencies, as well as individual and contextual aspects, associated with preparedness for practice. The transition from university to clinical practice is significant and requires personal capability and confidence, as well as a supportive training context. Enabling students to engage authentically in clinical environments enhanced preparedness by promoting understanding of role and responsibility. Individual resilience is important, but contextual factors, including provision of adequate support and feedback, can enhance or subtract from feeling prepared. We propose a novel conceptual framework for better understanding work readiness.

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“…In addition, practicing as a health professional in remote areas is significantly different from practicing in metropolitan centers [9,10]. However, frequently, the curriculum in health professional training programs pays scant attention to preparing students for remote practice [11][12][13].…”

Section: Introduction Backgroundmentioning

confidence: 99%

Health Professional Student Placements and Workforce Location Outcomes: Protocol of an Observational Cohort Study (Preprint)

Campbell¹,

Farthing²,

Witt³

et al. 2020

Preprint

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BACKGROUND

The successful recruitment and retention of health professionals to rural and remote areas of Australia is a health policy priority. Student undergraduate or graduate entry nursing or allied health learning placements in the Northern Territory of Australia (most of which is considered remote) may influence rural or remote work location decisions.

OBJECTIVE

The aim of the study is to determine where allied health professionals and nurses who have had a student placement/s in the Northern Territory of Australia end up practising.

METHODS

This research is an observational cohort study with a baseline data collection and then repeated annual data collection over 10 years (2017/18-2029). The baseline data collection is a demographic profile of allied health and nursing students and their evaluation of their NT placement using a nationally consistent questionnaire. Annual Work Location Surveys will track work location and the influences on work location decisions.

RESULTS

The study will have the unique ability to report on the impact of remote health training placements.

CONCLUSIONS

This study will generate important data on the remote and rural work locations of nursing and allied health professional students who had a placement in the Northern Territory of Australia. It will be able to determine what are the most important characteristics of those who take up remote and rural employment (even if outside NT), and identify barriers to remote employment.

CLINICALTRIAL

N/A

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Does a socially-accountable curriculum transform health professional students into competent, work-ready graduates? A cross-sectional study of three medical schools across three countries

Cited by 25 publications

References 27 publications

Training a Fit-For-Purpose Rural Health Workforce for Low- and Middle-Income Countries (LMICs): How Do Drivers and Enablers of Rural Practice Intention Differ Between Learners From LMICs and High Income Countries?

Training a Fit-For-Purpose Rural Health Workforce for Low- and Middle-Income Countries (LMICs): How Do Drivers and Enablers of Rural Practice Intention Differ Between Learners From LMICs and High Income Countries?

Transitioning from university to postgraduate medical training: A narrative review of work readiness of medical graduates

Health Professional Student Placements and Workforce Location Outcomes: Protocol of an Observational Cohort Study (Preprint)

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