Longer-term workforce impacts of rural immersion programmes

Abstract

Background: Australasia faces an ongoing shortage of rural doctors. To increase interest in rural practice, since 2008, the University of Auckland has offered a rural immersion programme, Pūkawakawa, in Northland, Aotearoa. Most medical schools have similar programmes. Research has shown that participation in such programmes is associated with a greater intention to practice rurally. What is less well-established is how these intentions materialise into longer-term outcomes, as well as wider benefits to the communities in which the programmes take place. A direct assessment of the impact of Pūkawakawa on workforce outcomes has been made possible via the linking of University collected datasets (from the Medical Student Outcome Database and Tracking Project and medical programme data) with government datasets on actual practice. This yields new avenues for investigation on how rural immersion interacts with student, programme and other factors to affect eventual practice. The latest outcome data for 980 students show those who undertook Pūkawakawa are more likely than those who did not to be in rural practice (RR 2.7), especially in Northland (RR 6.6). More details will be provided in the session. Purpose and outcomes: • Develop a deeper understanding of the potential and real impacts of rural immersion programmes on workforce outcomes • Share contemporary experiences of designing, implementing and evaluating medical school rural immersion programmes in Australasia • Tease out if there is a “Pūkawakawa effect” or if other factors are more important in determining future practice location Key discussion questions: - What constitutes a ‘rural’ immersion programme? - Who are the ‘best’ students to select into these resource-intensive programmes, and how should they be identified? - What outcomes are useful in evaluating the impact of rural immersion programmes? - What are the best practices for impact evaluation of a rural immersion programme on workforce development and outcomes?