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Pinidiyapathirage J, Heffernan R, Carrigan B, Walters S, Fuller L, Brumpton K. Recruiting students to rural longitudinal integrated clerkships: a qualitative study of medical educationists' experiences across continents. BMC MEDICAL EDUCATION 2023; 23:974. [PMID: 38115001 PMCID: PMC10731800 DOI: 10.1186/s12909-023-04949-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 12/07/2023] [Indexed: 12/21/2023]
Abstract
INTRODUCTION Many health systems struggle in the provision of a sustainable and an efficient rural health workforce. There is evidence to suggest that Longitudinal Integrated Clerkships (LIC) placing student learners in rural community settings have positively impacted the provision of rural health care services The recruitment and engagement of students in rural LIC have significant challenges. This study explored best practice methods of recruiting and supporting the transition of medical students into rural LIC. METHODS The study took place during the 2021 Consortium of Longitudinal Integrated Clerkships Conference, a virtual event hosted by Stellenbosch University, South Africa. Participants consisted of delegates attending the Personally Arranged Learning Session (PeArLS) themed 'Secrets to success'. The session was recorded with the participants' consent and the recordings were transcribed verbatim. Data was uploaded to NVivo software and coded and analyzed using constant comparative analysis. Salient themes and patterns were identified. RESULTS Thirteen attendees participated in the PeArLS representing a range of countries and institutions. Strategically marketing the LIC brand, improving the LIC program profile within institutions by bridging logistics, and the need to scaffold the transition to the rural LIC learning environment emerged as key themes for success. The attendees highlighted their experiences of using peer groups, early exposure to rural LIC sites, and student allocation strategies for promotion. Unique learning styles adopted in LIC models, student anxiety and the importance of fostering supportive relationships with stakeholders to support students in their transition to the LIC environment were discussed. DISCUSSION This PeArLS highlighted successful systems and processes implemented in rural settings across different countries to recruit and manage the transition of medical students to rural LIC. The process proved to be a quick and efficient way to elicit rich information and may be of benefit to educationists seeking to establish similar programs or improve existing rural LIC.
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Affiliation(s)
- Janani Pinidiyapathirage
- Rural Medical Education Australia, 190 Hume Street, Toowoomba, QLD, 4350, Australia.
- School of Medicine and Dentistry, Griffith University, Gold Coast Campus, Southport, Australia.
| | - Robert Heffernan
- Rural Medical Education Australia, 190 Hume Street, Toowoomba, QLD, 4350, Australia
- School of Medicine and Dentistry, Griffith University, Gold Coast Campus, Southport, Australia
| | - Brendan Carrigan
- Rural Medical Education Australia, 190 Hume Street, Toowoomba, QLD, 4350, Australia
- School of Medicine and Dentistry, Griffith University, Gold Coast Campus, Southport, Australia
| | - Sherrilyn Walters
- Rural Medical Education Australia, 190 Hume Street, Toowoomba, QLD, 4350, Australia
- School of Medicine and Dentistry, Griffith University, Gold Coast Campus, Southport, Australia
| | - Lara Fuller
- Rural Community Clinical School, School of Medicine, Deakin University, Geelong, Australia
| | - Kay Brumpton
- Rural Medical Education Australia, 190 Hume Street, Toowoomba, QLD, 4350, Australia
- School of Medicine and Dentistry, Griffith University, Gold Coast Campus, Southport, Australia
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Personality, Resilience, and Calling in Students Undertaking a Medical Degree Across Two Continents: Disparate Pathways to the Healing Profession. Ochsner J 2021; 21:143-151. [PMID: 34239373 PMCID: PMC8238092 DOI: 10.31486/toj.20.0029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Background: An educational partnership between The University of Queensland (UQ) in Australia and Ochsner Health in the United States developed the UQ-Ochsner medical program that trains American citizens to practice medicine in the United States. This program provides the opportunity to explore and compare the personal characteristics of UQ-Ochsner students with their domestic (Australian citizen) and international classmates not enrolled in the Ochsner program. Findings may offer some insights into the types of students who choose to study medicine across multiple countries. Methods: We used a quantitative cross-sectional design for our study. A first-year cohort of domestic, international, and UQ-Ochsner students completed a survey comprising demographic questions and measures of temperament and character personality, resilience, and calling to medicine. Univariate statistics were used to compare groups for all variables. Results: The whole sample response rate was 72.1% (375/520). Domestic students represented the greatest proportion of students <25 years, and UQ-Ochsner students represented the greatest proportion of students of ≥26 years. Gender did not differ significantly between groups. The majority first degree for all students was science, although 23% of UQ-Ochsner students reported arts/law/humanities degrees. In comparison to all other students (domestic and international combined), UQ-Ochsner students scored significantly lower in levels of harm avoidance (P=0.039) and higher in self-directedness and self-transcendence, resilience, and calling with medium to strong effect sizes (d>0.3). Conclusion: UQ-Ochsner students have a personality profile similar to their classmates but with levels of certain traits-higher self-directedness and lower harm avoidance-that in combination contribute to higher resilience and a strong sense of calling to medicine. Being slightly older may allow for more development of self-directedness, but low harm avoidance suggests an innate degree of confidence in and acceptance of risk to achieving goals.
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O'Doherty J, Hyde S, O'Connor R, Brown MEL, Hayes P, Niranjan V, Culhane A, O'Dwyer P, O'Donnell P, Glynn L, O'Regan A. Development and sustainment of professional relationships within longitudinal integrated clerkships in general practice (LICs): a narrative review. Ir J Med Sci 2021; 191:447-459. [PMID: 33641086 DOI: 10.1007/s11845-021-02525-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Accepted: 01/20/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND Longitudinal integrated clerkships (LICs) are a relatively new model of clinical medical education, whereby students participate in patient care over time and develop relationships with those patients', their clinicians, and other health care staff involved in the care of those patients. It has been called 'relationship-based education' but, to date, no review has investigated the development and impact of these central relationships within this curricula model. AIMS The aim of this study is to review the literature pertaining to relationships in LICs, specifically to understand how they come about and how they affect learning. METHODS The search strategy systematically explored PubMed, ERIC (EBSCO) and Academic Search Complete, using key words and MESH terms. Original research published in peer-reviewed journals between January 2007 and August 2020 that were written in the English language were included in the review. RESULTS After applying set inclusion and exclusion criteria, 43 studies were included in this review. A qualitative thematic analysis was undertaken, and results were synthesised narratively. Four distinct categories were identified: defining relationships in LICs, developing relationships in LICs, relationship maintenance and multi-stakeholder impact. CONCLUSIONS The longitudinal integrated clerkship model of clinical education facilitates the development of meaningful triangular relationships between student, clinical teacher and patient, which are the central drivers of successful learning within the context of an LIC. These relationships are nested in a set of important supporting relationships involving other supervisors, the medical school and university, the practice clinical and administrative team and peers.
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Affiliation(s)
- Jane O'Doherty
- School of Medicine, University of Limerick, Plassey, Limerick, Ireland.
| | - Sarah Hyde
- School of Medicine, University of Limerick, Plassey, Limerick, Ireland
- Health Research Institute, University of Limerick, Plassey, Limerick, Ireland
| | - Raymond O'Connor
- School of Medicine, University of Limerick, Plassey, Limerick, Ireland
- Health Research Institute, University of Limerick, Plassey, Limerick, Ireland
- Mid-West Specialist Training Programme in General Practice, University of Limerick, Plassey, Limerick, Ireland
| | - Megan E L Brown
- Health Professions Education Unit, Hull York Medical School, University of York, York, UK
| | - Peter Hayes
- School of Medicine, University of Limerick, Plassey, Limerick, Ireland
| | - Vikram Niranjan
- School of Medicine, University of Limerick, Plassey, Limerick, Ireland
- Health Research Institute, University of Limerick, Plassey, Limerick, Ireland
| | - Aidan Culhane
- School of Medicine, University of Limerick, Plassey, Limerick, Ireland
| | - Pat O'Dwyer
- School of Medicine, University of Limerick, Plassey, Limerick, Ireland
| | - Patrick O'Donnell
- School of Medicine, University of Limerick, Plassey, Limerick, Ireland
- Health Research Institute, University of Limerick, Plassey, Limerick, Ireland
| | - Liam Glynn
- School of Medicine, University of Limerick, Plassey, Limerick, Ireland
- Health Research Institute, University of Limerick, Plassey, Limerick, Ireland
| | - Andrew O'Regan
- School of Medicine, University of Limerick, Plassey, Limerick, Ireland
- Health Research Institute, University of Limerick, Plassey, Limerick, Ireland
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Childs-Kean L, Edwards M, Smith MD. Use of Personality Frameworks in Health Science Education. AMERICAN JOURNAL OF PHARMACEUTICAL EDUCATION 2020; 84:ajpe7231. [PMID: 32934378 PMCID: PMC7473231 DOI: 10.5688/ajpe7231] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Accepted: 02/24/2020] [Indexed: 06/11/2023]
Abstract
Objectives. To review the use of personality frameworks by educators as a tool to increase self-awareness in health professions students. Findings. After screening titles, abstracts, and/or the full text of the 415 articles identified in an initial search, 71 articles involving personality frameworks were included in the study. Several different personality frameworks, including the Five-Factor Model, Myers-Briggs Type Indicator, the Rational Experiential Inventory, and the CliftonStrengths assessment, were used in various health science education disciplines, including medicine, nursing, and pharmacy. Most publications were descriptive in nature and only reported on the personality attributes of the given research cohort. Some studies correlated personality framework results with either learning or non-cognitive outcomes. Very few studies described using personality frameworks as a tool for self-awareness and growth. Summary. While some personality frameworks have been used in health science education for multiple purposes, there is currently a lack of published evidence documenting the use of these frameworks for self-awareness in students.
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Affiliation(s)
| | - Mary Edwards
- University of Florida, Health Science Center Libraries, Gainesville, Florida
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Eley DS, Cloninger CR, Power DV, Brooks KD. The personalities of most medical students are suited to rural practice: Implications for rural education program recruitment. MEDICAL TEACHER 2019; 41:1160-1167. [PMID: 31203681 DOI: 10.1080/0142159x.2019.1623388] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Introduction: The success of rural longitudinal integrated clerkship (LIC) programs has contributed to our understanding of selecting and training students for rural practice. Studies have explored the personality traits of students who participate in rural LICs although few have compared them with classmates who have not. The purpose is to compare personalities of four successive cohorts of students in the LIC Rural Physician Associate Program (RPAP) with their non-RPAP classmates. Methods: In a longitudinal cross-sectional design, medical students RPAP and non-RPAP, from 2013 to 2017 completed identical questionnaires comprising measures of personality, perfectionism, ambiguity tolerance, and resilience. T-tests, ANOVA, and post-hoc tests compared groups. K-means cluster analysis identified profiles of traits. Results: Total sample 286; RPAP = 128; non-RPAP = 158. Gender and age proportions were not different between groups. RPAP students were significantly lower in levels of perfectionism and higher in cooperativeness compared to non-RPAP classmates. Similar proportions of both groups were distributed across three personality profiles detected. Conclusions: Lower perfectionism implies advantages for rural practice. Nevertheless, similarities between groups suggest that most students would be successful in rural practice. More encouragement to all students may improve uptake of rural LICs. Greater attention to issues that affect decisions to explore rural medical education, particularly for our next generation of students, is required.
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Affiliation(s)
- Diann S Eley
- Faculty of Medicine, Office of Medical Education, University of Queensland , Brisbane , Australia
| | - C Robert Cloninger
- Department of Psychiatry, School of Medicine, Washington University in St Louis , St Louis , MO , USA
| | - David V Power
- Department of Family Medicine and Community Health, University of Minnesota Medical School, University of Minnesota , Minneapolis , MN , USA
| | - Kathleen Dwyer Brooks
- Department of Family Medicine and Community Health, University of Minnesota Medical School, University of Minnesota , Minneapolis , MN , USA
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Eley DS, Leung JK, Campbell N, Cloninger CR. Tolerance of ambiguity, perfectionism and resilience are associated with personality profiles of medical students oriented to rural practice. MEDICAL TEACHER 2017; 39:512-519. [PMID: 28281843 DOI: 10.1080/0142159x.2017.1297530] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
PURPOSE Resilience, coping with uncertainty and learning from mistakes are vital characteristics for all medical disciplines - particularly rural practice. Levels of coping constructs were examined in medical students with and without a rural background or an interest in rural practice. METHODS Cross-sectional surveys identified two personality profiles, and their association with levels of Tolerance of Ambiguity, Resilience, Perfectionism-High Standards and Concern over mistakes as constructs indicative of coping. Medical students (N = 797) were stratified by rural background and degree of rural interest. Mediation analysis tested the effect of personality profile on levels of the coping constructs. RESULTS More (72%) rural background students had Profile 1 which was associated with higher levels of Tolerance of Ambiguity, High standards, and Resilience, but lower Concern over mistakes. Non-rural background students reporting a strong rural interest also had Profile 1 (64%) and similar levels of coping constructs. Personality profile mediated the association between rural interest and levels of coping constructs regardless of background. CONCLUSIONS Having a rural background or strong rural interest are associated with a personality profile that indicates a better capacity for coping. Personality may play a part in an individual's interest in rural practice. Rural workforce initiatives through education should encourage and nurture students with a genuine interest in rural practice - regardless of background.
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Affiliation(s)
- Diann S Eley
- a Faculty of Medicine , The University of Queensland , Brisbane , Australia
| | - Janni K Leung
- b School of Public Health , The University of Queensland , Brisbane , Australia
| | - Narelle Campbell
- c Northern Territory Medical Program, School of Medicine , Flinders University , Adelaide, Australia
| | - C Robert Cloninger
- d Department of Psychiatry, School of Medicine , Washington University in St Louis , St. Louis , MO , USA
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Campbell N, Eley DS, McAllister L. How Do Allied Health Professionals Construe the Role of the Remote Workforce? New Insight into Their Recruitment and Retention. PLoS One 2016; 11:e0167256. [PMID: 27907073 PMCID: PMC5131943 DOI: 10.1371/journal.pone.0167256] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2015] [Accepted: 11/11/2016] [Indexed: 11/19/2022] Open
Abstract
Purpose Allied health workforce recruitment and retention in remote areas is a global problem. Using case studies from the Australian allied health workforce, this paper adds new information by combining personality trait information with a detailed understanding of how the cases construe the demands of remote work, which may be useful in addressing this problem. Methods Four cases (two urban, two remote) are presented from a mixed methods study (n = 562), which used (1) the Temperament and Character Inventory to investigate personality traits of allied health professionals; and (2) repertory grid interviews to reveal quantitatively and qualitatively how the cases construed their Ideal work role compared with their Current and a Remote role. Cases also self-assessed their fit (‘suited’ or ‘not suited’) with remote. Findings Differences in the way cases construed their fit with remote work was related to prior experience. However all were satisfied with their work, perceiving their Current role as similar to their Ideal. All saw remote work as requiring generalist expertise and a reliance on relationships. Personality traits, especially Novelty Seeking and Harm Avoidance, fit with how allied health professionals perceived their role. Conclusions The combination of two distinct lines of investigation, illustrates what more can be revealed about allied health professional’s career choices by taking into account the fit or lack of fit between their personality tendencies, their construing of remote work and their life circumstances. Understanding the combined influence of perceptions and traits on an individual toward or away from remote work may enhance recruitment and retention internationally.
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Affiliation(s)
- Narelle Campbell
- School of Medicine, The University of Queensland, Brisbane, Queensland, Australia
- * E-mail:
| | - Diann S. Eley
- School of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Lindy McAllister
- Faculty of Health Sciences, The University of Sydney, Lidcombe, New South Wales, Australia
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Worley P, Couper I, Strasser R, Graves L, Cummings BA, Woodman R, Stagg P, Hirsh D. A typology of longitudinal integrated clerkships. MEDICAL EDUCATION 2016; 50:922-32. [PMID: 27562892 DOI: 10.1111/medu.13084] [Citation(s) in RCA: 117] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2015] [Revised: 10/14/2015] [Accepted: 03/14/2016] [Indexed: 05/13/2023]
Abstract
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.
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Affiliation(s)
- Paul Worley
- Prideaux Centre for Research in Health Professions Education, School of Medicine, Flinders University, Adelaide, Australia
- South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
| | - Ian Couper
- Ukwanda Centre for Rural Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | | | - Lisa Graves
- Department of Family and Community Medicine, School of Medicine, Western Michigan University, Kalamazoo, Michigan, USA
| | - Beth-Ann Cummings
- Centre for Medical Education, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
| | - Richard Woodman
- Flinders Centre for Epidemiology and Biostatics, Flinders University, Adelaide, South Australia, Australia
| | - Pamela Stagg
- Centre for Remote Health, School of Medicine, Flinders University, Darwin, Australia
| | - David Hirsh
- Department of Medicine, Harvard Medical School, Boston, Massachusetts, USA
- Department of Medicine, Cambridge Health Alliance, Cambridge, Massachusetts, USA
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Eley DS, Leung J, Hong BA, Cloninger KM, Cloninger CR. Identifying the Dominant Personality Profiles in Medical Students: Implications for Their Well-Being and Resilience. PLoS One 2016; 11:e0160028. [PMID: 27494401 PMCID: PMC4975484 DOI: 10.1371/journal.pone.0160028] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2016] [Accepted: 07/12/2016] [Indexed: 11/18/2022] Open
Abstract
PURPOSE There is a high prevalence of stress, depression, and burn-out in medical students. Medical students differ widely in personality traits, self-perceptions, and values that may have an impact on their well-being. This study aimed to investigate variability in their personality profiles in relation to their potential for well-being and resilience. METHOD Participants were 808 medical students from The University of Queensland. An online questionnaire collected socio-demographics and the Temperament and Character Inventory to assess personality traits. Latent profile analyses identified students' trait profiles. RESULTS Two distinct personality profiles were identified. Profile 1 ("Resilient") characterized 60% of the sample and was distinguished by low Harm Avoidance combined with very high Persistence, Self-Directedness and Cooperativeness compared to Profile 2 ("Conscientious"). Both Profiles had average levels of Reward Dependence and Novelty Seeking and low levels of Self-Transcendence. Profiles did not differ by age, gender, or country of birth, but rural background students were more likely to have Profile 1. While both Profiles indicate mature and healthy personalities, the combination of traits in Profile 1 is more strongly indicative of well-being and resilience. CONCLUSIONS Finding two distinct profiles of personality highlights the importance of considering combinations of traits and how they may interact with medical students' potential for well-being. Although both profiles of students show healthy personalities, many may lack the resilience to maintain well-being over years of medical training. Programs that develop character and personality self-awareness would enhance their well-being and prepare them to promote the health of their patients.
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Affiliation(s)
- Diann S. Eley
- School of Medicine, The University of Queensland, Brisbane, Australia
| | - Janni Leung
- School of Public Health, The University of Queensland, Brisbane, Australia
| | - Barry A. Hong
- Department of Psychiatry, School of Medicine, Washington University, St. Louis, Missouri, United States of America
| | - Kevin M. Cloninger
- The Anthropedia Foundation, St. Louis, Missouri, United States of America
| | - C. Robert Cloninger
- Department of Psychiatry, School of Medicine, Washington University, St. Louis, Missouri, United States of America
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Ball L, Eley DS, Desbrow B, Lee P, Ferguson M. Association between dietitians' personality profiles and practice areas. Nutr Diet 2015. [DOI: 10.1111/1747-0080.12222] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Lauren Ball
- Menzies Health Institute Queensland; Griffith University; Gold Coast Queensland Australia
| | - Diann S. Eley
- School of Medicine; The University of Queensland; Brisbane Queensland Australia
| | - Ben Desbrow
- Menzies Health Institute Queensland; Griffith University; Gold Coast Queensland Australia
| | - Patricia Lee
- Menzies Health Institute Queensland; Griffith University; Gold Coast Queensland Australia
| | - Maree Ferguson
- School of Human Movement and Nutrition Sciences; The University of Queensland; Brisbane Queensland Australia
- Department of Nutrition & Dietetics; Princess Alexandra Hospital; Brisbane Queensland Australia
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