Changes in Veterinary Students' Attitudes Toward the Rural Environment and Rural Veterinary Practice: A Longitudinal Cohort Study

Predictors of a positive attitude towards rural practice in female osteopathic medical students

CONTEXT

Women outnumber men in medical school. Given the growing need for rural physicians and the underrepresentation of women in rural medicine, understanding predictors of rural practice among female students is imperative for addressing future healthcare workforce shortages in rural areas. Utilizing current evidence, medical schools should seek to admit students with a rural background and interest in pursuing a primary care specialty; however, whether this holds true for female osteopathic medical students is unknown.

OBJECTIVES

This study aims to determine if a rural background, a plan to practice family medicine, and motivation toward civic duty are associated with attitudes toward eventual practice of rural medicine in female osteopathic medical students.

METHODS

An anonymous online survey was administered to actively enrolled female students at Arkansas Colleges of Health Education College of Osteopathic Medicine. The survey assessed the respondents' presence of a rural background, degree of civic-mindedness, intention to practice family medicine, and attitudes to rural work and life. Demographics of ethnicity and year of study in medical school were also collected. In total, 129 students responded to the survey, with 97 complete responses for analysis. Hierarchical regression was utilized to compare nested models and interpret interactions.

RESULTS

Of the 97 survey respondents, 34.0 % described themselves as first-year students, 37.1 % as second-year students, 16.5 % as third-year students, and 12.4 % as fourth-year students. Linear regression modeling indicated that for female medical students at Arkansas Colleges of Health Education, having a rural background had no relationship with their attitude toward practicing in a rural setting, β=-0.97, standard error (SE)=1.96, t=-0.49, p>0.05, CI [-4.86, 2.92]. Civic-mindedness had a positive relationship with their attitude toward practicing in a rural setting, β=0.17, SE=0.07, t=2.44, p=0.016, CI [0.03, 0.31], accounting for 4.57 % of its variance. Plan to practice family medicine was positively associated with a student's attitude toward practicing in a rural setting, β=4.38, SE=0.85, t=5.15, p<0.001, CI [2.69, 6.07], accounting for 20.25 % of its variance. Civic-mindedness appeared to moderate the relationship between planning to practice family medicine and attitudes toward practicing in a rural setting, F(1, 91) = 3.91, p=0.05, R 2=0.31. The p value for this interaction term was 0.05, but its effect size measure and graphical representation revealed a substantive effect.

CONCLUSIONS

The regression analysis showed that, for the women in this study, the greater the student's civic-mindedness, the more favorable her attitude toward practicing in a rural setting. Additionally, the stronger the student's plan to practice family medicine, the more favorable her attitude toward eventual rural practice was. Lastly, the student's civic-mindedness influenced the predictive value of having a plan to practice family medicine.

Actualizing Cultural Humility: An Exploratory Study of Veterinary Students' Participation in a Northern Community Health Rotation

Rotations in diverse, marginalized communities may offer health care students opportunities to develop cultural humility through different clinical experiences and activities. Through the actualization of cultural humility, veterinarians may offer accessible, affordable, culturally proficient, high-quality care to all their patients with a better understanding of how cultural differences affect the animal patient's health, well-being, and care. The purpose of this study was to explore whether participation in a community rotation in remote northern Indigenous communities promotes cultural humility among final-year veterinary students. Small groups of University of Calgary veterinary students travel annually to the Sahtu Settlement Area of the Northwest Territories, Canada, to participate in the Northern Community Health Rotation (NCHR). During the 4-week rotation, students spend 2.5 weeks providing veterinary services to domestic animals in five communities in the Sahtu. Eleven veterinary students who attended the NCHR between 2015 and 2020 answered exploratory open-ended questions in an online survey. Responses highlight areas of learning that contributed to their development of cultural humility. The rotation appears successful in increasing students' confidence working with people from diverse cultures, offering students opportunities to implement a client-centered approach, and advancing their capacity to recognize and challenge their preconceived biases about Indigenous cultures and animal ownership. These experiences are important to the acquisition of cultural humility for veterinary care providers.

Prior Experience, Career Intentions, and Post-Graduate Positions of Veterinary Students Who Participated in an 8-week Dairy Production Medicine Course

Three cohorts of senior veterinary students (n = 50) from seven United States (US) colleges of veterinary medicine took an 8-week dairy production medicine course at the Dairy Center of Excellence in Production Medicine Education for Veterinarians (DCE) between 2012 and 2014. Participants completed a questionnaire before and after the course and 1 to 2 years after graduation. Objectives were to determine the prior academic training and livestock experience of course participants, to compare students' career aspirations before and after taking the course, and to identify factors associated with post-graduate position. Response rates were 58%-96%. Most students had taken undergraduate animal science courses (83%), worked (76%) and/or lived (52%) on a livestock operation, participated in youth livestock activities (63%), worked at a mixed practice (71%), taken production medicine-related elective courses (65%), taken other food animal rotations (91%), and/or done dairy externships (65%) before taking the DCE course. Students who were very likely to pursue a dairy-focused position before taking the course (36%) remained committed after the course, whereas students who were not likely initially (39%) were not further motivated by the course. Students who had worked with a dairy veterinarian were more likely to pursue a dairy-focused position than those who had not. Most course alumni accepted positions in mixed practice, with a ≥ 50% (54%) or < 50% (23%) dairy component, and post-graduate positions were consistent with students' predictions. Students who held an undergraduate degree or had worked for a dairy veterinarian were more likely to accept a dairy-focused practice position than those who did not.