Association between experience quality in a short-term, voluntary, rural, funded, immersion placement program on future rural engagement decisions

Abstract

BACKGROUND: Rural immersion programs are commonly used to expose medical students to rural practice using curriculum-embedded placements. However, evidence regarding short-term, funded, voluntary, rural immersion placements that are not part of standard curricula-based training and their association with continued rural workforce engagement remains limited. Participants of the Bush Bursary, a voluntary, scholarship-based rural immersion program delivered through innovative partnerships between local councils, community organisations and the Rural Doctors Network (Australia). The program provides 2- to 6-week immersive rural exposure experiences across New South Wales. METHODS: This was a retrospective cohort study. A post-placement survey was distributed in 2022 to 357 former participants from 1996 to 2021 to measure subsequent self-directed rural placement participation and factors associated with excellence in rural experiences. RESULTS: Participants who rated their immersion experience as 'excellent' had a significantly higher likelihood of undertaking further rural placements compared with those providing only a 'good/poor' rating (OR 6.90; 95% CI 1.70-27.99; P = 0.007). Factors independently associated with an excellent experience included rural health experience (OR 4.98; 95% CI 1.22-20.39; P = 0.026). CONCLUSIONS: Brief, voluntary, scholarship-based rural immersion placements with local council and community organisation partnerships, beyond formal curricula-based training, may influence subsequent rural engagement when experience quality is high. Although duration is an important dimension of immersion, authentic participation in rural clinical and community settings is also a defining feature of immersive educational experiences. Short-term rural placements may influence future self-directed rural placement decisions, acting as important stepping stones within the rural workforce pathway. In this context, short-term, scholarship-based rural immersion placements may complement existing policy levers to strengthen rural workforce pathways.