The Parallel Rural Community Curriculum: an integrated clinical curriculum based in rural general practice

TLDR

The study proposes and pilots the Parallel Rural Community Curriculum to redistribute medical training to rural general practice and alleviate workforce maldistribution while providing students with broader clinical exposure. The PRCC delivers a full year of integrated clinical education in rural general practice, selecting volunteer students, recruiting practices, and evaluating the program through thematic analysis of structured interviews. Students in the PRCC reported increased patient access, longitudinal learning of common diseases, improved academic performance versus hospital peers, and the curriculum demonstrated the value of generalist training across disciplines.

Abstract

In an attempt to address the rural medical workforce maldistribution and the concurrent inappropriate caseload at the urban tertiary teaching hospitals, Flinders University and the Riverland Division of General Practice decided to pilot, in 1997, an entire year of undergraduate clinical curriculum in Australian rural general practice. This program is called the Parallel Rural Community Curriculum (PRCC). This paper is a discussion of the aims of the programme; student selection; practice recruitment; curriculum structure, and academic content, together with lessons learnt from the evaluation of the first cohort of students' experience of the course.Independent external evaluators undertook a thematic analysis of a series of structured interviews of students and faculty involved in both the PRCC and the traditional curriculum. The mean examination results were determined and a rank order comparison of student academic performance was undertaken.The eight selected volunteer students reported greater access to patients and clinical learning opportunities than their mainstream counterparts and learned clinical decision making in the context of the whole patient, their family, and the available community resources. They identified patients with 'core' clinical conditions and had a longitudinal exposure to common diseases, whereas hospital-based peers had a cross-sectional exposure to highly filtered illness. The PRCC students' academic performance improved in comparison with that of their tertiary hospital peers' and in comparison to their own results in previous years.The PRCC curriculum has cut across the traditional clinical discipline boundaries by teaching in an integrated way in rural general practice. It has affirmed the potential role of true generalist physicians in undergraduate medical education.