A framework for developing rural academic general practices: a qualitative case study in rural Victoria
Brown, JB and Morrison, T and Bryant, M and Kassell, L and Nestel, D, A framework for developing rural academic general practices: a qualitative case study in rural Victoria, Rural and Remote Health, 15, (2) Article 3072. ISSN 1445-6354 (2015) [Refereed Article]
Introduction: There is increasing pressure for Australian rural general practices to engage in educational delivery as a means of
addressing workforce issues and accommodating substantial increases in learners. For practices that have now developed a strong
focus on education, there is the challenge to complement this by engaging in research activity. This study develops a rural academic
general practice framework to assist rural practices in developing both comprehensive educational activity and a strong research
focus thus moving towards functioning as mature academic units.
Methods: A case study research design was used with the unit of analysis at the level of the rural general practice. Purposively
sampled practices were recruited and individual interviews conducted with staff (supervisors, practice managers, nurses), learners
(medical students, interns and registrars) and patients. Three practices hosted ‘multi-level learners’, two practices hosted one
learner group and one had no learners. Forty-four individual interviews were conducted with staff, learners and patients. Audio
recordings were transcribed for thematic analysis. After initial inductive coding, deductive analysis was undertaken with reference to
recent literature and the expertise of the research team resulting in the rural academic general practice framework.
Results: Three key themes emerged with embedded subthemes. For the first theme, organisational considerations, subthemes
were values/vision/culture, patient population and clinical services, staffing, physical infrastructure/equipment, funding streams
and governance. For the second theme, educational considerations, subthemes were processes, clinical supervision, educational
networks and learner presence. Third, for research considerations, there were the subthemes of attitude to research and research
activity. The framework maps the development of a rural academic practice across these themes in four progressive stages:
beginning, emerging, consolidating and established.
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