The Rural Integrated Community Clerkship: a vital stretch in the Alberta rural physician workforce pipeline.

Background: Longitudinal integrated clerkships are thought to operate synergistically with factors such as rural background and practice intent to determine medical graduates' practice types and locations-sometimes known as the pipeline effect. We examined the influence of the rural integrated community clerkship (ICC) at the University of Alberta on students choosing family medicine and rural practice. Methods: We completed a retrospective cohort analysis of graduates from 2009-2016. The cohort was cross-referenced by background, type of clerkship, practice type and practice location. We used χ2 analyses and risk ratios to measure the relative likelihood that ICC students would settle on rural practice and/or family medicine. Results: ICC participation had more influence than rural background on students' choice of rural and/or family practice, and both factors were synergistic. Rotation-based clerkship students were least likely to enter family medicine or rural practice. Conclusions: The ICC is a clerkship model that influences students to become rural and/or family physicians, regardless of their rural/urban origins. The ICC diverts rural-interested students into rural practice and protects rural-origin students from ending up in urban practice. Expanding ICC infrastructure, including sustaining the rural physician workforce, will benefit rural Alberta communities by increasing the numbers of UA graduates in rural practice.

Contexte: L'externat longitudinal intégré déterminerait, en synergie avec d'autres facteurs, notamment l'origine rurale et l'intention, le type de pratique et le lieu d'exercice des diplômés en médecine, un rapport appelé parfois « effet de pipeline ¼. Nous avons examiné dans quelle mesure l'externat communautaire intégré (ECI) en milieu rural à l'Université de l'Alberta incite les étudiants à choisir la médecine familiale ou l'exercice en milieu rural. Méthodes: Nous avons effectué une analyse de cohorte rétrospective des diplômés de 2009 à 2016. Les données sur la diplomation et celles sur l'origine, le type d'externat, la discipline et le lieu d'exercice ont été croisées. Nous avons utilisé le test du Chi-2 et le rapport de risques pour mesurer la probabilité relative que les étudiants qui ont fait l'ECI choisissent l'exercice en milieu rural et/ou la discipline de la médecine familiale. Résultats: Le fait d'avoir fait l'ECI a été un facteur plus déterminant que l'origine rurale quant au choix des étudiants d'exercer la médecine familiale ou de travailler en milieu rural, mais les deux facteurs étaient synergiques. Les étudiants ayant fait des stages rotatifs étaient les moins susceptibles d'opter pour la médecine familiale ou le milieu rural. Conclusions: L'ECC est un modèle d'externat qui incite les étudiants à se diriger vers la médecine familiale ou l'exercice en milieu rural, et ce, quelle que soit leur origine, rurale ou urbaine. Il amène ceux d'entre eux qui éprouvent déjà un intérêt pour l'exercice en milieu rural à concrétiser ce choix et ceux qui sont d'origine rurale à demeurer dans ce milieu pour y exercer leur profession. Le développement de l'infrastructure de l'ECC et le soutien que l'externat apporte à la main-d'œuvre médicale rurale profiteront aux collectivités rurales en dirigeant un plus grand nombre de diplômés de l'Université de l'Alberta vers l'exercice en milieu rural.

Provision of consumer health information in Alberta's Rural Public Libraries.

BACKGROUND: Access to health services is a major challenge in many rural communities within Canada. Rural public libraries can serve as centres for health resources. OBJECTIVE: The aim of this exploratory study was to analyse the manner in which Alberta's rural libraries provide health information to their patrons. METHODS: A questionnaire including closed ended and open ended questions was sent to the 285 rural libraries across the Canadian province of Alberta. Descriptive statistics and thematic analysis techniques were used for the data analysis. RESULTS: The findings indicate that in three quarters of Alberta's rural libraries, about 10% of requests for assistance were related to health issues. The provision of health information in these libraries is hampered by the lack of Internet, private space for reference interviews, and staff and volunteer training. Library staff members were inexperienced in conducting reference transactions and reported lacking confidence in meeting patrons' needs and ethical standards. DISCUSSION: Addressing these challenges will require the recruitment of more qualified librarians in rural library systems, possibly through incentive measures, and a comprehensive education and training programme for both staff and volunteers combined with the necessary resource support for the rural libraries. CONCLUSION: When human and material resources are adequate, rural libraries can contribute to improving the health literacy of their communities.