Non-technical skills of Norwegian medical students at different training sites: a comparative, observational cohort study.

PURPOSE: Mastering non-technical skills (NTS) is a fundamental part of the training of new physicians to perform effectively and safely in the medical practice environment. Ideally, they learn these skills during medical school. Decentralized medical education is being implemented increasingly worldwide. Two of the three training sites studied, Bodø (a regional hospital) and Finnmark (a rural local hospital), implemented decentralized medical education. The third training site was the main campus in Tromsø, located at an urban university hospital. The training in Finnmark emphasised training in non-technical skills using simulation to a larger extent than the two other university campuses. This study aimed to compare the NTS performance of medical students in their last year of education at three different training sites of the same university. METHODS: This blinded cohort study included students from the three training sites who participated in identical multi-professional simulations over a six-year period. Eight raters evaluated the video recordings of eight students from each training site using the Norwegian Medical Students Non-Technical Skills (NorMS-NTS) tool. The NorMS-NTS tool, which comprises four categories and 13 elements, assesses the NTS of Norwegian medical students and assigns an overall global score. Pairwise significant differences in the NTS performance levels between the training sites studied were assessed using Tukey's test. RESULTS: The overall NTS performance levels of the medical students from Finnmark (mean 4.5) were significantly higher than those of the students from Tromsø (mean 3.8) and Bodø (mean 3.5). Similarly, the NTS performance levels at category-level of the students in Finnmark were significantly higher than those of the students from Bodø and Tromsø. Except for one category, no significant differences were observed between the students from Bodø and Tromsø in terms of the overall or category-level NTS performance. CONCLUSION: The NTS performance levels of the medical students from Finnmark, which implements rural, decentralized medical education, were significantly higher than those of the students from Tromsø and Bodø.

Analysis of Formative and Evaluative Activities on Statistical Graphs in Textbooks for Chilean Rural Multigrade Education.

The aim of this paper is to analyze the formative and evaluative activities involving statistical graphs in the new textbooks for Chilean rural multigrade education. The methodology is qualitative, at a descriptive level and uses the content analysis technique. The sample is made up of the six primary education textbooks distributed by the Ministry of Education for rural multigrade schools. The results show the predominance of the bar chart, semiotic level 3, the task of calculating and the personal context in both types of activities, although with respect to the reading level, it is evident that level 4 predominates in the formative activities and level 2 in the evaluative ones. According to the results, it is recommended to incorporate graphs proposed by the curricular guidelines of the Ministry of Education, which are absent in textbooks as well as to include evaluative activities that require reflection on the nature of the data, context, representation and conclusions obtained from them.

Positive change in intent to practice rurally is strongly associated with nursing and allied health students of metropolitan origin after rural clinical placement.

OBJECTIVE: To: (1) assess whether rural clinical placements influence change in intention to practice rurally for nursing and allied health students, (2) to assess whether residential origin (metropolitan or rural) or university location (metropolitan or non-metropolitan) influence this change, and (3) assess residential origin of health professionals practicing rurally after graduation. DESIGN: Cross-sectional survey (2014-2022) conducted in Northern/Northeastern Victoria and Grampians region by nursing and allied health students completing rural clinical placements. Survey explored student placement satisfaction, intention to practice rurally and demographic information, with a follow-up two years' post-placement. FINDINGS: Experience of a rural placement increased students' intention of practicing rurally. Importantly, 57% of metropolitan origin students studying at metropolitan campuses exhibited positive change. Logistic regression analysis suggested that after controlling for age, gender and satisfaction with placement and supervision, students of metropolitan origin at metropolitan campuses were 6.4 times more likely to report positive change in intent to practice rurally after placement than students of rural origin studying at non-metropolitan campuses.Follow-up data suggested that a substantial proportion of health professionals providing services in rural areas were of metropolitan origin. RESULTS: These findings concur that rural origin and rural training are important predictors of working rurally. Additionally, metropolitan students can change their intention to practice rurally after a rural placement. CONCLUSIONS: This study supports strategies to enhance intention to practice rurally that are not restricted to rural origin students to build rural workforce.

Rural general practitioner confidence in diagnosing and managing dementia: A two-stage, mixed methods study of dementia-specific training.

INTRODUCTION: Dementias a prevalent chronic healthcare condition affecting 46 million people worldwide and projected to grow in the coming years. Australians living in rural and regional areas often lack access to specialist dementia care, despite greater prevalence relative to metropolitan areas. OBJECTIVE: This study aimed to explore general practitioners (GP) understanding, confidence and attitudes towards dementia management in the rural context, and design and pilot a dementia-specific training program. DESIGN: A two-stage, mixed methods design, using qualitative and quantitative methods. Sixteen regional GPs from across Victoria participated in scoping semi-structured interviews. Fourteen separate GPs in the St Anthony Family Medical Practice group in the regional Loddon-Mallee area of Victoria completed the pilot training intervention. Pre- and post-training surveys (n = 10), as well as post-training interviews (n = 10), assessed attitude and knowledge changes. FINDINGS: Analysis of semi-structured scoping interviews indicated three themes regarding experience of dementia management, including: (1) attitudes to and experiences of dementia; (2) supporting people living with dementia; and (3) knowledge, education and training of dementia. The pilot dementia-specific training was found to improve attitudes (agreement across 24 best-practice indicators improved from 30% to 79%), knowledge (median increase of 2.5/10) and confidence in managing dementia and disclosing dementia diagnoses (median increase 3/10 and 2.75/10, respectively). DISCUSSION: General practitioners in this study lacked initial confidence in detecting and managing dementia in a rural primary care setting. A targeted training program showed improvements in these areas. CONCLUSION: Accessible, locally delivered, dementia education has the potential to improve confidence in early detection and management of people with dementia and thereby may address gaps in access to care for people living with dementia in rural settings.

"Following the Breath:" A Trauma-Informed Intervention for Educator Wellness in Rural Montana.

Given the prevalence of mental health issues for both educators and adolescents in rural Montana, this project is designed to help mitigate the impact of stressors by providing coping strategies linked to improvements in overall mental health outcomes for teachers, which may ultimately lead to improved co-regulation of students and classroom climate. The immediate goal of this pilot study was to measure physical and mental health outcomes of educators resulting from a remotely-delivered trauma-informed yoga intervention. Findings suggest improvements in participants' depression and anxiety levels, trauma symptoms, sleep quality, and non-significant changes in heart rate variability and cortisol levels.

Exploring the future of GM technology in sustainable local food systems in Colombia.

The security of Earth's food systems is challenged by shifting regional climates. While agricultural processes are disrupted by climate change, they also play a large role in contributing to destabilizing greenhouse gases. Finding new strategies to increase yields while decreasing agricultural environmental impacts is essential. Tropical agriculture is particularly susceptible to climate change: local, smallholder farming, which provides a majority of the food supply, is high risk and has limited adaptation capacity. Rapid, inexpensive, intuitive solutions are needed, like the implementation of genetically modified (GM) crops. In the Latin American tropics, high awareness and acceptance of GM technologies, opportunities to test GM crops as part of local agricultural educations, and their known economic benefits, support their use. However, this is not all that is needed for the future of GM technologies in these areas: GM implementation must also consider environmental and social sustainability, which can be unique to a locality. Primarily from the perspective of its educators, the potential of a rural Colombian university in driving GM implementation is explored, including the role of this type of university in producing agricultural engineers who can innovate with GM to meet regionally-dependent environmental and cultural needs that could increase their sustainability.

[Information Strategies in Indigenous Communities During the COVID-19 Pandemic].

The COVID-19 pandemic has had an unprecedented impact on society, especially in densely populated areas. Schools have implemented distance learning, which has spawned many related problems. This paper focuses on the difficulties arising from the epidemic in indigenous communities and how appropriate information strategies may be used to solve these. Four main suggestions are provided to assist indigenous students and their teachers to protect themselves and learn during the pandemic and to ensure that educational goals are achieved.

Exploring rural medical education: a study of Canadian key informants.

INTRODUCTION: Recruiting and retaining primary healthcare professionals is a global healthcare problem. Some countries have been using medical education as a strategy to aid in the recruitment and retention of these healthcare professionals. The purpose of this study is to engage with key informants and explore the learning processes that support medical students to prepare for a rural career. METHODS: Seven key informants with extensive experience in rural medical education participated in semi-structured interviews. The interviews were audio-recorded and professionally transcribed. Transcripts were analyzed using thematic analysis. RESULTS: Four key themes were identified. Respondents discussed the different ways they conceptualized 'rural'. Informants suggested that relationships could either be barriers or facilitators to rural practice and that certain educational strategies were necessary to help train students for rural careers. Finally, informants discussed different characteristics that rural physicians need. CONCLUSION: The finding of this study suggests that preparing students for rural practice requires a multifaceted approach. Specifically, using certain educational strategies, pre-selecting or developing certain characteristics in students, and helping students develop relationships that attach them to a community or support working in a rural community are warranted.

«Somos estudiantes del campo¼: identificaciones de jóvenes rurales en Entre Ríos (Argentina) / «We are students of the countryside¼. Identities and identifications of rural youth in Entre Ríos (Argentina) / «Somos estudantes de campo¼. Identificações de jovens rurais em Entre Ríos (Argentina)

Resumen (analítico) La extensión de la escolaridad en Argentina y la creación de escuelas secundarias en el campo ha significado transformaciones en el espacio rural y las juventudes rurales. A partir de una investigación realizada desde el enfoque histórico-etnográfico en el norte de la provincia de Entre Ríos, advertimos que la escuela secundaria es el espacio privilegiado de sociabilidad de las y los jóvenes y nos centramos en la Fiesta del Estudiante Rural para comprender los procesos de identificación de estas juventudes. La condición de juventud y la condición de estudiante están estrechamente implicadas en el espacio rural y las y los jóvenes construyen identificaciones por oposición a sus pares urbanos y en relación con el campo, entendido en tanto paisaje natural escindido de las actividades productivas y laborales de la ruralidad.

Abstract (analytical) he rollout of public education across the country in Argentina and the building of secondary schools in the countryside generated transformations for rural areas and rural youth. This study uses a historical-ethnographic approach to conduct research in the northern area of the province of Entre Ríos. The authors identified that secondary school is a privileged space for the social development of young people, focusing on the Rural Student Festival to understand these youth identities. The youth condition and the student condition are closely linked to rural areas. Rural young people construct identifications that are in opposition to urban students and aligned with the countryside, which they understand as a natural landscape that is unrelated to agricultural and labor activities.

Resumo (analítico) A extensão da escolaridade na Argentina e a criação de escolas secundárias no campo geraram transformações no meio rural e na juventude rural. A partir de uma investigação realizada a partir de uma abordagem histórico-etnográfica no norte da província de Entre Ríos, afirmamos que o ensino médio é o espaço privilegiado de sociabilidade dos jovens e nos concentramos no Festival do Estudante Rural para compreender as identidades destes jovens. A condição de jovem e a condição de estudante estão intimamente envolvidas no meio rural e os jovens constroem identificações em oposição aos estudantes urbanos e em relação ao campo, entendido como paisagem natural alheia às atividades produtivas e laborais do campo.

Inviting Discomfort in Workshops with Educators on Supporting LGBTQ+ Students in Rural Schools.

Research shows the critical value of teacher affirmation of LGBTQIA+ identities in improving social and academic outcomes for youth, and in rural areas this need is significant as students often experience discrimination with limited community resources. When provided, professional development is often concerned with safety and bullying with less focus on disrupting heteronormative and transphobic belief systems. Educators experience difficulty discussing these topics, however drawing upon a theory of a pedagogy of discomfort can help facilitators to foster critical thinking and engage learners in emotional labor leading to positive transformation. This article uses survey data to examine the impacts of pedagogical approaches of facilitators that invite and navigate discomfort in a workshop for educators on supporting LGBTQIA+ students in a rural district. Findings show that participants engage in challenging discussions, leading to deeper understandings, compassion, and the potential for positive action in school settings.

Perceptions and Attitudes toward Community Health and Interprofessional Education in Students with and without an Additional Community Medicine-Focused Program.

The Rural Medical Education (RMED) Program at the University of Illinois College of Medicine Rockford campus, and part of the National Center for Rural Health Professions, strives to recruit students from rural areas, who, after completing residency, return to rural Illinois as primary care physicians. RMED students meet monthly to learn about the community and public health in rural communities. Furthermore, they complete a 16-week rural preceptorship during their fourth year. During the fourth year of medical school, all RMED students, as well as the students following the regular curriculum, are asked to complete a survey, related to the understanding of medical students' views of community and interprofessional education. We aimed to identify how the community-based curriculum affects the students' understanding and appreciation of community as they go into rural health practice. The results showed that students in the RMED Program are more aware of the community they are part of, as well as being more interested in becoming part of their community. RMED students reported a statistically significantly higher rating of feeling appreciated and accepted by their community and rated their confidence in their abilities in the community statistically significantly higher. Interestingly, RMED students were not more likely to be more familiar with several health professions and programs within their community, compared to non-RMED students. Results comparing self-rated capabilities for RMED students within the community both before and after adding components of an interprofessional education curriculum showed no statistically significant changes. These results support previous research, while also providing more support for the development of successful interprofessional education courses.

Aesthetic Literacy in Young People's and Adults' Awareness From a Developmental Learning Perspective.

In Brazilian schools, many teachers do not organize their teaching and students' tasks and actions in a way that facilitates theoretical thinking based on the abstraction and generalization of the work content. Because many students struggle to accomplish the tasks and actions themselves, teachers guide them. Over time, the students begin to have more autonomy in executing the proposed activities, as they completed mental operations while learning. This article aims to investigate how young people's and adults' awareness of the countryside is formed based on visual elements and writing, facilitating an understanding of their reality. A didactic-formative experiment was performed based on the cultural-historical theory. The comic books produced by the participants allowed them to develop their overall thinking, moving from the abstract to the concrete. They also formed an awareness of reality, which allowed them to have greater autonomy in the production of these stories as a means of representation and transformation of reality.

Importance of research higher degree training availability in rural and remote regions.

AIMS: This commentary contends that research by higher degree research training is a sustainable strategy for capacity building the rural and remote health research workforce, provided they have equitable opportunity for access, participation and attainment. CONTEXT: The path for health professionals into academic roles, particularly in rural and remote areas, can be fraught. A strong research skill set might not form a significant component of a clinician's prior experience. Concurrently, university academic positions usually include the PhD as an essential qualification which is misaligned with the experience and skills of rural and remote applicants who are otherwise well-qualified. APPROACH: Higher degree researches are one mechanism for extending the research expertise and capabilities. However, non-traditional and remotely located cohorts such as the rural and remote health research workforce can face barriers to accessing, participating in and successfully completing formal research training. Barriers include the prevalence of the apprenticeship model of research training grounded in assumptions of colocation and face-to-face learning and supervision and a focus on the binary relationship between supervisors and students. In this commentary, the authors call for greater flexibility and equity in the higher degree research training system to cater for health professionals located in rural and remote practice contexts. CONCLUSION: Institutional investment in, and commitment to, a truly distributed higher degree research model would ensure a stronger rural and remote workforce who can aspire to a range of career options and thereby positively impacting on the health and research outcomes for rural and remote Australia.

Using Design Thinking to Explore Rural Experiential Education Barriers and Opportunities.

INTRODUCTION: Design thinking is a creative problem-solving framework that can be used to better understand challenges and generate solutions in health professions education, such as the barriers to rural education. Rural education experiences can benefit students, providers, and patients; however, placement in and maintenance of rural education experiences offer unique challenges. Design thinking offers strategies to explore and address these challenges. METHODS: This study used a design thinking framework to identify barriers of student placement in rural locations; this was accomplished using strategies to empathize with users (eg, students, practitioners, and administrators) and define the problem. Data were collected from focus groups, interviews, and a design thinking workshop. Design activities promoted participant discussion by drawing pictures, discussing findings, and creating empathy maps of student experiences. Qualitative data were analyzed to identify salient barriers to rural experience selection and opportunities for support. RESULT: Focus group (n = 6), interview (n = 13), and workshop participants (n = 18) identified substantial advantages (eg, exposure to a wider variety of patients, less bureaucracy and constraints, more time with faculty) and disadvantages (eg, isolation, lack of housing, and commuting distances) of rural experiences. Participants identified physical, emotional, and social isolation as a significant barrier to student interest in and engagement in rural experiences. Workshop participants were able to generate over 100 ideas to address the most prominent theme of isolation. DISCUSSION: Design thinking strategies can be used to explore health professions education challenges, such as placement in rural settings. Through engagement with students, practitioners, and administrators it was identified that physical, social, and emotional isolation presents a significant barrier to student placement in rural experiences. This perspective can inform support systems for students, preceptors, and communities that participate in rural educational experiences.

The Rural Family Medicine Café Project: A Social Media Strategy to Reduce Occupational Isolation and Improve Support for Rural Healthcare Professionals.

Background: Globally rural medicine is currently suffering from staff shortages. Social and professional isolation are identified as significant pressures on health professionals working in rural areas. Social media (SOME) has created new methods of social engagement where conventional forms have failed. The Rural Family Medicine Café (RFMC) is a SOME project created to engage and support those interested in rural family medicine thus decreasing occupational isolation. Methods: A quantitative analysis of SOME activity associated with the RFMC was done by measuring the frequency of #ruralcafe, #ruralwomenGP, #ruralGP, #ruralstories, and #ruralmedicine from October 2015 to October 2016 along with the number of Facebook page likes and YouTube views. A time series and regression analysis were done to assess the correlation between the frequencies of hashtag use and the number of new likes or views. A qualitative analysis of the content of tweets using the associated hashtags and comments on the RFMC YouTube videos was then done to assess participants' response to the RFMC. To add context to the data collected, regularly attending participants were invited for a semi-structured interview. Results: There was a positive trend in the number of Facebook page likes (+273%) and Twitter hashtag use (+2,458%) but a negative trend (-92%) in the number of RFMC YouTube views. There was no statistically significant relationship between the number of views on the RFMC YouTube and RFMC associated SOME activity (p = 0.141). A significant relationship was shown between the number of Facebook page likes and the number of views on the RFMC YouTube (p = 0.037). Participants felt positively about the RFMC with recurring themes of; promotion, advocacy, public health, engagement, inspire, sharing, spreading information, feeling connected and general positive comments such as "enjoying tweets," "great discussion." Participants shared anecdotes, useful links, and book recommendations. Conclusion: The RFMC has seen an increase in the amount of associated SOME activity despite having less viewers. This is most likely due to the few participants of the RFMC continuing the café discussions on SOME, particularly Twitter, and engaging outside of the RFMC. The RFMC has developed into a virtual community which is reducing occupational isolation for its participants.

Promoción de la educación inclusiva e intercultural: estudio de caso en un colegio rural colombiano / Promotion of Inclusive and Intercultural Education: Case study in a Colombian rural School / Promoção da Educação Inclusiva e Intercultural: Estudo de caso em una escola rural colombiana

Resumen Introducción: debido al fenómeno de globalización actual, cada vez es más necesario aportar una visión inclusiva e intercultural al ámbito educativo. No responder adecuadamente a esta demanda puede provocar situaciones de exclusión, segregación y discriminación del alumnado. El gobierno colombiano ha planteado diferentes acciones para fortalecer este enfoque y evitar dichas problemáticas. No obstante, estas acciones deben ser analizadas en profundidad para evidenciar la promoción de la educación inclusiva e intercultural en las instituciones educativas. Objetivo: el propósito de la investigación es determinar el nivel de conocimiento y ejecución de las prácticas inclusivas e interculturales en el Colegio Llano de Palmas (Colombia). Materiales y métodos: el diseño de investigación se acomete mediante un estudio de caso. La metodología utilizada es cuantitativa descriptiva (Hernández, Fernández & Baptista, 2010), implementando el cuestionario sobre el reconocimiento y aplicabilidad de la competencia inclusiva e intercultural. Resultados: el análisis de datos revela que la educación inclusiva e intercultural apenas se fomenta de forma regular en el centro educativo (10 %), siendo mayoritaria su promoción inadecuada (90 %) mediante una implementación esporádica (49 %), no aplicándose en absoluto (36 %) o desconociendo por completo su estado de desarrollo (5 %). Conclusiones: los resultados obtenidos indican que el conocimiento y la ejecución de prácticas inclusivas e interculturales en el Colegio Llano de Palmas es notablemente mejorable. Esta situación demanda el diseño y aplicación de estrategias específicas de promoción más efectivas, así como el análisis de distintos entornos educativos para determinar la situación actual del país en este sentido.

Abstract Introduction. Due to the current phenomenon of globalization, it is increasingly necessary to provide an inclusive and intercultural vision to the education. Not responding adequately to this demand can lead to situations of exclusion, segregation, and discrimination for students. The Colombian government has proposed several actions to strengthen this approach and avoid those problems. However, these actions must be analyzed in depth to demonstrate the promotion of inclusive and intercultural education in institutions. Objective: the purpose of this research is to determine the level of knowledge and execution of inclusive and intercultural practices at Llano de Palmas School (Colombia). Materials and methods: this research applies a case study design. The methodology used is descriptive quantitative (Hernández et al., 2010), implementing the questionnaire on the recognition and applicability of inclusive and intercultural competency. Results: the data analysis reveals that inclusive and intercultural education is hardly encouraged on a regular basis in the school (10 %), with a widely inadequate promotion (90 %) through sporadic implementations (49 %), not being applied at all (36 %), or being completely unaware of their development status (5 %). Conclusions: the results obtained indicate that the knowledge and execution of inclusive and intercultural practices at Llano de Palmas School is remarkably low. This situation demands the design and application of specific strategies for more effective promotion, as well as the analysis of different educational contexts to determine the current situation of the country in this regard.

Resumo Introdução: devido ao atual fenômeno da globalização, é cada vez mais necessário fornecer uma visão inclusiva e intercultural ao campo educacional. Não responder adequadamente a essa demanda pode levar a situações de exclusão, segregação e discriminação de estudantes. O governo colombiano propôs diferentes ações para fortalecer essa abordagem e evitar esses problemas. No entanto, essas ações devem ser analisadas em profundidade para demonstrar a promoção da educação inclusiva e intercultural nas instituições de ensino. Objetivo: o objetivo da pesquisa é determinar o nível de conhecimento e execução de práticas inclusivas e interculturais na Escola Llano de Palmas (Colombia). Materiais e métodos: o desenho da pesquisa é realizado através de um estudo de caso. A metodologia utilizada é quantitativa descritiva (Hernández et al., 2010), implementando o questionário sobre o reconhecimento e aplicabilidade da competência inclusiva e intercultural. Resultados: a análise dos dados revela que a educação inclusiva e intercultural dificilmente é incentivada regularmente no centro educacional (10 %), sendo sua promoção inadequada a maioria (90 %) através de implementação esporádica (49 %), não sendo aplicada de forma alguma (36 %) ou desconhecem completamente o seu estado de desenvolvimento (5 %). Conclusões: os resultados obtidos indicam que o conhecimento e na execução de práticas inclusivas e interculturais na Escola Llano de Palmas são notavelmente melhorados. Essa situação exige o desenho e aplicação de estratégias específicas para promoção mais efetiva, bem como a análise de diferentes ambientes educacionais para determinar a situação atual do país nesse quesito.

Keys to Expanding the Rural Healthcare Workforce in Kyrgyzstan.

Objective/Background: This study assessed Kyrgyzstan's progress with developing its rural primary care workforce and prioritized next steps to build on its current momentum. Kyrgyzstan has improved rural health care since 1997 through the implementation of family medicine, retraining of rural doctors and nurses, and other efforts. Attrition, emigration, urbanization, and population growth are threatening these hard-won advances. In response, Kyrgyzstan is now educating family medicine residents at rural sites and improving salaries. This study explores other steps to strengthen its rural health care, especially its rural generalists. Methods: This was an observational study using a two-phase survey process. To access the current status of Kyrgyzstan's rural health care system, we surveyed key stakeholders within that system using a draft version of the new World Health Organization Rural Pathways Checklist. To prioritize next steps, we asked rural FM residents to rank the relative importance of 31 possible future actions to support Kyrgyzstan's rural primary care workers. Results: Doctors and nurses involved in teaching rural health workers identified that Kyrgyzstan has made good progress with rural professional support and upskilling of existing health workers through education. They saw the least progress with selection of health workers and monitoring. The rural family medicine residents' top ten suggestions for rural recruitment and retention all involved improving working conditions (providing housing, internet, basic medical equipment, protected time off, better salaries, and more respect) and improving clinic efficiency (switching clinic scheduling from walk-in based to appointment based, optimizing the roles of clinical team members, and decreasing low-value clinic visits). Conclusions: The WHO Rural Pathways Checklist helped to evaluate Kyrgyzstan's current efforts to promote rural primary care. The priorities listed above from the next generation of potential rural family doctors could help guide future steps to promote rural health in Kyrgyzstan and the Former Soviet Union.

Evaluation of the Spring Seedling Project-Zhaotong Program: A study of a novel continuing medical education program for rural doctors in China.

OBJECTIVE: To evaluate the effectiveness of the Spring Seedling Project-Zhaotong program, a novel continuing medical education program, to improve the knowledge and skills of rural doctors in China. DESIGN: An uncontrolled single-group pre- and post-intervention design based on quantitative and qualitative methods. SETTING: Zhaotong is a prefecture-level city located in Yunnan, China. PARTICIPANTS: A total of 1866 country doctors practising in Zhaotong were enrolled. INTERVENTIONS: The Zhaotong program consisted of three stages: remote education, workshops conducted in Zhaotong and field training in Shanghai. MAIN OUTCOME MEASURES: The effectiveness of the remote education and Zhaotong workshop stages was assessed based on differences between pre- and post-training test scores. Qualitative comments were collected to assess the experience of country doctors following the Shanghai field training stage. RESULTS: In total, 1866 country doctors (46.9% males; mean age: 38.2 ± 9.2 years) participated in the program. The average score of the post-training test was higher than that of the pre-training test, both online (P < .001) and offline (P < .001). In regard to the Zhaotong workshops, with the exception of incisions/suturing, the average scores of cardiopulmonary resuscitation, gynaecological examinations and child growth/development were improved after training (P < .001). Qualitative analysis showed that Shanghai field training enhanced understanding of general practice, with the majority of country doctors indicating that they would apply what they learned in daily practice. CONCLUSION: This study introduced an comprehensive form of continuing medical education for rural doctors in Zhaotong and proved the effectiveness of this program and also provided a reference point for the future development of continuing medical education.

Sentidos e significados da escola do campo na perspectiva da produção cultural das crianças / Senses and meanings of the rural school from the perspective of children's cultural production / Sentidos y significados de la escuela rural desde la perspectiva de la producción cultural infantil

Este texto apresenta reflexões sobre os sentidos e significados da escola do campo atribuídos por crianças, especialmente, a partir de sua produção cultural. A escola é central para os territórios camponeses, espaço de encontro entre conhecimentos científicos e populares, organização comunitária e partilha da vida. A investigação aconteceu em parceria com uma escola do campo localizada na Chapada dos Veadeiros (Goiás) no Bioma Cerrado. Com base na Psicologia Histórico-Cultural, Educação do Campo e Sociologia da Infância, a pesquisa prezou pela participação das crianças e consideração de suas diferentes linguagens. Contou com os instrumentos: fotografia, observação participante e entrevistas a partir de abordagem lúdica. A pesquisa demonstrou que as crianças se apropriavam da escola para encontrar com seus pares, estudar, brincar, inventar e como a escola do campo é um espaço-tempo fundamental de formação humana, existência e resistência camponesa.

This text presents reflections on the senses and meanings of the rural school attributedby children, especially, based on their cultural production. The school is central to peasant territories, a meeting place between scientific and popular knowledge, community organization and sharing of life. The investigation took place in partnership with a rural school located in Chapada dos Veadeiros (Goiás) in the Cerrado Biome. Based on the studies of the Body, Rural Education and Sociology of Childhood, the research valued the participation of children and consideration of their different languages. It counted on the instruments: photography, participant observation and interviews based on a playful approach. The research showed that children appropriated the school to meet with their peers, to study, to play, to invent and how the rural school is a fundamental space-time of human formation, existence and peasant resistance.

Este texto presenta reflexiones sobre los sentidos y los significados de la escuela rural atribuidos por los niños en función de su producción cultural. La escuela es fundamental para los territorios campesinos, un lugar de encuentro entre el conocimiento científico y popular, la organización comunitaria y el intercambio de vida. La investigación se llevó a cabo en asociación con una escuela rural ubicada en Chapada dos Veadeiros (Goiás) en el Bioma Cerrado. Con base en los estudios del Cuerpo, Educación Rural y Sociología de la Infancia, la investigación valoró la participación de los niños y la consideración de sus diferentes idiomas. Contaba con los instrumentos: fotografía, observación participante y entrevistas basadas en un enfoque lúdico. La investigación mostró que los niños se apropian de la escuela para reunirse con sus compañeros, estudiar, jugar, inventar y cómo la escuela rural es un espacio-tiempo fundamental de formación humana, existencia y resistencia campesina.

What students and new graduates perceive supports them to think, feel and act as a health professional in a rural setting.

OBJECTIVE: Clinical placements in rural locations are perceived by students to provide positive learning experiences to support their transition to practice. This study explores how clinical placements in a rural health setting might influence students and new graduates to think, feel and act as a health professional. DESIGN: A qualitative study comprising focus group discussions was conducted. SETTING: The study was conducted in a rural health service in Queensland, Australia. PARTICIPANTS: Allied health students (n = 12) on placement and new graduates (n = 11) working in a regional health service. MAIN OUTCOME MEASURES: This study identified allied health student and new graduate perspectives on clinical placement factors which support them to think, feel and act as a health professional. RESULTS: Thematic analysis was used to understand student and new graduate perceptions of how rural placements support thinking, feeling and acting as a health professional. Suggestions for supporting learning included the following: Development of learning partnerships between students and clinical educators with inbuilt expectations and opportunities for reflection and supervision. Creating a culture where students are welcomed, valued and encouraged to take meal breaks with the team supported connectedness. The importance of balancing student autonomy with educating and grading support to increase independence. CONCLUSIONS: Findings show clinical placement experiences identified by allied health students and new graduates which support them to begin to think, feel and act as a health professional. Suggestions provided by students and new graduates can be used to inform implementation of clinical placement experiences.