Abstract：
Rural medical training along all components of the medical training continuum has been shown to enhance rural workforce outcomes. However, due to the maldistribution of the Australian medical workforce, health services of increased rurality are limited in their ability to fulfil the supervision requirements for all levels of trainees, especially junior doctor training. Although longitudinal program design and pedagogy has flourished in medical school education through the Longitudinal Integrated Clerkship model, this has not yet been widely translated to prevocational training. This study describes how a longitudinal program design was conceptualised and implemented within a rural health service to create a novel internship program.
A descriptive case study methodology was employed to describe and evaluate the longitudinal integrated internship program. Relevant program documents such as rosters and accreditation submissions were reviewed to aid in describing the program. Interviews with participants involved in the program were conducted during the middle (May) and end (November) points of the program\'s first year (2021) to investigate perspectives and experiences of the internship model.
Each week, interns were rostered for 1 day in the hospital\'s emergency department and 3 days in general surgery or general medicine, swapping disciplines after 6 months. In this way, interns completed core rotations longitudinally, meeting accreditation and supervision requirements. Additionally, 1 day per week was spent parallel consulting in general practice. Participants described program enablers as the organisational vision and staff buy-in, as well as the longitudinal attachments to disciplines. Barriers identified were the tenuous nature of the medical workforce and long-term sustainability of the program. Benefits of the program included value-adding and preparedness for practice, particularly in a rural context.
Intern programs that meet the accreditation, supervision and learning requirements can be successfully delivered at rural health services through longitudinal models of medical education. As the intern year is a key component of the rural generalist training pathway, development of similar innovative models provides the opportunity for rural communities to grow their own future medical workforce.
A descriptive case study methodology was employed to describe and evaluate the longitudinal integrated internship program. Relevant program documents such as rosters and accreditation submissions were reviewed to aid in describing the program. Interviews with participants involved in the program were conducted during the middle (May) and end (November) points of the program\'s first year (2021) to investigate perspectives and experiences of the internship model.
Each week, interns were rostered for 1 day in the hospital\'s emergency department and 3 days in general surgery or general medicine, swapping disciplines after 6 months. In this way, interns completed core rotations longitudinally, meeting accreditation and supervision requirements. Additionally, 1 day per week was spent parallel consulting in general practice. Participants described program enablers as the organisational vision and staff buy-in, as well as the longitudinal attachments to disciplines. Barriers identified were the tenuous nature of the medical workforce and long-term sustainability of the program. Benefits of the program included value-adding and preparedness for practice, particularly in a rural context.
Intern programs that meet the accreditation, supervision and learning requirements can be successfully delivered at rural health services through longitudinal models of medical education. As the intern year is a key component of the rural generalist training pathway, development of similar innovative models provides the opportunity for rural communities to grow their own future medical workforce.
摘要：
背景：在医疗培训连续体的所有组成部分中，农村医疗培训已被证明可以增强农村劳动力的成果。然而,由于澳大利亚医疗劳动力分布不均，增加农村的卫生服务在满足各级受训人员监督要求的能力方面受到限制，尤其是初级医生培训。尽管纵向程序设计和教学法通过纵向综合职员模型在医学院教育中蓬勃发展，这尚未广泛转化为职前培训。这项研究描述了如何在农村卫生服务中概念化和实施纵向方案设计，以创建新颖的实习计划。
方法：采用描述性案例研究方法来描述和评估纵向综合实习计划。审查了相关的计划文件，例如名册和认证提交，以帮助描述计划。在该计划第一年（2021年）的中间（5月）和结束（11月）期间对参与该计划的参与者进行了访谈，以调查实习模式的观点和经验。
结果：每周，实习生在医院急诊科排行1天，在普外科或普通内科排行3天，6个月后交换纪律。这样,实习生纵向完成核心旋转，满足认证和监督要求。此外,每周1天在一般实践中进行平行咨询。参与者将计划推动者描述为组织愿景和员工支持，以及学科的纵向附件。确定的障碍是医务人员的脆弱性质和该计划的长期可持续性。该计划的好处包括增值和为实践做好准备，特别是在农村地区。
结论：符合认证的实习生计划，通过纵向医学教育模式，可以在农村卫生服务中成功实现监督和学习要求。由于实习年是农村通才培训途径的关键组成部分，类似创新模式的发展为农村社区提供了发展自己未来医疗劳动力的机会。
方法：采用描述性案例研究方法来描述和评估纵向综合实习计划。审查了相关的计划文件，例如名册和认证提交，以帮助描述计划。在该计划第一年（2021年）的中间（5月）和结束（11月）期间对参与该计划的参与者进行了访谈，以调查实习模式的观点和经验。
结果：每周，实习生在医院急诊科排行1天，在普外科或普通内科排行3天，6个月后交换纪律。这样,实习生纵向完成核心旋转，满足认证和监督要求。此外,每周1天在一般实践中进行平行咨询。参与者将计划推动者描述为组织愿景和员工支持，以及学科的纵向附件。确定的障碍是医务人员的脆弱性质和该计划的长期可持续性。该计划的好处包括增值和为实践做好准备，特别是在农村地区。
结论：符合认证的实习生计划，通过纵向医学教育模式，可以在农村卫生服务中成功实现监督和学习要求。由于实习年是农村通才培训途径的关键组成部分，类似创新模式的发展为农村社区提供了发展自己未来医疗劳动力的机会。
