Primary care in rural areas: a qualitative study on medical students' images and experiences of working in rural areas in southern Germany.

IF 2 Q2 MEDICINE, GENERAL & INTERNAL
Jan Gehrmann, Niklas Barth, Tom Brandhuber, Pascal O Berberat, Sophie Gigou, Antonius Schneider
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Abstract

Background: Rural areas are increasingly moving back into the focus of social research, especially in the context of health care. As the shortage of general practitioners (GP) in rural areas is a significant challenge in Germany, there are several programs to counteract underuse effectively, acutely, and sustainably. One of those programs is 'Beste Landpartie Allgemeinmedizin' (BeLA), which was developed to strengthen primary care in rural areas and to sustainably promote young doctors to work as general practitioners in rural regions through didactical and financial support. The program includes an accompanying qualitative study exploring the motivational structures of medical students from a sociological perspective. For this study, the nexus of working in rural areas from the perspective of medical students with different forms of rural experiences was of interest.

Methods: Qualitative interviews have been conducted at regular intervals on an ongoing basis since 2020 to investigate motivational retention effects during the program. The current 33 interviews were analysed using the sociological conceptual framework of spatial methods.

Results: The images and experiences of working in rural areas condition medical education in various ways. In addition to general images of living and working in rural areas in a biographical dimension, the idea of working as a GP in rural areas includes images of specific medical competencies and is conditioned by different medical tasks. From such a perspective, the images and attributions of working in primary care in a rural region demonstrate particularities, challenges, and the potential attractiveness of working in rural regions.

Discussion: The images and experiences of rural areas condition medical education in various ways and shape the expectations and the decision-making of possibly working in rural areas. The particularities, opportunities, and challenges of working in rural areas, which relate to both professional aspects and social life, are a major factor in the attractiveness of a potential rural practice. Didactical and educational curricula need to adapt the various attributions of working in rural areas.

背景:农村地区正日益成为社会研究的重点,尤其是在医疗保健方面。在德国,由于农村地区全科医生(GP)的短缺是一项重大挑战,因此有几项计划可以有效、迅速和可持续地解决使用不足的问题。其中一项计划是 "Beste Landpartie Allgemeinmedizin"(BeLA),该计划旨在加强农村地区的初级医疗服务,并通过提供教学和资金支持,持续推动年轻医生到农村地区从事全科医生工作。该计划包括一项配套的定性研究,从社会学角度探讨医学生的动机结构。在这项研究中,从具有不同形式农村经历的医科学生的视角出发,探讨在农村地区工作的关联性是研究的重点:自 2020 年起,持续定期进行定性访谈,以调查项目期间的动机保持效果。采用空间方法的社会学概念框架对当前的 33 个访谈进行了分析:在农村地区工作的形象和经历以各种方式影响着医学教育。除了在农村地区生活和工作的一般形象外,在农村地区担任全科医生的想法还包括特定医疗能力的形象,并受到不同医疗任务的制约。从这个角度看,在农村地区从事全科医生工作的形象和归因显示了在农村地区工作的特殊性、挑战性和潜在吸引力:农村地区的形象和经验以各种方式影响着医学教育,并决定着可能在农村地区工作的人的期望和决策。在农村地区工作的特殊性、机遇和挑战与专业方面和社会生活有关,是潜在的农村实践是否具有吸引力的主要因素。教学和教育课程需要适应在农村地区工作的各种属性。
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