Do Medical Graduates from a Rural Longitudinal Integrated Clerkship Work in Similar Rural Communities?

(1) Background: Medical graduates who have undertaken longitudinal rural training have consistently been found to be more likely to become rural doctors and work in primary care settings. A limitation of such findings is the heterogeneous nature of rural medical education and contested views of what constitutes 'rurality', especially as it is often reported as a binary concept (rural compared to metropolitan). To address the identified gaps in workforce outcomes for rural medical training and to demonstrate accountability to the communities we serve, we investigated whether Longitudinal Integrated Clerkship (LIC) graduates are practicing in communities with similar rural classification to those where they trained.

Sustained impacts of the COVID-19 pandemic on medical student learning and well-being in rural Australia: findings from a repeated national multicentre survey.

Objective: The impact of COVID-19 on medical students has predominantly been assessed by one-off survey studies at the pandemic onset. This national study investigated the sustained impacts of the COVID-19 pandemic on medical students' rural clinical placement learning and well-being.

Design: Repeated cross-sectional survey design.

Rapid Pleurodesis in Patients With Chronic Noninfectious Pleural Effusion: Twenty Years of Real-world Performance Data.

Background: Small cohort studies have shown rapid pleurodesis protocol's (RPP) effectiveness and capacity to expedite pleurodesis for malignant pleural effusion (MPE). This study intends to evaluate the effectiveness of the RPP in inducing pleurodesis in patients with pleural effusions from either malignant or benign etiologies.

Methods: In this single-center, retrospective cohort study spanning 2 decades, we assessed patients with recurrent symptomatic chronic noninfectious pleural effusion, both benign and malignant.

Airway Stents for Excessive Central Airway Collapse: A Randomized Controlled Open-label Trial.

Background: Short-term airway stent placement (stent evaluation) has been employed to evaluate whether patients with excessive central airway collapse (ECAC) will benefit from tracheobronchoplasty. Although retrospective studies have explored the impact of stent placement on ECAC, prospective randomized controlled trials are absent.

Methods: This was a randomized open-label trial comparing patients receiving airway stent placement and standard medical treatment (intervention group) versus standard medical treatment alone (control group) for ECAC.

Describing a medical school's rural activity footprint: setting selection and workforce distribution priorities.

Context: There is growing evidence supporting a shift towards 'grow your own' approaches to recruiting, training and retaining health professionals from and for rural communities. To achieve this, there is a need for sound methodologies by which universities can describe their area of geographic focus in a precise way that can be utilised to recruit students from their region and evaluate workforce outcomes for partner communities. In Australia, Deakin University operates a Rural Health Multidisciplinary Training (RHMT) program funded Rural Clinical School and University Department of Rural Health, with the purpose of producing a graduate health workforce through the provision of rural clinical placements in western and south-western Victoria.

Influence of a rural Longitudinal Integrated Clerkship on medical graduates' geographic and specialty decisions: a constructivist grounded theory study.

Background: Like many countries, Australia is suffering from a longstanding and persistent medical workforce maldistribution with fewer doctors per capita in rural locations and a trend towards sub-specialisation. Longitudinal Integrated Clerkships (LIC), a medical education model, are more likely than other clerkship models to produce graduates who work rurally, in communities of increasing remoteness and in primary care. While this quantitative data is essential, there has been a dearth of program-specific evidence explaining this phenomenon.

The incremental contribution of mobile cone-beam computed tomography to the tool-lesion relationship during shape-sensing robotic-assisted bronchoscopy.

Introduction: This study aims to answer the question of whether adding mobile cone-beam computed tomography (mCBCT) imaging to shape-sensing robotic-assisted bronchoscopy (ssRAB) translates into a quantifiable improvement in the tool-lesion relationship.

Methods: Data from 102 peripheral lung lesions with ≥2 sequential mCBCT orbital spins and from 436 lesions with 0-1 spins were prospectively captured and retrospectively analysed. The primary outcome was the tool-lesion relationship status across the first and the last mCBCT spins.

Characterizing a learning curve for robotic-assisted bronchoscopy: Analysis of skills acquisition in a high-volume academic center.

Objective: Shape-sensing robotic-assisted bronchoscopy is an emerging technology for the sampling of pulmonary lesions. We seek to characterize the shape-sensing robotic-assisted bronchoscopy learning curve at an academic center.

Methods: Shape-sensing robotic-assisted bronchoscopy procedures performed by 9 proceduralists at a single institution were analyzed.

Impact of text difficulty and visual emphasis on pediatric neuropsychological evaluation reports: The parent's perspective.

Despite varying opinions, little research has examined how to best write pediatric neuropsychology reports. This study gathered input from 230 parents on how text difficulty (reading level) and visual emphasis (bullets, underline, italics) affect report readability and utility. We focused on the most-read report section: summary/impressions.

Utilizing Large Language Models for Enhanced Clinical Trial Matching: A Study on Automation in Patient Screening.

Background Clinical trial matching, essential for advancing medical research, involves detailed screening of potential participants to ensure alignment with specific trial requirements. Research staff face challenges due to the high volume of eligible patients and the complexity of varying eligibility criteria. The traditional manual process, both time-consuming and error-prone, often leads to missed opportunities.

Treating benign paroxysmal positional vertigo in acute traumatic brain injury: a prospective, randomised clinical trial assessing safety, feasibility, and efficacy.

Background: Benign paroxysmal positional vertigo (BPPV) affects approximately half of acute, moderate-severe traumatic brain injury (TBI) patients. To date, there have been no rigorous studies of BPPV assessment or treatment in this cohort. We aimed to determine the safety, practicability, and efficacy of therapist-led BPPV management in acute TBI and the feasibility of a larger effectiveness trial.

The Importance of Cultural Awareness in the Management of Heart Failure: A Narrative Review.

Heart failure is a commonly encountered clinical syndrome arising from a range of etiologic cardiovascular diseases and manifests in a phenotypic spectrum of varying degrees of systolic and diastolic ventricular dysfunction. Those affected by this life-limiting illness are subject to an array of burdensome symptoms, poor quality of life, prognostic uncertainty, and a relatively onerous and increasingly complex treatment regimen. This condition occurs in epidemic proportions worldwide, and given the demographic trend in societal ageing, the prevalence of heart failure is only likely to increase.

Application of Raman Spectroscopy to Dynamic Binding Capacity Analysis.

Protein A affinity chromatography is a key step in isolation of biotherapeutics (BTs) containing fragment crystallizable regions, including monoclonal and bispecific antibodies. Dynamic binding capacity (DBC) analysis assesses how much BT will bind to a protein A column. DBC reduces with column usage, effectively reducing the amount of recovered product over time.

Rural longitudinal integrated clerkships and medical workforce outcomes: A scoping review.

Introduction: Internationally the medical workforce is suffering from a persistent geographic and specialist maldistribution. Longitudinal models of rural medical education such as longitudinal integrated clerkships (LIC) have been one of the strategies employed to redress this issue.

Aim: To map and synthesise the evidence on the medical workforce outcomes of rural LIC graduates, identifying gaps in the literature to inform future research.

Culture, ethnicity, and socio-economic status as determinants of the management of patients with advanced heart failure who need palliative care: A clinical consensus statement from the Heart Failure Association (HFA) of the ESC, the ESC Patient Forum, and the European Association of Palliative Care.

The delivery of effective healthcare entails the configuration and resourcing of health economies to address the burden of disease, including acute and chronic heart failure, that affects local populations. Increasing migration is leading to more multicultural and ethnically diverse societies worldwide, with migration research suggesting that minority populations are often subject to discrimination, socio-economic disadvantage, and inequity of access to optimal clinical support. Within these contexts, the provision of person-centred care requires medical and nursing staff to be aware of and become adept in navigating the nuances of cultural diversity, and how that can impact some individuals and families entrusted to their care.

Referral and triage patterns of a new rural paediatric outpatient service in south-western Victoria, Australia.

Introduction: There is limited available information describing referral and triage patterns for rural paediatric outpatient clinics to guide health service planning and delivery. To address this, referrals for all new patients who attended an appointment during the initial year of a new rural paediatric outpatient service in Portland, Victoria, Australia were examined.

Methods: This was a retrospective review of referrals with initial consultations between 29 October 2018 and 28 October 2019.

If you build it who will come? Case mix data of a new rural paediatric outpatient clinic.

Introduction: There is limited current evidence describing the case mix data of rural paediatric outpatient clinics. Collection and analysis of this data is essential for health service planning, facilitating the identification of areas of need within specific communities to support contextualised delivery of paediatric health care.

Objective: To describe the case mix of patients seen during the initial 12 months of a rural paediatric service, providing evidence to inform rural health service planning.

Feasibility of shape-sensing robotic-assisted bronchoscopy for biomarker identification in patients with thoracic malignancies.

Objective: Molecular diagnostic assays require samples with high nucleic acid content to generate reliable data. Similarly, programmed death-ligand 1 (PD-L1) immunohistochemistry (IHC) requires samples with adequate tumor content. We investigated whether shape-sensing robotic-assisted bronchoscopy (ssRAB) provides adequate samples for molecular and predictive testing.

Impact of the COVID-19 pandemic on student experiences during rural placements in Australia: findings from a national multi-centre survey.

Background: The aim of this national study was to explore the learning experiences of Australia's medical students who trained rurally during the COVID-19 pandemic in 2020.

Methods: A cross-sectional, national multi-centre survey was conducted in 2020, through the Federation of Rural Australian Medical Educators (FRAME). Participants were medical students who had completed an extended Rural Clinical School (RCS) training placement (≥ 12 months).

Causes of Industrial Protein A Column Degradation, Explored Using Raman Spectroscopy.

Monoclonal antibodies (mAbs) are used extensively as biotherapeutics for chronic and acute conditions. Production of mAbs is lengthy and expensive, with protein A affinity capture the most costly step, due both to the nature of the resin and its marked reduction in binding capacity with repeated use. Our previous studies using in situ ATR-FTIR spectroscopy indicated that loss in protein A binding capacity is not the result of leaching or degradation of protein A ligand, suggesting fouling is the principal cause.