Original Research

Trends in practice intentions and preferences of clinical associate students: Implications for training and health services in South Africa

Saiendhra V. Moodley, Jacqueline E. Wolvaardt, Jakobus M. Louw, Jannie Hugo
South African Family Practice | Vol 62, No 1 | a5033 | DOI: https://doi.org/10.4102/safp.v62i1.5033 | © 2020 Saiendhra V. Moodley, Jacqueline E. Wolvaardt, Jakobus M. Louw, Jannie Hugo | This work is licensed under CC Attribution 4.0
Submitted: 16 November 2019 | Published: 06 February 2020

About the author(s)

Saiendhra V. Moodley, School of Health Systems and Public Health, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
Jacqueline E. Wolvaardt, School of Health Systems and Public Health, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
Jakobus M. Louw, Department of Family Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
Jannie Hugo, Department of Family Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa


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Abstract

Background: The University of Pretoria (UP) had its first intake of Bachelor of Clinical Medical Practice (BCMP) students in 2009. The objectives of this study were to examine the trends in geographical practice intentions and preferences of the first nine cohorts of BCMP students. We also assessed sector and level of care preferences of six BCMP cohorts.

Methods: Cross-sectional studies were conducted 2011, 2014 and 2017. First-, second- and third-year UP BCMP students were invited to complete a electronic questionnaire. Our analyses consisted of calculating proportions for the practice intentions and preferences for each surveys, and performing multiple logistic regression on the aggregated date to determine their associations with sociodemographic and training characteristics.

Results: The proportion of participants intending to practise as a clinical associate in a rural area in South Africa directly after graduating was 62.5% in the 2014 survey and 69.7% in the 2017 survey, compared to 59.6% in the 2011 survey. The majority in all three surveys (53.4% in 2011, 56.6% in 2014 and 59.8% in 2017) indicated a preference for rural practice. Both rural practice intention and rural practice preference were found to be significantly associated with respondent’s self-description of having lived most of her/his life in a rural area, and rural district hospital exposure during training. In 2014 and 2017, approximately two-thirds of the participants selected a public sector option as their most preferred work setting. District hospitals were the most preferred setting of 30.3% participants in 2014 and 32.0% in 2017.

Conclusion: Most participants across the three surveys intended to work in rural settings. Considering that this could provide a sustainable solution to the shortage of health care workforce in rural areas, policy makers in both higher education and health need to promote and ensure the viability of the training of this category of health care providers.


Keywords

clinical associates; clinical officers; physician assistants; physician associates; practice intentions; practice preferences; study plans; rural practice; migration; district hospitals

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