title: Medical students on long-term regional and rural placements: what is the financial cost to supervisors?
abstract: BACKGROUND
  Medical student education is perceived as utilising significant amounts of preceptors' time, negatively impacting on clinical productivity. Most studies have examined short-term student rotations in urban settings, limiting their generalisability to other settings and educational models. To test Worley and Kitto's hypothetical model which proposed a 'turning point' when students become financially beneficial, this study triangulated practice financial data with the perspectives of clinical supervisors before and after regional/rural longitudinal integrated community-based placements.
  
  
  METHODS
  Gross practice financial data were compared before and during the year-long placement. Interview data pre- and post-placement were analysed by two researchers who concurred on emergent themes and categories.
  
  
  METHODS
  This study suggested a financial 'turning point' of 1-2 months when the student became beneficial to the practice. Most preceptors (66%) perceived the longitudinal placement as financially neutral or favourable. Nineteen per cent of supervisors reported a negative financial impact, some attributing this to reduced patient throughput, inadequacy of the government teaching subsidy and/or time spent on assessment preparation. Other supervisors were unconcerned about costs, perceiving that minor financial loss was outweighed by personal satisfaction. CONCLUISONS: Senior students learning in long-term clerkships are legitimate members of regional/rural communities of practice. These students can be cost-neutral or have a small positive financial impact on the practice within a few months. Further financial impact research should include consideration of different models of supervisor teaching subsidies. The ultimate financial benefit of a model may lie in the recruitment and retention of much-needed regional and rural practitioners.
authors.affiliation: Community Based Health Education, Graduate School of Medicine, University of Wollongong, New South Wales, Australia. nicky.hudson@une.edu.au
authors.forename: Judith N
authors.initials: JN
authors.lastname: Hudson
authors.forename: Kathryn M
authors.initials: KM
authors.lastname: Weston
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Farmer
mesh_terms: D002982:Clinical Clerkship; D006801:Humans; D009517:New South Wales; D011216:Practice Management, Medical; D011231:Preceptorship / Q000191:economics*; D011320:Primary Health Care / Q000191:economics; D019035:Rural Health Services / Q000191:economics*; D013337:Students, Medical / Q000706:statistics & numerical data*; D000078329:Workforce