title: Understanding rural clinical learning spaces: Being and becoming a doctor.
abstract: BACKGROUND
  Calls for health professions education that can foster transformative educational experiences have been voiced. Studies suggest that extended clinical training at rural sites potentially provides transformative learning spaces. This article explores 'being and becoming' as a construct for understanding the student experience at a rural clinical school (RCS).
  
  
  METHODS
  Sixty-two in-depth interviews were conducted over a three-year period with RCS students, graduates (as interns) and intern supervisors. Thematically analysed data were mapped according to the adapted Kirkpatrick model for appraising educational interventions. Drawing on realist perspectives, findings were further analysed to discern the mechanisms influencing the being and becoming of junior doctors.
  
  
  RESULTS
  Responses provided evidence of changed attitudes and behaviour, and the adoption of professional practice that was seen to influence patient outcomes. Analysis highlighted sharing of values through role modelling, engagement with preceptors, being respected as part of a team, and being trusted to assume responsibility for a patient as key mechanisms. The outcome was confident, competent and caring interns.
  
  
  CONCLUSIONS
  Rural clinical learning spaces influence the 'being and becoming' of a junior doctor. Understanding this process in the context of place (rural platform), participation (community of practice) and person can inform expanded agendas for students' clinical learning.
authors.affiliation: Stellenbosch University , South Africa.
authors.forename: Susan C
authors.initials: SC
authors.lastname: Van Schalkwyk
authors.forename: Juanita
authors.initials: J
authors.lastname: Bezuidenhout
authors.forename: Marietjie R
authors.initials: MR
authors.lastname: De Villiers
mesh_terms: D002321:Career Choice; D006801:Humans; D007396:Internship and Residency / Q000458:organization & administration*; D007407:Interviews as Topic; D017145:Models, Educational; D011365:Professional Practice Location; D019035:Rural Health Services / Q000458:organization & administration*; D013337:Students, Medical / Q000523:psychology*