Portrait of a rural health graduate: exploring alternative learning spaces.
BACKGROUND
Given that the staffing of rural facilities represents an international challenge, the support, training and development of students of rural origin at institutions of higher learning (IHLs) should be an integral dimension of health care provisioning. International studies have shown these students to be more likely than students of urban origin to return to work in rural areas. However, the crisis in formal school education in some countries, such as South Africa, means that rural students with the capacity to pursue careers in health care are least likely to access the necessary training at an IHL. In addition to challenges of access, throughput is relatively low at IHLs and is determined by a range of learning experiences. Insight into the storied educational experiences of health care professionals (HCPs) of rural origin has the potential to inform the training and development of rural-origin students.


METHODS
Six HCPs of rural origin were purposively selected. Using a narrative inquiry approach, data were generated from long interviews and a range of arts-based methods to create and reconstruct the storied narratives of the six participants. Codes, categories and themes were developed from the reconstructed stories. Reid's four-quadrant model of learning theory was used to focus on the learning experiences of one participant.


RESULTS
Alternative learning spaces were identified, which were made available through particular social spaces outwith formal lecture rooms. These offered opportunities for collaboration and for the reconfiguring of the participants' agency to be, think and act differently. Through the practices enacted in particular learning spaces, relationships of caring, sharing, motivating and mentoring were formed, which contributed to personal, social, academic and professional development and success.


CONCLUSIONS
Learning spaces outwith the formal lecture theatre are critical to the acquisition of good clinical skills and knowledge in the development of socially accountable HCPs of rural origin.
Department of Family Medicine, University of KwaZulu Natal, Durban, South Africa.
Andrew
A
Ross
Daisy
D
Pillay
D002983:Clinical Competence; D004504:Education, Medical, Undergraduate; D006282:Health Personnel / Q000193:education / Q000523:psychology; D006801:Humans; D008611:Mentors / Q000523:psychology; D036301:Qualitative Research; D019035:Rural Health Services / Q000600:supply & distribution; D012424:Rural Population; D013019:South Africa; D014146:Training Support / Q000379:methods*; D000078329:Workforce