title: Transition to practice: can rural interprofessional education make a difference? A cohort study.
abstract: BACKGROUND
  The transition from student to health practitioner at entry-to-practice is complex, requiring critical acquisition of collaborative practice skills. In rural communities where health need is multidimensional, there is potential for multiple intentional collaborative learning objectives to be met concurrently. A five-week, rurally-located, clinically-based interprofessional programme was introduced as a transition-to-practice rotation for final-year, pre-registration health professional students in the professions of dentistry, dietetics, medicine, nursing, pharmacy and physiotherapy. The programme integrated learning objectives in four related domains: interprofessional practice; hauora Māori (Māori health); rural health; long-term condition management. This study investigated student learning experiences over the first two complete years of the programme, comparing responses from participating students with those from a cohort of non-participating peers.
  
  
  METHODS
  Using a pre and post quasi-experimental design, respondents from two successive student year cohorts completed questionnaires at the start and end of their final year. Additional survey data were collected from participating students at the end of each rotation.
  
  
  RESULTS
  131 students participated in the programme during 2013-2014. Participating student respondents (55/131;42 %) reported being significantly better prepared than a cohort of 56 non-participating colleagues in many aspects of their understanding of and knowledge about each of four key learning domains. 94 % (123/131) of programme participants completed end-of-rotation questionnaires. Positive from the outset (mean 5-point Likert scale scores between 3 and 5; 5 = most positive), student satisfaction further increased across all domains in the second year (mean 5-point Likert scale scores between 4 and 5).
  
  
  CONCLUSIONS
  At entry-to-practice level, multiple learning objectives, including indigenous health learning, can be met simultaneously in the clinical context within an integrated, rotational programme. Rural settings are highly suitable for delivering such programmes if well supported.
authors.affiliation: Department Primary Health Care and General Practice, University of Otago, Wellington, P.O.Box 7343, Wellington, New Zealand. sue.pullon@otago.ac.nz.
authors.forename: Susan Sue
authors.initials: SS
authors.lastname: Pullon
authors.affiliation: Department Primary Health Care and General Practice, University of Otago, Wellington, P.O.Box 7343, Wellington, New Zealand.
authors.forename: Christine
authors.initials: C
authors.lastname: Wilson
authors.affiliation: Medical Education Unit, University of Otago, Wellington, P.O.Box 7343, Wellington, New Zealand.
authors.forename: Peter
authors.initials: P
authors.lastname: Gallagher
authors.affiliation: School of Physiotherapy, University of Otago, 325 Great King Street, P.O. Box 56, Dunedin, 9054, New Zealand.
authors.forename: Margot
authors.initials: M
authors.lastname: Skinner
authors.affiliation: Department Primary Health Care and General Practice, University of Otago, Wellington, P.O.Box 7343, Wellington, New Zealand.
authors.forename: Eileen
authors.initials: E
authors.lastname: McKinlay
authors.affiliation: Department Primary Health Care and General Practice, University of Otago, Wellington, P.O.Box 7343, Wellington, New Zealand.
authors.forename: Lesley
authors.initials: L
authors.lastname: Gray
authors.affiliation: Department Primary Health Care and General Practice, University of Otago, Wellington, P.O.Box 7343, Wellington, New Zealand.
authors.forename: Patrick
authors.initials: P
authors.lastname: McHugh
mesh_terms: D001291:Attitude of Health Personnel; D015331:Cohort Studies; D003299:Cooperative Behavior; D006281:Health Occupations / Q000193:education*; D006282:Health Personnel; D006801:Humans; D007400:Interprofessional Relations; D009520:New Zealand; D010348:Patient Care Team; D010819:Physician's Role; D018794:Problem-Based Learning; D036301:Qualitative Research; D019035:Rural Health Services / Q000592:standards*; D013336:Students, Health Occupations; D011795:Surveys and Questionnaires
keywords: Health sciences students; Indigenous health; Interdisciplinary; Interprofessional education; Pre-registration; Rural health