 Abstract | Objectives:
The Deakin University School of Medicine was developed as a rurally focused medical school, and adopted several innovative approaches to medical education. This original research was designed to examine whether the school's decision to base its clinical education on small, dispersed, student cohorts, in rural settings, disadvantaged students in comparison to the traditional large group tertiary training setting.
Methods:
A retrospective quasi-experimental cohort study was employed to assess the students' academic performance at the five, geographically dispersed, clinical training sites within the medical school. The internationally validated Dundee Ready Education Environment Measure (DREEM) questionnaire was also utilised to provide quantitative analysis of the students' perception of their educational environment. The examination results of all students within the first two cohorts to undertake clinical school training were included, and all final year students in 2011/2012 were asked to complete the DREEM questionnaire.
The data were analysed using both univariate (Student's T-Test for mean scores; chi-squared test for proportions), and multivariate (linear regression), analyses of association between explanatory variables and the outcome variables.
Results:
The mean final year assessment score was higher for rural placements (73.5, 70.9 & 70.5) then metropolitan (68.4, & 68.6). When adjusted for multiple potential predictive factors, the mean scores remained higher for the small cohort rural settings. The small group rural site produced a significantly higher mean DREEM score than the comparison tertiary centre (+16.9, 6.2-27.6). Both the highest assessment scores, and greatest satisfaction with educational environment, were found at the rural clinical school with small sized groups of students.
Conclusion:
This study, the first in Australia to examine student assessment outcomes within a school that adopted disseminated education sites from inception, indicates students perform better at the smaller clinical sites, and therefore medical schools may be better off distributing students across such smaller sites.
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