Student Perspectives of Rural Placements in 2020

2020 rural placement survey results

and advice for students on rural placements in 2021

The year 2020 will long be remembered for the COVID-19 pandemic challenges. In all likelihood it will not be the only year that is impacted greatly by the virus, but because it was new and caused massive changes from ‘normal’ life many people will never forget it. 

The impact on health student clinical placements has also been felt. Placements need to continue to enable the health workforce to be maintained. But cancelled placements, restrictions on travel, border closures, quarantine requirements, & Department of Health and Human Services (DHHS) guidelines all impacted placements for students, and caused stress, anxiety and uncertainty for everyone involved. The ‘ring of steel’ around Melbourne, travel restrictions, and border closures – when COVID cases were high in Victoria – restricted many rural placements especially.

The Going Rural Health (GRH) team provide support to students during their rural placements in Victoria; extra support was provided to many students during 2020 to help them through and allow their placements to go ahead. Innovative practices and placement models were adopted in response to the rapidly changing placement landscape and the COVID situation. As per usual, the GRH team encouraged students to complete the student rural placement survey at the end of their placements, evaluating all aspects of their rural placement experiences.

So how was the student rural learning experience affected, if at all?

Here are some direct student quotes:

‘Was very stressful and did not receive much information from uni or hospital on what was going to occur for students. Had to actively seek information.’

‘It was conducted through Covid-19, our accommodation only provided us 30hours notice to leave the premises. I would have liked more time to move…’

‘The experience was affected by COVID 19, so unfortunately was not as long as expected. Although this was not in the placement site’s control, we would’ve appreciated more communication between the site and us regarding the situation and how we fit into that.’

‘(I’d like to have) …..a consistent supervisor during placement, however due to unforeseen circumstances (coronavirus) that wasn’t possible.’

‘Much of my experience was impacted by the COVID-19 pandemic. This meant less patients were coming through and subsequently, less work and experience for me as a student. I believe if this had not have been the case, the placement would have been incredibly valuable. However, this is out of our control and I still learnt a lot with the patients I was able to see.’

‘Very thankful to everyone for helping get us as far through the placement as possible until it was unfortunately cancelled due to COVID-19.’

‘I absolutely loved this placement and was devastated at it having to be prematurely cut short by 2 weeks due to the COVID-19 pandemic. However I completely understand and agree with the reasoning behind this.’

‘Extremely well supported placement given the current circumstances of Covid-19. GRH as well as placement providers could have not have been of more assistance.’

‘The telehealth aspect was a good experience as we know that this could be implemented more into the future.   Making sure language, and verbal communication was on point was extra important, and physical interaction was limited.’

‘I found that it was a good environment to learn in as I was given time to think, research and ask questions about medications, conditions and care practices.’

‘I found that the staff I (was) with helped me achieve my goals, and promoted my learning. I was able to have responsibility with my allocated patients which helped me work on my time management.’

And this, which is common for rural placements:

‘I saw a broad range of clients due to the rural setting. I worked across acute, community and aged care. I would not have had that opportunity at a metro or larger health service.’

The challenges with COVID saw some strain on communication surrounding the placement, accommodation (availability and closures), and practice scope (less patients), though learning overall did not seem to be significantly impacted.  Both placement satisfaction and supervision satisfaction were still maintained to the levels of previous years, at or around 90%.

All of these issues seen can, with careful planning, be mitigated somewhat, though not completely eliminated – as last minute restrictions and changes will be unavoidable sometimes. Here are some recommendations of how students can reduce stress surrounding rural placements:

1. Actively seek information surrounding your placement, once you know where you are going.

Don’t wait for information – ask for it. There may be more disorganisation than usual from either end (placement providers or your placement co-ordinators). Everyone is under more stress.

2. Plan early for rural placement when you can.

Don’t leave anything that you can do now to later. Student accommodation is snapped up fast, so once you know where you are going, find somewhere to stay if you need to stay near your placement site. Later may be too late. Apply for financial assistance you may be eligible for ASAP, so you can plan finances. See the GRH website goingruralhealth.com.au home page and Student Support Scheme page https://goingruralhealth.com.au/student-information/student-support-scheme/ for more details.

3. Expect that there may be restrictions placed on your movements at times.

This may be due to changed COVID restrictions, placement site requirements, accommodation rules, etc. Accept that it may happen and be flexible. Adapt. Fighting against this will only cause angst for you and your placement site.

4. If a virtual rural placement, or a rural placement with a mix of virtual and face to face learning is offered, grab hold of it.

Virtual placements offer some unique learning experiences, including providing valuable experience in telehealth. Telehealth is likely to become more prevalent, and is especially useful in rural settings.

5. Accept mentoring support, and engage in external activities that are offered.

GRH offer mentoring and social support to students on rural placements, most of the time virtually. Don’t isolate yourself socially if you can help it – there are so many ways to keep in touch via technology. Everyone has different viewpoints and experiences that are useful, and connecting with other students is great for debriefing and comparing notes.

6. If education is offered, give it a go!

There are many fantastic online and virtual education sessions available now. GRH have their own. See the education tab on the GRH website for more details HERE. I’d recommend the ‘Introduction to Rural Health’ online module, especially if you have no experience in regional or rural areas.

7. Look after your mental health.

Take regular breaks, keep in contact with friends and family, eat as well as you can, and take time out to exercise. GRH has online education and resources that can help, and students on rural placements can access free 24/7 CRANA Plus counselling services. See the GRH website https://goingruralhealth.com.au/student-information/online-resources-for-students/ for details under ‘Resilience and Mental Wellbeing Resources’.

If you are looking for a particular type of setting or location for a rural placement experience, GRH can also assist you to try to find placements in our footprint. Get your placement co-ordinator to contact the GRH team for more details at going-ruralhealth@unimelb.edu.au

2021 will still have some challenges regarding rural placements. But GRH are here to help.

Trish Thorpe

Associate Lecturer, Rural Placement Co-ordinator

Going Rural Health Ballarat

Clinical Biochemist & Teacher