1. The Rural Clinical School of Western Australia Larger and smaller sites in The Rural Clinical School of Western Australia: benefits and down sides Harriet Denz-Penhey Senior Research Fellow

2. The Rural Clinical School of Western Australia History Operating since 2003 6 cohorts Now 68 students 2 universities UWA undergraduate : UNDA graduate

3. The Rural Clinical School of Western Australia Major concerns Is it possible to educate students in remote places to metropolitan standards? What are the students’ subjective experiences?

4. The Rural Clinical School of Western Australia Evaluation Close relationships with local coordinator Comparison of RCS & metro end of year results Mid year evaluation: interview 2003-7 DREEM: 2007-8

5. The Rural Clinical School of Western Australia Quantitative Comparison Dependent Variable: End of year marks Metropolitan students 71.0 RCS Large sites (Pop >25,000) 72.3 RCS Small sites (pop < 25000) 72.4 Statistically significant between Metro & RCS ( p <.03 lge, p<.04 sm)

6. The Rural Clinical School of Western Australia Qualitative Strong identification with their own sites Indications that students at small sites were more enthusiastic than larger sites even when teaching conditions less than ideal

7. The Rural Clinical School of Western Australia DREEM Questionnaire Dundee Ready Education Environment Measure Internationally validated & accepted Identified all the site issues known through the qualitative interviews

8. The Rural Clinical School of Western Australia DREEM Questionnaire Dundee Ready Education Environment Measure Highest scores in literature: 139 RCS overall mean score: 150.0 Small sites mean score:159.1 Larger sites mean score: 147.1

9. The Rural Clinical School of Western Australia Larger sites Smaller sites Student perception learning34.639.5 Student perception teaching34.034.9 Student academic self perception21.123.3 Student perception of atmosphere37.038.3 Student social perception20.521.8

10. The Rural Clinical School of Western Australia Larger Sites Rotational clinical exp Similar to metro exp More specialists More specialist teachers Structure Smaller Sites Clinically see what comes through door Generalist taught Access to all the odd, different, & technically challenging cases Flexibility

11. The Rural Clinical School of Western Australia Students sent to small remote sites With good systems & support Are not disadvantaged –End of year results –Subjective experience