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Objective Despite increases in Commonwealth funded general practice (GP) Registrar training positions, workforce trends continue to show geographical maldistribution. This study aimed to identify Registrar attributes which describe a cohort choosing to work in rural practice. Design Cross-sectional self-report questionnaire for socio-demographics, prior training, current training pathway, measures of personality and resilience. Participants and Setting GP Registrars ( N = 452) training in either the general or rural pathways of three Registered Training Providers in three states, or training through the Australian College of Rural and Remote Medicine's independent pathway. Main outcome measure Ordinal logistic regression tested the impact of key variables on the likelihood that Registrars would settle in rural practice. Univariate analysis explored differences between groups and effects of variables. Results A significantly increased interest in rural practice was to found to exist among registrars who were male, identified themselves as being rural, had a partner who identified as being rural, were enrolled in a rural training pathway and had high levels of Cooperativeness. Conclusion We present a discriminating model combining socio-demographics, prior training and personality variables which challenges Australia to rethink Registrar attributes when training for rural general practice. With significant changes about to occur to GP training in Australia, this paper highlights the need for a more holistic approach which considers personal attributes such as Cooperativeness, rural identity and provision of geographically focused rural training pipelines to encourage Registrars to bond to individual rural communities and further develop their personal connectedness to country life and rural medical practice. [ABSTRACT FROM AUTHOR]

Purpose:Resilience, coping with uncertainty and learning from mistakes are vital characteristics for all medical disciplines – particularly rural practice. Levels of coping constructs were examined in medical students with and without a rural background or an interest in rural practice. Methods:Cross-sectional surveys identified two personality profiles, and their association with levels of Tolerance of Ambiguity, Resilience, Perfectionism-High Standards and Concern over mistakes as constructs indicative of coping. Medical students (N = 797) were stratified by rural background and degree of rural interest. Mediation analysis tested the effect of personality profile on levels of the coping constructs. Results:More (72%) rural background students had Profile 1 which was associated with higher levels of Tolerance of Ambiguity, High standards, and Resilience, but lower Concern over mistakes. Non-rural background students reporting a strong rural interest also had Profile 1 (64%) and similar levels of coping constructs. Personality profile mediated the association between rural interest and levels of coping constructs regardless of background. Conclusions:Having a rural background or strong rural interest are associated with a personality profile that indicates a better capacity for coping. Personality may play a part in an individual’s interest in rural practice. Rural workforce initiatives through education should encourage and nurture students with a genuine interest in rural practice – regardless of background. [ABSTRACT FROM PUBLISHER]

Objectives To describe the personality profiles of International Medical Graduates ( IMGs) undertaking General Practice ( GP) training in Australia. A better understanding of the personal characteristics of IMGs may inform their training and enhance support for their vital contribution to the Australian rural workforce. Design Cross-sectional self-report questionnaires. Independent variables included socio-demographics, prior training, the Temperament and Character Inventory, and the Resilience Scale. Setting and participants GP registrars ( IMGs = 102; AMGs = 350) training in the Australian General Practice Training rural and general pathway and the Australian College of Rural and Remote Medicine independent pathway. Main outcome measures Univariate analysis explored the differences in levels of traits between IMG and AMG registrars. Results Compared to the general population both groups have moderately high resilience, and well-organised characters with high Self-directedness, high Cooperativeness and low Self-transcendence, supported by temperaments which were high in Persistence and Reward Dependence. IMGs were different than AMGs in two temperament traits, Novelty Seeking and Persistence and two character traits, Self-directedness and Cooperativeness. Conclusions Factors such as cultural and training backgrounds, personal and professional expectations, and adjustments necessary to assimilate to a new lifestyle and health system are likely to be responsible for differences found between groups. Understanding the personality profiles of IMGs provides opportunities for targeted training and support which may in turn impact on their retention in rural areas. [ABSTRACT FROM AUTHOR]

Objective. A major challenge for medical schools is the provision of clinical skills training for increasing student numbers. This case study describes the expansion of the clinical school network at The University of Queensland (UQ). The purpose of the study was to investigate consistency in medical education standards across a regional clinical teaching network, as measured by academic performance. Methods. A retrospective analysis of academic records for UQ medical students (n =1514) completing clinical rotations (2009-2012) was performed using analysis of covariance (ANCOVA) for comparisons between clinical school cohorts and linear mixed-effects modelling (LEM) to assess predictors of academic performance. Results. In all, 13 036 individual clinical rotations were completed between 2009 and 2012. ANCOVA found no significant differences in rotation grades between the clinical schools except that Rural Clinical School (RCS) cohorts achieved marginally higher results than non-RCSs in the general practice rotation (5.22 vs 5.10-5.18; P = 0.03) and on the final clinical examination (objective structured clinical examination; 5.27 vs 5.01-5.09; P< 0.01). LEM indicated that the strongest predictor of academic performance on clinical rotations was academic performance in the preclinical years of medical school (b = 0.38; 95% confidence interval 0.35-0.41; P< 0.001). Conclusions. The decentralised UQ clinical schools deliver a consistent standard of clinical training for medical students in all core clinical rotations across a range of urban, regional and rural clinical settings. Further research is required to monitor the costs versus benefits of regionalised clinical schools for students, local communities and regional healthcare services. What is known about the topic? To help meet the demand of increasing numbers of students, Australian medical schools locate clinical training outside the traditional tertiary hospitals. However the viability of maintaining teaching standards across regional and rural locations is uncertain. What does this paper add? Maintaining teaching standards outside established urban teaching hospitals and across a diverse range of urban, regional and rural clinical settings is viable. What are the implications for practitioners? Decentralised clinical teaching networks provide consistent quality of clinical placements while diversifying exposure to different patient populations and clinical environments. These important outcomes may not only alleviate the strain on clinical teaching resources, but also help address the maldistribution of doctors in Australia. [ABSTRACT FROM AUTHOR]

Objective. To determine the economic feasibility in Australian general practices of using a practice nurse (PN)-led care model of chronic disease management. Methods. A cost-analysis of item numbers from the Medicare Benefit Schedule (MBS) was performed in three Australian general practices, one urban, one regional and one rural. Patients (n =254; >18 years of age) with chronic conditions (type 2 diabetes, hypertension, ischaemic heart disease) but without unstable or major health problems were randomised into usual general practitioner (GP) or PN-led care for management of their condition over a period of 12 months. After the 12-month intervention, total MBS item charges were evaluated for patients managed for their stable chronic condition by usual GP or PN-led care. Zero-skewness log transformation was applied to cost data and log-linear regression analysis was undertaken. Results. There was an estimated A$129 mean increase in total MBS item charges over a 1-year period (controlled for age, self-reported quality of life and geographic location of practice) associated with PN-led care. The frequency of GP and PN visits varied markedly according to the chronic disease. Conclusions. Medicare reimbursements provided sufficient funding for general practices to employ PNs within limits of workloads before the new Practice Nurse Incentive Program was introduced in July 2012. [ABSTRACT FROM AUTHOR]

Purpose Medical schools worldwide have developed rural primary care immersive experiences to nurture students' interest in future rural careers and address workforce shortages. Few studies have looked at the students who participate in these programs. This study explores personality traits in US and Australian students who undertake rural-focused medical training. Methods A cross-sectional cohort design used the Temperament and Character Inventory to identify levels of the 7 basic dimensions of personality. Data were collected in successive cohorts over 2007-2011. Multivariate analysis compared trait levels between groups and by demographic variables. Findings The majority of the 302 students (US-167; Australia-135) were female, aged 20-29 years and single. A greater proportion of US students reported being partnered, living longest in a small rural/remote community and having a rural background. Significant differences between groups were detected in several traits but effect sizes were small. The personality pattern of the combined sample indicates students with a mature and stable personality high in Self-Directedness, Persistence, and Cooperativeness. Rural background and marital status enhanced this pattern. Conclusions Despite coming from different educational and societal backgrounds, similar personality patterns are evident in US and Australian students who pursue rural medical education. Data provide support for a pattern of traits associated with a rural background and its predictive influence on interest in rural practice. Considering the international expansion of rural longitudinal integrated clerkships, understanding student attributes may assist in identifying strategies to enhance the rural workforce that are relevant across cultures and continents. [ABSTRACT FROM AUTHOR]

Introduction: While there have been studies exploring the impact of personality on medical student selection and performance there has not been an investigation of the personality of students at different schools. Method: Demographic data and responses to the NEO measure of personality traits were collected from medical students in the first two weeks of their enrolment (2011) in seven medical schools in Australia. Personality traits were analysed by school features, gender and age using logistic regression. Results: Differences were detected between schools in the personality traits of Agreeableness and Conscientiousness. Higher Agreeableness and Conscientiousness were associated with attending an Undergraduate school (OR = 1.07 and 1.03, respectively) and a rural or community focussed school (1.06 and 1.03). Students attending a school that used interviews for selection had higher levels of Agreeableness (1.04) and lower levels of Neuroticism (0.96). Discussion: This is the first study to demonstrate that personality traits differ between students entering different medical schools. While there seems to be logic behind some differences, others are perplexing. Further research should expand on these findings and the implications to schools in regards to attracting students through selection processes, mission statements and their broader social focus. [ABSTRACT FROM AUTHOR]

Objective To describe the personality (temperament and character traits) of remote Australian allied health professionals ( AHPs) . Recent research shows that health professionals can be differentiated by personality traits but little is known about the personality traits of AHPs. Design Cross-sectional (online) survey design with snowball sampling of participants. Setting and Participants Australian AHPs ( N = 561; women, n = 502) classified into Remote ( n = 266), Not Remote ( n = 295). Main outcome measure(s) Demographic variables and the Temperament and Character Inventory ( TCI R-140). Results Remote AHPs were higher in novelty seeking ( P = 0.037) and self-transcendence ( P = 0.042). Remote women were lower in harm avoidance ( P = 0.042). Older remote AHPS were lower in reward dependence ( P = 0.001); younger remote AHPs were lower in self directedness ( P = 0.001) and higher in harm avoidance ( P < 0.001). Women were more reward dependent ( P < 0.001) and cooperative ( P = 0.008) than men. Conclusions The sample demonstrated personality trait levels aligned with research on rural doctors and nurses and which might be advantageous for working in a challenging environment. Exploring the more stable nature of temperament traits coupled with the modifiable potential of character traits provides new insight into people who choose to work as a remote AHP. These findings might contribute to a better understanding of the personality trends in these AHPs which might provide clues to improve recruitment and retention strategies. [ABSTRACT FROM AUTHOR]

The Australian government's commitment to health service reform has placed general practice at the centre of its agenda to manage chronic disease. Concerns about the capacity of GPs to meet the growing chronic disease burden has stimulated the implementation and testing of new models of care that better utilise practice nurses (PN). This paper reports on a mixed-methods study nested within a larger study that trialled the feasibility and acceptability of a new model of nurse-led chronic disease management in three general practices. Patients over 18 years of age with type 2 diabetes, hypertension or stable ischaemic heart disease were randomised into PN-led or usual GP-led care. Primary outcomes were self-reported quality of life and perceptions of the model's feasibility and acceptability from the perspective of patients and GPs. Over the 12-month study quality of life decreased but the trend between groups was not statistically different. Qualitative data indicate that the PN-led model was acceptable and feasible to GPs and patients. It is possible to extend the scope of PN care to lead the routine clinical management of patients' stable chronic diseases. All GPs identified significant advantages to the model and elected to continue with the PN-led care after our study concluded. [ABSTRACT FROM AUTHOR]

Objective Recent efforts to redress the deficit of rural medical practitioners have considered the problem of recruitment and retention of rural doctors as one of influencing individuals' career choices. Exposure to rural medical environments during basic medical training is one long-standing example of an initiative aimed in this direction and there is some evidence that it is effective. This study sought to determine whether or not various domains of personality are related to medical students' attitude to practising as rural doctors after graduation. Design The sample comprised 914 students commencing medical studies in Australian universities. They were recruited as part of the Medical Schools Outcomes Database project and indicated intended location of future medical practice. Setting Seven Australian basic medical training programs. Main outcome measures All students completed the NEO five-factor index ( NEO-FFI) and Adjective Checklist ( ACL) personality instruments. Results A preference for a rural practice location was associated with a combination of six domains of personality. The probability of rural preference was greater with higher scores on openness to experience, agreeableness and self-confidence but lower with higher scores on extraversion, autonomy and intraception. Taken together these six domains of personality provide useful although imperfect discrimination between students with a rural versus urban location preference. After controlling for student age the associations with extraversion and agreeableness failed to reach statistical significance. Conclusions While personality does not fully explain medical students' attitude towards practicing as a rural doctor, the data suggest it is an important factor and that some individuals may be better suited to a rural medical career than others. Considering personality along with other characteristics of the individual might allow targeted 'marketing' of rural practice. [ABSTRACT FROM AUTHOR]

eley d., eley r., bertello m. & rogers-clark c. (2012) Why did I become a nurse? Personality traits and reasons for entering nursing. Journal of Advanced Nursing 68(7), 1546-1555. Abstract Aims. This article is a report of a mixed method study of the association between personality traits of nurses and their reasons for entering nursing. Background. The worldwide nursing shortage prompts research into better understanding of why individuals enter nursing and may assist in exploring ways to increase their recruitment and long term retention. Design. A mixed method sequential explanatory design employed semi-structured interviews and a validated personality inventory measuring temperament and character traits. Methods. Registered Nurses ( n = 12) and nursing students ( n = 11) working and studying in a regional area of Queensland Australia were purposively sampled for the interviews in 2010 from their participation in the survey in 2009 investigating their personality traits. Qualitative data collection stopped at saturation. A thematic content analysis of the qualitative data using the framework approach was interpreted alongside their personality trait profiles. Results. Two dominant themes were identified from the participant interviews about reasons for entering nursing; 'opportunity for caring' and 'my vocation in life'. These themes were congruent with key temperament and character traits measured in the participants. All nurses and students were very high in traits that exude empathy and altruistic ideals regardless of other characteristics which included highly pragmatic and self-serving principles. Conclusions. Qualitative and quantitative findings suggest that a caring nature is a principal quality of the nursing personality. Recruitment and retention strategies whilst promoting multiple benefits for the profession should not forget that the prime impetus for entering nursing is the opportunity to care for others. [ABSTRACT FROM AUTHOR]

Eley DS, Eley RM. International Journal of Nursing Practice 2011; 17: 380-387 Personality traits of Australian nurses and doctors: Challenging stereotypes? This study compared temperament and character traits of Australian registered nurses and general practitioners. A cross-sectional quantitative design used the Temperament and Character Inventory. Total sample size was 426. Only main effects were detected. Nurses were higher in the temperament traits of Novelty Seeking and Reward Dependence, lower in the character traits of Self-Directedness and Cooperativeness but higher in Self-Transcendence compared with the sample of doctors. Differences in personality profiles between registered nurses and general practitioners might challenge existing stereotypes between these professions. Further exploration of traits exclusive to and shared among health professions would supplement a broad conceptualization of specialities and support the enhancement of appropriate training and career counselling. Awareness of one's temperament and character can lead to a clearer understanding of how they function in the workplace and might encourage reflection on and insight into the implications of their personality and career plans. [ABSTRACT FROM AUTHOR]

To describe individual temperament and character trait profiles associated with nurses and nursing students in a large regional health district and university in Australia. Identification of personality characteristics have been undertaken in most professions; however there is little extant literature on nurses which looks at specific aspects of temperament and character. A cross-sectional quantitative study of nurses and nursing students in a large regional health service district and university in South East Queensland, Australia. An online survey to nurses and nursing students included a demographic questionnaire and the temperament and character inventory (TCI) to identify levels of the seven basic dimensions of temperament and character. Univariate analysis made multiple and covariate comparisons between TCI scores, nurses, students, working status and age. The target number of responses was exceeded and totalled 451. Results are reported for females who comprised 90% of respondents; 53·5% students and 46·5% nurses. Significant main effects for age and student status were detected in several temperament and character inventory dimensions. Working students had significantly different temperament and character profiles compared to non-working students. Overall, this sample displays levels of temperament and character traits congruent with a profession requiring high levels of persistence, self-directedness, cooperativeness and reward dependence. Our findings prompt further investigation of whether individuals with the requisite temperament traits are attracted to nursing, or do individuals develop certain character traits as a product of their professional experiences/training. The identification of distinct profiles of temperament and character traits among different nursing roles may provide insight into what traits are conducive to retention of nurses in these roles. The predictive potential of the temperament traits plus the modifiable component of character traits may provide scope for nursing educators and policy-makers to assist in recruitment and retention of nurses in the workforce. [ABSTRACT FROM AUTHOR]

Background: Although contentious most medical schools interview potential students to assess personal abilities such as communication. Aims: To investigate any differences in clinical communication skills (CCS) between first year students admitted to UQ medical school with or without an admissions interview. Methods: A retrospective analysis of 1495 student assessment scores obtained after structured communication skills training (CCS) between 2007 and 2010. Results: The average assessment score was 3.76 ([95% CI, 3.73-3.78]) and adjusting for student characteristics, showed no main effect for interview ( p = 0.89). The strongest predictor of scores was gender with females achieving significantly higher scores (3.91 [95% CI, 3.54-4.28] vs. 3.76 [95% CI, 3.39-4.13]; p ≤ 0.001). Conclusions: Data show no differences in post-training assessment measures between students who were interviewed during selection or not. Further research about the quality and retention of communications skills after training is warranted. [ABSTRACT FROM AUTHOR]