Issues related to medical students' engagement in integrated rural placements: an exploratory factor analysis

The purpose of this study was to identify and investigate the factors derived from the rural integrated community clerkship (RICC) questionnaire that influenced the decision of medical students to pursue a 36-week rural community placement option.

A total of 162 first-year (n = 92) and second-year (n = 70) medical students completed the 35-item RICC questionnaire. We used qualitative interviews to develop questionnaire items, and we used subsequent descriptive statistics and exploratory factor analyses to analyze the data.

Students with origins in rural communities were not significantly more likely to consider a RICC than their urban counterparts. However, students who identified family medicine as their discipline of choice were 3 times more likely to consider a RICC. Exploratory factor analysis, based on correlation of questionnaire items, determined 7 factors (themes) for the questionnaire. The questionnaire had strong internal reliability (Cronbach a = 0.94).

Although generally supportive of the rural clerkship option, students are less concerned about the clinical experience than they are about the practical implications of moving to a rural community. The RICC questionnaire was shown to have strong reliability and construct validity in measuring students' perceptions of a long-term clerkship placement in a rural community.