A Clinical Experience in Remote Australia – Student Feedback

Background: Rural, remote & Indigenous (RRI) Australia is seriously underserved by oral care professionals, with high disease levels. Evidence indicates that if undergraduates experience this, some will devote part of their careers to such needs. The community chosen, Brewarrina, is ~900km from our University and metropolitan centres: activity involves trucking supplies and bussing students/teachers for ~12hr each-way. Objective: To assess the patient profile and identify issues from students' reflective journals related to this placement. Final-year dental students, in groups of ~8, spent 3-weeks there in 2009. Methods: The patient profile was derived from the assessment performance sheets completed for each appointment. All 44 reflective journals were systematically analysed for common themes/concepts using a mapping software (Leximancer). This analyses large pieces of text and formulates concepts, their relative occurrence and draws relationships. Specific examples of text are identified for each concept. Results: 1287 appointments were completed over 18-weeks. ~Two-thirds were public patients. One-quarter were from distant towns. 22% were younger than 16-years, 45% aged 15-46, 33% >45-years. Females constituted ~60%. Services rendered varied, however half was restorative in nature. Positive aspects identified by students were the very different disease profile and clinical experience to that of a University-based metropolitan clinic, the volume of patients treated (less beauracracy in a small setting), refinement of clinical skills, provision of service to a community in substantial need, a (for many unique) cultural experience, plus socialisation of the student group itself. Negative aspects revolved around problems of equipment failure, limited availability of consumables and slow responses to these matters due to logistical challenges consequent upon distance from base. Conclusion: Students have provided a substantial service to a community who previously had to travel >100 km for dental care, and have appreciated the plight of RRI communities, while refining their clinical skills prior to graduation.