Can a 'Rural Day' make a Difference to GP Shortage Across Rrural Germany?

Introduction: The ‘Verbundweiterbildung^plusBaden-Württemberg’ (Verbundweiterbildung^plus) – a structured general practice (GP) postgraduate training program – developed a 'rural day' as an intervention to ensure rural health exposure for GP trainees. This project report presents the outcome of the intervention: intention to work in a rural area. Methods: At the time of the study, 500 GP trainees were enrolled in Verbundweiterbildung^plus. Invitations to complete an internet-based questionnaire were distributed by email to the 274 GP trainees who had previously been asked to participate in one of eight rural days. The questionnaire contained 4 generic and 10 specific items for participants in the rural days and 4 items specific to non-participants. Mixed-methods analyses were performed using the Statistical Package for the Social Sciences. Results: Of the 274 GP trainees invited to complete the questionnaire, 38 of 80 rural day participants and 72 of 194 nonparticipants completed the questionnaire (overall response rate 40%). Participants and non-participants did not differ significantly regarding age, sex and origin. Nearly half of the participants claimed the rural day changed their overall attitudes towards rural areas positively. However, there was no significant difference in the intention to work in a rural area for participants before and after the rural day experience. Conclusions: The rural day increased positive attitudes towards rural areas in general but had no influence on intention to work in rural practice. More awareness and responsibility regarding workforce shortages in rural primary health care among political stakeholders, trainers and trainees is needed. Duration of the intervention should be extended and possibly complemented by offering rotations in rural practices to increase the effect. Enabling factors and barriers regarding working in rural areas are already known by political stakeholders, trainers and trainees and need to be more adequately addressed during GP postgraduate training.