Rural pharmacy in New Zealand: Effects of a compulsory externship on student perspectives and implications for workforce shortage

Abstract
To explore student perceptions of rural pharmacy practice, factors affecting interest in rural work and effects of an educational intervention designed to raise awareness of rural practice. Qualitative and quantitative survey questionnaire administered before and after a week-long rural externship. Undergraduate - rural pharmacy externship. Third-year Bachelor of Pharmacy undergraduate cohort (n = 123). Week-long exposure to rural pharmacy practice Rural/urban origin of students, interest in working in rural practice, views held of rural practice and towards externship. Rural-origin students were significantly more likely to report they would consider working in rural practice prior to the intervention than urban-origin students (77% rural origin versus 40% urban origin). The intervention significantly increased the overall proportion (48% pre-versus 73% post-externship), proportion of female students (48% pre versus 79% post-externship) and proportion of urban-origin students (38% pre-versus 67% post-externship) prepared to consider rural practice. Despite apprehension towards the externship, students reported overwhelmingly positive experiences of it. Negative aspects related mainly to travel and accommodation costs incurred. This targeted, experiential intervention affected perceptions of rural practice in a positive direction among urban-origin students by raising awareness and challenging their preconceptions of rural pharmacy practice. Further research is required to see whether this will affect recruitment and to investigate what appears to be a particular effect on female students.