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

Objective: 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. Methods: 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. Results: 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 α = 0.94). Conclusion: 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 longterm clerkship placement in a rural community.