in research.
Strengths and limitations
The study strengths include the sampling of the diverse types of practices and the interviews with multiple stakeholders. The method of analysis was robust, with several rounds of data interrogation. The case study method enabled interpretation of results at the level of the practice, reflecting a realistic unit of analysis for propelling significant change.
The study was set in rural Victoria, which may not reflect the broader landscape of general practices, training providers and higher education in other locations. The multidisciplinary research team (general practitioner, allied health academic/practitioner, organisational behaviour academic and education academic) enabled several perspectives to be offered during each phase of the study. This strengthens the study, reducing biases associated with a singular perspective. However, it may also mean that nuances were overlooked in data that are evident to those immersed in practice. Throughout the project, the research team met regularly and shared their perspectives and analyses. As in all interview-based studies, the quality of data may have been influenced by the context of the interview itself. Although the interviewer is experienced, it is possible that interviewees offered views that they thought socially desirable. However, early interview transcripts were reviewed by at least one other research member and interview technique examined. The interviewer approach was considered 'neutral' and 'encouraging'. The interviewer made notes on each interview and although some interviewees were noted as more forthcoming than others, with rapport established the flow of conversation in all interviews became easy.
Future research may investigate the transferability of the findings, especially using negative case analysis. It would be valuable to test the framework in other settings.
There is already sturdy evidence that learners are essential to addressing long-term workforce issues in Australian rural general practices. An established culture of learning is a fertile environment for developing research activity. This study documents that the pathway to becoming an academic rural general practice is a complex process, which requires many years of deliberate development. This development is best driven by a strategic vision of the practice shared by the key stakeholders such as practice owners, the permanent practitioners and the senior practice management staff. It is considered that the proposed framework will provide guidance to practices exploring one or more steps in the transition towards a full rural academic practice. It will also provide guidance for educational institutions and funding bodies wishing to support educational and research activity in rural general practices.
The authors acknowledge General Practice Education and Training for funding for this project and the five rural general practices that participated. The authors thank Associate Professor Elmer Villanueva for his contribution to the conception of the project.
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