Doctors’ rural practice self‐efficacy is associated with current and intended small rural locations of practice

OBJECTIVE: Key factors which positively influence recruitment and retention of doctors to rural practice include rural background and positive rural training experience. Despite this knowledge, there is no well‐established conceptual framework to explain how these factors influence intention. The aim of this study was to consider rural practice self‐efficacy and its influence on rural career choice by doctors. Questions relating to self‐efficacy were formulated using Bandura's four proposed sources of self‐efficacy, which include mastery experiences, vicarious experience, social persuasion and emotional and physical response to experiences. DESIGN: Cross‐sectional study. SETTING AND PARTICIPANTS: Medical school graduates from Flinders University, who completed a rural year as a part of the clinical component of the course between 1997 and 2015. MAIN OUTCOME MEASURES: Rural self‐efficacy; current and intended location of practice in small rural communities (<25 000 people). RESULT: It was found that 28.5% of participants were currently working in communities of <25 000 people. Levels of intent for future small town rural practice were consistent across career stages after internship. Higher rural practice self‐efficacy scores were found in doctors working in smaller towns (<25 000) and small communities (<10 000). Higher self‐efficacy was also associated with rural background, more senior career status, earlier speciality decision time and smaller expectation‐experience gap. CONCLUSION: An independent association exists between rural self‐efficacy and intention to remain or return to small rural practice. The article offers rural clinical schools the opportunity to consider how they can influence future rural career outcomes.