Learning in context: education for remote rural health care.

Ensuring access to high quality health care in remote and rural settings is particularly challenging. Remote and rural communities require health service models that are designed in and for these settings, and care provided by health practitioners with the requisite knowledge and skills responsive to people's health needs. Studies in many countries have shown that the three factors most strongly associated with entering rural practice are (1) a rural upbringing, (2) positive clinical and educational experiences in rural settings as part of undergraduate medical education and (3) targeted training for rural practice at the postgraduate level. After exploring the remote and rural context, this article presents examples from Canada and from Australia of education programs that provide the majority of clinical education in remote and rural settings, supported by electronic communications including remote clinical supervision. The success of these programs demonstrates clearly that education in remote rural communities for remote rural communities contributes to substantially improved access to and quality of remote rural health care.