Management of professional boundaries in rural practice

Brooks, Kathleen D., Eley, Diann S., Pratt, Rebekah and Zink, Therese (2012) Management of professional boundaries in rural practice. Academic Medicine, 87 8: 1091-1095. doi:10.1097/ACM.0b013e31825ccbc8

Author Brooks, Kathleen D.
Eley, Diann S.
Pratt, Rebekah
Zink, Therese
Title Management of professional boundaries in rural practice
Journal name Academic Medicine   Check publisher's open access policy
ISSN 1040-2446
Publication date 2012-08
Sub-type Article (original research)
DOI 10.1097/ACM.0b013e31825ccbc8
Volume 87
Issue 8
Start page 1091
End page 1095
Total pages 5
Place of publication Philadelphia, PA, United States
Publisher Lippincott Williams & Wilkins
Collection year 2013
Language eng
Formatted abstract
Purpose: Rural physicians wrestle with professional boundary issues routinely in everyday interactions, and their situation differs from the experience of their urban colleagues. Medical students receive limited exposure to professional boundary management in preclinical training. Increasingly, schools are implementing rural longitudinal clinical clerkships which expose students to rural boundary setting. This qualitative study explored the management of professional boundaries integral to rural practice and how this management may differ from their urban colleagues.
Method: Semistructured interviews were conducted in 2010 with 12 rural physicians across Minnesota exploring their perceptions of professionalism in rural practice. A social constructivist approach to grounded theory was used to analyze the data.
Results: Five primary themes regarding rural professionalism emerged from the data: centrality of care, rural influences on choice, individualization of boundary setting, advantages of dual relationships, and disadvantages of them. These themes served to illustrate rural boundary management.
Conclusions: This study’s findings indicate that rural physicians are routinely confronted with professional boundary issues in everyday situations, and these circumstances do not always reflect those of their urban colleagues. Given the increase in longitudinal immersion clinical clerkship programs to nurture student interest in future rural practice, acknowledgment and acceptance of the nuances of dual relationships and boundary setting in different clinical learning contexts are vital to help students identify their personal needs for privacy and be better prepared to negotiate the realities of rural practice. These findings may inform future medical education initiatives on professional boundary setting as an aspect of professionalism.
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2013 Collection
School of Medicine Publications
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Created: Sun, 09 Sep 2012, 14:49:32 EST by Diann Eley on behalf of School of Medicine