New insights on rural doctors' clinical courage in the context of the unfolding COVID-19 pandemic

Introduction: Rural doctors typically work in low-resource settings and with limited professional support. They are sometimes pushed to the limits of their usual scope of practice to provide the medical care needed by their community. In a previous phenomenological study, we described the concept of clinical courage as underpinning rural doctors' work in this context. In this paper, we draw on rural doctors' experiences during the unfolding COVID pandemic to re-examine our understanding of the attributes of clinical courage.Methods: Semi-structured interviews were conducted with rural doctors from 11 countries who had experience preparing for or managing patients with COVID-19. Interviews were transcribed verbatim and coded using NVivo. A deductive thematic analysis was undertaken to identify common ideas and responses related to the features of clinical courage.Results: Thirteen interviews from rural doctors during the unfolding COVID-19 pandemic affirmed and enriched our understanding of the attributes of clinical courage, particularly the leadership role rural doctors can have within their communities.Conclusion: This study extended our understanding that rural doctors' experience of clinical courage is consistent amongst participants in many parts of the world, including developing countries.