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Education and Training of the Rural Healthcare Workforce – Models and Innovations

These stories feature model programs and successful rural projects that can serve as a source of ideas and provide lessons others have learned. Some of the projects or programs may no longer be active. Read about the criteria and evidence-base for programs included.

Effective Examples

OHSU Rural Surgery Training
Updated/reviewed June 2020
  • Need: General surgeons are needed in rural communities.
  • Intervention: Oregon Health & Science University (OHSU) is sending residents to complete a general surgery rotation in rural southern Oregon.
  • Results: Almost 40% of the graduates of the rural residency program are now practicing in a rural setting, and the residents are more likely than other OHSU residents to enter general surgery practice and serve in a community of fewer than 50,000 people.
MU AHEC Summer Community Program
Updated/reviewed January 2020
  • Need: Lack of healthcare providers, specifically physicians, in rural Missouri.
  • Intervention: Rising second-year medical students at University of Missouri's School of Medicine are given the opportunity to participate in a clinical program in a rural community setting.
  • Results: Almost half of the participants from 1996-2010 chose to practice in rural locations upon graduation.
funded by the Health Resources Services Administration Appalachian Preceptorship Program
Updated/reviewed December 2019
  • Need: To prepare future physicians for practicing in rural southern Appalachia.
  • Intervention: The Appalachian Preceptorship Program offers medical students clinical preceptorships to give them experience practicing in rural, underserved communities of southern Appalachia.
  • Results: Students who participate in this preceptorship are more than 3 times as likely to practice medicine in a rural location.

Promising Examples

Successfully Training and Educating Pre-medical Students (STEPS)
Updated/reviewed November 2019
  • Need: To increase the number of primary care providers in northeast Kentucky.
  • Intervention: STEPS provides support such as physician shadowing, mock interviews, and MCAT practice exams for regional students applying to medical school.
  • Results: 22 of the initial 28 participants were accepted into medical school. The program is being replicated among all of Kentucky's regional AHECs.
funded by the Federal Office of Rural Health Policy TUSM-MMC Program Longitudinal Integrated Clerkship
Updated/reviewed April 2019
  • Need: To fill vacant medical positions in Maine's rural medical facilities.
  • Intervention: The Tufts Maine Track LIC program offers clerkships in rural medical facilities, exposing medical school students to the positives and possibilities that rural practices have to offer.
  • Results: The program has seen an increase in students' interest to practice in rural Maine. The majority have pursued medical careers in one of the 6 core specialties studied during their clerkship.
funded by the Health Resources Services Administration Rural and Underserved APRN Project
Updated/reviewed January 2019
  • Need: To reduce the primary care provider shortage in rural Colorado.
  • Intervention: A "grow your own" initiative in Colorado recruits rural registered nurses and trains them to become advanced practice RNs.
  • Results: 81 RNs have participated in the Rural and Underserved APRN Project so far.
funded by the Health Resources Services Administration Learning Exchange Reverse Demonstration (LERD) Model
Updated/reviewed July 2018
  • Need: To make it easier for rural nurses to continue their education by decreasing the need to travel.
  • Intervention: An innovative, online health assessment course uses telehealth to allow rural RN-BSN students to demonstrate skills acquisition.
  • Results: Rural participants had similar learning outcomes to those participating in the onsite version of the course, with fewer travel costs, less time away from work, and higher overall satisfaction.

Other Project Examples

Health Profession Rural Summer Immersion Program
Added June 2020
  • Need: To expose medical and physician assistant students to rural healthcare practices and a rural lifestyle.
  • Intervention: A two-week immersion program for second-year students to experience rural healthcare and rural life in Connecticut and New York.
  • Results: In post-program evaluations from 2016 to 2018, 50% of students reported being very likely to practice in a rural setting, compared to just over 10% of students before the program.
Rescue Divas EMT Recruitment
Updated/reviewed June 2020
  • Need: Increased number of emergency medical technicians in rural northern Wisconsin.
  • Intervention: Creation of a program, Rescue Divas, for middle school girls to spark interest in emergency medical services careers.
  • Results: Post-participation results demonstrate the camp increases interest in an emergency medical services career.
funded by the Federal Office of Rural Health Policy Rural Experiences for Health Professions Students (REHPS)
Updated/reviewed March 2020
  • Need: An ongoing shortage of healthcare providers in rural areas of South Dakota
  • Intervention: A 4-week summer program placing health professions students in rural communities.
  • Results: Of graduating participants, 71% practice in South Dakota with 30% of those graduates practicing in rural communities with populations fewer than 10,000, or veteran facilities.
funded by the Health Resources Services Administration Regional Initiatives in Dental Education (RIDE)
Updated/reviewed February 2020
  • Need: Address oral health disparities in Washington's rural and underserved communities.
  • Intervention: The University of Washington School of Dentistry developed the Regional Initiatives in Dental Education (RIDE) program preparing dentists for practice in rural and underserved areas.
  • Results: As of 2019, 77% of all RIDE graduates are practicing in Washington state. Of those, 82% are practicing in rural and underserved communities.
funded by the Health Resources Services Administration Nevada AIDS Education and Training Center
Added January 2020
  • Need: To provide trainings so health professionals can better treat people with HIV/AIDS, hepatitis C, and other infectious diseases.
  • Intervention: NAETC provides clinical preceptorships, conferences, technical assistance, webinars, and other services.
  • Results: In fiscal year 2018, NAETC provided over 1,300 hours in 38 trainings for more than 800 healthcare providers throughout Nevada.
Simulation in Motion-South Dakota (SIM-SD) EMS Educational Outreach Program
Updated/reviewed January 2020
  • Need: To provide increased educational opportunities for emergency care personnel in rural and frontier South Dakota.
  • Intervention: A technologically advanced training was created to enhance the delivery of emergency patient care.
  • Results: Hundreds of emergency medical services (EMS) staff and volunteers received training that in turn helped them in the field of emergency patient care.
Chuuk Women's Council Diabetes Prevention Program
Updated/reviewed December 2019
  • Need: A way to improve health of women in Chuuk, one of 4 states that make up the Federated States of Micronesia.
  • Intervention: The Chuuk Women's Council offers a program that educates and trains women to prevent and manage diabetes, and adopt healthy lifestyles.
  • Results: The program's goal of gaining 30 participants in its second year has been exceeded. Participants have lost weight, been referred to needed medical services, and are training others in diabetes education.
funded by the Federal Office of Rural Health Policy EMS Live@Nite
Updated/reviewed September 2019
  • Need: Distance, time, and cost make it difficult for EMS volunteers to attend continuing education and maintain certification.
  • Intervention: Inland Northwest Health Services delivers free online training to rural EMS providers via video teleconferencing.
  • Results: The EMS Live@Nite program provides free, monthly training to rural EMS providers in the northwestern part of the United States. The program is available through live video conferencing from certified locations in rural communities.
Club Scrub
Updated/reviewed July 2019
  • Need: Rural Wisconsin communities experience threatened healthcare infrastructure due to workforce shortages.
  • Intervention: The Rural Wisconsin Health Cooperative, in partnership with the Wisconsin Office of Rural Health, created a youth program to increase awareness of health-related professions known as Club Scrub.
  • Results: Middle-school students attend the program and gain a better understanding of career options in the healthcare industry.
funded by the Federal Office of Rural Health Policy funded by the Health Resources Services Administration Project Renew
Updated/reviewed July 2019
  • Need: To reduce deaths due to opioid overdose in rural southeast West Virginia.
  • Intervention: Project Renew trained and certified first responders, healthcare staff, and laypeople in naloxone administration.
  • Results: From April to June 2019, Project Renew has provided direct education to 120 individuals, completed 173 provider education activities, and distributed 260 Narcan kits.
Project PROMISE
Updated/reviewed April 2019
  • Need: An increased interest among young people to pursue a medical career in rural North Carolina
  • Intervention: Two medical students started a program that gives high school seniors medical academic training, mentor relationships, and hands-on experience in rural North Carolina facilities.
  • Results: Project PROMISE has graduated 26 high school students, 7 of whom are pursuing an undergraduate degree with an interest in studying medicine.
Hawai'i Island Family Medicine Residency
Updated/reviewed December 2018
  • Need: Hawaii is experiencing a huge shortage of family medicine physicians.
  • Intervention: The Hawai'i Island Family Medicine Residency (HIFMR) program uses an interprofessional team-based approach so residents learn how to care for many types of patients in different healthcare settings.
  • Results: In 2017, the first class of residents graduated from a fully accredited program as Board-certified Family Medicine physicians. There were over 1,000 applicants to the residency program, and the residency increased its complement from 4 to 6 residents per year.
Pathways to Healthcare Professions
Added December 2018
  • Need: Healthcare professionals and support staff are in high demand on tribal reservations in the Great Plains region.
  • Intervention: The Great Plains Tribal Chairmen's Health Board of South Dakota offer healthcare occupation courses for industry-recognized healthcare certifications and post-secondary degrees through the Health Profession Opportunity Grants program.
  • Results: Since the program's start, 241 participants have completed a healthcare training program, and 109 have found employment in healthcare occupations. Both participants and healthcare providers have expressed the value in local and cultural training for these healthcare professions.
funded by the Health Resources Services Administration Targeted Rural Underserved Track (TRUST) Program
Updated/reviewed December 2018
  • Need: There is a shortage of rural physicians in the Northwestern United States.
  • Intervention: University of Washington medical students are receiving training through the TRUST program in rural, underserved communities across a five-state radius.
  • Results: Long-lasting connections have been formed among regional and underserved communities, medical students, and rural health professionals, producing more rural physicians as a result.
Rural Nevada EMS Conference
Updated/reviewed September 2018
  • Need: To provide rural Nevada EMS personnel an opportunity to receive quality training and current EMS information from national EMS educators.
  • Intervention: The Rural Nevada EMS Conference offers continuing education units and engaging sessions for EMS personnel.
  • Results: Over 300 participants attended the 2018 conference.
funded by the Federal Office of Rural Health Policy Stone Mountain Health Services Behavioral Health Internship
Updated/reviewed September 2018
  • Need: Increase behavioral health services and providers in rural Appalachian communities of Southwest Virginia.
  • Intervention: Implementing a behavioral health internship that is a partnership of 2 universities and a community health center, with infrastructure to also support a social work internship.
  • Results: Behavioral health services now available in the 7-county area served by the health center, with designated behavioral health staff to supervise psychology and social work interns.
funded by the Federal Office of Rural Health Policy MaineGeneral Harm Reduction Program
Updated/reviewed August 2018
  • Need: To reduce deaths from opioid overdoses in rural Maine.
  • Intervention: The MaineGeneral Harm Reduction Program provides community education and training for healthcare staff and first responders in rural Kennebec and Somerset counties.
  • Results: During the grant period, MaineGeneral trained 45 deputies and 246 healthcare staff and educated 60 community members.
Minot-Williston Rural Training Track Program
Updated/reviewed August 2018
  • Need: Like many rural areas, parts of North Dakota lack primary care physicians to fulfill the needs of the community.
  • Intervention: The Minot-Williston Rural Track Program was developed to create new medical residency opportunities in rural North Dakota.
  • Results: Now over 1000 applicants are applying for the two residency slots.
funded by the Federal Office of Rural Health Policy FORWARD NM Pathways to Health Careers
Updated/reviewed June 2018
  • Need: New Mexico's southwestern counties of Hidalgo, Catron, Luna, and Grant have experienced chronic shortages of primary care providers. New Mexico has the oldest physician population in the country.
  • Intervention: A comprehensive workforce pipeline program, including programming for middle and high school students, undergraduate and graduate students, primary care program students, and medical and dental residents.
  • Results: The program reaches over 2,000 school-aged students throughout the service areas and hosts 70+ rural rotation experiences annually. It has also gained partnership with the HMS-Family Medicine Residency Program since 2013 and designation as an Area Health Education Center (AHEC) since 2012.
Wisconsin Collaborative for Rural Graduate Medical Education
Updated/reviewed June 2018
  • Need: Family physicians in the rural areas of Wisconsin.
  • Intervention: A collaborative was created that provides leadership, technical assistance, and training for expanding rural graduate medical education in Wisconsin.
  • Results: The collaborative expanded rural graduate medical education rotations, residencies, and fellowship opportunities for training rural family physicians in Wisconsin.
Right Side Up Falls Prevention
Updated/reviewed January 2018
  • Need: Falling is one of the leading causes of morbidity and mortality in adults over the age of 65.
  • Intervention: The Right Side Up program was implemented in rural Otter Tail County to address the prevention and management of falls and risk for falls through in-home assessments given by interdisciplinary healthcare professionals and students.
  • Results: Short-term outcomes revealed 100% of participants found the visit and recommendations for falls prevention to be helpful, and 78% implemented these recommendations.
funded by the Federal Office of Rural Health Policy Great Basin College Emergency Medical Services Program
Updated/reviewed December 2017
  • Need: Recognizing the need to increase emergency response times, rural Nevada struggled to recruit and retain EMTs, AEMTs, and Paramedics.
  • Intervention: Great Basin College created the EMS program to recruit and train new EMTs and paramedics.
  • Results: The program has now trained hundreds of state-certified EMTs and AEMTs in rural Nevada.

Last Updated: 6/15/2020