Preparing Physicians for Rural-Based Primary Care Practice: A Preliminary Evaluation of Rural Training Initiatives at OSU-COM

Wheeler, Denna L.; Hackler, Jeffrey B.

doi:10.7556/jaoa.2017.057

Cited by 6 publications

(4 citation statements)

References 8 publications

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“…25 As recognition of the importance of context and individualized student experience has increased, pipelines and singular tracks have evolved into longitudinal integrated clerkships, areas of concentration, streams, and other pathways. 11,[26][27][28][29][30][31] These newer strategies not only nurture those who enter medical school inclined toward or intent upon rural practice but may also recruit students from urban backgrounds who are encountering rural medicine for the first time. 32 Documenting this evolution in rural medical education is key to demonstrating which types of schools and programs are most likely to produce rural physicians.…”

mentioning

confidence: 99%

Pipelines to Pathways: Medical School Commitment to Producing a Rural Workforce

Longenecker

Andrilla

Jopson

et al. 2020

The Journal of Rural Health

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Purpose: Despite the efforts of numerous medical schools to produce rural physicians, many rural communities in the United States still experience physician shortages. This study describes the current landscape of rural efforts in US undergraduate medical education and catalogs medical school characteristics and activities that evidence has suggested, and that many experts in rural medical education believe, may result in more graduates choosing rural practice.Methods: This is a descriptive study of publicly available and rurally relevant characteristics of all 182 allopathic and osteopathic medical schools operating in the 50 states and the District of Columbia in 2016, with rural program information for these schools updated in 2019. The authors constructed a "rural program" definition in order to systematically catalog coordinated and strategic medical school efforts to produce a rural physician workforce.Findings: Few (8.2%) medical schools expressed an explicit commitment to producing rural physicians in public mission statements. However, most (64.8%) provided rural clinical experiences and many demonstrated their commitment in other ways. Only 39 (21.4%) did so through a formal rural program. Conclusions:In establishing an explicit rural program definition and documenting other markers of rural commitment, this paper provides a baseline for future studies of rural workforce production and medical school investment in these programs, activities, and personnel. Demonstrating the effectiveness of schools' rural physician education efforts will require collaboration across institutions and more intensive evaluations of programs involving students who, though relatively few in number, have great potential for contributing to the health of rural communities across the nation.

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confidence: 99%

Pipelines to Pathways: Medical School Commitment to Producing a Rural Workforce

Longenecker

Andrilla

Jopson

et al. 2020

The Journal of Rural Health

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“…Oklahoma is largely rural and medically underserved with every county identified as Health Professional Shortage Area (OSDH, 2022a; Wheeler & Hackler, 2017). Only 35% of seniors live within Oklahoma's 2 urban areas, leaving 65% geographically distant from specialized geriatric or neurologic care (Campbell et al, 2018).…”

Section: Oklahoma's Older Populationmentioning

confidence: 99%

Training Community Health Workers to Address Disparities in Dementia Care

Reinschmidt

Philip

Alhay

et al. 2023

Journal of Ambulatory Care Management

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The projected increase of dementia in the diverse aging US population calls for a wellprepared public health workforce. Community health workers (CHWs) can address dementia in culturally appropriate ways. Collaborating with stakeholders, we developed a train-the-trainer curriculum for CHWs and used a virtual training platform to test its feasibility with 77 CHWs. Pre-/post-evaluation data demonstrated modestly increased dementia knowledge scores. Training participants valued the resources shared and interacting with peers. Disseminating this training could contribute to closing gaps in dementia care in diverse communities, along with policies supporting CHWs as a workforce that reduces age-related disparities and promotes health equity.

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“…Improved knowledge of prevalence rates could lead to larger gains in positive outcomes and more efficient use of precious resources. This is especially important in high-burden, low-resource areas, such as Oklahoma [24][25][26][27]. Oklahoma has consistently been recognized as leading the nation in childhood adversity, with 28.5% of Oklahoma children experiencing 2 or more ACEs [28].…”

Section: Assessing Aces Through Instrumentsmentioning

confidence: 99%

“…Oklahoma also experiences poor social determinants of health (SDOH), such as health care shortages, violence, and food insecurity, among others [29]. Further, there is a lack of access to care due to a lack of primary care providers outside of metropolitan areas in rural communities, which make up the majority of Oklahoma [24][25][26][27]. These upstream deficiencies lead to high levels of adverse health outcomes such as diabetes, obesity, substance use disorders, and overdose mortality [24,30].…”

Section: Assessing Aces Through Instrumentsmentioning

confidence: 99%

Quantifying Adverse Childhood Experiences in Oklahoma With the Oklahoma Adversity Surveillance Index System (OASIS): Development and Cross-Sectional Study

Beaman¹,

Miner²,

Bolinger³

2023

JMIR Public Health Surveill

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Background Developmental trauma depending on several factors may lead to later adult health risks and is an increasing public health concern, especially in states with predominantly rural populations. Oklahoma remains one of the states in America with the highest count of adverse childhood experiences (ACEs); therefore, more refined research methods for quantifying ACEs are vital for ensuring proper statewide interventions. Objective While data sets already exist at the state level measuring specific ACEs like divorce or child abuse, the state currently lacks a single source for specific ACEs that can incorporate regions to allow for the identification of counties where ACEs are especially high. This county identification will allow for assessing trends in adversity prevalence over time to indicate where targeted interventions should be done and which counties experience amplified long-term consequences of high ACE rates. Thus, the model for the Oklahoma Adversity Surveillance Index System (OASIS) was born—a public health tool to map ACEs at the county level and grade them by severity over time. Methods County-level data for 6 ACEs (mental illness, divorce, neglect, child abuse, domestic violence, and substance use) were collected from the Oklahoma Department of Human Services, Oklahoma State Department of Health, and Oklahoma Community Mental Health Centers for the years 2010 to 2018. First, a potential ACEs score (PAS) was created by standardizing and summing county rates for each ACE. To examine the temporal change in the PAS, a bivariate regression analysis was conducted. Additionally, an ACEs severity index (ASI) was created as a standardized measure of ACE severity across time. This included scoring counties based on severity for each ACE individually and summing the scores to generate an overall ASI for each county, capturing the severity of all ACEs included in the analysis. Results Mental illness and substance use showed the highest rates at the state level. Results from the regression were significant (F1,76=5.269; P=.02), showing that county PAS showed an increase over years. The ASI scores ranged from 0 to 6, and 4 Oklahoma counties (Adair, McCurtain, Muskogee, and Pittsburg) received a score of 6. Conclusions OASIS involves the identification of counties where ACEs are most prevalent, allowing for the prioritization of interventions in these “hot spot” counties. In addition, regression analysis showed that ACEs increased in Oklahoma from 2010 to 2018. Future efforts should center on adding additional ACEs to the ASI and correlating adverse outcome rates (such as violence and medical disorder prevalence) at the county level with high ASI scores.

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Preparing Physicians for Rural-Based Primary Care Practice: A Preliminary Evaluation of Rural Training Initiatives at OSU-COM

Abstract: A collaboration between the JAOA and the American Association of Colleges of Osteopathic Medicine (AACOM) to recruit, peer review, publish, and distribute research and other scholarly articles related to osteopathic medical education.

Cited by 6 publications

References 8 publications

Pipelines to Pathways: Medical School Commitment to Producing a Rural Workforce

Pipelines to Pathways: Medical School Commitment to Producing a Rural Workforce

Training Community Health Workers to Address Disparities in Dementia Care

Quantifying Adverse Childhood Experiences in Oklahoma With the Oklahoma Adversity Surveillance Index System (OASIS): Development and Cross-Sectional Study

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