Written by Angie LaFlamme and Bridget Hart, National Rural Health Resource Center. This content originally appeared on the 3RNet website.
The 3RNet’s mission is to connect health care professionals searching for jobs in rural or underserved areas with health care facilities. They strive to find the right job for professionals in areas where they will live and work comfortably. Some health care professionals entering the workforce have come from large, urban areas and have never practiced in a rural community. But, for University of Minnesota medical students participating in the Rural Physician Associate Program (RPAP), this isn’t the case.
RPAP is a nine-month, community-based educational experience for third-year medical students. Not only does it allow them to train in rural communities, RPAP students and their families get to experience all aspects of rural community life by living in their host towns during the training period.
“RPAP was one of the most valuable experiences of my training,” said Maren Anderson, who participated in RPAP in fall 2016. “I've always felt I would be best served by training in the environment I plan to work in and for me that is rural Minnesota. I knew I was in the right place when we walked down the hallway of physician offices and they pointed at nearly every door, identifying that physician as either a University of Minnesota graduate, RPAP alumnus, or both. I was the only medical student there which gave me the benefit of the undivided attention of not just one preceptor or attending, but every practitioner I came into contact with.”
RPAP students experience hands-on learning as they care for patients of all ages. They learn clinical medicine, procedures, community health, and the business of medicine. Students experience the full spectrum of rural medical care as they follow patients and their families through a disease process or pregnancy. “In the course of a day I might start the morning with an early surgery or c-section, then start clinic, possibly see a patient or two in urgent care, get called to the ER to sew up a laceration, finish out clinic and write my notes, visit a patient or two on inpatient, and then wrap up the day with a delivery,” said Maren of her RPAP experience.
“I truly felt like a member of the team and got to know my patients and my fellow health workers. I felt so incredibly valued and supported during my time there. I also felt like I became a part of the community in a way that I haven't found since moving out of my hometown,” said Maren. “My official preceptor would have me over to his house for dinner regularly and I helped his family shear sheep to get ready for the fair. I joined a church choir there and a number of choir members became my patients, eagerly announcing to me during practice, ‘I'm coming to visit you next week!’”
From populations ranging from 350 to 30,000, over 110 Minnesota communities have participated in the program as teaching sites with a majority having at least one RPAP alum. Practices vary from small family medicine clinics to large multi-specialty outpatient centers, and hospitals ranging in size from 15 to 140 beds. Students see patients in clinics, hospitals, emergency rooms, nursing homes, hospice, at home, and in the community. Each student is the only student in a community and therefore has a greater opportunity to gain hands-on experience in a variety of procedures and specialties.
“When the Minnesota legislature sought a solution to the need for more rural physicians – particularly Family Physicians – in the late 1960’s, they were wonderfully wise to fund the establishment of the University of Minnesota Medical School’s Duluth campus program and the Rural Physicians Associate Program,” said Jim Boulger, Ph.D., Distinguished University Teaching Professor from University of Minnesota Medical School. Since RPAP’s inception in 1971, over 1,300 students have participated in the program, resulting in two out of three former students practicing in Minnesota, two out of three practicing in rural locations, and four out of five practicing primary care.
Statistics show that health care professionals with an educational background in rural areas are more likely to practice in these areas once they enter the workforce. “These programs have been extremely successful models for training our rural Minnesota medical workforce. Now having trained more family physicians – many of them RPAP graduates - than any other medical school in the United States, the University is a proud partner with greater Minnesota in providing care for all of us,” quoted Dr. Boulger.
Former RPAP student Maren states, “RPAP solidified my faith in my decision to become a rural physician because, for the first time since starting medical school, I felt that I actually understood what it means to be a rural doctor and how that shapes your life—and now I can't imagine wanting to do anything else.”
University of Minnesota, Duluth and Twin Cities Campus’ medical students with an interest in family medicine, primary care, or rural medicine specialties are strongly encouraged to apply to the Rural Physician Associate Program. Visit the RPAP website to learn more about the Rural Physician Associate Program, or if you have interest in supporting the Program.
Aligning and streamlining your planning efforts for long-term success
This article was written by Bonnie Noble, PhD, RN, Founder of The Ondina Group, for the April 2017 edition of “Networking News.” The Network Technical Assistance Project is funded by the Federal Office of Rural Health Policy, Health Resources and Services Administration, U.S. Department of Health and Human Services through a contract to Rural Health Innovations, LLC, a subsidiary of the National Rural Health Resource Center.
We’ve all heard that familiar quote, “Failing to plan is planning to fail." This is likely a contemporary paraphrase of one of Benjamin Franklin's quotes: "By failing to prepare, you are preparing to fail." And then, of course, Winston Churchill said, "He who fails to plan is planning to fail."
OK. You get it. You know planning is important. But, sometimes it feels as if we can spend so much time planning that we don’t have time to get anything done. And, what about all those plans required when we’re seeking funding? Just the other day, a client commented on how the funding agencies “require an odd collection of similar-looking documents—Strategic Plan, Logic Model, and Action Plan.” She groaned when I replied, “Don’t forget about the Evaluation Plan and the Sustainability Plan.”
This “odd collection of similar-looking documents” each have a specific purpose and make an important contribution to program and organizational success. Moreover, it is helpful to understand how these various plans fit together in a sort of “less is more” approach that provides simplicity, clarity, and good design while streamlining your planning and writing efforts.
First, let’s briefly examine the key purpose for each one of these plans.
So, how do these plans overlap with and link to one another? The following Planning Crosswalk describes, visually, how these various plans are related.
It is important that these plans are aligned and integrated. For example, your three- to five-year program goals and strategies identified in your Strategic Plan align with the program-specific impact and outcomes in your Logic Model(s). Likewise, your Work Plan is a more detailed description of the initiatives outlined in your Strategic Plan and the activities described in your Logic Model.
The usefulness of each of these planning tools is enhanced by regularly consulting and comparing them. Developing, linking, and using these planning tools will help to ensure that your programs, and your organization, remain focused on its core mission and reaches its goals and vision.
Two important Baldridge program concepts are especially useful here—alignment and integration.
Examples of alignment and integration include linking key goals and objectives in your overall organizational Strategic Plan and your program Logic Model(s). Then, the Work Plan provides more detail on how your stated objectives will be achieved and who will be responsible for doing the actual day-to-day work. Likewise, the Evaluation Plan is a drill-down on how you will collect, analyze, and report data to ensure you remain on target towards reaching stated goals. Finally, the Sustainability Plan describes what actions you will take to ensure long-term viability of your program.
There is great value in aligning and integrating this “odd collection of similar-looking documents,” and doing so will enhance the effectiveness of your organization and its various programs. And, of course, you will more efficiently utilize the most precious resource—your time.
Bonnie Noble, PhD, RN, has an extensive background in the healthcare industry, with more than 30 years of experience working in a variety of healthcare organizations. She has expertise in many quality and performance improvement methodologies, is certified in patient safety, and is a certified professional in healthcare quality. Bonnie has served a National Examiner for the Baldrige National Quality Award and also has managed large federal contracts with the Centers for Medicare & Medicaid Services (CMS) and the Agency for Healthcare Research and Quality (AHRQ). She currently serves as the project director for the Mendonoma Health Alliance, a grantee of the Rural Health Network Development Planning Grant Program through the Health Resources and Services Administration (HRSA).
[i] Balanced Scorecard Institute. Retrieved March 1, 2017 at http://www.balancedscorecard.org/Resources/Strategic-Planning-Basics
[ii] W.K. Kellogg Foundation. East Battle Creek, Michigan. 2004. https://ag.purdue.edu/extension/pdehs/Documents/Pub3669.pdf
[iii] Developing an Effective Evaluation Plan. Atlanta, Georgia: Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health; Division of Nutrition, Physical Activity, and Obesity, 2011.
[iv] The Grant Helpers.com. Five Key Elements of an Effective Sustainability Plan. 2014. Retrieved on March 2, 2017. http://www.thegranthelpers.com/blog/bid/204687/The-Five-Key-Elements-of-an-Effective-Sustainability-Plan-for-Grants
[v] Baldrige Performance Excellence Program. 2017. 2017–2018 Criteria for Performance Excellence.
Gaithersburg, MD: U.S. Department of Commerce, National Institute of Standards and Technology. http://www.nist.gov/baldrige
The National Rural Health Resource Center (The Center) is a nonprofit organization dedicated to sustaining and improving health care in rural communities. Rural Health Innovations, LLC is a subsidiary of the National Rural Health Resource Center.