Mercer University School of Medicine Center for Rural Health and Health Disparities Pedagogical Health Service Delivery Model

Topic: A Pedagogical Rural and Underserved Health Service Delivery Model

Objective: To describe, implement, and assess components of the Pedagogical Rural and Underserved Health Service Delivery Model

Background: Health disparities continue to be a concern for rural and underserved communities.

Recruiting and retaining a quality healthcare workforce provides a continuous challenge for many rural and poor communities. The Mercer University School of Medicine's mission is to prepare healthcare workers to serve in rural and underserved communities. Although most MUSM graduates remain in the state to practice, many rural communities in Georgia remain underserved.

Methods: This is the first stage in a longitudinal study that has a long term goal to maximize MUSM students' decision to practice in rural communities and impact health outcomes. The study is based on the MUSM class of 2012. Given the mission of MUSM, along with the needs of the citizens of Georgia, the MUSM faculty has developed a pedagogical model to facilitate the transformation of students into community-responsive health practitioners. The model constructs include: Identification, preparation, transformation, operationalization, impact, and feedback.

Identification- Through the application process students are selected in part based on their intent to embrace and comply with the mission.

Preparation- Students matriculate through an undergraduate medical school curriculum that is problem-based and utilizes a biopsychosocial framework including basic sciences along with early clinical and community experiences. These clinical and community experiences are followed during all four years of medical school.

Transformation- A transformational event is defined as an experience which causes a person to reassess pre-established beliefs, ideas, and attitudes and arrive at a different proactive conclusion. The planned events include the windshield tour and community dialogue, preceptor experiences, and community projects.

Operationalization – Ultimately, the end goal is for students to develop into community-responsive practitioners who are operationalized via a matrix of roles – clinician, collaborator, advocate, broker, educator, and community member.

Impact – Health outcomes

Feedback – This occurs throughout the process through assessment at each construct level.

Assessment includes, pre/post test, reflections, observations, and health statistics

Results: Results are preliminary and not exhaustive. Data collection and analysis is ongoing through June 2009.

Transformational Events

Windshield Tour and Community Dialogue (WT/CD)

Preliminary results revealed that 100% of students participating in the WT/CD thought the experience was valuable, would recommend the experience continue and felt the experience added to their understanding of rural life and health care. Overall, students were satisfied with the WT/CD experience.