1. OREGON FIRST – OREGON Family medicine Integrated Rural Student Training
Dwight Smith MD, Joyce Hollander-Rodriguez MD, Kristi Coleman MD, Michol Polson Ph.D.
Cascades East Family Medicine Residency and Oregon Health & Science University
Proposed Research Design:
Mixed Methods; Designs 1, 2
INTRODUCTION
FOURTH YEAR MEDICAL STUDENT CURRICULUM
Innovative 4th year curriculum for OHSU rural scholar MS4 students
4th year of medical school is spent at Cascades East Family Medicine Residency in Klamath Falls, Oregon
2 students per year
Early declaration of interest in rural family medicine training
Individualized 4th year curriculum to rural interests
Sequential rotations in core specialties and care delivery sites
Combined with longitudinal experiences in:
Chronic disease management
Population based health
Panel of continuity patients
Learner-Centered Medical Home within a PCMH
Dedicated scholarly activity time
Daily dedicated learning time with residency noon conference series
Wilderness Medicine curriculum
Certifications in ACLS, PALS, NRP, ALSO, and AWLS optional
Design 1: Qualitative Case Study Interviews with Purposive Sampling
Oregon FIRST Student Structured Individual In-Depth Interview, Focus Group Interview (N=2)
Structured Focus Group Interview with non Oregon FIRST CEFM Faculty (N=4)
First Level Pattern Code Analysis; Within Case Analytic, Conceptually Clustered Data Display Matrix
Design 2: Quantitative Quasi-Experimental Non-Equivalent Group Design with Repeated Measures; Corrections Made for Selection-Maturation Threats
Repeated Measures at June 2015, December 2015, May 2016
9 Repeated Measures Instruments
Design 2, Phase 1: Year 1-2
1. Frequency Distribution Tables for Repeated Measures
2. Chi Square Analysis when minimum of 5 units per cell is reached
Design 2, Phase 2: Year 3-5
Reliability-Corrected ANCOVA. Addresses bias in ANCOVA treatment effect estimates for the NEGD using a "reliability" correction adjusting the pretest for measurement error
OBJECTIVES
Immersion training in rural family medicine
Customized learning plans to needs of rural medicine
Improve medical students preparation and readiness for rural family medicine residency
Eliminate residency lag at start of residency
Decrease student interviewing costs if they choose to interview for fewer residency programs
Improve healthcare workforce needs and readiness for rural Oregon practices
Improve quality of residents at Cascades East (better prepared for our program)
Conclusion
Oregon FIRST is a new innovative program that will better prepare selected medical students for rural family medicine residency and practice.
Contact
Dwight W. Smith MD
Faculty, Cascades East Family Medicine Residency
Director, Oregon FIRST
Associate Director for Medical Student Education
Assistant Professor, Oregon Health Sciences University
TABLE KEY
YELLOW FILL = INPATIENT ROTATION
BLUE FILL = OUTPATIENT ROTATION
GREEN FILL = ELECTIVE/SELECTIVE