University of Louisville School of Medicine, Trover Campus at Baptist Health Madisonville, Madisonville, Kentucky 42431, USA.
Acad Med. 2013 Aug;88(8):1122-8. doi: 10.1097/ACM.0b013e31829a3df0.
Ten years of data for the rural-based Trover Campus (ULTC) were compared with data for the main campus of the University of Louisville School of Medicine to determine whether educational outcomes were equivalent and whether this method of optimizing the affinity model was effective in placing graduates in rural practice.
Demographic data and academic measures were compared for 1,391 graduates (60 from ULTC) for 2001-2010. A noninferiority model was developed to compare clinical experiences for each campus cohort. Residency match lists were examined for specialty choice. Graduates from 2001 to 2006 were matched to the American Medical Association Masterfile to determine practice site.
ULTC students scored lower on United States Medical Licensing Examination (USMLE) Step 1 and Step 2 Clinical Skills (CK) but tended to close this gap after clinical training when compared with Louisville graduates. The noninferiority model indicates that ULTC students' scores were noninferior to Louisville students' on adjusted shelf exams for obstetrics-gynecology, pediatrics, and surgery, and Step 2 CK (P<.001). ULTC graduates were 4.5 times more likely to choose family medicine (P<.001) and over 6 times more likely to choose a nonmetropolitan area as a practice site (P=.001).
These data support the value of a small regional rural clinical campus in optimizing the affinity model to place rural students into rural practice. The ULTC students showed equivalent adjusted test scores and slightly narrowed the gap in unadjusted USMLE scores compared with the main campus students.
将农村特罗弗校区（ULTC）的 10 年数据与路易斯维尔大学医学院主校区的数据进行比较，以确定教育成果是否相当，以及这种优化亲和模型的方法是否有效地将毕业生安置在农村实践中。
比较了 2001-2010 年 1391 名毕业生（60 名来自 ULTC）的人口统计学数据和学术成绩。为每个校区的队列开发了非劣效性模型，以比较临床经验。检查住院医师匹配名单以确定专业选择。将 2001 年至 2006 年的毕业生与美国医学协会主文件进行匹配，以确定实践地点。
ULTC 学生在美国医师执照考试（USMLE）第 1 步和第 2 步临床技能（CK）考试中的得分较低，但与路易斯维尔毕业生相比，在临床培训后，他们往往会缩小这一差距。非劣效性模型表明，在妇产科、儿科和外科学调整后的支架考试以及第 2 步 CK 考试中，ULTC 学生的成绩与路易斯维尔学生相当（P<.001）。ULTC 毕业生选择家庭医学的可能性高出 4.5 倍（P<.001），选择非大都市地区作为实践地点的可能性高出 6 倍以上（P=.001）。
这些数据支持小型区域性农村临床校区在优化亲和模型以将农村学生安置在农村实践中的价值。与主校区的学生相比，ULTC 学生的调整后测试成绩相当，而未调整的 USMLE 成绩差距略有缩小。
