WWAMI 农村医疗服务欠缺地区定向项目（TRUST）：应对农村医生劳动力短缺的创新举措。

The WWAMI Targeted Rural Underserved Track (TRUST) Program: An Innovative Response to Rural Physician Workforce Shortages.

作者信息

Greer Thomas, Kost Amanda, Evans David V, Norris Tom, Erickson Jay, McCarthy John, Allen Suzanne

机构信息

T. Greer is professor of family medicine, University of Washington School of Medicine, Seattle, Washington. A. Kost is assistant professor of family medicine, University of Washington School of Medicine, Seattle, Washington. D.V. Evans is associate professor of family medicine, University of Washington School of Medicine, Seattle, Washington. T. Norris is professor of family medicine, University of Washington School of Medicine, Seattle, Washington. J. Erickson is clinical professor of family medicine, University of Washington School of Medicine, Whitefish, Montana. J. McCarthy is clinical associate professor of family medicine, University of Washington School of Medicine, Spokane, Washington. S. Allen is clinical professor of family medicine, University of Washington School of Medicine, Boise, Idaho.

出版信息

Acad Med. 2016 Jan;91(1):65-9. doi: 10.1097/ACM.0000000000000807.

DOI:10.1097/ACM.0000000000000807

PMID:26200575

Abstract

PROBLEM

Too few physicians practice in rural areas. To address the physician workforce needs of the Washington, Wyoming, Alaska, Montana, and Idaho (WWAMI) region, the University of Washington School of Medicine developed the Targeted Rural Underserved Track (TRUST) program in August 2008. TRUST is a four-year curriculum centered on a clinical longitudinal continuity experience with students repeatedly returning to a single site located in a rural community or small city.

APPROACH

The overarching theme of TRUST is one of linkages. Students are strategically linked to a rural community, known as their TRUST continuity community (TCC). The program begins with a targeted admission process and combines new and established programs and curricular elements to form a cohesive educational experience. This experience includes repeated preclinical visits, clerkships, and electives at a student's TCC, and rural health courses, the Underserved Pathway, and the Rural Underserved Opportunities Program (which includes a community-oriented primary care scholarly project).

OUTCOMES

TRUST was piloted in Montana in 2008. With the matriculating class of 2015, every state in the WWAMI region will have TRUST students. From 2009 (the year targeted admissions began) to 2015, 123 students have been accepted into TRUST. Thirty-three students have graduated. Thirty (90.9%) of these graduates have entered residencies in needed regional specialties.

NEXT STEPS

Next steps include implementing a robust evaluation program, obtaining secure institutional programmatic funding, and further developing linkages with regional rural residency programs. TRUST may be a step forward in addressing regional needs and a reproducible model for other medical schools.

摘要

问题

在农村地区执业的医生太少。为满足华盛顿、怀俄明、阿拉斯加、蒙大拿和爱达荷（WWAMI）地区对医生劳动力的需求，华盛顿大学医学院于2008年8月制定了“定向农村医疗服务不足培养计划”（TRUST）。TRUST是一个为期四年的课程体系，以临床纵向连续性体验为核心，学生们会多次回到位于农村社区或小城市的同一个地点。

方法

TRUST的总体主题是建立联系。学生们被策略性地与一个农村社区建立联系，这个社区被称为他们的TRUST连续性社区（TCC）。该计划从有针对性的招生过程开始，将新的和已有的项目及课程元素结合起来，形成一个连贯的教育体验。这种体验包括在学生的TCC进行多次临床前访问实习、临床实习和选修课程，以及农村健康课程、医疗服务不足途径课程和农村医疗服务不足机会计划（其中包括一个以社区为导向的初级保健学术项目）。