Cecil G. Sheps Center for Health Services Research, University of North Carolina, Chapel Hill, North Carolina, USA.
Department of Family Medicine, University of North Carolina, Chapel Hill, North Carolina, USA.
J Rural Health. 2024 Jun;40(3):509-519. doi: 10.1111/jrh.12824. Epub 2024 Feb 5.
This study assesses how, among behavioral health clinicians working in rural safety net practices, the amount of exposure to care in rural underserved communities received during training relates to confidence in skills important in their work settings, successes in jobs and communities, and anticipated retention.
This study uses survey data from Licensed Clinical Social Workers, Licensed Professional Counselors, and Psychologists working in rural safety net practices in 21 states while receiving educational loan repayment support from the National Health Service Corps, from 2015 to April 2022.
Of the 778 survey respondents working in rural counties, 486 (62.5%) reported they had formal education experiences with medically underserved populations during their professional training, for a median of 47 weeks. In analyses adjusting for potential confounders, the estimated amount of rural training exposure was positively associated with a variety of indicators of clinicians' integration and fit with their communities as well as with longer anticipated retention within their rural safety net practices. The amount of training in care for rural underserved populations was not associated with clinicians' confidence levels in various professional skills or successes in their work, including connection with patients and work satisfaction.
Formal training in care for underserved populations is a large part of the education of behavioral health clinicians who later work in rural safety net practices. More training in rural underserved care for these clinicians is associated with greater integration and fit in their communities and longer anticipated retention in their practices, but not with skills confidence or practice outcomes.
本研究评估了在农村服务匮乏社区接受培训期间接触农村医疗服务的程度，如何影响在农村安全网医疗机构工作的行为健康临床医生的技能信心、工作和社区的成功以及预期的留任率。
本研究使用了来自 21 个州的在农村安全网医疗机构工作的持照临床社会工作者、持照专业顾问和心理学家的调查数据，这些人在国家卫生服务团接受教育贷款还款支持，时间为 2015 年至 2022 年 4 月。
在接受调查的 778 名在农村县工作的受访者中，有 486 名（62.5%）报告在专业培训期间有过与医疗服务匮乏人群相关的正规教育经历，中位数为 47 周。在调整了潜在混杂因素的分析中，农村培训经历的估计量与临床医生与社区融合程度的各种指标以及他们在农村安全网医疗机构中的预期留任时间呈正相关。针对农村服务匮乏人群的培训量与临床医生在各种专业技能方面的信心水平或工作中的成功，包括与患者的联系和工作满意度，没有关联。
为服务匮乏人群提供的正规培训是在农村安全网医疗机构工作的行为健康临床医生教育的重要组成部分。这些临床医生接受更多的农村服务匮乏人群培训与他们在社区中的融合程度和预期留任时间呈正相关，但与技能信心或实践结果无关。
