Rural Health Workforce Development Through the AHEC Scholars Model

It is widely understood that access to health care services is crucial to achieving and maintaining good health. The Indiana AHEC Scholars program was developed to help combat these shortages by providing post-secondary health professions students with a didactic curriculum paired with community-based rural and/or medically underserved experiences in local communities. This study aimed to assess any relationship between students' engagement in the AHEC Scholars program and both their intent to and actual practice in a rural community post-graduation.

We conducted a retrospective cohort study on five cohorts of post-secondary health professions students who engaged in the AHEC Scholars program between 2018 and 2023. We conducted a quantitative analysis using a pre-mid-and post-program evaluation. A paired t-test was conducted to assess a change between a student's self-reported intent to practice in a rural community at the start of the program compared to the midway point of the program and the end of the program. Additionally, a chi-square test was conducted to assess the relationship between the students' reported intent to practice in a rural area at the end of the Scholars program and their reported practice location 1 year post-program.

A statistically significant difference was found between the students' intent to practice in a rural setting before and after their involvement in the AHEC Scholars program with the post-experience scores being significantly higher than the pre-experience scores (p ≤ 0.01). Additionally, we found a significant change over time, as the students' reported interest in rural practice increased between the start of the program and the mid-point, (p ≤ 0.01), as well as a between the midpoint of the program and the end (p ≤ 0.01). Using a scale wherein 1 is low and 5 is high, the mean score for students' intent to practice in a rural area between the pretest, mid-point, and posttest evaluation were 3.02, 3.46, and 3.67, respectively. A significant correlation was also found between the students' intent to practice in a rural area and actual rural practice, p ≤ 0.001. At the time of 1-year follow-up, 24.6% (n = 92) of individuals reported employment in a rural area.

Our study highlighted that incorporating didactic and community-based experiences may contribute to health profession education students choosing to practice in rural communities when entering the workforce. Our findings demonstrate the vital need to develop clear career trajectories for health professional students to learn about rural-based care as a strategy for enticing practice in those communities.