Effect of the Rural Interprofessional Faculty Development Initiative on VHA Clinician Turnover by Level of Program...

VHA's Rural Interprofessional Faculty Development Initiative (RIFDI) is a structured program designed to develop teaching and leadership skills among clinical educators in rural settings. While prior literature indicates engagement in professional development programs increases retention of staff in health systems, no prior work has quantitatively evaluated the relationship between level of engagement and the associated effect on retention. We evaluated the impact of RIFDI on employee turnover by level of program engagement among VHA clinicians nationwide.

We employed a quasi-experimental study design using RIFDI program records and VHA administrative data from 2019 to 2024. Turnover was defined as leaving employment within 1 year after completing RIFDI. We used latent class methods to identify sub-groups among 134 RIFDI participants based on completion rate of RIFDI curriculum activities, allowing us to classify participants by level of program engagement. Using a propensity weighting approach, we compared predicted probabilities of turnover between each engagement group and 150,045 comparable non-RIFDI clinicians.

We identified two sub-groups among RIFDI participants: lower engagement participants (31%); and higher engagement participants (69%). In adjusted models, turnover was 12.8% among lower engagers, <1.0% among higher engagers, and 11.3% among non-RIFDI participants. Turnover was approximately 11 times lower for higher engagers compared with non-RIFDI participants (p-value < 0.001).

The impact of RIFDI on VHA clinician turnover varied by level of program engagement, with highly engaged participants experiencing significantly lower turnover rates. Health systems should consider programs like RIFDI as a potential strategy for improving rural clinician retention.