Date of Graduation

5-2023

Document Type

Dissertation

Degree Name

Doctor of Education in Adult and Lifelong Learning (EdD)

Degree Level

Graduate

Department

Rehabilitation, Human Resources and Communication Disorders

Advisor/Mentor

Kevin M. Roessger

Committee Member

Kenda S. Grover

Second Committee Member

Gary W. Udouj, Jr.

Keywords

civic-mindedness, family practice, medical education, osteopathic medicine, rural health

Abstract

The United States is facing a growing physician shortage that threatens the ability of our healthcare system to provide needed services. This shortage will be more acutely felt in rural and underserved areas. Osteopathic medical education, with its priority of primary care specialties, plays a significant role in meeting the healthcare needs of rural communities in America. The fastest-growing demographic of osteopathic physicians is women under the age of 45 (American Osteopathic Association, 2021). Additionally, for the first time in history, women outnumber men in medical schools, accounting for 51% of current medical students (Boyle, 2019). Who is admitted to medical school is a fundamental issue in medical education. In an effort to alleviate the healthcare workforce maldistribution, preferences should be given to candidates with a higher likelihood of eventually practicing in rural or underserved communities. Studies have looked at factors that influence practice location, including age, the influence of a rural background, parental education, and gender. The literature describes factors that have a strong relationship with an eventual rural practice, including planning to practice family medicine and growing up rural. Women physicians are more likely to choose primary care than their male counterparts but are less likely to practice in rural areas. This non-rural preference, combined with the increase in the proportion of female medical students, represents a risk to the future supply of rural physicians. No studies have been conducted to understand what factors best predict a female osteopathic medical student's choice to practice in a rural setting. This study used multiple linear regression to investigate the relationship between female osteopathic medical students' attitudes toward practicing in a rural setting and their characteristics of a rural upbringing, a plan to practice in a primary care specialty, and degree of civic-mindedness. The results of this study illustrate three substantial effects. First, the greater the degree of civic-mindedness of the student, the more favorable the attitude toward practicing in a rural setting. Second, students who plan to practice family medicine have a more favorable attitude toward practicing in a rural setting. Third, a conditional effect of civic-mindedness was found in which, for students with high civic-mindedness, planning to practice family medicine is associated with a more favorable attitude toward rural practice than students with low civic-mindedness. Of note, although the literature overwhelmingly suggests that a rural background is a predictor of eventual rural practice for medical students in aggregate, the results did not indicate that this was true for female osteopathic medical students in Arkansas. This study has implications for medical school admission practices, and further investigation with a larger sample may provide added insight into what characteristics predict eventual rural practice for women physicians.

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