Travel (staff, students):  $20,000

The coordinator will work with departments at MSU to identify internships and experiences required in the curriculum.  With the departments, the coordinator will prepare an application process for rural/underserved healthcare organizations, and coordinate the matching process with departments.  Student support services will vary with community, but will include travel reimbursement, and potentially stipends for food and lodging.  Often lodging can be provided by the community.  Approximately 30 students annually will participate in targeted experiences.  An additional 30 students will participate in group experiences (e.g. a clinical day for WWAMI students in Browning).

The Montana Area Health Education Center is a grant funded program  in the College of Nursing, and affiliated with the WWAMI Program.  The AHEC is a statewide program that interacts with hospitals, clinics, and other healthcare organizations from throughout the state.  It operates a program that conducts community health assessments with rural hospitals; places WWAMI students in rural/underserved clinical settings; assists pre-health professions students with shadowing experiences; assists with arrangements for group clinical/experiences on Indian Reservations, and manages a host of programs that build partnerships with high school students and healthcare organizations.  The AHEC conducts strategic planning on healthcare workforce issues, and supports major statewide initiatives in nursing and graduate medical education.

These programs have built strong partnerships with hospitals, clinics, the Montana Hospital Association, the MT Primary Care Association (community health centers) and tribal health. Through these relationships, AHEC staff learn of many opportunities that would make excellent internship or learning experiences for MSU students.  For example, the AHEC provides coordination for a project with the Montana Hospital Association, several small rural hospitals, and the Industrial Engineering Program.  Students, supervised by faculty, work with the small hospitals on a process improvement project.  Travel and costs of supervision have been coordinated by AHEC, with funding from a grant.  AHEC also supervises students from Community Health seeking internships in healthcare.  We combine their internship with office based experience in Bozeman, and pay for travel to rural/underserved communities to assist with health assessments, health fairs, community wellness projects, and similar experiences.  AHEC coordinates with WWAMI for a variety of rural experiences including a month long placement with a rural physician, arranging travel and housing.  The AHEC program pays travel costs for nursing and WWAMI students for experiences on Indian reservations.

In our work, AHEC staff have identified many more opportunities than we have capacity to coordinate or fund.  The rural hospitals and clinics are interested in having more students, and have expressed interest in connecting with business and architectural students, for example, in addition to health professions students and the engineering students. 

The challenges faced in making these arrangements are:

• Faculty are often too busy to build the relationships with facilities hundreds of miles from campus
• Facilities are often unfamiliar with academic requirements, and how to create relationships with MSU students and faculty
• Students cannot afford travel costs to communities far from campus
• The experiences available within the Bozeman community are often at capacity, and students have difficulty finding organizations that will host their internships or shadowing experiences
• There are not formal processes in place to identify appropriate experiences in rural facilities, and to assure that educational requirements are met

This proposal addresses those challenges by

• Providing dedicated staff to coordinate with MSU departments, faculty and staff to identify learning requirements
• Identifying rural healthcare settings that would serve as appropriate learning environments
• Serving as a liaison to coordinate placement opportunities
• Identifying appropriate travel costs and housing arrangements, and facilitating payment
• Finding housing and hosts for MSU students
• Providing guidance/coordination with departments on preparing a research paper/poster on the rural experience
• Hosting a semester poster session for students who participate in rural experiences

Strengthening ties to rural/underserved communities in Montana:  The AHEC program spends approximately 100 days per year in rural communities including Indian reservations in Montana, working with healthcare facilities and interacting with community members.  We also work with rural schools to prepare students to enter postsecondary health professions education.  It is very clear that small communities in Montana have strong ties to MSU, and have an interest in strengthening opportunities for partnership.  The facilities are very interested in working with MSU students.  They find these projects energizing, and the students bring up to date ideas with them.  The facilities also see student interaction as a tool for showing that career opportunities exist in rural communities.  Students find the experiences very positive.  They often get a more indepth experience in a small community and one on one attention from clinicians and administrators.  It is not unusual for students to be interviewed by the local paper and to have people from around town welcome them to the community.

Interprofessional education:  When students from multiple professions are working in a small community, there are opportunities for interprofessional education.  An example is the engineering students’ process improvement projects.  This project has led to discussions with the College of Nursing faculty.  Engineering students and faculty can benefit from a better understanding of clinical issues and process; nursing student and faculty can learn from the engineers about process improvement.  When students are in the same location, opportunities exist for increasing knowledge of interprofessional interaction and roles of other professions, and the increasing role of teams in delivering healthcare.

Implementation Plan

Activity                                                                                   Timeline

Identify department opportunities for student projects,       

experiences or internships appropriate to rural healthcare

facilities                                                                                               Spring 2013

Identify rural/underserved communities and facilities

as potential placement sites                                                                 Summer 2013 and ongoing

For complex projects and placements, create application

process and placement criteria with departments                               Spring 2013, ongoing

Obtain agreements with facilities for student experiences,

internships or projects                                                                         Summer 2013, ongoing

• Scope of student activity
• Supervision
• Length of time
• Responsibilities

Create and implement travel reimbursement guidelines                     Summer 2013

Identify and make arrangements for student housing as needed       Month prior to placement

Identify requirements for reporting student research or experience

as paper and poster                                                                             Month prior to placement

Monitor agreed upon supervision of students                                                During student placement

Present student papers and posters at semester session                      End of each semester

Metric E.1.2, E.1.3, E.1.4:  The number of students, by discipline, length of experience, credit granted will be tracked.  The communities will be identified by rurality (USDA measures), medically underserved (HRSA measures), and demographics.  Students will report on the experience of service, outreach and engagement in a report and poster.

Metric I.1.1; I 1.2, I.1.3:  The number of students that had an experience tied to a specific curricular requirement will be reported.  The number of departments participating will be reported.  The number of students completing a community based participatory research project as part of the project will be reported, and presented during a semester poster session.

Students will complete an assessment of knowledge gained of rural and underserved communities as a result of the experience or internship.  Facilities will complete a satisfaction survey of the experience.  Sample instruments for these assessments are available from the WWAMI program and the Industrial Engineering Process Improvement Project.

If the project is not successful, the AHEC program will cease to offer coordination of student experiences with rural healthcare facilities.