University of Colorado Rural Track:
Increasing Availability of Care

Since its inception in 2005, the University of Colorado's Rural Track has expanded its programming beyond the walls of the medical school. Where the program once worked only with medical students, it now consists of students from a variety of disciplines, including pharmacy, physician's assistant, nursing, public health, psychology and dentistry, and offers a variety of programs focused on delivering health care in rural communities.

"We're trying to give students the knowledge and reinforcement that when you're in rural practice, you are responsible for all of people's health care," said Mark Deutchman, MD, Rural Track Director. "The medical home idea is not strange to rural providers – they've been doing it for years: trying to coordinate care, follow up with patients – and so our students experience an emphasis on that."

In between a students' first and second years, they now have the opportunity to participate in what Dr. Deutchman calls a week-long "invasion" of a rural town: Rural Immersion Week.

"We place students from four different disciplines into a rural community and break into groups and work through a host of rural health topics," said Jack Westfall, MD, Associate Dean for Rural Health and Colorado AHEC (Area Health Education Center) Director in the Department of Family Medicine. "Because in a rural community, health care interfaces with every other aspect of the community – education, the justice system, behavioral health, acute care – the health care system runs right into and overlaps all those things."

Casey Beardsley is in her final year of the Child Health Associate/Physician Assistant program at the University of Colorado.

Each year the program chooses a different rural location. Casey Beardsley, who is in her final year of the Child Health Associate/Physician Assistant program at the University of Colorado, participated in Rural Immersion Week during summer 2009, when the program just happened to be in her hometown.

"I'm from Sterling, so being from a rural area, I knew what it was like, and I really enjoy rural life. Knowing there is a need for professionals in rural areas, I knew I'd be interested and applied for Rural Immersion Week," she said. "I got to work with students from all the other disciplines, and I learned so much. ... I did my rotation for four months in Sterling and through that rotation got a job offer. I am seriously considering going back there for the long term."

University of Colorado School of Nursing Professor Amy Barton, PhD, RN, said the Rural Immersion Week experience has provided students in the nursing program with real life evidence of how interdisciplinary training supports emerging new models of care delivery, like medical homes, accountable care organizations and interdisciplinary primary care.

"The fact of the matter is that, in order to achieve patient care quality, health professionals have to work together as a team," Dr. Barton said. "That's why we've tried to come up with a viable and professional curriculum that facilitates students working together in both rural and underserved urban areas." Indeed, the School of Nursing is working to develop its own rural program, modeled after the School of Medicine's successful Rural Track.

Dr. Deutchman credited the University for promoting interdisciplinary work. Classrooms on the campus are shared between all disciplines. Another way the school brings the various disciplines together is through Rural Grand Rounds. Every month the Rural Track brings together 80-100 interdisciplinary students for a lecture and in-depth discussion.

"It's really a no brainer for a rural provider - you have to know what people do in all different areas. We're trying to demystify the idea of what it's like to live and work in a rural area and show students that they could do that," he said.