Background and Objectives: The Scholars in Rural Health (SRH) program at the University of Kansas School of Medicine (KUSOM) aims to address rural physician shortages by recruiting and supporting college students from rural Kansas. This study evaluated the outcomes of the early assurance program to determine its effectiveness in increasing participation in the rural physician workforce. Methods: We conducted a retrospective cohort study (1997–2024) to analyze data from 403 participants in the SRH program. We reviewed program and medical school records to assess completion rates, residency placements, and practice locations. Rural practice was defined using the Federal Office of Rural Health Policy (FORHP) criteria. Results: Medical College Admission Test (MCAT) performance was a key factor in medical school matriculation, with an increase in nonmatriculation following the 2015 MCAT revision. A total of 200 people completed the SRH program and medical school. Of these, 136 (68%) matched into primary care residencies (family medicine, internal medicine, pediatrics), with 110 (55%) matching into family medicine residencies. Of those studied, a total of 150 residency graduates were in practice; 84 (56%) practiced in fully FORHP rural counties. Additionally, 122 (81%) practiced in Kansas overall. Conclusions: The SRH program is associated with a higher proportion of graduates practicing in rural Kansas compared to the overall KUSOM cohort. Continued support, particularly in MCAT preparation, may improve retention and further enhance rural physician workforce development. Future studies should explore the impact of state loan repayment or service-obligation programs and the role of SRH alumni in academic and mentorship roles at KUSOM.
BACKGROUND AND OBJECTIVES:Point-of-care ultrasound (POCUS) is increasingly used in primary care and is now an Accreditation Council for Graduate Medical Education training expectation for family medicine residents. However, standardized methods for teaching, observing, and assessing POCUS skills in clinical settings remain limited. METHODS:The University of Hawai'i Family Medicine Residency Program developed direct-observation checklists for obstetric (OB) and musculoskeletal (MSK) POCUS. OB assessments included first- and third-trimester scans, while MSK assessments focused on knee and shoulder examinations. Checklist content was adapted from existing validated tools and refined through Plan-Do-Study-Act cycles. The checklists were designed for use before, during, and/or after patient encounters to guide observation and feedback. Faculty and residents completed surveys to evaluate usability, workflow integration, and educational impact. RESULTS:From March to October 2025, 39 checklists (28 OB, 11 MSK) and 60 surveys were collected from faculty and residents at two clinical sites. Most attending physicians reported checklist completion and feedback delivery in less than 5 minutes. Faculty most frequently used the tools postencounter. Perceived utility was high: 76% of OB and 88% of MSK attending responses rated the checklist as very useful, and nearly all residents (95% OB; 100% MSK) reported that the checklists supported a systematic approach and reinforced learning. Time constraints and certain indirectly observable checklist items were identified as implementation challenges. CONCLUSIONS:Structured POCUS teaching checklists are feasible and well-received in family medicine residency training. These tools support direct observation, structured feedback, and standardizing expectations during supervised scanning encounters.
BACKGROUND AND OBJECTIVES:New Accreditation Council for Graduate Medical Education and American Board of Family Medicine guidelines encourage training family medicine residents in point-of-care ultrasound (POCUS). Prior studies have focused on the perceived needs of learners but did not assess patient or community need. METHODS:We performed a triangulated learner- and patient-oriented needs assessment to inform POCUS curriculum development within a family medicine residency. Our learner assessment consisted of a Likert scale survey of the perceived skill and importance of 36 POCUS modalities discussed in the 2016 American Academy of Family Physicians POCUS curriculum guidelines. Our patient-oriented needs assessment was collected through analysis of all family medicine practice (FMP) site imaging orders placed in 2023. RESULTS:The learner survey demonstrated the highest skill gaps in POCUS training to be evaluation for hemothorax and evaluation for pleural effusion. FMP site imaging order analysis demonstrated that hepatobiliary and obstetrics/gynecology concerns were the most frequently answered by POCUS for patients seen at the FMP site. CONCLUSIONS:POCUS is an important and underutilized diagnostic tool in family medicine. POCUS curricula in graduate medical education are vital to successful implementation of POCUS in primary care; however, needs assessment techniques used in prior studies differ from the patient and community needs in our study. We recommend the use of both needs assessment strategies for optimal POCUS training outcomes. Further research replicating this modality is necessary to determine the optimal needs assessment approach for POCUS in family medicine.
BACKGROUND AND OBJECTIVES:As more family medicine residency programs incorporate point-of-care ultrasound (POCUS), effective ways to teach and assess POCUS competency remain a major challenge. This Delphi study aimed to create expert consensus to define POCUS general competencies for family medicine residents. METHODS:We used a traditional Delphi study design to draft and validate a list of POCUS general competencies. We recruited a panel of 25 family medicine POCUS education experts from various backgrounds. Three rounds of voting occurred between February and July of 2025. Drafted survey items were categorized to correspond to the six Accreditation Council for Graduate Medical Education (ACGME) milestones. In each round, panelists rated agreement using a 5-point Likert scale. Items failing to reach consensus after round three were excluded from the final general competency list. RESULTS:A total of 49 general competencies were drafted prior to round one, and an additional three competencies were added between rounds. After three rounds, 45 general competencies met positive consensus, and seven lacked consensus leading to their exclusion from the final list. CONCLUSIONS:This study used standardized, evidence-based Delphi methodology to establish the first set of POCUS general competencies for teaching and assessing family medicine residents. The general competencies identified represent a broad scope of skills correlating to the six ACGME milestones. The study provides the foundation for future research evaluating how these general competencies can be used to assess POCUS competence for family medicine residents.
BACKGROUND AND OBJECTIVES:Place-based clinical education is vital for promoting the growth of the rural clinician workforce; where learners receive their education strongly influences where they practice. Yet students may struggle to find rural placements. In this study, we sought to understand trends in teaching by family physicians for varied health professions and the associated physician, practice, and community factors. METHODS:We analyzed data from 14,789 early career family physicians surveyed from 2016 to 2023. We compared the teaching status of rural and urban physicians overall and by year. We conducted trend analyses and multivariate regression to investigate the relationship between physician and practice characteristics, practice activities, community characteristics, and teaching status. RESULTS:More rural than urban physicians taught premedical students (30.8% vs 18.7%), medical students (62.2% vs 54.4%), and advanced practice professional students (51.2% vs 33.7%), while more urban than rural physicians taught residents (41.9% vs 37.8%) and fellows (8.7% vs 2.3%). Trend analyses showed an 8.4% increase in rural physicians teaching residents from 2016 to 2023, and a decline in teaching advanced practice professional students over the same time period. In adjusted analyses, family physicians who were younger, male, and White non-Hispanic were more likely to teach, as were osteopathic physicians, those with a broad scope of practice, and those who provided obstetric services. CONCLUSIONS:A larger share of rural than urban early career family physicians teach health professions students, but the rate who are teaching advanced practice professional students has declined significantly. Understanding and arresting the decline will be essential to addressing rural workforce capacity.
