title: Practice locations of graduates of family physician residency and nurse practitioner programs: considerations within the context of institutional culture and curricular innovation through Titles VII and VIII.
abstract: BACKGROUND
  Studies have described the aggregate results of federal funding for health professions education at the national level, but analysis of the long-term impact of institutional participation in these programs has been limited.
  
  
  OBJECTIVE
  To describe and assess federally supported curricular innovations at East Tennessee State University designed to promote family medicine and nurse practitioner graduate interest in rural and underserved populations.
  
  
  METHODS
  Descriptive analysis of a survey to determine practice locations of nurse practitioner graduates (1992-2002) and graduates of 3 family medicine residencies (1978-2002). Graduates' (N = 656) practice locations were documented using specific federal designations relating to health professions shortages and rurality.
  
  
  RESULTS
  Overall, 83% of family medicine residency and 80% of nurse practitioner graduates selected practice locations in areas with medically underserved or health professions shortage designations; 48% of family physicians and 38% of nurse practitioners were in rural areas.
  
  
  CONCLUSIONS
  Graduates who study in an educational setting with a mission-driven commitment to rural and community health and who participate in curricular activities designed to increase their experience with rural and underserved populations choose, in high numbers, to care for these populations in their professional practice.
authors.affiliation: Department of Family and Community Nursing, College of Nursing, East Tennessee State University, Johnson City, TN 37614, USA. edwardsj@etsu.edu
authors.forename: Joellen B
authors.initials: JB
authors.lastname: Edwards
authors.forename: Jim L
authors.initials: JL
authors.lastname: Wilson
authors.forename: Bruce A
authors.initials: BA
authors.lastname: Behringer
authors.forename: Patricia L
authors.initials: PL
authors.lastname: Smith
authors.forename: Kaethe P
authors.initials: KP
authors.lastname: Ferguson
authors.forename: Reid B
authors.initials: RB
authors.lastname: Blackwelder
authors.forename: Joseph A
authors.initials: JA
authors.lastname: Florence
authors.forename: Bruce
authors.initials: B
authors.lastname: Bennard
authors.forename: Fred
authors.initials: F
authors.lastname: Tudiver
mesh_terms: D001061:Appalachian Region; D002321:Career Choice; D003479:Curriculum; D005194:Family Practice / Q000193:education; D006801:Humans; D007396:Internship and Residency / Q000706:statistics & numerical data; D008507:Medically Underserved Area; D009722:Nurse Practitioners / Q000523:psychology / Q000600:supply & distribution*; D015279:Organizational Culture; D010821:Physicians, Family / Q000523:psychology / Q000600:supply & distribution*; D011365:Professional Practice Location / Q000706:statistics & numerical data*; D012577:Schools, Medical / Q000191:economics / Q000458:organization & administration*; D013714:Tennessee; D014146:Training Support / Q000331:legislation & jurisprudence*