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.
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.
Edwards
Joellen B
JB
Department of Family and Community Nursing, College of Nursing, East Tennessee State University, Johnson City, TN 37614, USA. edwardsj@etsu.edu
Wilson
Jim L
JL
Behringer
Bruce A
BA
Smith
Patricia L
PL
Ferguson
Kaethe P
KP
Blackwelder
Reid B
RB
Florence
Joseph A
JA
Bennard
Bruce
B
Tudiver
Fred
F
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*