Collaborative Rural Curriculum of
Rural Medical Educators of the
National Rural Health Association
Rural Medical Educators Conference
National Rural Health Association
May 22, 2001 3:15-4:45"
Documents used to compile list:
Special Considerations in the Preparation of Family Practice Residents Interest in Rural
Practice, Reprint #289-A http://faculty.washington.edu/dacosta/specialconsider.html
Rural Family Medicine Website http://www.ruralfamilymedicine.org
Issues of the Pipeline of Rural Medical Education, Residency Training, David Acosta, M.D. http://www.ruralfamilymedicine.org/educational%20strategies/residencytraining.htm
Proposed Document Revision and/or Development Core Curriculum Guidelines: Rural Practice
Training for Family Physicians 9/15/1998 AAFP Rural Health Committee http://www.ruralfamilymedicine.org/document%20revision%20development.pdf
Rural Family Practice, You Can Make a Difference, AAFP Monograph, 1997
Rural Issues
Rural Hospitals
Rural Emergency Medical System
Rural Mental Health
Rural Migrant Workers
Rural Physician's Office/Practice Management
* Professional and personal time management
* Leadership and adult lifelong learner skills
* Organizational management skills
* Delivery of medical care utilizing the team
model, including development of collaborative and interactive
relationships with
nurse practitioners, physician assistants, social workers, physical therapists, home
health
nurses and hospice
workers
* Applications of computer systems and other
information technologies pertinent to clinical practice and medical
practice management,
including office and hospital information management systems, remote access to the
internet, use of
websites and computer-based systems for medical library searches and patient education
databases
* Office human resource management and systems
development
* Small office systems development and
management including development of patient education materials,
office policies and
procedures, clinical care plans, quality assurance (hospital and office) and strategic
planning mechanisms
* Familiarity with economic and political
issues identified common to successfully practice medicine and manage
a business in a small
rural community setting
* Conflict resolution and negotiation skills
* Knowledge and experience with reimbursement
systems, contracts, government funding of rural programs
Non-physician rural providers
* Nurse practitioners, physician assistants,
chiropractors, naturopaths, homeopaths
Rural Telemedicine
* Use of telemedicine, telehealth distance
learning, video conference resources for communication, consultation,
professional
networking, and continuing education needs
Rural Nursing Homes
Rural Public Health
Professional Isolation
Information/Evidence-Based Medicine Management
Computer Resources
Rural Physician/Family Lifestyle
* Understand unique social issues of rural
practice, community and lifestyle, call, off hours school duties, athletics,
leadership, privacy
issues and professional isolation
Rural America
* Demographics
* Culture and Social Perspectives
* Economics and Rural Development
* Rural Occupations
* Rural Environment
Rural Policy
* Rural research centers
* Leadership skills
* Recruitment and retention issues
* Government rural policies
* Political advocacy
* National Rural Health Association Policy
Board
Rural Resources
* Federal organizations/resources
* State organizations/resources
* Local organizations/resources
* Private organization/resources
* Information Databases
Rural Literature
Rural Safety
Rural Networks
* Provider availability
* Consultant availability
* Tertiary Care support
* Small group and solo practices
Rural Safety Net
Rural Health Clinical Topics
*Agromedicine Literature and Reference Books
* Animal Handling
* Agriculture in General
* Dermatologic Problems
* Children in Agriculture
* Water Contamination
* Chemical Hazards
* Special Hazards of Veterinarians
* Role of Antibiotics in feed
* Hypothermia
* Rural drug addiction
* Hyperthermia
* Rural domestic violence
* Infections-Zoonoses
* Wilderness medicine
* Fungal Infections
* Fishing industry
* Protozoa Cryptosporidiosis
* Mental health of farm families
* Tick Borne Infections
* Farm Equipment
* Aids in Rural America
* Electrocution Risk and Treatment
* Cancer Risk among Agricultural Workers
* Chronic Accumulated Disease
* Rural Disabilities
* Lung Disease
* Rural Traffic Safety
* Farm Facilities Hazards
Skills and Skill Knowledge Enhancement for Rural Practice
Women's Health
* Network of obstetrics care-not all rural
areas offer OB services
* Core Guidelines in Women's Health http://www.aafp.org/edu/guide/rep261.htm
* Special Rural Emphasis
- Gestational Diabetes
- Multiple Gestation
Care
- Ultrasonography
- Outlet Forceps
- Vacuum Extraction
- Management of Breech
Delivery
- Emergency Care
- Cesarean section
training
- Enhanced gynecologic
skills
# D&C
# Colposcopy
# Cervical Biopsy and Treatment
# Endometrial biopsy
# Postpartum Tubal Ligation
- Enhanced neonatal
stabilization
# Intubation
# Umbilical line placement
# Initial sepsis and fluid management
# Preparation for transport
Trauma and Emergency Care
* Emergency Cardiac care (management of Acut MI, thrombolysis
initiation, arrhythmia's and cardiogenic shock
* Occupational injuries of rural and agricultural areas
* Major trauma (initial management and stabilization, preparation for
transfer)
* Enhanced trauma procedural skills
* Pericardiocentesis
* Tracheal intubation
* Cricothyroidotomy
* Thoracentesis
* Paracentesis
* Tracheostomy
* Central venous line insertion
* Advanced interpretation of acute condition radiographs (extremities,
chest, spine, abdomen, etc)
* Complex laceration repair
* Psychiatric emergencies including techniques for stabilization,
transfer and referral
* Poisoning and exposure to toxic substances including use of
computerized reference materials and poison control
centers
* ACLS, ATLS, ALSO, PALS certifications
Occupational Health
* Agricultural
* Industrial
* Environmental
* Infectious Diseases
* Communicable Diseases
* Mining
* Workplace Stressors
Critical Care
Enhanced ICU/CCU experience, management of unstable cardiac and
other critically ill patients with an emphasis on
the use of technology commonly available in rural hospitals
and stabilizing for transfer
Surgery and Procedural Skills
* Surgical emergencies evaluation and management
* First surgical assisting and postoperative care skills in
collaboration with outreach surgeons
* Enhanced surgical training if the resident expects to function as a
primary surgeon
* Consultation and collaborative management with local and outreach
surgeons
* Office procedures such as vasectomy, gastroscopy,
sigmoidoscopy/colonoscopy, dermatalogic procedures,
treadmill testing, fine-needle aspiration and
biopsy of breast and other superficial tissues, joint aspiration and
injection, conscious sedation, regional and
local anesthesia
* Placement and management of catheters, venous and arteria lines
Musculoskeletal Medicine and Sports Medicine
* Closed reduction and casting of common fractures
* Advanced casting
* Reduction of dislocations
* Splinting and referral of complex and open fractures
* Radiographic recognition of common and serious fractures
* Team physician services, athletic training
* Consultation and management with local and outreach orthopedic
surgeons
* Soft tissue injury management
Geriatrics
* Advance home health, hospice and case management of the older patient
including reimbursement systems,
documentation of care and team based care, functional assessment
* Enhanced skilled nursing faculty experience
* Prescription and utilization of Durable Medical Equipment and goods
* Consideration of elder care in a rural or remote setting
Child's Health
* Trauma Care
* Chronic childhood illness
* Growth disorders
* Learning disorders
Behavioral Medicine
* General Counseling
* Domestic Violence
* Psychopharmacology
* Palliative Care
* Crisis Intervention Skills
* Case
Management team approach to chronically mentally ill
* Family and parental counseling * Team approach to
behavioral health
* Marital counseling
* Short term psychotherapy
* Developmental problems
Community-Oriented Primary Care
* Community health assessment
* Experiences that foster community-oriented delivery of health care
and the role of family physicians in community
public health, school health, community leadership,
community development and political action
* Public health education principles
* Knowledge and skills in community sanitation systems and water
quality assurance
* Exposure to the role of family physician as medical examiner
* Role of the family physician as medical director
* Role of the family physicians in interaction with delivery of medical
care at correctional facilities
Other identified needs
Nephrology, Rheumatology, Allergy, Nutrition