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Rural Preceptorship Handbook

Goals and Objectives | Student Evaluation Methods | Course Evaluation Methods | Preceptor Evaluation of Student Performances | Preceptor Tips | Guidelines for Clinical Activities by Medical Students | Student Work Duty Hours


The goal of this required course is to immerse students in primary care as practiced in a setting distant from immediate access to a tertiary care center. The focus is on the following themes:

  1. Development of autonomy dealing wtih common and serious conditions in rural primary care
  2. Exploration of roles played by physicians in the community
  3. Service learning particularly as applied to rural underserved care
  4. Understanding referral and consultation relationships in a rural environment


  • Gather a history and perform a physical exam that are accurate, organized, and tailored to the rural environment and specific patient encounter.
  • Explain the advantages of first contact and continuous care in rural settings.
  • Propose appropriate strategies for evaluating and managing patients with limited resources in more than one rural health care setting (inpatient, outpatient, other).
  • Under supervision, appropriately order and interpret diagnostic testing/procedures both locally and that require referral to distant, higher acuity institutions.
  • Use information technology to retrieve information to advance patient care and, under supervision, document clinical encounters.
  • Actively participate in transfers of care of patients in or out of the rural health care system, demonstrating a working knowledge of EMTALA laws regarding proper referral and transfer of patients.
  • Demonstrate altruism, respect, accountability, duty, honor, integrity and commitment to excellence in all clinical and educational activities.
  • Describe the role of rural physicians in providing leadership in health care and other community settings.
  • Demonstrate sensitivity and responsiveness to patient individuality, including the role of culture, ethnicity, gender, age, and other aspects in health practices and decisions.
  • Describe rural health care systems including the CAH and Support Hospital structure.
  • Assess the resources available in your preceptor's community to address social determinants of health.
  • Perform patient visits in another community setting than a physician office or hospital such as nursing home or home visit.
  • Explore the function of the members of the health care team in rural settings, such as CRNAs, APRNs, PAs, CNMs, Emergency Medicine Personnel, Pharmacists, RNs, Mental Health Professionals, Dieticians, PTs, OTs, Speech Therapists, etc.
  • Collaborate effectively as a member of the clinical health care team.
  • Accept and provide constructive feedback as part of a commitment to continuous learning and improvement.
    Provide an oral presentation of a clinical encounter.
  • Recognize a patient requiring urgent or emergent care and, under supervision, initiate evaluation and management.
  • Under supervision, obtain informed consent for tests and/or procedures.
  • Under supervision, perform procedures appropriate to the practice.
  • Identify system failures and contribute to a culture of safety and improvement.

Student Evaluation Methods

The Phase II Clinical Performance Rating (CPR), modified to address specific objectives of this course, is completed by the rural preceptor and reviewed by the course director. It is the basis for the student's letter grade.

Students must satisfactorily prepare a written letter of consultation or referral between health professionals or organizations. The letter is submitted to the course director and graded pass/fail.

Students must also satisfactorily complete a reflective assignment that compares and contrasts medical decision-making, physician roles, and referral/consultation relationships in the rural vs. urban practice, addressing priorities, opportunities, and constraints in the rural setting. The assignment is graded pass/fail by the course director.

Students submit patient encounter logs as a pass/fail component of their grade.

Course directors may assign an additional service project as available and appropriate (Tar Wars®, office system improvement intervention, nurse/staff in-service presentation, other community talks or outreaches). The project is reviewed by the course director and graded as pass/fail.

Course Evaluation Methods

Student feedback is solicited via Office of Medical Education surveys and other departmental methods as indicated.

Patient encounter log data is reviewed by the course director.

Course directors perform review of existing rural preceptor sites annually and site visits as necessary to assure a positive learning environment for students. Directors recruit new preceptors and sites as necessary to meet the course goals and objectives.

Last modified: Jun 15, 2020