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Health Care Provider Education: Older Farmers


Health Care Provider Education: Older Farmers Shannon Lizer PhD APN-CS Director of Nursing Highland Community College Freeport Illinois; And UIC College of Nursing – PowerPoint PPT presentation

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Title: Health Care Provider Education: Older Farmers

Health Care Provider Education Older Farmers
  • Shannon Lizer PhD APN-CS
  • Director of Nursing
  • Highland Community College
  • Freeport Illinois
  • And UIC College of Nursing

Focus of Presentation
  • The purpose of this presentation is to review
    current educational modalities of health care
    providers for optimal care of older farmers
  • Short discussion about why this is important
  • Examples given are not meant to be an exhaustive

So, why is this important?
  • A partnership exists between a health care
    provider and patient/family when care is optimal
  • Partnerships are difficult when a knowledge
    deficit exists
  • The culture of farming rural is unique
  • Language and concepts are different in farming
    rural culture
  • Traditional health care health promotion take
    on new meaning

Review of Access to Care Issues
  • 30 of rural residents live in areas with a
    shortage of health providers services
  • Shortage cuts across all disciplines
  • EMS services in rural and frontier is a critical
    problem across the country
  • Lack of health care insurance or high deductibles
    is also an issue for rural residents

Health Care Professions Education
  • Emergency Medical Services
  • Medicine predoctoral residency
  • Nursing undergraduate graduate
  • Pharmacy
  • Dental
  • Allied Health
  • Public Health
  • Interdisciplinary programs

Current Educational System Overview
  • Intentional Programs
  • Agricultural Health Safety Coursework
  • Rural Location
  • Community Partnerships
  • Serendipitous Exposures
  • Continuing Education Programs

Intentional Programs
  • Programs have a rural focus
  • Programs have some rural content
  • Programs are located in rural areas
  • Programs may or may not involve multiple

Rural Nursing Programs
  • Nurse Agricultural Educational Project University
    of Kentucky
  • farm injuries awareness, agricultural curriculum,
    injury prevention research, development of
    instructional materials, and support of
    research/dissertation work around this topic
  • Rural Nurse Internship (RNI)
  • 1 year acute care preceptorship in Oregon,
    Montana, Washington, Idaho

More Nursing Programming
  • Decker School of Nursing in upstate New York has
    a rural nursing tract
  • Frontier Nursing Program in Kentucky
  • East Tennessee State University
  • Rural Family Nursing Program at University of
    Central Missouri

Medical Education
  • Predoctoral Programs
  • May be aligned with state scholarships ex.
    Rural Health Associations
  • May be tied to commitment to practice in rural
  • Postdoctoral Programs
  • Most typically tied to a family practice
    residency program

Predoctoral Medical Rural Programs
  • Several examples across US
  • Texas College of Osteopathic Medicine
  • University of Illinois College of Medicine in
    Rockford, Illinois
  • Oklahoma State University
  • Components include
  • Regular curriculum
  • Rural topics
  • COPC projects

Medical Residency Programs
  • Formal Rural Training Track Programs
  • Richard G. Lugar Center for Rural Health
  • Memorial Family Medicine in South Bend, Indiana
  • Wisconsin Academy for Rural Medicine WARM at
    the University of Wisconsin

Rockfords RMED Program
  • Currently linked with National Center for Rural
    Health Professions (NCRHP)
  • Special admittance process through the University
    College of Medicine
  • Some interdisciplinary exposure
  • Rural curriculum as add-on in M1-M4 years
  • Rural preceptorship COPC project in M4 year

No Harm On The Farm Tour
  • Joint activity with RMED UIC CON Occupational
    Health Nursing Program in Fall 2006
  • Joint presentation between ag safety farmers
  • Toured 2 farms in rural Lee County, Illinois at
  • Beef/grain operation
  • Hog/grain operation

Tenets of Intentional Programs
  • Rural education and exposure are necessary for
    graduates to understand rural culture
  • Rural people may have credibility
  • Rural people (after education) live in rural

Interdisciplinary Programs
  • East Tennessee University
  • Rural Primary Care Tract longitudinal exposure to
    rural folks
  • Short QI Program - Interdisciplinary teams
    working together to solve a problem/challenge
    faced in health care (Burdick funding)
  • Overarching goals are to increase of health
    professionals, develop strengthen links in
    system, and increase access to services

Rural Mental Health
  • Rube Farmer Suicide Prevention, University of
    Michigan School of Social Work
  • http//

Gerontology Programs
  • Many out there looking at elderly population,
    some of which are in rural areas
  • Most of these programs are interdisciplinary by
    design and mission
  • All have gerontology content, some have rural
  • Case study programs ex. Ithaca College Rural
    Cases (

Agricultural Safety Health Courses
  • Individual courses offered as electives or part
    of a non-health care program
  • Ag Safety Centers offer courses
  • NIOSH ERC health professions offer programs and
    courses (OHN, Occ. Med)
  • Texts and supplemental materials are available

Rural Location
  • Programs that are housed in universities
    colleges located in rural and frontier areas
  • These programs by their location provide a rural
  • There may or may not be curriculum related to
    agriculture issues or rural life

Community Partnership Models
  • Tend to be grant supported
  • Kellogg
  • Robert Woods Johnson
  • CCPH Service Learning programs
  • Structured learning combining community service
    with objectives reflection
  • Tend to be interdisciplinary by design

Examples of Community Partnerships
  • Rural Health Education Network (RHEN) in rural
    Nebraska focus on rural folks choosing a
    healthcare career
  • Area Health Education Centers (AHEC) in many
    states (Florida, Wisconsin, Illinois, Montana,
    Washington, and others)
  • AHEC supported residency rural tracks
  • Other AHEC programs ex. SCRIPT
  • Quentin N. Burdick Rural Program for
    Interdisciplinary Training multiple programs

More programs
  • RMED Program in Rockford UIC-R
  • Multiple projects in rural Illinois counties
  • Partnerships between community agencies, leaders,
    UIC, and M4 students
  • Projects include exercise programs for older
    adults, diabetes management in public schools,
    barriers to diabetes care, screening programs for
    osteoporosis, and others

Serendipitous Exposures
  • Students who without intention are exposed to
    rural locations
  • Students who are involved in the care of farmers
    or farm workers transferred to tertiary centers
    post injury, post exposure, or as a result of
    required treatment for chronic diseases

Continuing Education Programs
  • Focused programs
  • UW Partners in Agricultural Health 12 contact
    hours of programming including 10 courses
    developed by an interdisciplinary group.
    Participants can enroll for each of the courses
    or the entire program
  • Agricultural Safety and Health topics
  • NIOSH training topics
  • Other training (Farmedic, hazmat, etc.)

Current Limitations of Review
  • The extent of the agricultural safety and
    health/injury prevention content remains unclear
  • Evaluation of agricultural safety and
    health/injury prevention content is also unclear
  • The relationship between adequately prepared
    health care providers and farmer health and
    safety is also unclear

Barriers to Change
  • Traditional silo education
  • Complex systems
  • Professional conflict and competition
  • Resources
  • Personnel lack of available faculty
  • Funding
  • Integration of curriculum and interdisciplinary
    focus is labor time intensive

Take Home Points
  • There is a need for the development of integrated
    rural training programs with agricultural safety
    and health curricula
  • Opportunities exist for further integration of
    existing programs
  • Interdisciplinary training could be strengthened
  • Program development/modification should be
    research driven
  • The use of the Internet could be increased

  • Educational needs are present at ALL health care
    provider levels
  • There are common themes in agricultural safety
    and health with regional differences
  • Would a common core curriculum be of value?
  • Where do we go from here?