Medical EducationOriginal Article
Self Efficacy of Osteopathic Medical Students in a Rural-Urban Underserved Pathway Program
J Osteopath Med; 117(9): 577-585
Abstract
Context: Self-efficacy has been shown to play a role in medical students’ choice of practice location. More physicians are needed in rural and urban underserved communities. Ohio University Heritage College of Osteopathic Medicine has a co-curricular training program in rural and urban underserved practice to address this shortage.
Objectives: To assess whether participation in the cocurricular program in rural and urban underserved practice affects self efficacy related to rural and underserved urban practice.
Methods: This cross sectional study explored self efficacy using Bandura’s 5 sources of self efficacy (vicarious learning, verbal persuasion, positive emotional arousal, negative emotional arousal, and performance accomplishments). A validated scale on self efficacy for rural practice was expanded to include self efficacy for urban underserved practice and e-mailed to all 707 medical students across 4 years of medical school. Composite rural and urban underserved self-efficacy scores were calculated. Scores from participants in the rural and urban underserved training program were compared with those who were not in the program.
Results: Data were obtained from 277 students. In the overall sample, students who indicated that they grew up in a rural community reported significantly higher rural self-efficacy scores than those who did not grow up in a rural community (F1,250=27.56, P<.001). Conversely, students who indicated that they grew up in a nonrural community reported significantly higher urban underserved self efficacy scores than those who grew up in a rural community (F1,237=7.50, P=.007). The participants who stated primary care as their career interest (n=122) had higher rural self efficacy scores than the participants who reported a preference for generalist specialties (general surgery, general psychiatry, and general obstetrics and gynecology) or other specialties (n=155) (F2,249=7.16, P=.001). Students who participated in the rural and urban underserved training program (n=49) reported higher rural self efficacy scores (mean [SD], 21.06 [5.06]) than those who were not in the program (19.22 [4.22]) (t65=2.36; P=.022; equal variances not assumed). The weakest source of self efficacy for rural practice in participants was vicarious experience. The weakest source of urban underserved self efficacy was verbal persuasion.
Conclusions: Opportunities exist for strengthening weaker sources of self efficacy for rural practice, including vicarious experience and verbal persuasion. The findings suggest a need for longitudinal research into self efficacy and practice type interest in osteopathic medical students.