A Thematic Analysis Exploring the Impact of a Rural Emergency Medicine Rotation on Resident Perceptions of Care and Readiness for Rural Practice.

Objectives: Despite data showing many opportunities for emergency medicine (EM) physicians to practice in rural settings, only 8% of EM graduates are exposed to rural environments during training.5 The authors of this study noted a curricular gap in their EM training program and developed a 4-week rural elective for PGY-2 and PGY-3 EM residents. While prior literature has focused on the logistics of a rural rotation and associated procedural experiences, to our knowledge, no previous studies have focused on resident perceptions of the rural experience or preparedness for a future career in rural EM. This qualitative study aimed to gain a rich understanding of the residents' experiences and the impact of those experiences on the 2 study aims. Methods: Between June 2019 and May 2020, upper-level residents (PGY-2/3) completing a rural EM rotation participated in semistructured interviews exploring their perceptions of a rural EM rotation, and data was analyzed using inductive thematic analysis. Codes were informed by social cognitive theory, and a constant comparative approach was applied, with data collection concluding upon reaching thematic saturation. Results: Four overarching themes were established. Rural EM electives provide (1) understanding of differing patient presentations in a rural emergency department, (2) exposure to differing approaches to patient care when compared to academic settings, (3) appreciation of the transport logistics associated with transferring patients to higher level care, and (4) understanding of the perceived benefits of the rural experience on EM resident training and preparedness for rural EM practice. Conclusion: Exposure to a rural EM elective provides residents with unique experiences on rural EM, which enhances a deeper understanding of care provided in a rural environment and leads to a sense of preparedness for practice in rural EM.