Cross-sectional United Kingdom surveys demonstrate that owners and veterinary professionals differ in their perceptions of preventive and treatment healthcare needs in ageing dogs.

Perceptions of dog owners and veterinary professionals (surgeons/nurses) can influence the preventive healthcare and treatment provided to dogs, especially at the senior life-stage, when chronic diseases become more common. This study compared perceptions of healthcare of dogs as they age between dog owners and veterinary professionals. Data from two online surveys (owners: N = 633, veterinary professionals: N = 305) examined perceived need for veterinary visits and vaccinations. In addition, 48 clinical signs were rated on perceived prevalence (whether owners' dogs had experienced them) and how urgently they should seek veterinary advice. Groups were compared using descriptive statistics and chi-square. Owners most often believed a 'healthy' senior dog (>7 years) should go to the vet once a year (47% owners vs. 25% veterinary professionals, p < 0.001), compared with veterinary professionals every 6 months (39 vs. 73%). A minority (14%) of owners would just take the dog 'if they got sick' but only 2% of veterinary professionals advised this, and 16% of owners of dogs of all ages had not had any contact with their veterinary practise in the previous year. Nearly all veterinary professionals (92%) believed that senior/geriatric dogs should receive yearly vaccinations. However, 28% of owners' dogs of all ages were not vaccinated in the previous year and, of these, 33% did not believe that older dogs need vaccinations. Only 10% of dogs considered 'old' by their owners had attended a senior wellness clinic or examination, despite 14% of practises offering them. The three most common clinical signs reported by owners were slowing down on walks (57%), dental tartar (53%) and being stiff on rising (50%). Owners perceived urgency to seek veterinary care was lower if they had experienced the clinical sign before. In the current study, dog owners and veterinary professionals differed in their opinions about the need for veterinary care, suggesting new educational initiatives, and more effective communication is required.

Predicting Rural Practice and Service to Indigent Patients: Survey of Dental Students Before and After Rural Community Rotations.

Community-based clinical rotations in rural areas expose dental students to diverse patient populations, practice models, and career opportunities as well as rural culture. The aims of this study at West Virginia University were to determine the best predictors of rural practice, assess the predictive validity of students' intention to practice in a rural area before and after their rural rotations, and evaluate the relationship between students' intention to practice in a rural area and intention to provide care for indigent patients. Online survey data were submitted pre- and post-rural clinical rotation by 432 of 489 dental students over the study period 2001-12, yielding an 88% response rate. In 2013, practice addresses from the West Virginia Board of Dentistry were added to the student database. The results showed that significant predictors of rural practice site were intended rural practice choice, rural hometown, and projected greater practice accessibility for indigent patients. The likelihood of students' predicting they would choose a rural practice increased after completion of their rural rotations. After the rotations, students predicted providing greater accessibility to indigent patients; these changes occurred for those who changed their predictions to rural practice choice after the rotations and those who subsequently entered rural practice. The dental students with a rural background or a greater service orientation were also more likely to expect to enter a rural practice and actually to do so after graduation. These findings suggest that dental school curricula that include rural rotations may increase students' sensitivity to issues of indigent patients and increase students' likelihood of rural practice choice.

Validity of Medical Student Questionnaire Data in Prediction of Rural Practice Choice and Its Association With Service Orientation.

PURPOSE: The validity of medical student projection of, and predictors for, rural practice and the association of a measure of service orientation, projected practice accessibility to the indigent, were investigated. METHODS: West Virginia (WV) medical student online pre- and postrural rotation questionnaire data were collected during the time period 2001-2009. Of the 1,517 respondent students, submissions by 1,271 met the time interval criterion for inclusion in analyses. Subsequent WV licensing data were available for 461 in 2013. These 2 databases were used to assess for validity of projection of rural practice, for predictors of rural practice, and for student projected accessibility of the future practice to indigent patients. FINDINGS: There were statistically significant associations between both pre- and postrotation projections of rural practice and subsequent rural practice. The most significant independent predictors of rural practice were student rural background, reported primary care intent, prediction of rural practice and projection of greater accessibility of the future practice to indigent patients. For scoring of practice access, there were trends for higher scoring by rural students and rural practitioners, with greater pre-post increases for those with urban hometowns. CONCLUSIONS: This study demonstrates the utility of medical student questionnaires for projections of numbers of future rural physicians. It suggests that students with a rural background, rural practice intent, or greater service orientation are more likely to enter rural practice. It also suggests that students, particularly those with urban hometowns, are influenced by rural rotation experiences in forecasting greater practice accessibility and in entering rural practice.

A study of predictive validity of physician assistant students' reported practice site intent.

PURPOSE: With the downward trend in numbers of primary care physicians, it is anticipated that mid-level providers will increasingly fill the resulting void in rural health care. Recruitment of health care providers into rural areas has been historically difficult, and West Virginia has been at the forefront of developing programs to address rural recruitment. One of these programs is the West Virginia Rural Health Education Partnership, which provides rural clinical rotation opportunities for students from multiple disciplines and schools in West Virginia. This study assessed the predictive validity of physician assistant (PA) students' prediction, after completion of rural rotations, of a rural or an urban practice site and also assessed for factors associated with subsequent rural practice. METHODS: The Institutional Review Board of West Virginia University approved this study. The West Virginia Rural Health Education Partnership's electronic database, which has collected students' postrotation evaluation information since 2001, was coupled with West Virginia licensing information that included information on PA practice site(s). Data on 168 practicing West Virginia PAs who had completed rural rotation questionnaires during their clinical education were examined. Designation of a rural or an urban practice site was done using rural-urban commuting area codes. RESULTS: Student prediction of rural practice was significantly associated with subsequent rural practice (P < 0.04). Variables most predictive of rural practice were student reporting of high school hometown as rural and of West Virginia practice intent. CONCLUSIONS: This study suggests moderate predictive validity of PA student reporting on rural practice and on West Virginia practice intent; such methods may have potential in prediction of the future rural PA workforce.

Evaluation of a required statewide interdisciplinary rural health education program: student attitudes, career intents and perceived quality.

INTRODUCTION: A shortage of healthcare providers in West Virginia led to the creation of a statewide, community-based program with a required three-month rural experience for most state-sponsored health professions students. Project description: Initiated using funding from the W. K. Kellogg Foundation and expanded using both state funds and Area Health Education Center support, the West Virginia Rural Health Education Partnerships (WVRHEP) program impacts institutions of higher learning, 50 counties, and 332 training sites, and all students in state-funded health professions schools. A longitudinal database has been constructed to study program effects on students' reported attitudes, service orientation, and career intents. METHODS: Baseline data are collected from medical students, and students in all disciplines provide feedback on rotations and information about career intents, social responsibility, and attitudes towards rural practice. RESULTS: Data indicate an association between perceived quality of the rural experience and increased interest in rural health, social responsibility and confidence in becoming part of the community. Medical students may tend to rate social responsibility higher after completion of the first rural rotation. Students who anticipate practice in smaller towns also tend to rate the quality of the rotation higher, to anticipate careers in primary care, and to acknowledge social responsibility. CONCLUSION: As WVRHEP program graduates who have completed these surveys enter practice, both personal and community-specific program characteristics may be identified which strengthen interest in rural practice. The predictive validity of intermediate outcomes of attitudes and career intents in forecasting the ultimate outcomes of recruitment and retention may be studied.

A comparative assessment of West Virginia's financial incentive programs for rural physicians.

CONTEXT: Financial incentive programs are increasingly being used as a strategy to recruit physicians to underserved rural areas. Critical evaluation of state-supported programs is often lacking but is necessary to determine their efficacy and to improve outcomes. PURPOSE: The purpose of this study was to assess 4 service-contingent programs in West Virginia, a state with critical physician shortages. METHODS: Survey instruments were developed to evaluate the effectiveness of these programs and to document the practice environments and career paths of obligated allopathic and osteopathic physicians compared with a control group of nonobligated rural practitioners. Data were also collected from physicians who were recipients of multiple incentive programs and from obligated physicians who had defaulted. FINDINGS: Responses from more than 60% of surveyed physicians indicated that the typical respondent was a married white male who was a midcareer family practice physician. Obligated physicians were more likely than nonobligated physicians to have graduated from a West Virginia medical school and residency program, to be influenced by financial factors in their career decisions, to provide care to uninsured patients, and to work in offices that offered sliding fee scales. Both groups of physicians demonstrated similar retention patterns, reported a high degree of job satisfaction, and expressed a need for more practice management training. CONCLUSIONS: Although these financial incentive programs were found to be effective in recruiting primary care physicians to medically underserved areas of the state, the financial support of these programs was found to be too modest, and improved marketing of the programs was indicated.