Experiential Learning in Rural Medicine (ELRM): RPAP Scholars Program

The RPAP Undergraduate Shadowing Program is a collaborative initiative designed to provide pre-medical and pre-physician assistant students with a transformative opportunity to gain shadowing experience in a clinical setting. By leveraging the University of Minnesota’s established Rural Physician Associate Program (RPAP) network, (20 total) sophomore,  junior students (seniors interested in Rural health are also welcome to apply). (10 from St. Olaf College and 10 from the University of St. Thomas) will spend a dedicated January Term (J-Term) within a RPAP clinical site. (Note: initial cohort could be smaller.)

In addition to providing needed shadowing opportunities for pre-health students in their sophomore, junior, and senior year, this program would also address the critical deficit of rural healthcare providers by fostering early professional interest in rural medicine. Because students will also shadow a third-year medical student, students will also have the opportunity to develop insight into the experience of a medical student.

Selected students will spend 4 weeks over J-term embedded at a RPAP clinical site outside of the Metro area. Student participants in this program will 1) shadow an RPAP provider and may also shadow a third-year medical student in the RPAP Program, 2) participate in a cohort-based curriculum to enable reflection and meaning-making of the experience, and 3) engage with the local community through a healthcare-related project.

• • Schedule: Occurs annually over 4 weeks during J-Term (January). First cohort in January 2027.
  • Participants: Cohort of up to 20 students annually (10 from St. Olaf, 10 from St. Thomas) or as arranged between the two schools.  Each RPAP will host 2-3 students.  At least one student from each institution will be placed at an individual RPAP site.

• Reflective Curriculum: Students will engage in a cohort-based curriculum that combines individual activities with a weekly cohort-meeting with students from both institutions.  

• Community Engagement: Students at each RPAP site will engage in a community project related to rural healthcare.
• Academic Credit: Participants must enroll for academic credit
  • St. Olaf: 1.0 credit through enrollment in BIO 294

Students will:

1. Identify the unique clinical, social, and economic factors that define rural medicine, including the scope of practice for providers and barriers to care faced by non-metropolitan populations. 
2. Synthesize personal values and clinical observations and community engagement to further vocational discernment, readiness and fit for a future career as a physician or physician assistant in a rural setting. 
3. Through direct observation of a third-year medical student, articulate the academic and professional expectations of clinical rotations, gaining a realistic understanding of the transition from undergraduate to medical/PA education. 

• Current undergraduate sophomore, juniors, and seniors enrolled in a degree-seeking program pursuing a pre-med or pre-PA track.
• Students must obtain academic credit or use 0-credit option (UST)
• Demonstrated commitment to the mission of addressing the deficit of rural healthcare providers and facilities.
• Students must be able to commit to the full 4 weeks of the program.
• Students will need access to transportation to travel to the clinic site; students may need transportation for travel between housing and the clinic site.
• Students must have or be able to obtain authorization to work in the United States.
• Students must be able to comply with required clinical immunization requirements.
• Each institution will develop their own selection process. 

• • Opportunity posted: Second Monday in September (or earlier)
  • Applications due: Friday, October 16 by 11:59pm
  • Interviews: Third week of October
  • Final Selections Announced: Last week of October (should ideally be one week before J-term course registration opens)

• Register for Academic Credit: by end of November (or as determined by academic calendar for J-Term)

• • On-boarding/Orientation: early December
• Note: Application process is designed to ensure students studying abroad are eligible.

Students shadow an RPAP provider and may also shadow a third-year medical student in the RPAP Program through their daily activities in a rural clinical setting, observing the delivery of healthcare in primary and specialty areas and in practices with all age groups.

Program Sites

Students will be placed in an RPAP teaching site.  Students will not be able to select their sites but will be provided with a list of the 5 options and a description of those sites.  Two students, one from each institution, will be placed per site for a total of 5 sites.  Sites selected based on proximity to flexible, short-term housing & dining options. (e.g. near a college/university campus with available student housing).  Possible housing alternatives may exist via airbnb/vrbo.

• Pilot site options would likely include, but not be limited to: Waconia, Hutchinson, Blue Earth, Sleepy Eye, New Ulm, Staples, Wadena, St. Croix Falls, Wabasha, Winona and Princeton.  RPAP would assist in making connections for housing options. We may be able to negotiate low cost/free housing at some sites, but advise students to expect room and board costs.

Shadowing Structure

Will students shadow a variety of physicians or primarily with the RPAP med student?

• RPAP Response: Some sites may not have an RPAP student at the time of this program.  RPAP will identify a primary preceptor to shepherd the student experience. The college student will also spend time with the RPAP student if there is one in place- but we will have a staff  physician lead for the student at each site.

Who will supervise the student on-site?

• One of the staff physicians/ RPAP preceptors would be responsible for “on site” supervision.

What paperwork is needed?

• Privacy/confidentiality/HIPPA acknowledgement at a minimum. Each clinical site will likely have slightly different requirements, which the RPAP office can help c0-navigate.

This component will provide an opportunity for students to reflect on their program experience, to bridge their academic and experiential learning, and clarify their vocational goals.  Participants will engage in independent reflection activities, activities with their site partner, as well as a weekly reflection seminar (virtual) with the full program cohort.  Students will benefit from reflecting with their institutional peers and with students studying at the other institution.

Students will be guided through the reflection curriculum by a STO/UST faculty advisor(s) with weekly touchpoints throughout the month.

1. Weekly lecture/class by faculty and/or RPAP lead on relevant topics.
2. Weekly journal entries with group reflection sessions.
3. Weekly reading groups (3-4 groups) – read books/articles on rural healthcare and lead discussion with the full cohort.  Structure as a seminar model (e.g., small groups of students leading discussions), paired with a shared text across the cohort to support broader conversation and integration.

Students will identify individual learning goals: 

• List one at least one vocational or career exploration goal. How will this experience help you progress towards that goal? (2-3 sentences)
• List at least one academic learning/application goal. How will this experience help you progress towards that goal? (consider connections between this experience and prior/concurrent coursework) (2-3 sentences)
• List at one least skill development goal. How will this experience help you progress towards that goal? (2-3 sentences)

Sample Syllabus

Possible Elements for Curriculum:

• • Readings: Students read a relevant book or series of articles and discuss topics in a group.  Possible reading topics: rural healthcare, ethics, wellness, access/equity, policy, community engagement, etc.

• Virtual Lecture(s): RPAP faculty will help deepen students knowledge about topics and/or issues in healthcare.

• Reflective Journaling: Students write and submit a weekly journal reflection of their experience.  Question prompts to be provided to scaffold their reflection..  
• Portfolio/Presentation: Documentation of clinical insights and community project milestones, shared via a cohort-wide digital portfolio.
• Review of Physician Pathways Stories: e.g. Homepage – Medics Voices
• Possible Option: Group to come to a “skills assessment” that Dr. Stelter/RPAP team could put on in Mankato.  It would be suturing pigs feet, doing skin biopsies, maybe intubations on a mannequin, ob delivery on a mannequin, etc
• We may be able to have students visit family medicine residency hospitals/clinics for a day (St. John’s, Woodwinds, Mankato) 

Rural healthcare requires engagement with the broader community. Participants in this program will engage in a small community-based project.

Drs. Stelter and Clark to offer skills-lab, likely at the end of the program, as part of a capstone experience.  They may also consider inviting other St. Olaf or UST alumni in their networks, and offer up an alumni/student networking opportunity as part of the skills lab & capstone.  This would take place in Mankato, and also include opportunities for meaning making, reflection.  Perhaps also tapping back into the theme of food insecurity in some way as well.

Possible Projects:

• Community-based Clinics: Injections, ultrasound, dental hygiene, healthy eating, wellness, education
• Volunteer: Naloxone packing, etc.
• CNA Certification: Students could receive a CNA certification and volunteer in a local senior living facility. (St. Olaf has already piloted this program, which could be used with this program.)
• Emergency Services Shadowing: Engaging with local EMS or EMT services to observe the “pre-hospital” journey of rural patients.
• Provide CPR/AED training:  (Obtain American Heart Association (AHA) Certification – training others in the community.)
• Bystander Intervention: Students will lead training sessions for rural residents, increasing the “chain of survival” in areas with longer EMS lead times.
• Community-based health education/outreach (e.g., health literacy, school-based programming)