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Rural Rotation Offers Students New Perspectives, Learning Opportunities

(Originally published in Nebraska Hospital Association's Healthier Nebraska magazine.)

Nestled on the eastern edge of the Nebraska Sandhills, where head of cattle outnumber people and stoplights are a rare sight, Ord, Neb., a town of 2,200, may seem an unlikely home to a growing and flourishing medical student rotation program. Yet, Ord-based Valley County Health System (VCHS) – on pace this year to host a record number of medical students in the organization’s recent history – is helping mold the next generation of doctors, physician assistants, nurse practitioners and other healthcare providers.

“The program enlightens students to the healthcare needs of rural communities,” VCHS CEO Nancy Glaubke says. “We offer a broad perspective with our wide range of services, as well as the opportunity to work with each member of our medical staff and other clinicians.”

With a critical access hospital, three medical clinics and rehab centers, a specialty clinic, home health and hospice, public transportation, geriatric mental health and many other ancillary services, VCHS is dedicated and equipped to play a key role in a student’s overall educational experience.

“Our goal is to expose students to the wide variety of diagnoses and health issues seen in rural family practice,” VCHS’s Jeff Breitkreutz, PA-C, says. “We offer a challenging, yet supportive, hands-on and individualized learning environment that blends didactic knowledge with clinical application. It’s rewarding to expose them to rural medicine, where we often not only treat the patient but extend that sense of care to their family, friends and neighbors.”

Working with multiple providers, at various locations and in numerous capacities reflects the flexibility and range of skills needed by rural and family practice providers – one not often offered at larger facilities or at specialized rotation sites.  

“At VCHS, the program was set up so a student could tailor their experience to what they wanted to get out of it … seeing inpatients in the morning, outpatients at different locations in the late morning and afternoon and then working in the ER other times,” Charles Kelly of Omaha, who completed his University of Nebraska Medical Center (UNMC) rural family medicine clerkship at VCHS, says. “This was valuable because I was able to see a wide range of patients. In family medicine and a more rural environment, you are everything for the patient, taking care of all of their health concerns and managing that range of care.”

That range of care and the provider-patient relationship that can result from such an environment was one of the highlights of Jose Nuño’s, a UNMC physician assistant (PA) program student and Fremont, Neb., native, VCHS rotation experience.

“It was really impressive to see the autonomy and skill level of the PAs, providing full continuity of care for chronic illnesses as well as taking care of acute illnesses. That’s not often seen in larger, urban organizations,” Nuño says. “[And] because of that, the patients were very appreciative of the providers, especially the PAs [Jeff Breitkreutz, PA-C, and Bob Reilly, PA-C] I worked most closely with. The patients’ faces would just light up when they saw them.”

Beyond the hospital walls, medical rotations expose students to different communities and experiences as well.

“Growing up in a more suburban/urban area, the rotation at VCHS gave me exposure to a rural area. It showed me small towns like Ord can be exciting and have a lot to offer; there were friendly, hospitable young people and families, entertainment options, great local businesses and lakes and other recreation opportunities nearby,” Nuño says, noting similar attitudes were evident back in the workplace as well. “It was impressive to have Nancy [VCHS CEO] so interactive with staff, knowing people’s names and being out and about around the facility. That’s rarely seen in larger organizations. Everyone was hospitable, accommodating and helpful – both at VCHS and in the communities.” 

Due to the success of the long-standing UNMC partnership, VCHS officially partnered with additional programs – Union College (Lincoln) and College of St. Mary (Omaha) physician assistant programs – earlier this year. From Creighton University to Kansas City University of Medicine and Biosciences to Central Community College, VCHS has a history of working with medical, nursing and other healthcare students to enhance their education and expose them to a progressive rural healthcare environment. VCHS also participates in the local school-to-work program, through which high school students have hands-on learning opportunities in nearly every VCHS department over the course of a semester.

“Partnerships with universities and other educational institutions are win-win for all. The students learn, the providers receive assistance, everyone builds their network for potential job or recruitment opportunities in the future and everyone receives feedback about their programs,” Glaubke says. “One of the most powerful comments we consistently receive from students is they are surprised by the extensive services and advanced technology at VCHS. We are proud to be a part of their educational experience, showcasing our hospital, our communities and the great things happening – and opportunities available – in rural healthcare.”

To learn more about the student learning opportunities at VCHS, contact VCHS Medical Clinics Manager Gary Satchell at 308.728.4312 or HR Director Danielle Proskocil at 308.728.4325, or visit www.valleycountyhealthsystem.org.