Implementing and Sustaining a Rural Interprofessional Clinical Education Program

Background: After a successful pilot project introducing interprofessional (IP) clinical education in a rural hospital, expansion to other rural hospitals was attempted. Despite enthusiasm for the pilot project and funding, the university-based project team had difficulty persuading administrators and staff to become involved or to maintain the project. Of 9 institutions, 2 implemented and sustained the project for more than 2 years, 2 initiated but dropped it, and 5 declined. Methods and Findings : A qualitative, interpretive description study was conducted to identify facilitators and barriers to implementing an IP clinical education program in rural settings. Semi-structured interviews were conducted with representatives of organizations that sustained the project, dropped out, or never participated. Using the National Health Service Sustainability Model we identified the staff, organization, and process factors that affected the program implementation. Three staff roles were required for success: sponsor, champion, and gatekeeper. Organizational factors included infrastructure to identify participants and perceived project enhancement of organizational values. Process factors included organizational benefits, compatible priorities, and adaptability. Conclusions: Introduction of IP education to rural institutions requires complex combined factors. However, continuation of the project at two sites demonstrates that when IP education is valued and sustainability factors are present, staff will maintain it.