First Advisor

Candyce Reynolds

Date of Publication

Summer 8-15-2013

Document Type


Degree Name

Doctor of Education (Ed.D.) in Educational Leadership: Postsecondary Education


Educational Leadership and Policy




Medical education -- Oregon -- Case studies, Medicine, Rural -- Oregon -- Case studies, Rural health services -- Oregon -- Case studies, Social constructionism



Physical Description

1 online resource (vii, 173 pages)


There is a severe shortage of rural physicians in America. One reason physicians choose not to practice, or persist in practice, in rural areas is due to a lack of professional community, i.e., community of practice (CoP). Online, "virtual" CoPs, enabled by now common Internet communication technology can help give rural physicians the CoP experience they traditionally have lacked, despite their remote practice locations. Therefore, it is important for rural medical education programs to provide technological experiences that give students the skills needed to create virtual CoPs in future rural practice contexts.

The Oregon Rural Scholars Program (ORSP) provides such a technological experience in the form of the Student Clinical Round (SCR) activity. ORSP students located in remote, rural parts of Oregon "meet" in a synchronous online space (i.e., a virtual meeting room) with a faculty member, where they participate in the SCR activity via video chat, screen and document sharing, real-time collaborative note taking, and text chatting. The literature indicates that activities like the SCR may be precursors to virtual CoPs, and therefore it is important to better understand the ORSP SCR as it could be a strategy for creating virtual CoPs among rural practitioners.

As the ORSP SCR is a novel educational approach among U.S. rural medical education programs, an intrinsic case study design was used to explore the impact of the SCR activity on one cohort of ORSP third-year medical students. Additionally, the study sought to better understand the nature of the ORSP students' experiences of having participated in the SCR. Recorded SCR sessions were coded using the Community of Inquiry (CoI) framework, a well validated methodology for analyzing higher education online learning. The CoI analysis revealed a movement of the group away from an individual, task focus towards a community, collaborative focus as the SCR sessions progressed. Additionally, student interview and field notes analyses revealed that the SCR experience reduced isolation, increased sense of community and positively influenced rural practice choice among the study participants.

Conclusions drawn from this study are that the online ORSP SCR experience provides a strong social constructivist learning environment, thus creating the context for virtual CoP emergence. Additionally, the SCR activity is capable of generating an actual virtual CoP, an event directly observed during the study.

Recommendations call for rural medical education programs as well as current rural practitioners to adopt similar online approaches to group learning, as such approaches may provide contexts for virtual CoP formation, thus contributing to the likelihood future physicians may become and current physicians may persist as rural practitioners.


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