2025 Southeastern Residency Conference

Title: The Impact of a Rural Health Scholars Program on Pharmacy Students' Attitudes Toward Rural Healthcare Delivery at Graduation


Authors: Anna Hale, PharmD; Amanda Savage, PharmD; Stephanie Kiser, RPh


Objective: Assessing the impact of a Rural Pharmacy Health Certificate on pharmacy students' outlook on practicing healthcare in rural settings and their attitudes toward rural health. 


Self-assessment question: Why is providing pharmacy students with exposure to rural healthcare important for the population health of North Carolina residents? 


Background: Approximately 20% of the U.S. population lives in rural areas, where residents face higher rates of chronic conditions like COPD, obesity, and heart disease, as well as limited access to healthcare and higher poverty levels. As of September 2024, 66.33% of Primary Care Health Professional Shortage Areas were in rural regions. Integrating pharmacists into team-based care can help address this shortage, as they are well-equipped to manage chronic illnesses and provide comprehensive medication management. Since 2014, the Rural Pharmacy Health Certificate program at UNC Eshelman School of Pharmacy has provided rural health seminars, population health projects, experiential education in rural communities, service and leadership activities, and interprofessional education. Certificate faculty wanted to assess rural certificate participants prior to their graduation as it relates to students’ attitudes towards rural health and their desire to practice in rural areas.


Methods: The participants were final-year pharmacy students at the University of North Carolina Eshelman School of Pharmacy and completing a graduate certificate in Rural Pharmacy Health.  All students who participated in the program were invited to complete a survey in the Spring semester prior to graduation. A total of 12 students, across the classes of 2022, 2023, 2024, and 2025 completed the survey. Students’ rural health attitudes data was collected using a Likert scale. Descriptive statistics were used to analyze students’ responses and determine the overall patterns of agreement or disagreement for each question. In addition, thematic analysis was conducted on open-ended questions exploring participants' background in rural health, their current knowledge and confidence from working in rural communities, and their future intentions to practice in rural settings.


Results: Pharmacy students enrolled in a Rural Pharmacy Health Certificate program had a high level of agreement in regard to social determinants of health that they found things they enjoy in a rural environment, living in rural environments provided an enjoyable lifestyle and that rural workplace settings are friendly environments. When exploring a sense of community there was a high level of agreement with people in rural communities being friendly, there is a great sense of belonging. There was a high level of disagreement that working in a rural area isolated the students from their family. When examining professional goals there was a high level of agreement that working in a rural area provided more opportunity to practice a variety of skills, staff are often more supportive in a rural environment and that they found greater opportunity for autonomy in rural practice. Students strongly agreed that rural seminars and rural rotations increased student confidence, knowledge of health disparities and barriers and increased understanding of the role of the pharmacist. After graduation 85% of students said they were likely or very likely to practice in a rural setting, compared to reporting 54% prior to pharmacy school being likely or very likely to practice in a rural setting. 

Conclusion: Overall pharmacy students in a Rural Pharmacy Health Certificate Program had a high level of agreement that living in a rural area would be enjoyable, that sense of community and friendliness was prominent in rural communities and that there were opportunities for professional development in rural communities. Pharmacy students indicated that prior to pharmacy school compared to after completion of the Rural Pharmacy Health Certificate Program they had a higher likelihood of wanting to practice in a rural area.