training for social and other reasons. In addition, rural providers tend to prefer to reserve their evenings and weekends for family and use vacation time to receive training during the week. There needs to be more creativity in strategies for meeting the training needs of rural providers.

Dr. Blum noted the importance of being respectful in the way the rural workforce is described and addressed. Special interest groups often emphasize deficiencies of the rural workforce in terms of their ability to care for certain types of patients, for example, children or trauma victims. The rural workforce has close connections to the community and needs to be viewed as a partner rather than providers that need to be “saved from themselves.”

Thomas Foley from the American College of Surgeons’ Rural Trauma Committee described the Rural Trauma Development Course, which brings together all providers who care for trauma victims in a rural community, including prehospital providers, and provides direction on how to manage care during “the golden hour,” the 60 minutes after the occurrence of trauma during which a victim’s chances of survival with definitive care are greatest. The course is taught by instructors from an urban trauma center. Experience from the course has shown that participants from both the community hospitals and the trauma centers develop a sense of understanding and camaraderie, and it has worked to foster the relationship between the two groups.


Mr. Sanddal closed the workshop, thanking the panelists and attendees for their participation. He acknowledged that some differences of opinion exist concerning a few of the IOM committee’s recommendations; however, there are many more areas of agreement. He encouraged the workshop attendees to move forward collectively to push for change in those areas of common agreement.

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