In 2014, VA was authorized to expand Graduate Medical Education by 1,500 new physician training positions in the most needed specialties and geographic areas, including rural areas.

While adding 1,500 positions to the nation’s largest health professions training program may seem easy, there was a challenge: Many VA locations eligible for expansion were in highly rural communities with limited or no academic affiliation. And many were experiencing staffing shortages that impacted Veteran access to care and clinician retention.

That’s when VA’s Rural Interprofessional Faculty Development Initiative (RIFDI) was born.

RIFDI is a year-long program to improve the teaching skills and confidence of existing VA clinician educators at rural sites. Clinicians tend to work where they train and clinicians providing education may be more satisfied.

Rural doctor learning through simulation training.

Their work to build rural VA educational programs is paying off.

More than 90 participants and 20 clinical professions at 34 VA sites

To better retain existing clinician educators and train future health professionals at VA’s most rural sites, VA’s Office of Academic Affiliations and VA’s Office of Rural Health started RIFDI in 2018.

To date, more than 90 participants representing 20 clinical professions at 34 VA sites have participated in the program.

The program has built a network of educators who learn together to meet the unique challenges of caring for rural Veterans while effectively teaching their health professions trainees to do the same.

Learning to teach

For Dr. Brad Schimelman and VA Psychiatric Nurse Practitioner Tara Molloy, it started with a face-to-face introduction during the first RIFDI meeting in 2019.

“We were literally a half hour apart,” said Schimelman. “I would get consults from her, but I’d never met her.”

As they got to know each other, they also developed relationships with the diverse group of interprofessional staff participating in the meeting.

They were all facing the same challenges:

  • Sharpen their education skills
  • Build educational infrastructure, such as simulation labs
  • Develop new residency programs to bring more trainees to their rural sites for training and providing Veteran care

“I wanted to learn more about how to teach my students,” explained Molloy, who mentors students from the University of Southern Maine.

“We don’t have a pool of large academic affiliates to draw from,” added Schimelman. “There is some fear of not feeling equipped to train others.”

The training they received through RIFDI was the best development program he has experienced.

“In VA we have all these professionals you can reach out to,” said Molloy about learning from other clinicians in the RIFDI network. “It’s a team approach.”

Schimelman is Associate Chief of Staff for Education at Togus VA. Malloy is a former Air Force Pilot now at the Saco, Maine, Community Based Outpatient Clinic near Portland, Maine.

Partnering to build an Educators’ Network

Schimelman and Molloy started the Education Leadership Forum, a network of rural VA clinicians focused on addressing the challenges of teaching health care professionals in small rural programs and enhancing a culture of education at their VA sites.

Today, Schimelman and Molloy continue their RIFDI journey mentoring new participants from their sites. Their work to become better educators and build rural VA educational programs is paying off.

Schimelman brings medical residents and fellows to train at Togus VAMC and help care for Veterans there. His site received an education infrastructure grant and is currently constructing a simulation lab for teaching trainees.

“It’s not just education. It’s also pursuing goals.”

Togus VAMC is also starting a new Post-Baccalaureate Nurse Residency program.

Those goals, they both agree, include being better teachers at their rural VA sites and training the next generation to deliver the highest quality care to every Veteran.

 Learn more

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