Rural Clinical Experiences Increase the Likelihood of Graduates to Practice in Underserved Areas: An 11-Year Retrospective Analysis of a Rural Physical Therapy Program

INTRODUCTION: Rural health care disparities are a pressing issue in the United States, particularly since the COVID-19 pandemic. Therefore, the purpose of this study was to explore a rural health initiative by the University of Mary (UMary) entry-level Doctor of Physical Therapy (DPT) educational program, investigating whether full-time rural clinical education experiences (CEEs) were associated with graduates' decisions to practice in a rural setting after graduation. REVIEW OF LITERATURE: Rural populations in the United States are underserved, demonstrating lower use of health care services and poorer health. Although the American Physical Therapy Association highlights the importance of physical therapists serving these communities, challenges exist, such as sparse rural training in DPT curricula. SUBJECTS: Three hundred thirty-nine UMary DPT graduates between 2014 and 2024. METHODS: An 11-year retrospective analysis of the UMary DPT program examined biological sex, rural CEEs (<10,000 population), and initial postgraduation job placements with calculation of descriptive statistics. A binary logistic regression was used to model the relationships between biological sex, CEE placements, and job placements postgraduation. RESULTS: More than half of the graduates (51.3%; n = 174) experienced at least 1 rural CEE throughout the curriculum, whereas 17.7% (n = 60) had a rural CEE in their final year. Nearly one-quarter (22%; n = 75) practiced in a rural setting immediately after graduation. Graduates with at least 1 full-time rural CEE were more likely to practice in a rural setting after graduation (odds ratio [OR] = 3.25, P < .001, 95% confidence interval [CI] 1.71-6.17), as were those with a rural CEE in their final year (OR = 2.91, P = .002, 95% CI 1.50-5.65). DISCUSSION AND CONCLUSION: The findings of this study highlight a positive association between rural DPT CEEs and graduates' decisions to practice in a rural setting after graduation. This study may serve as a benchmark for DPT education in prioritizing rural health, including strategically incorporating rural CEEs to promote physical therapist practice in underserved areas.