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Purpose – This paper's aim is to describe the health experiences of a recently arrived group of refugees, the Karen from Burma, in an American midwestern city. Design/methodology/approach – Four focus groups were conducted in their native language with 40 Karen refugees: one group of ten Sgaw Karen speaking men and one of women, one of East Pwo Karen speaking men and one of women. The focus groups and two additional individual interviews were coded using NVivo-9. Findings – The findings emphasize the significant communication barriers experienced by the Karen. The data provide rich insights into the struggles being experienced by these new Americans in their own words and highlight some of their differences from previous Asian refugees. Research limitations/implications – These data are derived from focus groups with refugees in one city in the USA with few available demographic details. Their experiences and observations may not apply to other Burmese refugee groups in other cities and countries. Practical implications – The data emphasize the complexity of language of this group of Burmese refugees which acts as a significant barrier to accessing health care. Poor or improper interpretation has increased obstacles. Data indicate that many struggle with simple health care tasks that are likely taken for granted by most providers. There appears to be more alcohol and tobacco usage amongst both genders than in other recently arrived Asian groups. Originality/value – This is original research, which supplements a prior chart review and overview paper by the first author and supplements the otherwise scant literature on this group outside Asia. [ABSTRACT FROM AUTHOR]

Introduction: The success of rural longitudinal integrated clerkship (LIC) programs has contributed to our understanding of selecting and training students for rural practice. Studies have explored the personality traits of students who participate in rural LICs although few have compared them with classmates who have not. The purpose is to compare personalities of four successive cohorts of students in the LIC Rural Physician Associate Program (RPAP) with their non-RPAP classmates. Methods: In a longitudinal cross-sectional design, medical students RPAP and non-RPAP, from 2013 to 2017 completed identical questionnaires comprising measures of personality, perfectionism, ambiguity tolerance, and resilience. T-tests, ANOVA, and post-hoc tests compared groups. K-means cluster analysis identified profiles of traits. Results: Total sample 286; RPAP = 128; non-RPAP = 158. Gender and age proportions were not different between groups. RPAP students were significantly lower in levels of perfectionism and higher in cooperativeness compared to non-RPAP classmates. Similar proportions of both groups were distributed across three personality profiles detected. Conclusions: Lower perfectionism implies advantages for rural practice. Nevertheless, similarities between groups suggest that most students would be successful in rural practice. More encouragement to all students may improve uptake of rural LICs. Greater attention to issues that affect decisions to explore rural medical education, particularly for our next generation of students, is required.

Background: Demonstrating the equivalency between the traditional metro-based clerkships within close proximity to the academic health center and the nontraditional rural preceptorships is important. The University of Minnesota has had a 9-month longitudinal rural elective for third-year medical students for 40 years, the Rural Physician Associate Program (RPAP). In the metro area, traditional students rotate through clerkships of 4 to 8 weeks in length. Both cohorts of students are evaluated in similar ways., Methods: We analyzed the test scores and demographic data for two cohorts of students: RPAP (n=201) and traditional (n=1,129) who graduated between 2004 and 2009. Tests included pre-medical school data (Medical College Admission Tests, college grade point averages) as well as National Board of Medical Examiners subject examinations (shelf), US Medical Licensing Examination Step One and Two (Clinical Knowledge and Clinical Skills), and an Objective Structured Clinical Examination (OSCE). Scores were analyzed using descriptive/comparative statistics for the two groups of students., Results: For the most part, RPAP students performed similarly to students in the traditional metro-based curriculum on the standard educational outcome metrics. On the obstetrics shelf, while a similar proportion of the RPAP students passed, they scored statistically significantly lower (traditional: median 72 (range 50-98) versus RPAP: 71 (51-89)., Discussion: This study is the largest cohort demonstrating equivalency between students taking a rural longitudinal clerkship and their metro-trained colleagues.

Since 2004, Minnesota has seen an influx of refugees from Burma. Many of these newcomers came from the Karen state and spent time in refugee camps in Thailand before resettling in the United States. To better understand the health needs of this population, the authors of this article conducted chart reviews at a St. Paul family medicine clinic that serves a number of Karen refugees and reviewed formal data from the Minnesota Department of Health's Refugee Health Program. Here, they briefly describe this community, the cultural issues that could affect health care providers' ability to care for Karen patients, and the health concerns of these refugees.

Background: Although it is well-established and considered successful, there is limited data on how the graduates of a Minnesota rural medical education program (Rural Physician Associate Program [RPAP]) compare with their peers., Purpose: To compare the performance of RPAP students with their peers on a primary care observed structured clinical examination (OSCE)., Methods: The performances of RPAP students and a group of non-RPAP Year 4 medical students were compared on the same OSCE., Results: RPAP students performed at least as well as their peers on stations assessing performance on common primary care clinical scenarios but not as well on a small number of stations that assessed applied knowledge of specific content taught in the traditional clerkship curriculum., Conclusions: We provide evidence that rurally trained students at this institution performed at least as well as their peers on OSCE stations testing performance in common primary care scenarios. The broader implications of this study are that medical students may receive high-quality training in rural communities, as documented by their performance on an objective structured clinical examination.

Background: Some medical schools have replaced all student practice peer physical examinations in the curriculum with examinations of standardized patients (SPs)., Purpose: To assess attitudes of medical students toward practicing physical examinations with classmates, including genital, rectal, or female breast components., Methods: Survey administered to all 235 Year-4 students at University of Minnesota Medical School (69% response rate)., Results: Ninety-five percent believed that limited peer practice exams are valuable. Six percent of students were uncomfortable with these exams: This was strongly associated with having had an uncomfortable experience., Conclusions: Although most students value practicing limited exams with classmates, a small, consistent number of students are very uncomfortable with these. Explicit guidelines for faculty and classmate behavior may minimize their discomfort, but alternatives to peer exam, such as SP exams, need to be provided this small group. There is no role for peer genital, rectal, or female breast exams in the curriculum.