Due to teacher shortages at the study site, teaching positions in the state that is the focus of this study are filled by alternate route (AR) teachers, who earned bachelor degrees in the fields that were not related to education and received teacher certification through alternative teacher education programs. Because there is limited information about the preparation and performance of AR teachers at the site of this study, the purpose of this sequential mixed methods project study was to explore AR teachers' preparation and their effect on student learning as measured by Northwest Evaluation Association's Measures of Academic Progress/Discovery Education Assessments. Guided by Mezirow's experiential learning theory and Dewey's educational philosophy, this project study investigated the relationship between the alternate route teachers' field experiences and years of experience, and teachers' effect on student learning. Data collection included a survey of 36 K-12 AR teachers selected through convenience sampling, document analysis of their student assessment scores, and 6 structured interviews with purposefully selected high performing AR teachers. Data were triangulated and cross-analyzed. Findings indicated that when AR teachers engage in field experiences prior to teaching, their students have higher levels of achievement as evidenced in their assessment scores. There was no correlation between AR teachers' years of teaching experience and their student assessment scores. Analysis of AR teachers' interview responses revealed a need for professional development, which was then created to address those needs. This study may contribute to social change by offering the targeted professional development of AR teachers and improving the design of AR preparation programs to better influence student learning.

The purpose of this qualitative study was to examine teachers' perspectives of the key factors contributing to the retention of rural teachers who entered teaching through an alternate route certification program in Mississippi. It was specifically the goal of this study to understand how alternatively certified teachers perceive their own characteristics (e.g., teacher preparation, personal experiences), school conditions (e.g., students, administration), and compensation (e.g., salary, benefits) to be related to their decision to remain in the profession. In this study, 9 rural alternate route teachers were interviewed from 8 schools in Mississippi. The research questions were: (1) How do rural alternate route teachers who stay describe their decision to continue teaching in terms of teacher characteristics?; (2) How do rural alternate route teachers who stay describe their decision to continue teaching in terms of school conditions?; and (3) How do rural alternate route teachers who stay describe their decision to continue teaching in terms of compensation? Sher's (1983) rural retention 3 C's framework provides a model for understanding retention. Sher proposed that attracting and retaining teachers in rural schools is a function of 3 C's: teacher characteristics, school conditions, and compensation. The data revealed that for teacher characteristics teacher preparation that included practice teaching combined with coursework was important, and participants valued experience working/teaching children. Data also revealed school conditions factors as student were a source of satisfaction for teachers, most teachers had little induction and mentoring support, teachers lacked administration and collegial support, and teachers found networks of support outside the school setting. The data revealed that the relationship between compensation and retention is complex, and that compensation was less important than intangible benefits. Although the study failed to find a simple and direct cause of retention, these findings do provide further insight into teacher retention. The findings of the study suggest implications for teacher preparation, school districts, and policy.

Behovet av akut vård har ökat under de senaste åren och satt ökad press på ambulanssektorn i stort. Hur man kan förbättra och effektivisera olika delar av vårdkedjan är en fråga som beslutsfattare inom denna sektor ständigt behöver ha i åtanke för att kunna möta detta behov. Det finns visioner om en likvärdig vård för alla människor i vårt samhälle, som tyvärr kan vara svåra att nå i praktiken. Människor som bor i glesbefolkade områden behöver i regel vänta längre på en ambulans än personer som bor i urbana områden, och transporttiden för dessa ambulansutryckningar blir längre eftersom det ofta är långt till närmaste akutmottagning. För ambulanspersonalen kan det dessutom i vissa fall vara svårt att göra en korrekt bedömning om huruvida en mindre akut patient behöver transporteras till en akutmottagning eller inte. En tänkbar förändring i vårdkedjan kan vara att transportera mindre akuta patienter till en närliggande vårdcentral istället för en akutmottagning - en så kallad alternativ vårdväg. Detta hade både kunnat resultera i kortare transporttider på glesbyggden (vilket i sin tur kan ha en påverkan på ambulansens tillgänglighet) och ge ambulanspersonal möjlighet att välja ett mellansteg mellan att lämna kvar en patient i hemmet och att transportera den till en akutmottagning.  För att undersöka vilken påverkan en alternativ vårdväg kan ha på ambulanser sett till både tid och tillgänglighet, har en diskret händelsestyrd simuleringsmodell utvecklats. Denna modell har använts i en scenariostudie för att undersöka hur en alternativ vårdväg kan påverka ambulans och patienter på glesbygden. Data från SOS Alarm och Region Skåne har möjliggjort en generering av indata som bättre överensstämmer med verkligheten. Resultatet av scenariostudien tyder på att en alternativ vårdväg kan förbättra tillgängligheten för en ambulans på glesbygden genom att förkorta transporttiden till mottagande vårdinstans. / The need for emergency care has increased in recent years and has put increased pressure on the ambulance sector in general. How to improve and streamline different parts of the care chain is an issue that decision-makers in this sector constantly need to keep in mind in order to meet this need. There are visions of equal care for all people in our society, which unfortunately can be difficult to achieve in practice. People who live in sparsely populated areas usually experience longer waiting times to receive an ambulance than people in urban areas, and the transport time for these ambulance calls is longer because of the (usually) longer distance to the nearest emergency room. In addition, for ambulance personnel, it can in some cases be difficult to make a correct assessment of whether a less acute patient needs to be transported to an emergency department. A possible change in the care chain could be to transport less acute patients to a nearby health center instead of an emergency room - a so-called alternate route of care. This could result in both shorter transport times in sparsely populated areas (which in turn can have an impact on the availability of the ambulance) and give ambulance staff the opportunity to choose an intermediate step between leaving a patient at home and transporting it to an emergency department. To investigate the impact that an alternate route of care can have on the aspects of time and accessibility for ambulances, a discrete event-driven simulation model was developed. This model has been used in a scenario study to investigate how an alternate route of care can affect ambulances and patients in sparsely populated areas. Data from SOS Alarm and Region Skåne have made it possible to generate input data that better corresponds to reality. The results of the scenario study indicate that an alternate route of care can improve the accessibility of an ambulance in sparsely populated areas by shortening the transport times to the receiving care institution.