Purpose of Study: Workplace-based assessment is an opportunity for a learner to be assessed in their community of practice by an expert rater. The challenges and biases brought into this assessment relationship are complex. A shift towards Competency Based Medical Education in post-graduate residency education has triggered consideration of how to implement feasible assessment tools for the operating room, the in-patient ward, and the outpatient clinic. Competent performance in outpatient clinic is vital to surgical practice, yet no assessment tool currently exists to assess daily performance of technical and nontechnical skills of surgery residents. This project describes the development of a competency-based assessment tool, the Ottawa Clinic Assessment Tool (OCAT). Research Question: How does the OCAT demonstrate validity for measurement of surgical resident performance in clinic? Method: A consensus group of experts was gathered to generate ideas reflective of a competent ‘generalist’ surgeon in clinic. An entrustability anchor scale was developed. A six-month pilot study of the OCAT was conducted in orthopedics, general surgery and obstetrics and gynecology with quantitative and qualitative evidence of validity collected. Two subsequent feedback sessions, and a survey for staff and residents evaluated the OCAT for clarity and utility. Results: The OCAT was developed as a 13-item tool, with a global assessment item and 2 short answers questions. 44 staff surgeons completed 132 OCAT assessments of 79 residents. Psychometric data was collected as evidence of internal structure validity and relations with other variables. Analysis of feedback indicated the rating scale was practical and useful for surgeons and residents. Conclusions & Contribution to the Research Field: Surgical programs will require a daily clinic assessment tool to help define resident competency progression. Multiple sources of validity evidence collected in this pilot project demonstrate that the OCAT can measure resident clinic competency in a valid and feasible manner.

Arts and humanities programming is becoming increasingly incorporated in the medical school, balancing the biomedical paradigm, and nurturing human and emotional qualities and understandings in medical students. Music is often listed among these arts and humanities disciplines; yet there exists an acknowledged gap in the literature pertaining to musical activities and programming in the medical school, despite the prevalence of choirs, a cappella groups, small instrumental ensembles, and musical theatre programs in medical schools. Literature on choirs, musical ensemble, and community music suggests that choral singing can cultivate many of the intra and interpersonal skills that medical humanities programming encourages, such as empathy, cooperation, self-awareness, and human connection. Within the medical humanities, music has been tied to metaphors of “medicine as a performing art” or “the art of listening,” but very little literature exists delving into the actual musical experience of medical students. Drawing from medical humanities, community music, and education theory, and shaped by the metaphor of musical and emotional ‘resonance,’ this phenomenological study explores the relationships between choral singing and medical scholarship. Through semi-structured interviews, the primary goal of this inquiry was to develop in-depth understandings of the experiences of medical students singing as members of a musical community of practice: an extra-curricular medical school choir at a Canadian university. Findings indicate that choir is an informal, non-medical venue where students can engage with their musical identity during medical school; that choral singing can offer a means of stress-relief and creative outlet, mitigating symptoms of student burnout; and that engagement in the choir builds meaningful relationships and a supportive, connected community. Moreover, this study describes the role of music and choral singing in medical humanities and medical education, as well as suggests how involvement in a medical school choir may influence a medical student’s professional identity formation.

There is a well-established ‘achievement gap’ in medical education, with ‘ethnic minority’ students achieving less well in examinations than their white counterparts. The processes underlying this difference are currently unknown. Most research to date has taken a student-deficit approach, suggesting that lower performing students lack the cognitive or cultural capacity of their higher achieving peers. These models have so far failed to explain the variation in achievement by ethnicity. In order to address this gap in the literature and further our understanding of ethnic minority students’ underachievement, this thesis takes a sociocultural approach to the problem. It addresses two research questions: firstly, how does ethnicity impact on medical school achievement? Secondly, how do social networks affect achievement? This research uses qualitative interviews (n=33 medical students), quantitative survey methods and social network analysis (n=160 medical students) to explore ethnicity and the achievement gap within medical education. Sociocultural theories of learning, specifically concepts from communities of practice and Pierre Bourdieu are employed in the design and analysis phases. This thesis demonstrates that medical students’ achievement is best conceptualised as part of a wider learning trajectory toward becoming a doctor. Relationships are important channels through which the resources and support can flow, these in turn facilitate learning and achievement. Lower achieving students are less well connected to their PBL peers and have fewer tutors or clinicians in their network. The medical world has a tightly prescribed, yet often hidden, set of legitimate dispositions; students must learn to embody these norms, values and behaviours in order to succeed. This process relies on experiences of participation, facilitated by relationships with peers and seniors. Socialisation is clearly mediated by culture. Ethnic minority students, due to their differing cultural practices and identities, have fewer experiences of participation, often experience the medical domain as outsiders and find it harder to interact with tutors and clinicians. This is reflected in their social networks as some minority students have fewer seniors in their network. These factors interact to cut ethnic minority students off from potential and actual resources that facilitate learning and achievement. If the situation is to be improved, medical schools must do more to acknowledge the extra difficulties many ‘ethnic minority’ students face in becoming an insider. Processes of identification and participation must be supported as these students negotiate the extra distance and tensions between their home world and those of medical education and medicine.

Most research on medical professional socialization was conducted when medical students were almost uniformly white, upper- to upper-middle class, young men. Today 50% of medical students in Canada are women, and significant numbers are members of racialized minority groups, come from working class backgrounds, identify as gay or lesbian, and/ or are older. This research examined the impact of such social diversity on processes of corriing to identify as a medical professional, drawing on a survey of medical students in one third-year class, interviews with 25 third-year students, and interviews with 23 medical school faculty members. Almost all of the traits and processes noted by classic studies of medical professional socialization were found to still apply in the late 1990s. Students learn to negotiate complex hierarchies; develop greater self-confidence, but lowered idealism; learn a new language, but lose some of their communication skills with patients. They begin playing a role that becomes more real as responses from others confirm their new identity. Students going through this training process achieve varying degrees of integration between their medical-student selves and the other parts of themselves. There is a strong impetus toward homogeneity in medical education. It emphasizes the production of neutral, undifferentiated physicians - physicians whose gender, 'race/ sexual orientation, and social class background do not make any difference. While there is some recognition that patients bring social baggage with them into doctor-patient encounters, there is very little recognition that doctors do too, and that this may affect the encounter. Instances of blatant racism, sexism, and homophobia are not common. Nonetheless, students describe an overall climate in the medical school in which some women, students from racialized minority groups, gays and lesbians, and students from working class backgrounds seem to 'fif less well. The subtlety of these micro-level experiences of gendering, racialization and so on allows them to co-exist with a prevalent individual and institutional denial that social differences make any difference. I critique this denial as (unintentionally) oppressive, rooted in a liberal individualist notion of equality that demands assimilation or suppression of difference. / Arts, Faculty of / Sociology, Department of / Graduate

Submitted by Kely Alves (kely.alves@unifenas.br) on 2018-07-31T14:39:26Z No. of bitstreams: 1 Dissertação Lúcia Mairot.pdf: 1064790 bytes, checksum: dd87051c063270b72d1fe09ccdc7fb4d (MD5) / Approved for entry into archive by Kely Alves (kely.alves@unifenas.br) on 2018-07-31T14:41:40Z (GMT) No. of bitstreams: 1 Dissertação Lúcia Mairot.pdf: 1064790 bytes, checksum: dd87051c063270b72d1fe09ccdc7fb4d (MD5) / Approved for entry into archive by Kely Alves (kely.alves@unifenas.br) on 2018-07-31T14:44:13Z (GMT) No. of bitstreams: 1 Dissertação Lúcia Mairot.pdf: 1064790 bytes, checksum: dd87051c063270b72d1fe09ccdc7fb4d (MD5) / Made available in DSpace on 2018-07-31T14:44:32Z (GMT). No. of bitstreams: 1 Dissertação Lúcia Mairot.pdf: 1064790 bytes, checksum: dd87051c063270b72d1fe09ccdc7fb4d (MD5) Previous issue date: 2018-02-27 / Introduction: The introduction of the arts into the medical curriculum has aroused increasing interest since they present unique qualities that can aid in the development of the social aspects of medical practice, offering new and distinctive ways of exploring knowledge and professional identity. Objective: To evaluate the effectiveness of the use of the arts in the medical curriculum, through a bibliographical review. Methodology: The Lilacs, Scielo, PubMed and ERIC databases were searched for published articles on studies that attempted to evaluate the effectiveness of an arts-based approach in undergraduate medical education. Other articles were identified through active search. The following descriptors (Art or visual arts or paintings or literature or narrative or poetry or theare ormovies or films or cinema) AND (Medical education or medical student or medical curriculum) were used. We included only the articles whose study was conducted with medical students and whose effectiveness of the intervention was evaluated by comparison between groups (quantitative studies) or by medical student satisfaction by questionnaire (qualitative studies). We excluded articles that addressed the use of art in patients and professionals from other health areas, as well as articles describing the importance of art or those that did not describe the intervention used. The selected articles were read in full in order to identify the type of art used in the intervention, the author, the sample, the methodology and the conclusion about the reported activity. Results: A total of 28 articles were included in the study, distributed according to the type of art used: (n = 16) visual arts; (n = 6) literature; (n = 3) theater; (n = 3) cinema. The arts-sensitive educational skills reported in the studies evaluated were: Skills diagnostic observation, teamwork, and reflection and argumentation; facilitating cognitive learning; humanistic aspects of medicine (empathy / patient medical relationship); professionalism. Some studies state that arts-based interventions are effective at changing attitudes; however, they did not define how this success was measured. No study considers the effects on behavior. Evidence for the use of arts-based interventions to promote diagnostic observation skills has been shown to be stronger. However, its effect on other clinical skills has not been studied. Conclusion: Art can be a strategy to facilitate learning, since it helps the student to deal with the complexity of the human being and human health. This broader understanding of health and illness can lead to improved physician-patient relationships in clinical practice. However, due to the qualitative nature of most of the studies, based mainly on the student's opinion of the changes in their attitudes, the effectiveness of the interventions have not always been effectively demonstrated. / Introdução: A introdução das artes no currículo médico tem despertado interesse crescente, uma vez que as artes apresentam qualidades únicas que podem auxiliar no desenvolvimento dos aspectos sociais da prática médica, oferecendo maneiras novas e distintivas da exploração do conhecimento e da identidade profissional. Objetivo: Avaliar a eficácia da utilização das artes no currículo médico, por meio de uma revisão bibliográfica. Metodologia: As bases de dados Lilacs, Scielo, PubMed e ERIC foram pesquisadas para artigos publicados sobre estudos que tentaram avaliar a eficácia de uma abordagem baseada em artes na educação médica de graduação. Outros artigos foram identificados por meio de busca ativa. Foram utilizados os seguintes descritores (Art or visual arts or paintings or literature or narrative or poetry or theatre or movies or films or cinema) AND (Medical education or medical student or medical curriculum). Foram incluídos somente os artigos cujo estudo foi realizado com estudantes de medicina e cuja eficácia da intervenção foi avaliada por comparação entre grupos (estudos quantitativos) ou pela satisfação do estudante de medicina por questionário (estudos qualitativos). Foram excluídos artigos que abordavam a utilização da arte em pacientes e profissionais de outras áreas de saúde, bem como os artigos de descrição da importância da arte ou aqueles que não descreviam a intervenção utilizada. Os artigos selecionados foram lidos na íntegra de modo a identificar o tipo de arte utilizada na intervenção, identificar o autor, a amostra, a metodologia e a conclusão sobre a atividade relatada. Resultados: Foram incluídos 28 artigos no estudo, sendo distribuídos de acordo com o tipo de arte utilizada: (n=16) artes visuais; (n=6) literatura; (n=3) teatro; (n=3) cinema. As competências educacionais sensíveis a artes, relatadas nos estudos avaliados, foram: habilidades de observação diagnóstica; trabalho em equipe, reflexão e argumentação; facilitação do aprendizado cognitivo; aspectos humanísticos da medicina (empatia/relação médico-paciente) e profissionalismo. Alguns estudos afirmam que as intervenções, baseadas em artes, são eficazes na alteração de atitudes, entretanto, não definiram como esse sucesso foi medido. Nenhum estudo considera os efeitos sobre o comportamento. As evidências para o uso de intervenções, baseadas em artes para promover habilidades de observação diagnóstica, mostraram-se mais fortes. No entanto, seu efeito em outras habilidades clínicas não foi estudado. Conclusão: A arte pode ser uma estratégia facilitadora do aprendizado, uma vez que auxilia o estudante a lidar com a complexidade do ser humano e da saúde humana. Esse conhecimento mais amplo sobre saúde e doença pode levar à melhoria da relação médico- -paciente na prática clínica. Entretanto, devido à natureza qualitativa da maioria dos estudos, baseados, principalmente, na opinião do estudante sobre as modificações ocorridas em suas atitudes, a eficácia das intervenções nem sempre foram efetivamente demonstradas.

Submitted by Kely Alves (kely.alves@unifenas.br) on 2018-07-31T16:56:35Z No. of bitstreams: 1 Dissertação Flávia Matos.pdf: 868333 bytes, checksum: 75207be4679ddfd22055131d0846333d (MD5) / Approved for entry into archive by Kely Alves (kely.alves@unifenas.br) on 2018-07-31T16:57:10Z (GMT) No. of bitstreams: 1 Dissertação Flávia Matos.pdf: 868333 bytes, checksum: 75207be4679ddfd22055131d0846333d (MD5) / Approved for entry into archive by Kely Alves (kely.alves@unifenas.br) on 2018-07-31T16:58:19Z (GMT) No. of bitstreams: 1 Dissertação Flávia Matos.pdf: 868333 bytes, checksum: 75207be4679ddfd22055131d0846333d (MD5) / Made available in DSpace on 2018-07-31T16:58:49Z (GMT). No. of bitstreams: 1 Dissertação Flávia Matos.pdf: 868333 bytes, checksum: 75207be4679ddfd22055131d0846333d (MD5) Previous issue date: 2018-02-26 / Although the objective structured clinical examination (OSCE) is considered golden standard for the assessment of clinical skills, the exam is both expensive and complex. On the other hand, structured oral examinations (SOE) have much simpler application and lower cost. Nonetheless, SOE may have lower validity and reliability. Objective: To compare Medical students’ academic performance and perception in regard of assessing skills through OSCE and SOE. Method: Two tests were designed (OSCE and SOE) to evaluate five obstetrical skills in a mannequin (the first three Leopold maneuvers, fundal height measurement, and fetal heart rate auscultation). The SOE assessed skills separately and the OSCE evaluated the skills after the analysis of a contextualized case. Students of the 4th term of Medical School were distributed into two groups. In the first phase of the study, Group 1 performed SOE, and Group 2, OSCE. Three weeks later, in the second phase, the same tests were applied inversely. Tests were applied by the same teacher, who employed the same checklist in both tests. In the second phase, a survey about students’ perception towards both test types was also applied. The mean score in each question was compared, as well as the final score, concerning the following crossings: test type in each of the two phases; test type regardless of phase; intragroup OSCE and SOE, and scores of the first and second stages, regardless of test type, as well as between groups, regardless of phase. Students’ perception was analyzed according to frequency distribution and grouping of open-ended answers by similarity. Results: 21 students participated in the study: 13 in Group 1, and 8 in Group 2. No difference was found in all the other crossings, except for the scores between phases. As for the intragroup comparison, the final score and the question 2 (fundal height measurement) score were superior in the second phase in both groups. The comparison between mean scores of the first and second phases, regardless of test type, demonstrated that the scores of the second phase were superior in the final score and in all questions, except for the second and third Leopold maneuvers. The scores’ improvement on the second day may be related to the testing effect. Conclusion: the test type did not influence students’ performance. Most candidates preferred the OSCE type. / Apesar do exame clínico objetivo estruturado (OSCE) ser considerado padrão ouro para avaliação de habilidades clínicas, ele é uma prova de organização complexa e de alto custo. Por outro lado, as provas do tipo prática-oral estruturada (POE) são de aplicação mais simples e de menor custo, ainda que possam apresentar menor validade e confiabilidade. Objetivo: comparar o desempenho acadêmico e a percepção de alunos de Medicina na avaliação de habilidades por OSCE e POE. Método: foram elaboradas duas provas (OSCE e POE) para avaliação de cinco habilidades obstétricas em manequim (três primeiras manobras de Leopold, medida de útero-fita e ausculta de batimentos cardíacos fetais). A POE avaliou as habilidades isoladamente e o OSCE avaliou as habilidades após a análise de um caso clínico contextualizado. Estudantes do 4º período do curso de Medicina foram distribuídos em dois grupos. Na primeira fase, o Grupo 1 realizou a POE e o Grupo 2 o OSCE. Na segunda fase, 3 semanas após, aplicou-se novamente as mesmas provas, de modo invertido. As provas foram aplicadas por um único avaliador, que utilizou o mesmo checklist nas duas provas. Na segunda fase, aplicou-se também um questionário sobre a percepção dos alunos em relação aos dois tipos de prova. Comparou-se a nota média em cada questão e a nota total nos seguintes cruzamentos: tipo de prova em cada uma das fases; tipo de prova independentemente da fase; OSCE e POE intragrupo e notas da primeira e da segunda fases, independentemente do tipo de prova, bem como entre os grupos, independentemente da fase. A percepção do aluno foi analisada por distribuição de frequência e agrupamento das respostas abertas por semelhança. Resultados: 21 alunos participaram do estudo, sendo 13 do Grupo 1 e oito do Grupo 2. Não houve diferença entre as notas das questões e a nota total, entre os dois tipos de prova, nas duas fases do estudo. Também não se observou diferenças em todos os outros cruzamentos, exceto quando se comparou as notas entre as fases do estudo. Na comparação intragrupo, a nota total e a nota da questão 2 (útero-fita) foi superior na segunda fase nos dois grupos. A comparação entre as médias das notas na primeira fase e na segunda fase, independentemente do tipo de prova, demonstrou que as notas da segunda fase foram superiores na nota total e em todas as questões, exceto na 2ª e 3ª manobras de Leopold. A melhora das notas, no segundo dia, pode estar relacionada ao efeito teste. Conclusão: o tipo de prova não influenciou o desempenho do aluno. A maioria dos alunos preferiu a prova tipo OSCE.

Submitted by Kely Alves (kely.alves@unifenas.br) on 2018-07-31T18:14:09Z No. of bitstreams: 1 Dissertação Edson Dell Amore Filho.pdf: 708297 bytes, checksum: d624f6ac7e0eb9fcbdcd4058c5e05da6 (MD5) / Made available in DSpace on 2018-07-31T18:14:09Z (GMT). No. of bitstreams: 1 Dissertação Edson Dell Amore Filho.pdf: 708297 bytes, checksum: d624f6ac7e0eb9fcbdcd4058c5e05da6 (MD5) Previous issue date: 2018-03-12 / The medicine dehumanization has been largely attributed to the medicine schools, which privilege scientific aspects to the detriment of those theoreticians and focus on the humanism. The medicine schools were driven to review their curricula, emphasizing disciplines and organizing interventions for recovering of the humanism in medical practice. The general objective of the dissertation was to identify the actions proposed or developed in medicine courses for resumption of humanization in the medical practice. The specific objectives were to highlight the main attributes of the humanism and to describe the main educational interventions adopted for the humanism development in medical practice. A systematic revision of the literature was carried out for the attainment of the study objectives, by means of researching in the databases of the Latin American and Caribbean Health Sciences Literature and Pub Med, from 2010 to 2016, in Portuguese and English languages. The research resulted in the selection of 23 publications. The results showed that the humanism main attribute is the empathy, which the schools of medicine are developing as main actions the changes in the curriculum of the courses. The main educational implemented actions involve, besides the curricular changes, exchanges and extension programs, through the inclusion of new disciplines, the use of play activities and cultural contexts that are distinct from those of the students' origin. It was concluded that the range of the measures is still small, considering the universe of the medicine courses and its lack of results for more objective analysis. / A “desumanização” da medicina tem sido atribuída em grande parte às escolas de medicina, que privilegiam aspectos científicos, em detrimento daqueles teóricos e voltados ao humanismo. As escolas de medicina se viram impelidas a rever seus currículos, enfatizando disciplinas e organizando intervenções para retomada do humanismo na prática médica. O objetivo geral da dissertação foi identificar as ações propostas ou desenvolvidas nos cursos de medicina para a retomada da humanização na prática médica. Os objetivos específicos foram evidenciar os principais atributos do humanismo e descrever as principais intervenções educacionais adotadas para o desenvolvimento do humanismo na prática médica. Para a consecução dos objetivos do estudo, foi realizada uma revisão sistemática de literatura, mediante pesquisa nas bases de dados da Literatura Latino-Americana e do Caribe em Ciências da Saúde e PubMed, no período de 2010 a 2016, nos idiomas português e inglês. A pesquisa resultou na seleção de 23 publicações. Os resultados mostraram que o principal atributo do humanismo é a empatia e que as escolas de medicina estão desenvolvendo como principais ações alterações nos currículos dos cursos. As principais ações educacionais implementadas envolvem alterações curriculares, intercâmbios e programas de extensão, mediante a inclusão de novas disciplinas, uso de atividades lúdicas e atuação em contextos culturais distintos dos de origem dos estudantes. Concluiu-se que a abrangência das medidas ainda é pequena, considerando-se o universo dos cursos de medicina, e seus resultados carecem de análise mais objetiva.

The purpose of this study was to investigate pharmacy students’ experiences, perceptions, and beliefs regarding peer-reporting of academic dishonesty by adopting a cross-sectional anonymous survey to pharmacy students in the United States. In addition, this study identified factors that may affect pharmacy students’ likelihood of reporting peers’ academic dishonesty including the relationship between the cheater and their observer, the severity of the punishment on the reported cheating, and the reporting systems. Fifty-six out of 271 respondents (20.7%) reported their engagement of academic dishonesty. One hundred forty-four respondents (53.1%) reported that they directly observed someone else’s cheating behavior. One hundred eighty-nine respondents (69.7%) reported that they indirectly heard about someone else’s cheating behavior from others who directly observed cheating; yet, only 25 respondents (9.2%) peer-reported their classmates’ cheating.The current study shows that although the majority of participants believe that peer-reporting is ethical, they have not reported the cheating they observed due in part to fear of retaliation and no information (or clear direction) on who they should report to or how to report. Additionally, the current study shows that if an innovative system to anonymously report cheating (e.g., a specific peer-reporting website or hotline to protect confidentiality) is adopted, the likelihood to report in the innovative system is higher than in the current system across all types of student-student relationships and all levels of punishment. The current study also demonstrated a statistically significant inverse relationship between likelihood to report and punishment severity. Peer-reporting can be an effective method when well-established polices protect peer-reporters from retaliation and when transparent and reasonable punishments are assigned to those who engage in academic dishonesty. It is imperative that pharmacy schools consider these findings, review their policies regarding academic integrity and its peer-reporting, and modify practices so that professionalism is encouraged and expected.

Medical educators advocate the need for medical students to acquire information management skills, including the ability to search the MEDLINE database. There has been no published validated method available to use for assessing medical students' MEDLINE information retrieval skills. This research proposes and evaluates a method, designed as the MEDLINE Metric, for assessing medical students' search skills. MEDLINE Metric consists of: (a) the development, by experts, of realistic clinical scenarios that include highly constructed search questions designed to test defined search skills; (b) timed tasks (searches) completed by subjects; (c) the evaluation of search results; and (d) instructive feedback. A goal is to offer medical educators a valid, reliable, and feasible way to judge mastery of information searching skill by measuring results (search retrieval) rather than process (search behavior) or cognition (knowledge about searching). Following a documented procedure for test development, search specialists and medical content experts formulated six clinical search scenarios and questions. One hundred and forty-five subjects completed the six-item test under timed conditions. Subjects represented a wide range of MEDLINE search expertise. One hundred twenty complete cases were used, representing 53 second-year medical students (44%), 47 fourth-year medical students (39%), and 20 medical librarians (17%). Data related to educational level, search training, search experience, confidence in retrieval, difficulty of search, and score were analyzed. Evidence supporting the validity of the method includes the agreement by experts about the skills and knowledge necessary to successfully retrieve information relevant to a clinical question from the MEDLINE database. Also, the test discriminated among different performance levels. There were statistically significant, positive relationships between test score and level of education, self-reported previous MEDLINE training, and self-reported previous search experience. The findings from this study suggest that MEDLINE Metric is a valid method for constructing and administering a performance-based test to identify mastery in searching the MEDLINE database. The test's reliability needs to be established.

Healthcare resources are especially limited in rural regions of the US. The lack of Primary Care Providers (PCPs) and mental/behavioral health services is problematic, as there are high rates of behavioral and medical concerns within rural populations. Special populations, such as rural persons with Serious Mental Illness (SMI), are medically complex and represent a vulnerable and underserved population. Healthcare outcomes for persons with SMI are poor compared to the general population and commonly lead to premature death. Various barriers prevent this population from accessing optimal healthcare, especially in rural areas, due to negative perceptions/stigma, a lack of understanding from PCPs, and a shortage of resources in general. The current study aimed to determine the extent of mental health training that rural PCPs receive regarding patients with SMI, as well as to evaluate their perceptions, knowledge, and experiences with these patients and understand providers’ perceptions regarding rates of patients with SMI who present to primary care clinics in rural settings. The current study used a sample of rural primary care providers (N = 90) , surveyed via USPS mail. Results indicated significant differences in reported mental health training among providers from different disciplines. Greater reported mental health training significantly predicted lower levels of stigma, more correctly identified medical conditions comorbid with SMI, and greater reported comfort and confidence in treating patients with SMI. Providers reported differences in the number of patients with and without SMI seen in rural clinics. Implications for these findings are discussed.