The last phase centered on connecting with rural stakeholders through a workshop to generate ideas addressing identified challenges. Practitioners and community partners from North Carolina Mountain Area Health Education Center (MAHEC) were invited to the workshop. This region was selected since more than 90% of the 28 MAHEC counties are rural and most do not offer experiential rotations due to limited student housing and excessive driving distances.16 Individuals who were interviewed in the initial phases were not asked to participate in the workshops. The workshop started with a similar background survey used in the focus group and interviews. Next, participants completed a design thinking activity called empathy mapping—during this activity, participants were asked to consider the perspective of a final-year student in their profession assigned to a rural rotation location. Participants reflected on what they would feel, think, do, and say while they were at the assigned rotation. These ideas were placed on sticky notes to populate a larger board that grouped ideas. A short debrief reviewed the comments and identified the most significant challenges based on the providers’ perspectives. Workshop participants also received the 1-page summary of the interview and focus groups findings and they commented on their agreement with the findings. Photos of the empathy maps and a list of significant challenges were recorded as artifacts of the discussion and a compilation of the sticky notes were documented as evidence of the conversation.

Next, participants completed a design thinking activity around brainstorming potential solutions to the identified challenges. Individuals were requested to select several challenges and generate as many solutions as possible to address the challenge. Rules for the brainstorming process focused on the quantity of ideas rather than the quality and individuals were encouraged to think of ideas regardless of funding potential or implementation concerns. Ideas were put on individual sticky notes and placed onto boards where participants as a collective could review and group similar solutions. The list of ideas were documented as evidence of the conversation and summarized in a 1-page document. The document was distributed to workshop participants after the event to confirm the findings; the member checking of the results was done to provide feedback if the findings were inaccurate or incomplete.41

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