Train in Place: Place-Based Nursing Education Models in the Rural Mountain West

• In Event: Improving Rural Students’ College Persistence: Using Cultural Assets and Innovative Programming for College Completion

Abstract

Purposes
This study examines innovative "train in place" nursing education models across Colorado, New Mexico, and Wyoming that enable rural students to complete professional preparation while remaining in their home communities, addressing critical rural nursing workforce shortages while supporting students' place-based identities. The research aims to understand how nursing programs successfully adapt curriculum delivery, clinical experiences, and student support services to serve geographically dispersed populations while maintaining educational quality and professional licensure outcomes.
Framework
The study employs place-based theory that recognizes the value of connecting professional preparation to local contexts, community assets, and regional workforce needs. This work draws from rural education literature which emphasizes "grow your own" strategies and community development approaches. The theoretical foundation incorporates professional identity development theory, sense of belonging frameworks, and rural healthcare literature to understand how place-based training influences nursing students' professional preparation, cultural competency, and career commitment to rural practice.
Methods
This comprehensive mixed-methods case study examines three distinct place-based nursing programs representing different educational levels, institutional partnerships, and rural contexts. Focus groups and interviews with students, faculty, clinical partners, and community stakeholders will capture program evolution, relationship development, and student experiences. Data collection encompasses systematic document review of institutional policies, partnership agreements, curriculum materials, and public communications to understand program design and implementation strategies. Quantitative analysis will examine enrollment patterns, persistence rates, completion outcomes, licensure pass rates, and employment patterns.
Data Sources
Data sources include interviews and focus groups with nursing students, faculty, clinical supervisors, and community partners. Program administrative data encompasses enrollment, student demographics, persistence and completion rates, licensure exam pass rates, and employment outcomes including geographic location. Institutional documents include partnership agreements, adapted curriculum materials, relevant policy documents, and program marketing materials. Contextual data include regional healthcare workforce needs assessments, demographic and economic indicators for communities served, and relevant education and workforce development policies.
Results
Focus groups will begin in late 2025. Initial findings are expected to focus on student perceptions of financial and academic supports that aid their ability to remain in their rural communities, and how their nursing education supports their community connection. Findings from focus groups will explore how the programs embeds cultural learning support rural nursing workforce development. Initial contextual data analysis underscored the need for research and support for rural nursing workforce development. Nationally, there are 98 registered nurses per 10,000 people in urban areas compared to 64 RNs in rural areas (Rural Healthcare Workforce, 2025). Additionally, nursing workforce projections expect that by 2037 the supply of nurses will only meet 87% of the demand in rural settings (Nurse Workforce Projections, 2022-2037, 2024).
Significance
This research contributes essential evidence about place-based professional education models that address rural student access and workforce development needs. The multi-state comparative approach enables identification of successful practices across different institutional, policy, and geographic contexts. Methodological contributions include innovative approaches to rural education case study research. Findings inform nursing education policy development, rural healthcare workforce planning, and innovative rural higher education delivery models that address critical professional shortages.

Author

• Colleen Falkenstern, Western Interstate Commission on Higher Education