Incorporating Geographic Information Systems (GIS) into Program Evaluation: Lessons from a Rural Medicine Initiative

University School of Medicine developed an integrated rural core curriculum to interest students in ru-ral practice careers. Here we focus on the evaluation strategy used to determine the extent to which students in the new rural medicine interest group who self-identified as selecting a rural clerkship or externship did secure a clinical training experience in a rural setting. Methods: Three measures of rurality were compared to determine whether students were placed in rural training settings: (1) the percentage of the county living in rural areas; (2) a county-level dichoto-mous measure of rural/nonrural; and (3) a dichotomous measure based on urban area boundaries within the county. Practice address and geographic data were integrated into geographic information systems software, which we used to map out rural characteristics of Michigan counties through a pro-cess called thematic mapping; this shows characteristic variation by color-shading geographic features. In addition, reference maps were created showing the boundaries of urban areas and metropolitan/ micropolitan areas. Once these processes were completed, we overlaid the practice location on the con-textual-level geographic features to produce a visual representation of the relationship between student placement and rural areas throughout the state. Results: The outcome of student placement in rural practices varied by the definition of rural. W