Education Supplement Research Articles

COVID-19 vaccinations pre- and antepartum: a consideration of the evidence and discussion of issues.

The COVID-19 vaccine should be universally offered to pregnant women and women planning pregnancies. This is on the basis that COVID-19 infection can complicate the pregnancy and have adverse health implications in pregnancy, as compared to non-pregnant women, which the vaccine helps to mitigate. This is the recommendation of many governing bodies in medical care. However, certain issues require consideration, which are not discussed in the current guidelines. These include the induction of fever by the vaccines and the role fever can play in teratogenicity, the induction of hyper-coagulable and thrombocytopenic states by the vaccines and other known contraindications to the vaccines. In this article, we develop strategies to minimize risks in these situations. We also discuss the theoretical advantage of calling for a booster COVID-19 vaccinate in all pregnant women in the late second or early third trimester, even if previously immunized, and encourage further research, to investigate the possible benefits of this proposed intervention. This article acts as an educational supplement to help clinicians manage pregnant women and addresses many issues, not discussed in most COVID-19 vaccine recommendations by international societies related to pregnant women. This article is a literature review of the current, limited data. The information extrapolated allowed for suggestions regarding COVID-19 vaccination during pregnancy. RESULTSAND CONCLUSIONS: The study discusses hypothetical issues, to minimize any risks associated with COVID-19, and serves as a compilation of data to further the current literature, in proving that COVID-19 vaccines have minimal risks in pregnancy.

Tailoring language for genitourinary function in patients with newly diagnosed prostate cancer to facilitate discussions in diverse populations and overcome health literacy barriers.

Poor comprehension of prostate cancer (PCa) medical terms can create barriers to PCa treatment discussions. The authors measured comprehension of PCa terms and its relationship to health literacy in a group of Black men who were newly diagnosed with PCa. Theyexaminedwhether tailoring communication with alternative colloquial words would be helpful and acceptable. Patients were recruited from urology clinics (N=152). After they met with their providers to discuss PCa treatment options, they participated in an educational supplement delivered as a structured interview. The supplement tailored PCa treatment information by allowing men to choose between colloquial and medical terms for genitourinary (GU) function. Health literacy was measured using the Rapid Estimate of Adult Literacy in Medicine, and comprehension of common PCa terms was assessed using published methods. Pearson correlation was used to estimate the association between health literacy and comprehension of PCa terms. Spearman rank correlation (r) was used to assess the relation between the total number of medical terms preferred (range, 0-10) and Rapid Estimate of Adult Literacy in Medicine scores (range, 0-66). Most patients (62%) had low health literacy, which was strongly correlated with their understanding of PCa terms (r=0.526; p<.001). Poor comprehension of many PCa terms established the need to use alternative language for GU function (only 20% knew the word incontinence). There was a statistically significant positive association between the number of medical terms preferred and health literacy (r=0.358; p<.001). A majority of patients (91%) preferred a mixture of medical and colloquial terms. Tailoring communications with colloquial terms for GU function was preferred by most patients regardless of health literacy.

Measuring Vitamin Literacy and Information-Seeking Behavior.

Background The significance of vitamins in maintaining health necessitates a comprehensive understanding among the population, which is critical for making informed decisions pertaining to diet and vitamin supplementation. Nevertheless, there is a notable deficiency in research regarding the mechanisms through which individuals in the Kingdom of Saudi Arabia (KSA) acquire and utilize vitamin-related knowledge, marking a considerable void in public health and nutrition education. Methods This study proposes a quantitative, cross-sectional analysis to evaluate vitamin literacy and information-seeking behaviors within KSA's diverse demographic sectors. Survey instruments will be utilized to ascertain the primary sources from which individuals derive vitamin information and to analyze the factors that influence the integration of this knowledge into daily health practices. Results Analysis showed significant variance in vitamin literacy with age and education acting as key differentiators. Kruskal-Wallis tests indicated significant differences in self-rated vitamin knowledge across age groups (p < 0.001), and Chi-square tests confirmed the association between education level and supplement use (p = 0.0022). The majority of participants demonstrated moderate knowledge of vitamins, yet a discrepancy exists between this knowledge and dietary application. Trust in information sources emerged as a significant predictor of dietary change (Chi-square, p < 0.001), although a substantial portion of participants did not actively incorporate vitamin knowledge into their daily diet. Conclusion The enhancement of vitamin literacy is paramount for the formulation of effective public health strategies. Our findings suggest that targeted educational programs, especially for younger and less-educated populations, are crucial to bridge the gap between vitamin knowledge and its application in daily diet. In addition, efforts should focus on improving the credibility of information sources, as this significantly influences dietary changes. These initiatives can lead to more informed decision-making regarding diet and vitamin supplementation, ultimately fostering healthier living practices and reducing the occurrences of vitamin-related health issues within the KSA populace. This research contributes substantively to the development of tailored educational initiatives and informed policymaking, guiding future efforts to advance nutrition guidelines and public health in the region.

PREHABILITATION BEFORE GASTROINTESTINAL CANCER SURGERY (PREHAB-GI): AN IMPLEMENTATION STUDY

BACKGROUND Surgery continues to be the primary treatment option for early-stage colorectal and upper gastrointestinal (UGI) cancers. However, up to 30-40% will experience a major complication. Prehabilitation aims to improve preoperative functional reserves through physical, nutritional, and/or psychological interventions. We aimed to evaluate the implementation of a multimodal prehabilitation program in gastrointestinal cancer surgery patients. METHODS A single-arm implementation study using a pre-post design. Colorectal or UGI cancer patients scheduled for curative intent surgery at Concord Hospital with ≥14 days pre-surgery were recruited. The intervention was face-to-face or by telehealth (COVID adaptations): a 2-4-week program consisting of i) supervised exercise, ii) dietary education and protein supplements, iii) nursing support. The primary outcome was implementation using the RE-AIM (Reach/Effectiveness/Adoption/Implementation/Maintenance) framework. Secondary outcomes included functional, nutritional, and surgical outcomes. RESULTS Over 16 months, 181 were screened; 95 (52%) were eligible. Reach: 77/95 recruited (64 colorectal, 13 UGI). The median age was 70 years; 46 (60%) were males. Median intervention duration was 16 days. Effectiveness: Functional capacity using the 6-minute walk test and 2-minute step test improved from baseline to pre-surgery; 9.3m (p=0.038) and 6.5 steps (p=&amp;lt;0.001), respectively. Self-reported moderate, vigorous and resistance training statistically increased from baseline to pre-surgery. Hospital length of stay decreased by 1.9 days (p=0.010). There was no difference in total complications and readmissions. Adoption: 91% of referrals were directly from surgeons. Implementation: 72 completed the intervention; 5 withdrew after baseline assessment. 34% of assessments and intervention were delivered by telehealth. Adherence to the intervention was high; 94% exercise, 97% nutrition, 98% nursing. Overall, participant and clinician satisfaction was high. Maintenance: The program has been adopted as standard care with modifications post-study completion. CONCLUSIONS Our study shows that multimodal prehabilitation can be successfully implemented in a real-world setting, with a trend to improve functional and surgical outcomes.

Association of Combining Diet and Physical Activity on Sarcopenia and Obesity in Elderly Koreans with Diabetes.

This study aimed to identify the combined factors of physical activity and diet associated with non-sarcopenic non-obese status in 1586 diabetic patients aged ≥65 years from the Korean National Health and Nutrition Examination Survey (2016 to 2019). Participants were categorized into non-sarcopenic non-obesity (NSNO), sarcopenia non-obesity (SNO), non-sarcopenic obesity (NSO), and sarcopenic obesity (SO) groups. NSNO had lower insulin, HOMA-IR, and triglycerides compared to NSO and SO. NSNO had lower perceived stress, higher nutrition education and dietary supplement intake. As assessed by the Korean Healthy Eating Index, NSNO scored higher total than SNO and SO, in breakfast and energy balance compared to SO, and in the adequacy of vegetables and meat/fish/egg/bean compared to SNO. NSNO had significantly higher energy and protein intake and physical activity, with BMI/waist circumference lower than NSO, SO, and comparable to SNO. Physical activity was positively associated with NSNO. Low Total KHEI score and protein intake level reduced the odds ratio (OR) of NSNO, particularly when physical activity was insufficient, with OR = 0.38 for KHEI Q1 and OR = 0.32 for protein T1. In conclusion, physical activity, diet quality, and protein intake are associated with NSNO prevalence in Korean elderly with diabetes, and energy balance through active intake and expenditure may be effective.

Exploring the Path of Cultivating College Students’ “Innovation and Entrepreneurship” Ability under the Integration of Research and Teaching

In higher education, research and teaching supplement and support each other. Under the trend of deep integration of the new round technological and industrial revolution, the transformation role of higher education in technological innovation and industrial development is becoming increasingly prominent. The integration of research and teaching is an important measure to solve the problem of separation and even contradiction between education and scientific and technological research. The dialectical and unified theoretical mechanism among education, technology, and talent can promote the integration of research and teaching from three aspects: education and teaching, technological innovation, and talent cultivation, in response to the problems and difficulties in the current “innovation and entrepreneurship” ability of college students. This can promote the improvement of college students’ “innovation and entrepreneurship” ability.

Impact Of Preschool Education Financial Expenditures on The Number of Full-Time Preprimary Teachers in Rural Regions--An Analysis Based on Chinese Provincial Panel Data, 2012-2021

Education is an essential problem concerning the whole society, creating citizens with well-educated is the foundation of a good country. Financial expenditure on education is the basic supplement and support of advanced education. However, preschool education has lower attention compared to other seminars. There is a certain gap in allocation. Therefore, the focus of this study is on how education spending affects the number of rural kindergarten teachers, using the quantitative analysis method, from the Economy Prediction System (EPS) database to collect the corresponding panel data of China's provinces during the decade 2012-2021 to analyze and hypothesize, and finally concludes as follows. The amount of kindergarten full-time teachers in rural areas is obviously and positively related to the total investment in preprimary education, and this relationship is more significant in the western region. The study also found that among the items of financial expenditures on preschool education. Spending on products and services, as opposed to pay, benefits, and assistance for individuals and families, had a greater impact on the amount of kindergartens full-time teachers in rural areas. Through the path analysis in the study, we can know that the educational financial expenditure can increase the number of full-time kindergarten teachers in rural areas by increasing the number of kindergartens and students.

Uncollegial governance and the restructuring of the University of Alberta

This article provides an account of the undermining of collegial governance at the University of Alberta in relation to the restructuring of the university in 2020 by the senior administration and board on advice provided by the Australian consultancy firm, the Nous Group. The current president of the university has publicly promoted the restructuring in venues including the Times Higher Education supplement as a model for other universities. The model, a disastrous one for collegial governance, demands widespread attention along with the means by which it was achieved. As Bill Readings declared in his 1997 book The University in Ruins, “the changing institutional form of the university is something that intellectuals cannot afford to ignore.” At the University of Alberta, that changing form is being determined by fossil-fuelled academic capitalism. The account of what has happened is provided by a professor who has served on the university’s senior academic body, the General Faculties Council, for almost a decade. It concludes with several concrete recommendations for bolstering collegial governance at universities in Alberta, elsewhere in Canada, and possibly worldwide—wherever collegial governance is being undermined by restructuring, the corporatization of the academy, academic capitalism, or the disrespect of university boards for the authority of faculty and the academic mission.

Protein and Exercise to Reverse Frailty in Older Men and Women Undergoing Transcatheter Aortic Valve Replacement: Design of the PERFORM-TAVR Trial

Despite the high procedural success of transcatheter aortic valve replacement (TAVR), 2 out of 5 older adults report poor physical performance and health-related quality of life (HRQOL) in the ensuing months, particularly those with frailty. There has yet to be a trial examining the synergistic effects of exercise and protein supplementation to counteract frailty and improve patient-centred outcomes following TAVR. The PERFORM-TAVR trial is a multicentre parallel-group randomised clinical trial that is enrolling 200 frail older adults ≥ 70 years of age undergoing TAVR. Patients will be randomly allocated to 1 of 2 treatment groups: standard-of-care lifestyle education (control group) or protein-rich oral nutritional supplement for 4 weeks before TAVR with the addition of home-based supervised exercise sessions for 12 weeks after TAVR (intervention group). The primary outcome will be physical performance as measured by a blinded observer using the Short Physical Performance Battery at 3 months. Secondary outcomes at 3, 6, and 12 months will include HRQOL, as measured by the Short-Form 36 Physical and Mental Component summary scores, and a composite safety end point. The PERFORM-TAVR trial is testing a novel frailty intervention in older adults undergoing TAVR to optimise recovery and downstream HRQOL. This represents a potential paradigm shift that highlights the value of assessing and treating patients’ frailty in parallel with their underlying heart valve disease. Clinical Trial RegistrationURL: https://www.clinicaltrials.gov. Unique identifier: NCT03522454.

Research participants' perspectives about the return of uninformative genomic test results in a clinical research setting.

The majority of genomic sequencing and microarray results are clinically uninformative, meaning that they do not suggest a need for any behavioral action or medical intervention. Prior studies have shown that recipients of uninformative genomic testing results ("uninformative results" hereafter) may incorrectly interpret them to imply a lowered risk of disease or false reassurance about future health risks. Few studies have examined how patients understand uninformative results when they are returned in a research setting, where there is wide variation in analytical specifications of testing, interpretation and reporting practices, and resources to support the return of results. We conducted cross-sectional interviews (N = 17) to explore how a subset of research participants in one genomics study at the National Institutes of Health reacted to and understood their uninformative test results, which were returned to them via a patient portal without genetic counseling. We found that most participants did not remember the details of the informed consent process, including the distinction between "primary" and "secondary" findings. Participants had questions about what genes were tested for and, in most cases, requested a list of the genes covered. Several participants incorrectly assumed that autosomal recessive carrier results would have been reported to them if detected. Some participants interpreted their uninformative results to mean that they could forgo prenatal testing, and participants had mixed expectations about whether their results might be reinterpreted in the future. These themes suggest that there are specific challenges to returning uninformative results in research settings. Educational supplements to uninformative test reports may be most useful if they contextualize results in relation to other types of clinical genetic or genomic testing that may be made available to research participants in their lifetimes.

A comprehensive modelling and experimental approach for damped oscillations in U-tubes via Easy JavaScript Simulations

In recent years, science simulations have become popular among educators due to their educational usefulness, availability, and potential for increasing the students’ knowledge on scientific topics. In this paper, we introduce the implementation of a user-friendly simulation based on Easy Java/JavaScript Simulations (EJS) to study the problem of damped oscillations in U-tubes EJS. Furthermore, we illustrate various advantages associated with the capabilities of EJS in terms of design and usability in order to encourage teachers to use it as an educational supplement to physics laboratories.

Early introduction of 3D modeling modules promotes the development of simulation skills in downstream biomedical engineering curricula

BackgroundRecent advancements in additive manufacturing have made 3D design a desirable skill in combating the historically slow development of biomedical products. Due to the broad applicability of additive manufacturing to biomedical engineering, 3D design and 3D printing are attractive educational tools for biomedical engineering students. However, due to the multidisciplinary nature of biomedical engineering, finding a suitable spot in the curriculum to teach students basic and application-based skills for 3D manufacturing is difficult. Furthermore, prior training in fundamental 3D design skills may be needed to support the use of application-based supplementary content.ResultsWe designed a SolidWorks Simulations toolkit to complement a sophomore (2nd-year)-level Biomechanics course and distributed this assignment to students with and without prior training in 3D design delivered in an introductory biomedical engineering course. Using short videos, example-based problem solving, and step-by-step tutorials, students completed this as an extra-credit assignment and completed a survey gauging student opinion on SolidWorks and 3D design, confidence in each target skill, and the effectiveness of assignment delivery. The compilation of survey responses suggests that the assignment effectively increased positive responses in student opinion on interest in and likeliness to use SolidWorks in both groups. However, confidence in the target assignment skills was higher in the trained group and fewer problems occurred in operating SolidWorks for trained students. Further, analyzing the distribution of student grades with respect to survey responses suggests that responses had no relationship with initial class grade.ConclusionThese data collectively indicate that prior training provided to the students had a positive impact on the effectiveness of the assignment although increases in student opinion on the utility of 3D design were observed in both trained and untrained students. Our work has generated and identified a useful educational supplement to enrich existing biomedical engineering course materials with practical skills.

Education Supplement for International Holocaust Remembrance Day

About This Issue This Education Supplement has been created in honor of International Holocaust Remem-brance Day, marked on 27 January of each year. It begins with a brief background of the commemoration day and then moves into the harder work of defining the Holocaust. Here, students are presented with five definitions of the Holocaust and asked to read them for similarities and differences before considering which they feel is most appropriate. The heart of this supplement consists of three Genocide Studies International articles. Each has been selected because of its important content and the critical conversation it will provoke. In addition, each piece employs a different style of writing commonly seen in academic articles.

Education Supplement for Genocide Awareness Month

Genocide Studies International ( GSI) is owned, operated, and managed by the International Institute for Genocide and Human Rights Studies (a division of the Zoryan Institute). The journal is published twice a year by the University of Toronto Press. Zoryan Institute, a nonprofit organization, serves the cause of scholarship and public awareness relating to issues of universal human rights, genocide, and diaspora-homeland relations. This is done through the systematic continued efforts of scholars and specialists using a comparative and multidisciplinary approach and in accordance with the highest academic standards.

Video-Based Education Improves Sampling (Grossing) Confidence in Pathology Trainees.

Pathology resident education has a steep learning curve. Specimen sampling (grossing) is a procedural task, and procedural fields add video materials to their curricula to familiarize trainees with procedure(s), reduce errors, and improve patient care. Our team applied this strategy to develop original in-house sampling videos for our program. To evaluate the effect of in-house sampling videos on resident sampling confidence. Sampling videos covering all major organ systems (AMOS) were created for our postgraduate year 1 (PGY1) trainees. Videos were hosted on a Northwestern cloud server for on-demand access. Trainees completed 3 surveys (0, 6, 12 months) evaluating sampling confidence comparing those who used in-house videos as an educational supplement with those who did not use the videos. Sampling confidence significantly improved at 6 and 12 months (P < .001) across AMOS and PGY levels. When compared with those who did not use in-house sampling videos, trainees who supplemented their education with in-house sampling videos had significantly higher confidence ratings across AMOS and PGY levels at the start of the study (P < .001) and at 6 months (P = .004). Sampling confidence significantly improved for PGY1 trainees at 6 and 12 months (P < .001); for PGY2 and PGY3 trainees, confidence significantly improved at 6 months (P < .001). When evaluated by organ-specific analyses, sampling and teaching confidence improved across all organ systems and, except for the gastrointestinal system, reached significance at 12 months for all PGY levels. Sampling videos, when used as a supplement to the existing curriculum, significantly improved trainee confidence.

Comparison of the effects of therapeutic exercise with either an educational booklet or vitamin-D3 supplement in the management of chronic low back pain: study protocol for an assessor blinded multicenter randomized clinical trial

Background: It is important to know the best intervention approach to replenish serum vitamin D levels along with therapeutic interventions for chronic low back pain (CLBP) patients. From the researcher’s knowledge, no study compared “vitamin D supplement” or “booklet education on sun exposure, nutrition and lifestyle” with therapeutic exercise for CLBP cases. Researchers hypothesize that multidimensional comprehensive management of therapeutic exercise and an education booklet (TEB) on sun exposure, nutrition, and lifestyle might be superior to therapeutic exercise and oral vitamin D supplement (TED) for CLBP patients with vitamin D deficiency. Methods: We planned for an assessor-blinded two-arm multicenter Randomized Clinical Trial (RCT) protocol to compare the efficacy of TEB compared to TED for CLBP patients with vitamin D deficiency at 2 months and 6 months after baseline recruitment in designated centers in Dhaka city. The primary outcome measures will include pain by Brief Pain Inventory (BPI), and serum vitamin D3 level and secondary outcome measures will include disability by Ronald Morris Disability Questionnaire (RMDQ). Discussion: This study will provide evidence for an appropriate prescription for the management of CLBP patients having vitamin D deficiency. Registration: Clinical Trials Registry India (CTRI/2022/11/047074).

The association between dietary insulin index and load with mental health

BackgroundDepression, anxiety, and stress are common mental problems. The aim of this cross-sectional study was to investigate the association between two indexes that measure postprandial insulin response to different food, dietary insulin index (DII) and insulin load (DIL), with psychological disorders.MethodParticipants (n = 10,000) aged 20–69 were randomly selected from 200 clusters in Yazd from the recruitment phase of the Yazd Health Study. The dietary intake of participants was collected by a reliable and validated food frequency questionnaire (FFQ) consisting of 178 food items. DII and DIL were calculated from the FFQ data using previously published reference values. To assess psychological disorders an Iranian validated short version of a self-reported questionnaire (Depression Anxiety Stress Scales 21 [DASS21]) was used.ResultsNo significant association was observed between DIL and DII with odds of depression or anxiety using crude or adjusted models. However, individuals in the highest quartiles of DIL had the lowest odds of stress (OR: 0.69; 95% CI 0.48–1.01, P-trend = 0.047). This association remained significant after adjustment for potential confounders in model II including marital status, smoking, education, job status, salt intake, and multi-vitamin supplement use (OR: 0.38; 95% CI 0.16–0.91, P-trend = 0.039) and the third and final model which is further adjusted for BMI (OR: 0.39; 95% CI 0.16–0.91, P-trend = 0.041).ConclusionOverall, consumption of foods with higher DII as well as DIL were associated with lower stress scores; however, no significant relationship was observed between DII or DIL with respective depression or anxiety scores.

A New Treatment Paradigm: Targeting Trace Amine-Associated Receptor 1 (TAAR1) in Schizophrenia.

All currently available antipsychotics work via essentially the same mechanism: by antagonizing the dopamine D2 receptor. However, schizophrenia is an extremely heterogeneous condition, and antipsychotics do not adequately control symptoms for all patients. Negative and cognitive symptoms are especially difficult to manage with existing medications. Therefore, antipsychotic agents with novel mechanisms of action are urgently needed. Recently, a phase 2 clinical trial and extension study demonstrated that, relative to placebo, the trace amine-associated receptor 1 (TAAR1) agonist ulotaront was effective at controlling the positive, negative, and cognitive symptoms of schizophrenia. In addition, ulotaront seems to lack the weight gain, metabolic issues, and extrapyramidal symptoms associated with traditional antipsychotics. This agent is currently undergoing multiple phase 3 trials for the treatment of schizophrenia. Another TAAR1 agonist, ralmitaront, is being investigated for the treatment of schizophrenia and schizoaffective disorders. Two phase 2 clinical trials are underway, evaluating ralmitaront both as a monotherapy and an add-on therapy to traditional antipsychotics. In this supplement, we review the biologic, preclinical, and clinical data available for TAAR1 agonists, so that if and when they are approved for the treatment of schizophrenia, psychiatry specialists will be ready to use them to optimize patient outcomes. We also briefly review other emerging therapies in late-stage development for the treatment of schizophrenia.

AN OTTOMAN TURKISH PERIODICAL AS A SOURCE BOOK FOR YOUTH: ‘MECMÛʻA-İ NEVRESÎDEGÂN’

Mecmûʻa-i Nevresîdegân, Osmanlı Devleti’nin son dönemlerinde (1298/1882) İstanbul’da gençler için çıkarılmış olan bir süreli yayındır. Mecmua, kendilerini “Rüfekâ-yı selâse-yi tahririyye” imzasıyla tanıtan H. Tayfur, A. Âsaf ve A. Vasfi adlı üç genç arkadaş tarafından çıkarılmış ve iki kuruştan satışa sunulmuştur. Üç ayrı kütüphanede nüshaları bulunan mecmuanın sadece iki sayısına rastlanır. Her iki sayı da dört bölümden oluşmaktadır. Bu bölümler; mütenevviʻa, ilm-i hesap, coğrafya ve tarihtir. Sayıları otuz iki sayfadan oluşan mecmuanın her bölümüne sekizer sayfa ayrılmıştır. Mecmuanın tasarımına bakıldığında bir süreli yayından çok kitap bölümleri gibi planlandığı görülmektedir. Mecmûʻa-i Nevresîdegân, tek sütun olarak tasarlanmıştır. Mecmûʻa-i Nevresîdegân’ı gençler/çocuklar için çıkarılan diğer süreli yayınlardan ayıran temel özellikler; yardımcı kaynak niteliğinde birer kitap olarak toplanabilecek dört ayrı ilimden oluşması ve mecmuanın, mekteplerdeki eğitimin bir tamamlayıcısı, destekleyicisi niteliğinde olmasıdır. Bu makale ile gençler/çocuklar için çıkarılan süreli yayınlar arasında adında “mecmua” kelimesini ilk kullanan, Mecmûʻa-i Nevresîdegân tanıtılarak ilgilenenlerin dikkatine sunulmuştur.

Family Medicine Residencies: How Rural Training Exposure in GME Is Associated With Subsequent Rural Practice.

Rural US populations face a chronic shortage of physicians and an increasing gap in life expectancy compared to urban US populations, creating a need to understand how to increase residency graduates' desire to practice in such areas. This study quantifies associations between the amount of rural training during family medicine (FM) residencies and subsequent rural work. American Medical Association (AMA) Masterfile, AMA graduate medical education (GME) supplement, American Board of Family Medicine certification, Accreditation Council for Graduate Medical Education (ACGME), and Centers for Medicare and Medicaid Services hospital costs data were merged and analyzed. Multiple logistic regression measured associations between rural training and rural or urban practice in 2018 by all 12 162 clinically active physicians who completed a US FM residency accredited by the ACGME between 2008 and 2012. Analyses adjusted for key potential confounders (age, sex, program size, region, and medical school location and type) and clustering by resident program. Most (91%, 11 011 of 12 162) residents had no rural training. A minority (14%, 1721 of 12 162) practiced in a rural location in 2018. Residents with no rural training comprised 80% (1373 of 1721) of those in rural practice in 2018. Spending more than half of residency training months in rural areas was associated with substantially increased odds of rural practice (OR 5.3-6.3). Only 4% (424 of 12 162) of residents spent more than half their training in rural locations, and only 5% (26 of 436) of FM training programs had residents training mostly in rural settings or community-based clinics. There is a linear gradient between increasing levels of rural exposure in FM GME and subsequent rural work.