Future Healers: Assessing Interests in Health Professions among Younger Individuals from Rural & Urban Communities

Future Healers: Assessing Interests in Health Professions among Younger Individuals from Rural & Urban Communities | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Future Healers: Assessing Interests in Health Professions among Younger Individuals from Rural & Urban Communities Anthony Stultz, Erica Ausel This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8502425/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background: The shortage of healthcare professionals in rural and underserved areas in the United States significantly impacts access to healthcare. Studies have identified many contributing factors but less is known about the role life experiences play in drawing healthcare workers into these communities. The experiences that influence students’ healthcare career decisions, especially sociodemographic background, remain underexplored. This study aims to fill this gap by investigating factors and experiences that shape undergraduate students’ healthcare aspirations and comparing differences among students fromrural and urban backgrounds. Methods: This study utilized a mixed-methods approach. Traditional undergraduate students (N=111) from 12 institutions across Indiana completed a Qualtrics survey including Likert scale items, rank order questions, and open-ended responses. Statistical analyses (Mann-Whitney U tests and independent t-tests) were used to compare anonymous responses between students who grew up in rural and urban environments. Qualitative responses were analyzed thematicallyusing Artificial Intelligence (AI). Results: Quantitative analysis revealed that rural students were significantly more influenced by family members working in healthcare (p = 0.044) and motivation to better their community (p = 0.046). Urban students reported higher influence from personal drive and mentorship. Across both groups, college coursework and clinical experiences reinforced students’ interest in health careers but were not primary motivators. For both groups, personal health-related experience was most commonly ranked as the top motivating factor. Qualitative findings supported these results. Rural students often stated witnessing community health needs and early healthcare exposure as key experiences influencing their decision. Urban students described the influence of structured programs, college mentorship, and volunteering. Across both groups, mentorship, hands-on experience, and early healthcare exposure were the most motivational experiences influencing students to choose a career in the health professions. Some students noted that college helped them redirect or clarify their career paths. Conclusions: Undergraduate students’ backgrounds influence their motivations to pursue healthcare careers, with rural students more driven by familial and community-oriented factors. Our findings suggest that experiences such as early exposure, mentorship, and localized outreach strategies, particularly those tailored by geography, may be crucial for healthcare workforce development. Addressing disparities in pre-health advising, clinical exposure, and information access is key to improving rural healthcare pipelines. Trial registration: Not applicable (no clinical intervention conducted). Health Professions Urban Communities Rural Communities Indiana Healthcare & Career Development Midwest Healthcare Figures Figure 1 Figure 2 Figure 3 Background Undergraduate education represents a critical period when students develop and refine their career interests, influenced by factors such as background, experiences, and exposure to professional fields [ 1 , 2 ]. This study explores factors influencing undergraduate students’ decisions to pursue careers in healthcare, particularly how educational, social, and geographic contexts impact those decisions. By investigating these influences, this study seeks to inform strategies aimed at addressing the healthcare workforce shortage in underserved rural and urban communities. Rural areas in the United States face critical shortages of healthcare providers, especially where access to care is limited and rates of chronic illness are higher [ 3 , 4 ]. By 2030, Indiana will need over 800 new primary care physicians to meet demand [ 5 ]. Current workforce data reflect an aging healthcare labor force and declining interest among young professionals, further exacerbating workforce gaps [ 6 , 7 ]. These challenges have been intensified by the COVID-19 pandemic, which worsened provider shortages and widened rural–urban disparities in healthcare access [ 8 , 9 ]. Understanding why some students choose healthcare careers can inform workforce development. Research highlights key motivators including family influence, economic security, and personal interest [ 10 , 11 ]. Social Cognitive Career Theory (SCCT) and Achievement Goal Theory (AGT) suggest that students’ career choices develop from a complex interaction of self-efficacy, personal goals, and external influences [ 12 , 13 , 14 ]. For instance, parental guidance and socioeconomic status have been shown to influence both general career paths and specific specialty preferences [ 15 , 16 ]. Early exposure to healthcare environments, such as through clinical placements or educational outreach, plays a crucial role in career development and retention [ 17 , 18 ]. However, rural students often face structural barriers, including geographic isolation, limited mentorship, and insufficient advising, which could discourage health career exploration [ 19 , 20 ]. These barriers are compounded by uneven healthcare resource distribution across both rural and urban regions [ 6 , 21 ]. Demographic factors such as gender and minority status also affect motivation and access to healthcare careers. Female and minority students are often driven by people-oriented values but may experience lower self-efficacy due to limited role models or mentorship [ 22 , 23 , 24 ]. Cultivating students’ vocational calling and adaptability through early career exploration can improve alignment with healthcare roles and reduce professional burnout [ 1 , 25 ]. Workforce retention remains a current major issue, with job dissatisfaction, burnout, and lack of long-term support systems contributing to high attrition rates across healthcare fields [ 26 , 25 ]. These findings emphasize the need for early and sustained career development strategies, particularly in rural settings where recruitment and retention challenges are more common [ 17 , 7 ]. Despite research on healthcare career choice, gaps remain, particularly in understanding the unique experiences of rural students and the early influences that spark interest in healthcare fields. This study aims to address these gaps by examining how educational, geographic, and sociocultural factors influence undergraduates’ aspirations to enter the health professions. Insights from this research will support targeted interventions that aim to build a stronger, more equitable healthcare workforce. Methods This study utilized a mixed methods design to explore factors influencing undergraduate students' decisions to pursue careers in healthcare. This study targeted students at 12 higher educational institutions across the state of Indiana, including universities from both rural and urban settings. This approach allowed for the exploration of potential differences in experiences between students from rural and urban environments. Participants were full-time undergraduate students enrolled at these universities, selected to capture a diverse range of perspectives. Online students were excluded to ensure consistency in the participants' experiences with campus-based learning environments. Data was collected through a Qualtrics survey designed by the authors to assess students' backgrounds and experiences (access the complete survey instrument here). The survey included both quantitative and qualitative components. The quantitative measures consisted of Likert scale statements and ordering questions. The 5-point Likert scale statements assessed students' agreement with factors influencing their healthcare career decisions, and an ordering-style question asked participants to rank potential factors influencing their career decisions from most to least important. Demographic information was also collected through multiple-choice questions about students’ backgrounds (e.g., small town, large town) and year in college. Qualitative measures included open-ended questions to capture insights about students' personal experiences and motivations for pursuing healthcare careers. An optional question at the end allowed students to enter their school email address for a chance to win a $ 100 incentive. The survey was distributed via email to university department chairs and professors in biology, biochemistry, exercise science, nursing, and other pre-health related programs at each institution. Faculty members were asked to share the survey link with students in pre-health programs. Students' participation was anonymous. Data Analysis Non-parametric analyses were used to assess the quantitative Likert scale and ranking data while thematic analysis was employed for open-ended responses. Descriptive statistics were calculated to summarize demographic information and response patterns. Quantitative data were analyzed using IBM SPSS software. Mann-Whitney U tests were conducted to determine statistical significance between response distributions when comparing different groups, particularly when examining differences between rural and urban student populations. Independent t-tests examined correlation between background factors and career motivations. Responses to open-ended questions were analyzed using thematic analysis with the aid of artificial intelligence tools. ChatGPT version 4 was utilized to identify trends, patterns, and common themes in qualitative responses, providing a systematic approach to content analysis. Results from the AI-assisted analysis were reviewed to identify key motivational factors and experiences influencing students' healthcare career choices. All personal identifying information was removed before processing through ChatGPT to maintain participant anonymity. The integration of quantitative and qualitative methods provided a comprehensive understanding of the factors influencing healthcare career choices among undergraduate students from different backgrounds. Ethical Considerations This study received exempt approval from the Marian University Institutional Review Board on January 22, 2025 (Protocol #25.102). The initial page of the Qualtrics survey was the informed consent statement where participants were advised that selecting to continue the survey represented their informed consent. Participation was voluntary and anonymous and consent coule be withdrawn at anytime. Email addresses collected for the gift card raffle were collected in a separate survey via a link at the end of the initial survey, stored separately from survey responses to ensure anonymity and on a password protected server. Results A total of 111 undergraduate students completed the survey, including 58 students from rural backgrounds and 53 from urban backgrounds. Participants represented all undergraduate class years and reported diverse intended healthcare careers. Percentages reported in this section were calculated using the total number of respondents within each demographic group (rural or urban) for each item. Table 1 Analysis of Likert Scale Responses Question Setting Sample Size (N) Mean (M) Median Rank Sum of Ranks Mann-Whitney U p-value The college courses you’ve taken have furthered your interest in entering healthcare. Rural 58 3.34 3 194 1583.000 0.761 Urban 53 3.34 3 177 Growing up in your community has inspired you to pursue a healthcare career to serve similar areas. Rural 58 2.76 3 160 1368.000 0.282 Urban 53 2.96 3 157 You chose a healthcare career to address the shortage of providers in your community. Rural 58 2.67 3 155 1520.000 0.916 Urban 53 2.70 3 143 Family members working in healthcare influenced your decision to pursue a career in medicine. Rural 58 2.60 3 151 1867.500 0.044 Urban 53 2.19 2 116 Growing up, your family encouraged you to pursue a career in healthcare. Rural 58 2.47 2 143 1434.000 0.521 Urban 53 2.60 2 138 Caring for or having a sick family member influenced you to pursue a career in medicine. Rural 58 2.81 3 163 1591.000 0.740 Urban 53 2.77 3 147 Individuals from rural communities are less likely to pursue careers in healthcare due to a lack of resources. Rural 58 2.64 3 153 1368.500 0.372 Urban 52 2.77 3 144 Individuals from rural communities are less likely to pursue careers in healthcare due to a lack of information. Rural 58 2.79 3 162 1503.000 0.974 Urban 52 2.79 3 145 Overall, Likert-scale responses demonstrated similar patterns between rural and urban students across most items (Table 1 ). Median responses for both groups generally reflected neutral to moderate agreement for statements related to coursework, community influence, healthcare shortages, and personal or family health experiences. One significant difference was observed for the statement “Family members working in healthcare influenced your decision to pursue a career in medicine”, with rural students reporting higher agreement than urban students (p = 0.044). Figure 1 displays the distribution of responses for this item; additional Likert-scale figures are available in the supplementary materials. No other Likert-scale items differed significantly between groups (p > 0.05). Among rural students, 32 of 58 (55%) agreed that family members influenced their decision to pursue a career in the health professions, compared to 18 of 53 urban students. In contrast, urban students were more likely to strongly disagree with this statement, with 19 of 53 (36%) selecting strong disagreement compared to 11 of 58 (18%) rural students. Additional Likert-scale response distributions are provided in the supplementary materials. Table 2 Analysis of Ordered Responses Question Setting Sample Size (N) Mean (M) Median Rank Sum of Ranks Mann-Whitney U p-value Personal health related experience Rural 57 4.21 3 240 1592.000 0.621 Urban 53 3.94 3 209 Better my community Rural 57 4.93 5 281 1840.000 0.046 Urban 53 4.08 4 216 College courses Rural 57 6.12 6 349 1464.500 0.781 Urban 53 6.23 6 330 Health needs of a loved one Rural 57 5.12 6 292 1390.500 0.470 Urban 53 5.53 5 293 Personal health experiences Rural 57 5.21 5 297 1600.500 0.588 Urban 53 4.92 5 261 High school courses Rural 57 6.91 7 394 1613.500 0.529 Urban 53 6.58 8 349 Personal drive Rural 57 2.28 1 130 1434.000 0.622 Urban 53 2.30 2 122 Motivated by family Rural 57 4.60 4 262 1165.000 0.037 Urban 53 5.60 6 297 Shortage of health professions Rural 57 6.39 7 364 1436.000 0.652 Urban 53 6.60 7 350 Other Rural 57 9.23 10 526 1521.500 0.903 Urban 53 9.21 10 488 Students ranked ten factors from most to least influential in their decision to pursue a healthcare career (Table 2 ). Across both rural and urban groups, “personal drive” was the most highly ranked factor, with similar median rankings and no significant difference between groups (p = 0.622). Most factors including “personal health experiences,” “college coursework,” “high school coursework,” “healthcare workforce shortages,” and “health needs of a loved one” showed comparable ranking distributions between rural and urban students (p > 0.05). Two factors differed significantly in rank ordering. The factor “better my community” differed between groups (p = 0.046), as did "motivated by family" (p = 0.037). The distribution of rankings for these factors is shown in Figs. 2 and 3 . Figure 2 illustrates rankings for “better my community.” Among rural students, 37 of 57 ranked this factor within their top five, and 13 of 57 ranked it within their top three. Among urban students, 40 of 53 ranked it within their top five, and 21 of 53 ranked it within their top three. Nine urban students ranked this factor as their most important influence, compared to one rural student. Figure 3 displays rankings for “motivated by family.” A total of 23 of 57 rural students ranked this factor within their top three, compared to 12 of 53 urban students. Rural students more frequently assigned this factor a first or second ranking, while urban students more often placed it in mid-range rankings. Table 3 Statistical Analysis of Top Three Rankings of Ordered Responses Question Setting Sample Size (N) Mean (M) Median Rank Sum of Ranks Mann-Whitney U p-value Personal health related experience Rural 57 1.25 2 107 1617.000 0.494 Urban 53 1.04 Better my community Rural 57 0.56 2 64 1313.500 0.149 Urban 53 0.75 College courses Rural 57 0.32 3 31 1554.500 0.626 Urban 53 0.25 Health needs of a loved one Rural 57 0.60 2 46 1642.000 0.309 Urban 53 0.49 Personal health experiences Rural 57 0.58 2 62 1310.000 0.156 Urban 53 0.85 High school courses Rural 57 0.37 3 32 1438.500 0.503 Urban 53 0.49 Personal drive Rural 57 1.07 1 104 1263.500 0.110 Urban 53 1.38 Motivated by family Rural 57 0.82 2 72 1749.500 0.083 Urban 53 0.53 Shortage of health professions Rural 57 0.32 2.5 17 1613.000 0.219 Urban 53 0.13 Other Rural 57 0.12 1 5 1530.500 0.801 Urban 53 0.09 When examining whether factors appeared within students’ top three rankings (Table 3 ), no statistically significant differences were observed between rural and urban students for any factor (p > 0.05). Descriptively, “personal drive,” “motivated by family,” and “better my community” were most frequently included among the top three influences across both groups. Students’ Open-Ended Responses to Interest in Pursuing a Career in Medicine Theme Summary Supporting Quote Reinforcement of Pre-existing Interest (23.9%, N = 23) College experiences such as coursework, mentorship, and exposure to clinical environments strengthened an already established interest in pursuing medicine and increased students’ confidence in their career choice. “My experiences have reinforced my decision to pursue medicine and given me confidence that I can succeed.” Influence of Coursework and Academic Rigor (35.4%, N = 34) Rigorous science coursework, including anatomy, physiology, and biochemistry, sparked or deepened interest in medicine. Engaging instructors and applied learning opportunities were frequently cited as influential. “Courses like biochemistry, anatomy, and physiology made me excited for medicine.” Hands-On Clinical and Experiential Learning (16.0%, N = 15) Clinical exposure, shadowing, and practicum experiences played a pivotal role in clarifying career goals and, in some cases, redirecting students toward specific healthcare paths. “The Medical Practicum trip sealed the deal… It changed my perspective.” Personal and Community Experiences (8.3%, N = 8) Personal healthcare encounters and increased awareness of health inequities motivated interest in medicine. Some students described how experiences outside their home communities broadened their perspectives. “Being a Black woman and experiencing healthcare as a patient.” Mentorship and Support Networks (8.3%, N = 8) Faculty mentorship, encouragement, and exposure to healthcare role models supported students’ confidence and persistence in pursuing medicine. “My classes and mentor inspired me… the faculty were encouraging.” Career Exploration and Redirection (5.2%, N = 5) Exposure to a range of health professions during college led some students to shift career goals toward alternative healthcare roles such as physician assistant or public health. “I wanted to become a doctor, but I changed to be a PA.” Limited or Negative Influence (3.1%, N = 3) A small subset of students reported minimal or discouraging influence from college experiences, often citing uninspiring pre-clinical coursework. “College prior to nursing school had very little impact on my interest in medicine.” Discussion This study examined differences in how undergraduate students from rural and urban backgrounds prioritize factors influencing their interest in healthcare careers. Although overall motivational patterns were similar across groups, Figs. 2 and 3 highlight meaningful differences in the relative importance of community- and family-based influences, providing important context for the statistically significant findings observed in Table 2 . Figure 2 illustrates differences in rankings for the factor “better my community.” While this motivator was commonly identified by both groups, urban students more frequently ranked it among their top three influences and were more likely to identify it as their most important factor. In contrast, rural students tended to rank “better my community” within their top five rather than at the highest rank. This pattern suggests that community impact is valued across settings but may be weighted differently: urban students may view community service as a primary driver of career choice, whereas rural students may conceptualize it as one of several interconnected motivations. Figure 3 further contextualizes the significant difference observed for “motivated by family.” Rural students more frequently ranked family influence among their top three motivators and were more likely to assign it a first- or second-place ranking. Urban students, by comparison, more often placed this factor lower in their overall rankings. These findings are consistent with prior research indicating that family expectations and experiences play a particularly influential role in shaping healthcare aspirations among rural students. Together, these figures suggest that while intrinsic motivation remains central for students across geographic backgrounds, the external influences shaping career decisions differ in emphasis. Community- and family-centered motivations appear more prominent in rural students’ decision-making processes, whereas urban students may integrate these values alongside academic and institutional experiences encountered during college. These distinctions underscore the importance of tailoring recruitment and pipeline initiatives to reflect students’ lived contexts rather than relying on uniform strategies. Several limitations should be noted. The use of self-reported rankings may introduce response bias, and categorizing geographic background as rural or urban may oversimplify complex identities. Additionally, the cross-sectional design limits insight into how motivations change over time. Future research should employ longitudinal approaches to examine how early influences persist or evolve and should include students who discontinue pursuit of healthcare careers to better identify barriers within the pipeline. The qualitative findings from students’ open-ended responses provide important context for the quantitative results by illustrating how college experiences shape interest in pursuing a career in medicine. The most prominent theme, Influence of Coursework and Academic Rigor (35.4%), highlights the role of foundational science courses in deepening students’ engagement with medicine, particularly when instruction was applied and clinically relevant. Nearly one-quarter of respondents described Reinforcement of Pre-existing Interest (23.9%), indicating that college experiences often strengthened rather than initiated students’ aspirations toward medicine, highlights the role of early exposure to healthcare careers. Hands-on clinical exposure, shadowing, and practicum experiences further emerged as pivotal in clarifying career goals and solidifying commitment to medical careers. Additional themes, including Mentorships and Support Networks, Personal and Community Experiences, and Career Exploration or Redirection, underscore the importance of guidance and exposure in shaping students’ healthcare trajectories. Collectively, these qualitative findings demonstrate that undergraduate education serves as a critical reinforcing and filtering stage in the healthcare pipeline, complementing the quantitative results and highlighting mechanisms that influence students’ persistence toward medical careers. Conclusion This research confirms the importance of personal, familial, and community influences, particularly among rural students, and emphasizes the impact of early clinical and mentorship experiences for all students. It also highlights college as a crucial stage in the formation of healthcare career interest. These findings are relevant for institutions and policymakers aiming to address the healthcare workforce shortage in underserved areas. By expanding outreach and support mechanisms tailored to geographic and cultural backgrounds, stakeholders can more effectively guide students into meaningful healthcare careers, ultimately improving access to care where it is most needed. Abbreviations AI Artificial Intelligence DO Doctor of Osteopathic Medicine IRB Institutional Review Board MD Doctor of Medicine SCCT Social Cognitive Career Theory AGT Achievement Goal Theory SPSS Statistical Package for the Social Sciences Declarations Ethics approval and consent to participate The Marian University Institutional Review Board identified this research as exempt [25.102]. Documentation of the exempt status is provided in the supplementary files. The first page of the research survey was the informed consent statement; participants were informed that continuing the survey represented their informed consent which could be withdrawn at any time. Consent for publication Participants were informed that their data may be used in scholarly presentations and/or publication in the informed consent statement in the research survey. Availability of data and materials The raw data set can be found in here. The reliability and validity of the data set can be accessed here. Competing Interests The authors declare that they have no competing interests. Funding The Marian University Tom & Julie Wood College of Osteopathic Medicine Master’s in Biomedical Science Program funded the $100 survey participation raffle in this study. Authors' Contributions Erica Ausel, Ph.D. (EA) assisted in research design, survey creation, and manuscript review. Anthony M. Stultz (AS) networked with pre-health faculty chair professors at Indiana institutions to request their student body to participate in the study. AS and EA performed statistical analysis using the Mann Whitney U tests and independent t-tests. AS analyzed trends and themes in students’ open-ended responses. EA aided in organizing material in the SPSS data sets. AS monitored the Qualtrics Survey daily to ensure no technical issues occurred. Acknowledgements Not Applicable References Albaum L. 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19:38:55","extension":"xml","order_by":11,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":106997,"visible":true,"origin":"","legend":"","description":"","filename":"ee431b703fe4479388c0e64fa2ee9f1e1structuring.xml","url":"https://assets-eu.researchsquare.com/files/rs-8502425/v1/a03613bbc9048ff6ea9470b2.xml"},{"id":100720593,"identity":"ae6cb4cd-11be-46c0-8e18-c31057639753","added_by":"auto","created_at":"2026-01-20 19:38:12","extension":"html","order_by":12,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":122795,"visible":true,"origin":"","legend":"","description":"","filename":"earlyproof.html","url":"https://assets-eu.researchsquare.com/files/rs-8502425/v1/03f7027146a8ad68bf20dc8a.html"},{"id":100720182,"identity":"0eef596a-ad74-4a61-93ab-60015cec4e4b","added_by":"auto","created_at":"2026-01-20 19:33:54","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":102136,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eResponses to the Likert scale question stating family members have influenced your decision to pursue a career in medicine. Responses compared between demographic setting.\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-8502425/v1/beecd09bf253c68d02149bd6.png"},{"id":100720811,"identity":"9203239d-4271-4444-b575-f01480ccf9c4","added_by":"auto","created_at":"2026-01-20 19:40:04","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":71771,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eStudent rankings of “better my community” compared between demographic setting.\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"2.png","url":"https://assets-eu.researchsquare.com/files/rs-8502425/v1/0593a5ffafb5c2cb5f1af8a6.png"},{"id":100720591,"identity":"842df60a-5333-4460-b3f0-17af7b9a493f","added_by":"auto","created_at":"2026-01-20 19:38:11","extension":"png","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":77535,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eStudent rankings of “motivated by family” compared between demographic setting.\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"3.png","url":"https://assets-eu.researchsquare.com/files/rs-8502425/v1/060a78ed0937284949c1d204.png"},{"id":102404154,"identity":"368185ab-1239-47b5-8b6f-85784d2647d1","added_by":"auto","created_at":"2026-02-11 11:01:28","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1353704,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-8502425/v1/86efb0ef-2e0f-4935-bf62-77167336871f.pdf"},{"id":100720813,"identity":"1b81fc2a-b373-4dda-a869-4b5ceaa64219","added_by":"auto","created_at":"2026-01-20 19:40:08","extension":"docx","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":26842,"visible":true,"origin":"","legend":"","description":"","filename":"QualtricsResearchSurvey.docx","url":"https://assets-eu.researchsquare.com/files/rs-8502425/v1/2094acc39d799a9b2e13aaa5.docx"}],"financialInterests":"No competing interests reported.","formattedTitle":"Future Healers: Assessing Interests in Health Professions among Younger Individuals from Rural \u0026 Urban Communities","fulltext":[{"header":"Background","content":"\u003cp\u003eUndergraduate education represents a critical period when students develop and refine their career interests, influenced by factors such as background, experiences, and exposure to professional fields [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. This study explores factors influencing undergraduate students\u0026rsquo; decisions to pursue careers in healthcare, particularly how educational, social, and geographic contexts impact those decisions. By investigating these influences, this study seeks to inform strategies aimed at addressing the healthcare workforce shortage in underserved rural and urban communities.\u003c/p\u003e \u003cp\u003eRural areas in the United States face critical shortages of healthcare providers, especially where access to care is limited and rates of chronic illness are higher [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. By 2030, Indiana will need over 800 new primary care physicians to meet demand [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. Current workforce data reflect an aging healthcare labor force and declining interest among young professionals, further exacerbating workforce gaps [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]. These challenges have been intensified by the COVID-19 pandemic, which worsened provider shortages and widened rural\u0026ndash;urban disparities in healthcare access [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e, \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eUnderstanding why some students choose healthcare careers can inform workforce development. Research highlights key motivators including family influence, economic security, and personal interest [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e, \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]. Social Cognitive Career Theory (SCCT) and Achievement Goal Theory (AGT) suggest that students\u0026rsquo; career choices develop from a complex interaction of self-efficacy, personal goals, and external influences [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e, \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]. For instance, parental guidance and socioeconomic status have been shown to influence both general career paths and specific specialty preferences [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eEarly exposure to healthcare environments, such as through clinical placements or educational outreach, plays a crucial role in career development and retention [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e, \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e]. However, rural students often face structural barriers, including geographic isolation, limited mentorship, and insufficient advising, which could discourage health career exploration [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e, \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e]. These barriers are compounded by uneven healthcare resource distribution across both rural and urban regions [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eDemographic factors such as gender and minority status also affect motivation and access to healthcare careers. Female and minority students are often driven by people-oriented values but may experience lower self-efficacy due to limited role models or mentorship [\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e, \u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e, \u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e]. Cultivating students\u0026rsquo; vocational calling and adaptability through early career exploration can improve alignment with healthcare roles and reduce professional burnout [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eWorkforce retention remains a current major issue, with job dissatisfaction, burnout, and lack of long-term support systems contributing to high attrition rates across healthcare fields [\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e, \u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e]. These findings emphasize the need for early and sustained career development strategies, particularly in rural settings where recruitment and retention challenges are more common [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e, \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eDespite research on healthcare career choice, gaps remain, particularly in understanding the unique experiences of rural students and the early influences that spark interest in healthcare fields. This study aims to address these gaps by examining how educational, geographic, and sociocultural factors influence undergraduates\u0026rsquo; aspirations to enter the health professions. Insights from this research will support targeted interventions that aim to build a stronger, more equitable healthcare workforce.\u003c/p\u003e"},{"header":"Methods","content":"\u003cp\u003eThis study utilized a mixed methods design to explore factors influencing undergraduate students' decisions to pursue careers in healthcare. This study targeted students at 12 higher educational institutions across the state of Indiana, including universities from both rural and urban settings. This approach allowed for the exploration of potential differences in experiences between students from rural and urban environments.\u003c/p\u003e \u003cp\u003eParticipants were full-time undergraduate students enrolled at these universities, selected to capture a diverse range of perspectives. Online students were excluded to ensure consistency in the participants' experiences with campus-based learning environments.\u003c/p\u003e \u003cp\u003eData was collected through a Qualtrics survey designed by the authors to assess students' backgrounds and experiences (access the complete survey instrument here). The survey included both quantitative and qualitative components. The quantitative measures consisted of Likert scale statements and ordering questions. The 5-point Likert scale statements assessed students' agreement with factors influencing their healthcare career decisions, and an ordering-style question asked participants to rank potential factors influencing their career decisions from most to least important. Demographic information was also collected through multiple-choice questions about students\u0026rsquo; backgrounds (e.g., small town, large town) and year in college. Qualitative measures included open-ended questions to capture insights about students' personal experiences and motivations for pursuing healthcare careers. An optional question at the end allowed students to enter their school email address for a chance to win a \u003cspan\u003e$\u003c/span\u003e100 incentive.\u003c/p\u003e \u003cp\u003eThe survey was distributed via email to university department chairs and professors in biology, biochemistry, exercise science, nursing, and other pre-health related programs at each institution. Faculty members were asked to share the survey link with students in pre-health programs. Students' participation was anonymous.\u003c/p\u003e \u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eData Analysis\u003c/h2\u003e \u003cp\u003eNon-parametric analyses were used to assess the quantitative Likert scale and ranking data while thematic analysis was employed for open-ended responses. Descriptive statistics were calculated to summarize demographic information and response patterns. Quantitative data were analyzed using IBM SPSS software. Mann-Whitney U tests were conducted to determine statistical significance between response distributions when comparing different groups, particularly when examining differences between rural and urban student populations. Independent t-tests examined correlation between background factors and career motivations.\u003c/p\u003e \u003cp\u003eResponses to open-ended questions were analyzed using thematic analysis with the aid of artificial intelligence tools. ChatGPT version 4 was utilized to identify trends, patterns, and common themes in qualitative responses, providing a systematic approach to content analysis. Results from the AI-assisted analysis were reviewed to identify key motivational factors and experiences influencing students' healthcare career choices. All personal identifying information was removed before processing through ChatGPT to maintain participant anonymity. The integration of quantitative and qualitative methods provided a comprehensive understanding of the factors influencing healthcare career choices among undergraduate students from different backgrounds.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eEthical Considerations\u003c/h3\u003e\n\u003cp\u003e This study received exempt approval from the Marian University Institutional Review Board on January 22, 2025 (Protocol #25.102). The initial page of the Qualtrics survey was the informed consent statement where participants were advised that selecting to continue the survey represented their informed consent. Participation was voluntary and anonymous and consent coule be withdrawn at anytime. Email addresses collected for the gift card raffle were collected in a separate survey via a link at the end of the initial survey, stored separately from survey responses to ensure anonymity and on a password protected server.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eA total of 111 undergraduate students completed the survey, including 58 students from rural backgrounds and 53 from urban backgrounds. Participants represented all undergraduate class years and reported diverse intended healthcare careers. Percentages reported in this section were calculated using the total number of respondents within each demographic group (rural or urban) for each item.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eAnalysis of Likert Scale Responses\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"8\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eQuestion\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSetting\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eSample Size (N)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eMean (M)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eMedian Rank\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eSum of Ranks\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eMann-Whitney U\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003ep-value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eThe college courses you\u0026rsquo;ve taken have furthered your interest in entering healthcare.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRural\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e58\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e3.34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e194\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e1583.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.761\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUrban\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e53\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e3.34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e177\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eGrowing up in your community has inspired you to pursue a healthcare career to serve similar areas.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRural\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e58\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2.76\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e160\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e1368.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.282\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUrban\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e53\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2.96\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e157\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eYou chose a healthcare career to address the shortage of providers in your community.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRural\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e58\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2.67\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e155\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e1520.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.916\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUrban\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e53\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2.70\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e143\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eFamily members working in healthcare influenced your decision to pursue a career in medicine.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRural\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e58\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2.60\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e151\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e1867.500\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.044\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUrban\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e53\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2.19\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e116\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eGrowing up, your family encouraged you to pursue a career in healthcare.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRural\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e58\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2.47\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e143\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e1434.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.521\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUrban\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e53\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2.60\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e138\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eCaring for or having a sick family member influenced you to pursue a career in medicine.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRural\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e58\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2.81\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e163\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e1591.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.740\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUrban\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e53\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2.77\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e147\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eIndividuals from rural communities are less likely to pursue careers in healthcare due to a lack of resources.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRural\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e58\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2.64\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e153\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e1368.500\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.372\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUrban\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e52\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2.77\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e144\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eIndividuals from rural communities are less likely to pursue careers in healthcare due to a lack of information.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRural\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e58\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2.79\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e162\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e1503.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.974\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUrban\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e52\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2.79\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e145\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eOverall, Likert-scale responses demonstrated similar patterns between rural and urban students across most items (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e). Median responses for both groups generally reflected neutral to moderate agreement for statements related to coursework, community influence, healthcare shortages, and personal or family health experiences.\u003c/p\u003e \u003cp\u003eOne significant difference was observed for the statement \u0026ldquo;Family members working in healthcare influenced your decision to pursue a career in medicine\u0026rdquo;, with rural students reporting higher agreement than urban students (p\u0026thinsp;=\u0026thinsp;0.044). Figure\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e displays the distribution of responses for this item; additional Likert-scale figures are available in the supplementary materials. No other Likert-scale items differed significantly between groups (p\u0026thinsp;\u0026gt;\u0026thinsp;0.05).\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003eAmong rural students, 32 of 58 (55%) agreed that family members influenced their decision to pursue a career in the health professions, compared to 18 of 53 urban students. In contrast, urban students were more likely to strongly disagree with this statement, with 19 of 53 (36%) selecting strong disagreement compared to 11 of 58 (18%) rural students. Additional Likert-scale response distributions are provided in the supplementary materials.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eAnalysis of Ordered Responses\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"8\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eQuestion\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSetting\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eSample Size (N)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eMean (M)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eMedian Rank\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eSum of Ranks\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eMann-Whitney U\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003ep-value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003ePersonal health related experience\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRural\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e57\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e4.21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e240\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e1592.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.621\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUrban\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e53\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e3.94\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e209\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eBetter my community\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRural\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e57\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e4.93\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e281\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e1840.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.046\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUrban\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e53\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e4.08\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e216\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eCollege courses\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRural\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e57\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e6.12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e349\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e1464.500\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.781\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUrban\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e53\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e6.23\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e330\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eHealth needs of a loved one\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRural\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e57\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e5.12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e292\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e1390.500\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.470\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUrban\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e53\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e5.53\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e293\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003ePersonal health experiences\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRural\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e57\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e5.21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e297\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e1600.500\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.588\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUrban\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e53\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e4.92\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e261\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eHigh school courses\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRural\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e57\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e6.91\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e394\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e1613.500\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.529\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUrban\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e53\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e6.58\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e349\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003ePersonal drive\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRural\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e57\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2.28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e130\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e1434.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.622\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUrban\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e53\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2.30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e122\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eMotivated by family\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRural\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e57\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e4.60\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e262\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e1165.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.037\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUrban\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e53\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e5.60\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e297\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eShortage of health professions\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRural\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e57\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e6.39\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e364\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e1436.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.652\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUrban\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e53\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e6.60\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e350\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eOther\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRural\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e57\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e9.23\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e526\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e1521.500\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.903\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUrban\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e53\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e9.21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e488\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eStudents ranked ten factors from most to least influential in their decision to pursue a healthcare career (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e). Across both rural and urban groups, \u0026ldquo;personal drive\u0026rdquo; was the most highly ranked factor, with similar median rankings and no significant difference between groups (p\u0026thinsp;=\u0026thinsp;0.622). Most factors including \u0026ldquo;personal health experiences,\u0026rdquo; \u0026ldquo;college coursework,\u0026rdquo; \u0026ldquo;high school coursework,\u0026rdquo; \u0026ldquo;healthcare workforce shortages,\u0026rdquo; and \u0026ldquo;health needs of a loved one\u0026rdquo; showed comparable ranking distributions between rural and urban students (p\u0026thinsp;\u0026gt;\u0026thinsp;0.05). Two factors differed significantly in rank ordering. The factor \u0026ldquo;better my community\u0026rdquo; differed between groups (p\u0026thinsp;=\u0026thinsp;0.046), as did \"motivated by family\" (p\u0026thinsp;=\u0026thinsp;0.037). The distribution of rankings for these factors is shown in Figs.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003e and \u003cspan refid=\"Fig3\" class=\"InternalRef\"\u003e3\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003eFigure \u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003e illustrates rankings for \u0026ldquo;better my community.\u0026rdquo; Among rural students, 37 of 57 ranked this factor within their top five, and 13 of 57 ranked it within their top three. Among urban students, 40 of 53 ranked it within their top five, and 21 of 53 ranked it within their top three. Nine urban students ranked this factor as their most important influence, compared to one rural student.\u003c/p\u003e \u003cp\u003eFigure \u003cspan refid=\"Fig3\" class=\"InternalRef\"\u003e3\u003c/span\u003e displays rankings for \u0026ldquo;motivated by family.\u0026rdquo; A total of 23 of 57 rural students ranked this factor within their top three, compared to 12 of 53 urban students. Rural students more frequently assigned this factor a first or second ranking, while urban students more often placed it in mid-range rankings.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eStatistical Analysis of Top Three Rankings of Ordered Responses\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"8\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eQuestion\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSetting\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eSample Size (N)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eMean (M)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eMedian Rank\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eSum of Ranks\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eMann-Whitney U\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003ep-value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003ePersonal health related experience\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRural\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e57\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e107\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e1617.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.494\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUrban\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e53\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.04\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eBetter my community\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRural\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e57\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.56\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e64\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e1313.500\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.149\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUrban\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e53\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.75\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eCollege courses\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRural\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e57\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.32\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e31\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e1554.500\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.626\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUrban\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e53\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eHealth needs of a loved one\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRural\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e57\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.60\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e46\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e1642.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.309\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUrban\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e53\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.49\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003ePersonal health experiences\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRural\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e57\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.58\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e62\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e1310.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.156\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUrban\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e53\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.85\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eHigh school courses\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRural\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e57\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.37\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e32\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e1438.500\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.503\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUrban\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e53\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.49\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003ePersonal drive\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRural\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e57\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.07\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e104\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e1263.500\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.110\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUrban\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e53\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eMotivated by family\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRural\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e57\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.82\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e72\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e1749.500\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.083\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUrban\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e53\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.53\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eShortage of health professions\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRural\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e57\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.32\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e1613.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.219\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUrban\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e53\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eOther\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRural\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e57\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e1530.500\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.801\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUrban\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e53\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.09\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eWhen examining whether factors appeared within students\u0026rsquo; top three rankings (Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e), no statistically significant differences were observed between rural and urban students for any factor (p\u0026thinsp;\u0026gt;\u0026thinsp;0.05). Descriptively, \u0026ldquo;personal drive,\u0026rdquo; \u0026ldquo;motivated by family,\u0026rdquo; and \u0026ldquo;better my community\u0026rdquo; were most frequently included among the top three influences across both groups.\u003c/p\u003e\n\u003ch3\u003eStudents’ Open-Ended Responses to Interest in Pursuing a Career in Medicine\u003c/h3\u003e\n\u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"No\" id=\"Taba\" border=\"1\"\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTheme\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSummary\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eSupporting Quote\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eReinforcement of Pre-existing Interest (23.9%, N\u0026thinsp;=\u0026thinsp;23)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCollege experiences such as coursework, mentorship, and exposure to clinical environments strengthened an already established interest in pursuing medicine and increased students\u0026rsquo; confidence in their career choice.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cem\u003e\u0026ldquo;My experiences have reinforced my decision to pursue medicine and given me confidence that I can succeed.\u0026rdquo;\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eInfluence of Coursework and Academic Rigor (35.4%, N\u0026thinsp;=\u0026thinsp;34)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRigorous science coursework, including anatomy, physiology, and biochemistry, sparked or deepened interest in medicine. Engaging instructors and applied learning opportunities were frequently cited as influential.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cem\u003e\u0026ldquo;Courses like biochemistry, anatomy, and physiology made me excited for medicine.\u0026rdquo;\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eHands-On Clinical and Experiential Learning (16.0%, N\u0026thinsp;=\u0026thinsp;15)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eClinical exposure, shadowing, and practicum experiences played a pivotal role in clarifying career goals and, in some cases, redirecting students toward specific healthcare paths.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cem\u003e\u0026ldquo;The Medical Practicum trip sealed the deal\u0026hellip; It changed my perspective.\u0026rdquo;\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003ePersonal and Community Experiences (8.3%, N\u0026thinsp;=\u0026thinsp;8)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePersonal healthcare encounters and increased awareness of health inequities motivated interest in medicine. Some students described how experiences outside their home communities broadened their perspectives.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cem\u003e\u0026ldquo;Being a Black woman and experiencing healthcare as a patient.\u0026rdquo;\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eMentorship and Support Networks (8.3%, N\u0026thinsp;=\u0026thinsp;8)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFaculty mentorship, encouragement, and exposure to healthcare role models supported students\u0026rsquo; confidence and persistence in pursuing medicine.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cem\u003e\u0026ldquo;My classes and mentor inspired me\u0026hellip; the faculty were encouraging.\u0026rdquo;\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eCareer Exploration and Redirection (5.2%, N\u0026thinsp;=\u0026thinsp;5)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eExposure to a range of health professions during college led some students to shift career goals toward alternative healthcare roles such as physician assistant or public health.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cem\u003e\u0026ldquo;I wanted to become a doctor, but I changed to be a PA.\u0026rdquo;\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eLimited or Negative Influence (3.1%, N\u0026thinsp;=\u0026thinsp;3)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eA small subset of students reported minimal or discouraging influence from college experiences, often citing uninspiring pre-clinical coursework.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cem\u003e\u0026ldquo;College prior to nursing school had very little impact on my interest in medicine.\u0026rdquo;\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThis study examined differences in how undergraduate students from rural and urban backgrounds prioritize factors influencing their interest in healthcare careers. Although overall motivational patterns were similar across groups, Figs.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003e and \u003cspan refid=\"Fig3\" class=\"InternalRef\"\u003e3\u003c/span\u003e highlight meaningful differences in the relative importance of community- and family-based influences, providing important context for the statistically significant findings observed in Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e.\u003c/p\u003e \u003cp\u003eFigure \u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003e illustrates differences in rankings for the factor \u0026ldquo;better my community.\u0026rdquo; While this motivator was commonly identified by both groups, urban students more frequently ranked it among their top three influences and were more likely to identify it as their most important factor. In contrast, rural students tended to rank \u0026ldquo;better my community\u0026rdquo; within their top five rather than at the highest rank. This pattern suggests that community impact is valued across settings but may be weighted differently: urban students may view community service as a primary driver of career choice, whereas rural students may conceptualize it as one of several interconnected motivations.\u003c/p\u003e \u003cp\u003eFigure \u003cspan refid=\"Fig3\" class=\"InternalRef\"\u003e3\u003c/span\u003e further contextualizes the significant difference observed for \u0026ldquo;motivated by family.\u0026rdquo; Rural students more frequently ranked family influence among their top three motivators and were more likely to assign it a first- or second-place ranking. Urban students, by comparison, more often placed this factor lower in their overall rankings. These findings are consistent with prior research indicating that family expectations and experiences play a particularly influential role in shaping healthcare aspirations among rural students.\u003c/p\u003e \u003cp\u003eTogether, these figures suggest that while intrinsic motivation remains central for students across geographic backgrounds, the external influences shaping career decisions differ in emphasis. Community- and family-centered motivations appear more prominent in rural students\u0026rsquo; decision-making processes, whereas urban students may integrate these values alongside academic and institutional experiences encountered during college. These distinctions underscore the importance of tailoring recruitment and pipeline initiatives to reflect students\u0026rsquo; lived contexts rather than relying on uniform strategies.\u003c/p\u003e \u003cp\u003eSeveral limitations should be noted. The use of self-reported rankings may introduce response bias, and categorizing geographic background as rural or urban may oversimplify complex identities. Additionally, the cross-sectional design limits insight into how motivations change over time. Future research should employ longitudinal approaches to examine how early influences persist or evolve and should include students who discontinue pursuit of healthcare careers to better identify barriers within the pipeline.\u003c/p\u003e \u003cp\u003eThe qualitative findings from students\u0026rsquo; open-ended responses provide important context for the quantitative results by illustrating how college experiences shape interest in pursuing a career in medicine. The most prominent theme, Influence of Coursework and Academic Rigor (35.4%), highlights the role of foundational science courses in deepening students\u0026rsquo; engagement with medicine, particularly when instruction was applied and clinically relevant. Nearly one-quarter of respondents described Reinforcement of Pre-existing Interest (23.9%), indicating that college experiences often strengthened rather than initiated students\u0026rsquo; aspirations toward medicine, highlights the role of early exposure to healthcare careers. Hands-on clinical exposure, shadowing, and practicum experiences further emerged as pivotal in clarifying career goals and solidifying commitment to medical careers. Additional themes, including Mentorships and Support Networks, Personal and Community Experiences, and Career Exploration or Redirection, underscore the importance of guidance and exposure in shaping students\u0026rsquo; healthcare trajectories. Collectively, these qualitative findings demonstrate that undergraduate education serves as a critical reinforcing and filtering stage in the healthcare pipeline, complementing the quantitative results and highlighting mechanisms that influence students\u0026rsquo; persistence toward medical careers.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThis research confirms the importance of personal, familial, and community influences, particularly among rural students, and emphasizes the impact of early clinical and mentorship experiences for all students. It also highlights college as a crucial stage in the formation of healthcare career interest. These findings are relevant for institutions and policymakers aiming to address the healthcare workforce shortage in underserved areas. By expanding outreach and support mechanisms tailored to geographic and cultural backgrounds, stakeholders can more effectively guide students into meaningful healthcare careers, ultimately improving access to care where it is most needed.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cdiv class=\"DefinitionList\"\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eAI\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eArtificial Intelligence\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eDO\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eDoctor of Osteopathic Medicine\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eIRB\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eInstitutional Review Board\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eMD\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eDoctor of Medicine\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eSCCT\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eSocial Cognitive Career Theory\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eAGT\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eAchievement Goal Theory\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eSPSS\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eStatistical Package for the Social Sciences\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003c/div\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe Marian University Institutional Review Board identified this research as exempt [25.102]. Documentation of the exempt status is provided in the supplementary files. The first page of the research survey was the informed consent statement; participants were informed that continuing the survey represented their informed consent which could be withdrawn at any time.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eParticipants were informed that their data may be used in scholarly presentations and/or publication in the informed consent statement in the research survey.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003ca id=\"_anchor_7\" href=\"#_msocom_7\" language=\"JavaScript\" name=\"_msoanchor_7\"\u003e\u003c/a\u003e\u003c/p\u003e\n\u003cp\u003eThe raw data set can be found in here.\u003c/p\u003e\n\u003cp\u003eThe reliability and validity of the data set can be accessed here.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting Interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe Marian University Tom \u0026amp; Julie Wood College of Osteopathic Medicine Master\u0026rsquo;s in Biomedical Science Program funded the $100 survey participation raffle in this study.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026apos; Contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eErica Ausel, Ph.D. (EA) assisted in research design, survey creation, and manuscript review. Anthony M. Stultz (AS) networked with pre-health faculty chair professors at Indiana institutions to request their student body to participate in the study. AS and EA performed statistical analysis using the Mann Whitney U tests and independent t-tests. AS analyzed trends and themes in students\u0026rsquo; open-ended responses. EA aided in organizing material in the SPSS data sets. AS monitored the Qualtrics Survey daily to ensure no technical issues occurred.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot Applicable\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eAlbaum L. Exploring the relationship between pre-medical student motivation and academic performance: Strategies to improve student success [dissertation]. 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Inquiry. 2023;60:469580231159318.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Health Professions, Urban Communities, Rural Communities, Indiana Healthcare, \u0026 Career Development, Midwest Healthcare","lastPublishedDoi":"10.21203/rs.3.rs-8502425/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8502425/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground:\u003c/strong\u003e\u003cbr\u003e\nThe shortage of healthcare professionals in rural and underserved areas in the United States significantly impacts access to healthcare. Studies have identified many contributing factors but less is known about the role life experiences play in drawing healthcare workers into these communities. The experiences that influence students’ healthcare career decisions, especially sociodemographic background, remain underexplored. This study aims to fill this gap by investigating factors and experiences that shape undergraduate students’ healthcare aspirations and comparing differences among students fromrural and urban backgrounds.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods:\u003c/strong\u003e\u003cbr\u003e\nThis study utilized a mixed-methods approach. Traditional undergraduate students (N=111) from 12 institutions across Indiana completed a Qualtrics survey including Likert scale items, rank order questions, and open-ended responses. Statistical analyses (Mann-Whitney U tests and independent t-tests) were used to compare anonymous responses between students who grew up in rural and urban environments. Qualitative responses were analyzed thematicallyusing Artificial Intelligence (AI).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults:\u003c/strong\u003e\u003cbr\u003e\nQuantitative analysis revealed that rural students were significantly more influenced by family members working in healthcare (p = 0.044) and motivation to better their community (p = 0.046). Urban students reported higher influence from personal drive and mentorship. Across both groups, college coursework and clinical experiences reinforced students’ interest in health careers but were not primary motivators. For both groups, personal health-related experience was most commonly ranked as the top motivating factor.\u003c/p\u003e\n\u003cp\u003eQualitative findings supported these results. Rural students often stated witnessing community health needs and early healthcare exposure as key experiences influencing their decision. Urban students described the influence of structured programs, college mentorship, and volunteering. Across both groups, mentorship, hands-on experience, and early healthcare exposure were the most motivational experiences influencing students to choose a career in the health professions. Some students noted that college helped them redirect or clarify their career paths.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusions:\u003c/strong\u003e\u003cbr\u003e\nUndergraduate students’ backgrounds influence their motivations to pursue healthcare careers, with rural students more driven by familial and community-oriented factors. Our findings suggest that experiences such as early exposure, mentorship, and localized outreach strategies, particularly those tailored by geography, may be crucial for healthcare workforce development. Addressing disparities in pre-health advising, clinical exposure, and information access is key to improving rural healthcare pipelines.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTrial registration:\u003c/strong\u003e\u003cbr\u003e\nNot applicable (no clinical intervention conducted).\u003c/p\u003e","manuscriptTitle":"Future Healers: Assessing Interests in Health Professions among Younger Individuals from Rural \u0026amp; Urban Communities","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-01-20 16:27:14","doi":"10.21203/rs.3.rs-8502425/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"b7501b02-6c7b-479c-bae8-e783d48db475","owner":[],"postedDate":"January 20th, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2026-02-09T04:09:53+00:00","versionOfRecord":[],"versionCreatedAt":"2026-01-20 16:27:14","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8502425","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8502425","identity":"rs-8502425","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}