Virginia Via Research Day Book 2026

Medical Student Research Public Health

18 ADDRESSING GAPS IN RURAL HEALTH: UPBRINGING IN ENDEMIC AREAS AS A PREDICTOR OF PROVIDER PREPAREDNESS FOR TICK-BORNE ILLNESS

David Grace, OMS-II; Hailey Harbert, OMS-II; Jake Castle, OMS-II; Charles Ellen, OMS-II; Jess Nicholson, MAT; Dr. Jenny Hall, PhD Corresponding author: dgrace@vcom.edu

VCOM-Virginia, Blacksburg, Virginia

Tick-borne diseases (TBDs) are an emerging public health crisis in the United States with a steady increase in incidence of Lyme disease, Alpha-Gal Syndrome, Rocky Mountain Spotted Fever, and other, more rare diseases. Concurrently, provider accuracy in diagnosing TBDs remains a concern due to the variable, nonspecific nature of their presentation. Combined with the disproportionate impact of TBDs on rural, medically underserved communities, the issue of misdiagnosed tick-borne illness carries major potential for harm in this patient population. It has been shown that providers who practice in areas where a given disease is endemic are more diagnostically accurate than providers who practice in non-endemic areas. What remains unknown, however, is whether providers who were exposed as children to certain diseases through upbringing in endemic areas also display heightened diagnostic accuracy when compared to their non-endemic peers. This study evaluates whether medical students raised in TBD-endemic regions display greater accuracy and comfort in identifying tick-borne illnesses in comparison to their peers who were not raised in tick-endemic regions. 31 second year medical students completed a 16-item survey

that included a five-question knowledge assessment and seven Likert-style items measuring diagnostic comfort. Students raised in endemic regions achieved higher knowledge scores on the five aptitude questions which included a very easy and a very hard question to appropriately bracket the results (mean 6 correct/ question vs. 3.6 correct/question). Initial analysis showed that the p-value comparing the accuracy of the two groups (p~0.08) was too great to generate any meaningful conclusion. When the two outlying questions (of which the two groups had a roughly equivalent score) were removed, the p-value dropped to ~0.02, indicating that there was a significant difference between the two groups when only examining medium difficulty questions. When comparing the self assessment scores, there was no statistically significant difference between the two groups regardless of how the data was analyzed. This indicates that medical students in endemic areas are more accurate when identifying TBDs in their patients but do not feel more comfortable than their non-endemic, less accurate counterparts. These findings have the potential to be worthwhile for medical schools who have students originally from areas distant to where the school is

located. By identifying those students who likely have a lesser exposure to the diseases that are endemic in the patient population that medical school serves, the school may be able to provide those students with additional resources to bring them up to speed on the diseases they will be seeing in the community. This research also has implications for residents who will attend residencies and begin seeing patients from communities distant to where they were raised. Finally, the findings are yet another datapoint that reinforces the recruiting philosophy of many medical schools seeking to improve care in rural and underserved areas. By targeting and accepting applicants from local regions and regions similar to those that the medical school serves, they will, in effect, be producing more competent physicians than they would by recruiting and accepting students from a range of regions across the country. Further research is currently ongoing to include more participants and further validate our findings.

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32 Edward Via College of Osteopathic Medicine (VCOM)