Transformation in the west

School of Medicine - Strategic Priority: Advance the West Campus as a model interprofessional educational hub with a unique rural community commitment

How a community hospital became a hub of rural care research, learning and opportunity

By many measures, Lewistown is idyllic. It’s a rural community with easy access to the picturesque Juniata River and plenty of boating and fishing. It’s a small town where neighbors know one another and have been friends for generations.

However, Lewistown is also not immune to the issues that plague such communities. Because it is so representative of rural and small-town America — in both its blessings and its challenges — Lewistown could be a laboratory for analyzing and solving the health disparity issues faced by similar communities nationwide.

And now it is. Thanks to a convergence of healthcare, academia and research at Geisinger, Lewistown is a growing hub of discovery and learning.

Lewistown’s community hospital has always been a gem, delivering basic services the surrounding area needed. The hospital also had its own diplomagranting nursing school. But when it was acquired in 2013 by Geisinger, the depth and breadth of services dramatically increased. Education leaders recognized they had an unusual opportunity.

“Speaking from experience, it’s very hard to mount a medical student education program in a rural community hospital because of the accreditation requirements and the need for a coverage of a wide array of services,” said Geisinger College Provost and Vice Dean for Education William Jeffries, PhD. “With Geisinger, we have the ability to cover all the essentials — but the population is also uniquely rural and so we have the added opportunity to take advantage of Geisinger’s practice model. We’re very fortunate to have that constellation of factors come together.”

The “constellation” has, since 2013, shown results:

• In 2018, the Lewistown Family Medicine Residency Program, a collaborative effort between Geisinger and the Family Practice Center, was established with a substantial grant from the U.S. Health Resources and Services Administration (HRSA).

• In 2020, the Geisinger Lewistown Hospital Pharmacy Residency welcomed its first cohort of residents.

• In 2022, the first cohort of Geisinger Commonwealth medical students arrived at the newly launched West Campus.

• In 2023, the Geisinger Lewistown Hospital School of Nursing dipolma program closed and the Geisinger School of Nursing opened, which offers an associate degree in nursing. To house the new school, the Geisinger College of Health Sciences began renovating a large property in the heart of Lewistown.

• In 2023, Geisinger also received two new HRSA grants: one for a first-of-its-kind in the Commonwealth residency program in preventive medicine and another for a Clinical Faculty and Preceptor Academy to enhance teaching skills of nursing faculty in the midAtlantic region.

With medical and nursing students, and medicine and pharmacy residents, the West Campus is a hive of interprofessional education, another “uniquely Geisinger quality” that education claims.

Fourth-year medical student Evan Bair has found the collaborative atmosphere energizing. “I worked with a pharmacy resident during my inpatient medicine rotation,” he said. “Right before I would present my patient, I would go to her and say, ‘Here’s what medication changes we’re making. What do you think?’ It was an interdisciplinary collaborative experience that I don’t think you’ll get anywhere else. We all got comfortable with collaborating and asking questions.”

The Drive to THRIVE strategic plan calls for revving up the synergy with physical infrastructure.

“We’ll open a brand new state-of-the-art medical simulation center in the new home of the nursing school,” Julie Xanthopoulos, MD, PhD, regional associate dean of Geisinger Commonwealth School of Medicine’s West Campus in Lewistown said. “We plan to use that simulation space for all our learners, and we’re looking forward to doing simulations with mixed students working as a team.”

The new nursing school building, in the heart of Lewistown, will do more than host interprofessional activities. The plan is to open the doors of the renovated 46,660-square-foot building to the community.

Rebecca Stoudt, PhD, DNP, CRNA, Geisinger College’s associate dean of nursing student education, explains the vision. “We’ll take part in the community life of Lewistown and invite people to come to the building for things like blood pressure screenings by the medical students. We’ll offer community education and let our neighbors hear from nurses, medical students and residents.”

Dr. Xanthopoulos said learners respond to this focus on understanding the distinct place in which they are learning. “A small community likes ours puts the learner in a different perspective, where they’re aware of the impact we have on patients, families and the community,” she said. “In addition to infrastructure, we are building other community immersion partnerships too. We’re also working on an Amish healthcare elective at a clinic that’s a medical home for patients and their families from the Plain and English communities of Central Pennsylvania who have special needs caused by genetic disorders.”

For Dr. Xanthopoulos, the change happening in Lewistown is personally meaningful because Lewistown is her hometown. She returned to it after earning her MD/PhD from Yale University. “I was born in this hospital that I work in,” she said. “And my grandfather was a family medicine doctor who did everything. I grew up watching how much he was appreciated. After my residency, I had planned to go on to fellowship and do more, but at that point I felt I could have meaningful relationships with patients here that I couldn’t have in a large city in a tertiary care setting with all its complexities. Sometimes I walk in a patient’s room and my name is up on the board and the patient expects to see my grandpa. I am constantly reminded of him and what he’s done for people.”

Dr. Stoudt also comes from tiny, rural communities. She said that growing access in these communities is as important to her as the relationships she builds. “It just gives me chills because I came from a very small town in Indiana,” she said. “It was smaller than Lewistown and to get any kind of specialized healthcare, we had to travel a few hours away.”

In addition to access to care, the West Campus gives back in another vital way — opportunity, especially that provided by the School of Nursing.

“The resources that are available to students has vastly increased with the transition to the ADN program,” said Beth Finkbiner, MSN, RN, director of the School of Nursing. “Whether it’s academic assistance or mental health assistance or even library services, there’s just so much more since we joined the College and even the collaboration with other facilities within Geisinger. I think the community ultimately benefits, because most of our students are from this area and graduate to then fill positions at our local rural hospital.”

Dr. Stoudt said that cycle is a powerful economic engine. “I can just share some of our students’ sentiments about having this opportunity to come to our school and become a nurse, especially those who are part of the Nursing Scholars program who receive tuition relief” she said. “This is giving them an opportunity to take themselves out of poverty. Some of our students are the first people in their family to go to college, so they’re very grateful for the chance.”