Institutional collaboration and competition in community-based education.

We sought to determine whether competition for community-based training sites exists among health professions schools, and to examine faculty and senior administrators' perspectives on institutional collaboration for community-based education. Eight academic health centers (AHCs) in the USA were selected by objective criteria for their significant community involvement. Chief executive officers, vice chancellors, deans, and the individuals responsible for community-based education, research and community service responded to written surveys. The overall response rate was 79% (n = 91). Responses were subjected to quantitative and qualitative analyses. Leaders of community-based education reported that "competition for community-based training sites" is a barrier to community involvement. "Competition for community-based training sites"was positively related to 'call for increasing percentage of graduates to enter primary care careers' (0.30, p < 0.01) and negative related to "collaboration exists between the community and your school/AHC" ( - 0.28, p < 0.05). Respondents reported that a moderate level of collaboration across schools exists. While medical school respondents reported having collaborative relationships with other health professions schools and with the community, nursing respondents reported medicine's performance at a significantly lower level. Public health and nursing faculty reported that they are competing with medical schools for sites they had traditionally used for their students. Competition for sites is an unintended outcome of the increased emphasis on community-based education in health professions curricula. We recommend AHCs form joint committees across schools to effectively address community-based sites as a limited resource, and to consider a wider range of community-based organizations as training partners.