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Background: The Rural Trauma Team Development Course (RTTDC) is designed to help rural hospitals better organize and manage trauma patients with limited resources. Although RTTDC is well-established, limited literature exists regarding improvement in the overall objectives for which the course was designed. The aim of this study was to analyze the goals of RTTDC, hypothesizing improvements in course objectives after course completion., Methods: This was a prospective, observational study from 2015 through 2021. All hospitals completing the RTTDC led by our Level 1, academic trauma hospital were included. Our institutional database was queried for individual patient data. Cohorts were delineated before and after RTTDC was provided to the rural hospital. Basic demographics were obtained. Outcomes of interest included: Emergency Department (ED) dwell time, decision time to transfer, number of total images/computed tomography scans obtained, and mortality. Chi square and non-parametric median test were used. Significance was set at P < .05., Results: Sixteen rural hospitals were included with a total of 472 patients transferred (240 before and 232 after). Patient demographics were similar before and after RTTDC. ED dwell time was significantly reduced by 64 min ( P = .003) and decision to transfer time was cut by 62 min ( P = .004) after RTTDC. Mean total radiographic images and CT scans were significantly reduced ( P < .001 and P = .002, respectively) after RTTDC. Mortality was unaffected by RTTDC completion ( P = .941)., Conclusion: The RTTDC demonstrates decreased ED dwell time, decision time to transfer, and number of radiographic images obtained prior to transfer. More rural hospitals should be offered this course., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: This research was presented via podium presentation during the 36th Annual Eastern Association for the Surgery of Trauma Annual Scientific Assembly, Lake Buena Vista, FL on January 17th-21st. Dr Zachary Bauman is a paid educational consultant for KLS-Martin, Zimmer-Biomet, Smith & Nephew, and Atricure.