Objective. This paper describes stages in the research literature related to recruitment and retention of health professionals to rural health careers. Data sources. Electronic databases accessed included Medline, CINAHL, Social Sciences and Humanities. Key search terms included ‘high school’, ‘career choices’, ‘rural’, ‘attachment’, ‘recruitment’ and ‘retention’. Data synthesis. We identified four stages: (1) making career choices; (2) being attached to place; (3) taking up rural practice; and (4) remaining in rural practice. This is termed the ‘rural pipeline’. However, as some stages of the ‘rural pipeline’ refer specifically to the medical profession, we propose an extension of the notion of the medical ‘rural pipeline’ to include other professions such as nursing, midwifery and allied health. Conclusions. Utilising the ‘rural pipeline’ as a template for medicine, nursing and allied health would strengthen current approaches to the recruitment and retention of professionals in rural areas and provide a consolidated evidence base that would assist in policy development to improve availability and service provision of the rural health workforce. Future research that utilises a multidisciplinary approach could explore how the role and relationship between place and identity shape needs of career choices and would provide important information to advance the practical aspects supporting rural health career pathways. What is known about the topic? A universal shortage of rural health professionals is a significant issue and is becoming critical in rural areas of Australia. Although there have been many studies, internationally and in Australia, there are several gaps in recruitment and retention of rural health professionals that require further attention. What does this paper add? This paper examines workforce studies related to recruitment and retention of health professionals to rural health careers. The pipeline, however, refers mainly to the medical profession. The stages in this paper extend the notion of the medical ‘rural pipeline’ to include other professions such as nursing and allied health. This paper focusses on literature concerning developed countries such as Australia, New Zealand, Europe, the USA and Canada and identifies several proposed areas of future research. What are the implications for practitioners? The literature clearly identifies important issues for the rural health workforce. Having an understanding of the key issues underpinning the recruitment and retention of health professionals in rural areas allows the development and enhancement of appropriate workforce strategies. Utilising the ‘rural pipeline’ as a template for medicine, nursing and allied health would strengthen current approaches to the recruitment and retention of professionals in rural areas and provide a consolidated evidence base.
With increasing interest and research into interprofessional learning, there is scope to more deeply understand what happens when students from different professions live and study in the same location. This study aimed to explore the issue of co-location and its effects on how students learn to work with other professions. The setting for this study was a rural health education facility in Australia with close links to local health care and community services. Philosophical hermeneutics informed the research method. Interviews were undertaken with 29 participants, including students, academic educators and clinical supervisors in diagnostic radiography, medicine, nursing, nutrition and dietetics, pharmacy, physiotherapy, occupational therapy, and speech pathology. Photo-elicitation was used to facilitate participant engagement with the topic. The findings foreground the value of interprofessional rapport building opportunities for students learning to work together. Enabled by the proximity of different professions in shared educational, clinical and social spaces, interprofessional rapport building was contingent on contextual conditions (balance of professions, shared spaces and adequate time) and individual's interpersonal capabilities (being interested, being inclusive, developing interpersonal bonds, giving and receiving respect, bringing a sense of own profession and being patient-centred). In the absence of these conditions and capabilities, negative professional stereotypes may be inadvertently re-enforced. From these findings suggestions are made for nurturing interprofessional rapport building opportunities to enable students of different professions to learn to work together.
20 April 2021 in Australian Journal of Rural Health
Objective: Linking enrolment and professional placement data for students' from 2 universities, this study compares characteristics across universities and health disciplines. The study explores associations between students' location of origin and frequency, duration and type of placements.Design: Retrospective cohort data linkage.Setting: Two Australian universities, Monash University and the University of Newcastle.Participants: Students who completed medical radiation science, nursing, occupational therapy, pharmacy or physiotherapy at either university between 2 February 2017 and 28 February 2018.Interventions: Location of origin, university and discipline of enrolment.Main outcome measure(s): Main measures were whether graduates had multiple rural placements, number of rural placements and cumulative rural placement days. Location of origin, discipline and university of enrolment were the main explanatory variables. Secondary dependent variables were age, sex, socio‐economic indices for location of origin, and available placements.Results: A total of 1,315 students were included, of which 22.1% were of rural origin. The odds of rural origin students undertaking a rural placement was more than 4.5 times greater than for urban origin students. A higher proportion of rural origin students had multiple rural placement (56.0% vs 14.9%), with a higher mean number of rural placement days. Public hospitals were the most common placement type, with fewer in primary care, mental health or aged care.Conclusions: There is a positive association between rural origin and rural placements in nursing and allied health. To help strengthen recruitment and retention of graduates this association could be further exploited, while being inclusive of non‐rural students
RRH: Rural and Remote Health. Published article number: 6407 - Rationale and protocol for the Nursing and Allied Health Graduate Outcomes Tracking (NAHGOT) study: a large-scale longitudinal investigation of graduate practice destinations