Introduction: Pre-vocational placement experiences are known to considerably influence the career preferences of health graduates and are a key factor in growing the rural allied health workforce. This paper explores the rural placement experiences and future work intentions of students who attended a placement with the University of Newcastle Department of Rural Health. Methods: Part of a larger longitudinal mixed methods study of students’ placement experiences and subsequent career choices, this study explored students’ placement evaluations responses. Following each placement, students were invited to complete an online survey which asked about their placement experiences and future work intentions. Counts and proportion tests were performed for frequencies of quantitative variables. Wilcoxon signed rank tests were conducted on the paired pre- and post-rural intent scores to determine any perceived differences in intent before and after placement for students both with and without a rural background. Qualitative data from short answer questions were analyzed thematically guided by qualitative content analysis. Data were comparatively analyzed for students of a rural or urban background. Results: Four hundred and forty end of placement surveys were completed by 275 students (response rate 69.8%). There was a positive shift in intention to work rurally for students of both rural and urban background post-placement, but this was only statistically significant in the group from an urban background (p≤0.001). From the qualitative analysis three themes emerged: immersed rural supported placement experience, immersed interaction in rural life with other students, and immersed interaction in the rural community. Students from both rural and urban backgrounds indicated similar benefits and challenges. Conclusion: While the positive impact of rural placement experiences and rural background on future rural practice is well known, this study highlights the importance of positive supported placement experience for students from both rural and urban backgrounds.

The future allied health workforce needs to be flexible to meet the needs of an ageing population with increasing chronic health care needs and geographically dispersed populations in many developed countries. Existing research shows the maldistribution of the Australian health workforce, with allied health professionals being poorly represented in rural and remote areas. This mixed-methods longitudinal workforce outcomes study is ongoing to determine the rural and remote allied health workforce outcomes from an immersive student placement program based in rural New South Wales, Australia. Outcomes, to date, show 52% of graduates working in a rural or remote area (RA2–RA5) after one year and 37.5% at three years post-graduation. Students from a rural or remote background were 2.35 times (95% CI 1.056–5.229) more likely to be located in a rural or remote workplace after one year than graduates from a metropolitan background. Graduates provided reasons for their plans to move from or stay in their current position. Four key themes emerged: Seeking new and different opportunities; Better income and job security; Personal change and lifestyle improvement and Level of job satisfaction. An existing program to develop the allied health workforce in rural Australia is demonstrating positive short-term outcomes. Ongoing monitoring of workforce outcomes is required to determine the long-term outcomes for rural and remote communities.

RRH: Rural and Remote Health. Published article number: 5337 - Powerless facing the wave of change: the lived experience of providing services in rural areas under the National Disability Insurance Scheme

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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