1
|
Terry D, Peck B, Elliott J, East L, Ryan L, Baker E, Schmitz D. The threshold of rural placement frequency and duration: A repeated cross-sectional study examining rural career aspirations among student nurses. Nurse Educ Pract 2024; 77:103989. [PMID: 38718573 DOI: 10.1016/j.nepr.2024.103989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Revised: 04/20/2024] [Accepted: 04/28/2024] [Indexed: 05/27/2024]
Abstract
AIM This study aimed to explore what changes rural placement had on the perceptions of nursing students and the impact of placement frequency and duration on student considerations for rural practice. BACKGROUND A strong rural healthcare workforce is a global concern and has led countries to look for creative ways to address this challenge. One approach is to train more health professionals, however, nursing students who grew up or lived in metropolitan or urbanised areas are suggested to be less inclined to pursue a rural career. As such it is posited that recurrent exposure to rural settings may exert a positive impact on future intention for rural practice. However, there is a need to explore the specific thresholds related to both the frequency and duration of rural placement exposure, as well as the cumulative impact multiple rural placements may have on the intention to engage in rural practice. DESIGN A repeated cross-sectional design. METHODS All nursing students from an Australian regional university were invited to complete an online questionnaire between 2019 and 2023. Demographic and placement specific questions were included. A modified version of the Nursing Community Apgar tool also measured the importance of key variables in rural career decision-making. Data were analysed using independent sample t-tests and one-way ANOVAs. Significance was determined at two-tailed p≤.05. RESULTS Among the 835 respondents (response rate 15.4%), the average number and duration of rural placements was 2.45 placements and 3.01 weeks respectively. Rural placements did not have an impact on students who resided rurally or regionally. However, among metropolitan students who had experienced more than three rural placements, or more than sixteen cumulative weeks of placement, were significantly more likely to consider rural employment. Greater number of rural placements and longer cumulative duration had the greatest impact. CONCLUSION Issues related to the nursing rural workforce are dynamic and complex. Understanding the unique drivers that improve the rural experiences among students, particularly metropolitan students, can have an impact on decision-making to pursue employment in rural environments. Importantly, whilst professional and clinical motivation and experiences are influential factors, the socialisation, environment and community features are essential elements that influence students' decisions to pursue a career in rural practice. Undertaking a nuanced approach that facilitates rural practice understanding among students may help shape future employment decision-making.
Collapse
Affiliation(s)
- Daniel Terry
- School of Nursing and Midwifery, University of Southern Queensland, Queensland, Australia; Centre for Health Research, University of Southern Queensland, Queensland, Australia; Institute of Health and Wellbeing, Federation University Australia, Victoria, Australia.
| | - Blake Peck
- School of Nursing and Midwifery, University of Southern Queensland, Queensland, Australia; Institute of Health and Wellbeing, Federation University Australia, Victoria, Australia
| | - Jessica Elliott
- School of Nursing and Midwifery, University of Southern Queensland, Queensland, Australia; Centre for Health Research, University of Southern Queensland, Queensland, Australia
| | - Leah East
- School of Nursing and Midwifery, University of Southern Queensland, Queensland, Australia; Centre for Health Research, University of Southern Queensland, Queensland, Australia; School of Health, University of New England, New South Wales, Australia
| | - Liz Ryan
- School of Nursing and Midwifery, University of Southern Queensland, Queensland, Australia; Centre for Health Research, University of Southern Queensland, Queensland, Australia
| | - Ed Baker
- Center for Health Policy, Boise State University, Boise, ID, USA
| | - David Schmitz
- Department of Family and Community Medicine, University of North Dakota School of Medicine and Health Sciences, USA
| |
Collapse
|
2
|
Philibert JBH. The importance of developing potential for rural practice: a student's journey influenced by rural health opportunities. Med J Aust 2023; 219 Suppl 3:S31-S32. [PMID: 37544009 DOI: 10.5694/mja2.52024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 03/17/2023] [Accepted: 04/06/2023] [Indexed: 08/08/2023]
|
3
|
Sheepway L, Jessup B, Podubinski T, Heaney S, Bailie J, Hoang H, Bourke L. A qualitative exploration of health student perspectives of rural and remote placements during the early stages of the COVID-19 pandemic. Aust J Rural Health 2022; 31:294-307. [PMID: 36444653 PMCID: PMC9878096 DOI: 10.1111/ajr.12952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 11/01/2022] [Accepted: 11/16/2022] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE To explore health student perspectives of rural and remote placements during the early stages of the COVID-19 pandemic. SETTING Australia. PARTICIPANTS Allied health, nursing and medical students with a planned rural or remote placement between February and October 2020. DESIGN Semi-structured interviews (n = 29) with data thematically analysed. RESULTS Five main themes emerged from student experiences: (1) 'Do we go? Don't we go? Like how much risk is involved?' related to student concerns regarding acquiring and transmitting COVID-19 on placement; (2) 'We are sort of just standing at the door trying to watch' encompassed student perceptions of missed clinical learning opportunities in response to health and safety measures related to COVID-19; (3) 'I, as a student, sort of fell under the radar' related to student perceptions of suboptimal supervision; (4) 'It was a bit more difficult to engage with that wider community' recognised student feelings of social disconnection and their lack of opportunity for community immersion; and (5) 'We felt like we got something that is more than we expected' emerged from student reflections on training during the pandemic and alternative placements (virtual, simulated and non-clinical) that exceeded expectations for learning. CONCLUSIONS Although most students were willing and able to undertake their rural or remote placement in some form during the early stages of the pandemic and identified unanticipated learning benefits, students recognised lost opportunities to build clinical skills, become culturally aware and connect with rural communities. It remains unknown how these rural and remote placement experiences will impact rural intention and in turn, rural workforce development.
Collapse
Affiliation(s)
- Lyndal Sheepway
- La Trobe Rural Health SchoolLa Trobe UniversityWodongaVictoriaAustralia
| | - Belinda Jessup
- Centre for Rural HealthThe University of TasmaniaLauncestonTasmaniaAustralia
| | - Tegan Podubinski
- Department of Rural HealthThe University of MelbourneSheppartonVictoriaAustralia
| | - Susan Heaney
- The University of Newcastle Department of Rural HealthThe University of NewcastlePort MacquarieNew South WalesAustralia
| | - Jodie Bailie
- University Centre for Rural HealthThe University of SydneyLismoreNew South WalesAustralia
| | - Ha Hoang
- Centre for Rural HealthThe University of TasmaniaLauncestonTasmaniaAustralia
| | - Lisa Bourke
- Department of Rural HealthThe University of MelbourneSheppartonVictoriaAustralia
| |
Collapse
|
4
|
Green E, Quilliam C, Sheepway L, Hays CA, Moore L, Rasiah RL, Bailie J, Howard C, Hyde S, Inyang I, Matthews K, Ferns J, Brown LJ, Jones S, Collett M. Identifying features of quality in rural placements for health students: scoping review. BMJ Open 2022; 12:e057074. [PMID: 35396299 PMCID: PMC8995951 DOI: 10.1136/bmjopen-2021-057074] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES To explore and synthesise the evidence relating to features of quality in rural health student placements. DESIGN Scoping review. DATA SOURCES MEDLINE, CINAHL, Embase, ProQuest, Informit, Scopus, ERIC and several grey literature data sources (1 January 2005 to 13 October 2020). STUDY SELECTION The review included peer-reviewed and grey literature from Organisation for Economic Co-operation and Development listed countries that focused on quality of health student placements in regional, rural and remote areas. DATA EXTRACTION Data were extracted regarding the methodological and design characteristics of each data source, and the features suggested to contribute to student placement quality under five categories based on a work-integrated learning framework. RESULTS Of 2866 resulting papers, 101 were included for data charting and content analysis. The literature was dominated by medicine and nursing student placement research. No literature explicitly defined quality in rural health student placements, although proxy indicators for quality such as satisfaction, positive experiences, overall effectiveness and perceived value were identified. Content analysis resulted in four overarching domains pertaining to features of rural health student placement quality: (1) learning and teaching in a rural context, (2) rural student placement characteristics, (3) key relationships and (4) required infrastructure. CONCLUSION The findings suggest that quality in rural health student placements hinges on contextually specific features. Further research is required to explore these findings and ways in which these features can be measured during rural health student placements.
Collapse
Affiliation(s)
- Elyce Green
- Three Rivers University Department of Rural Health, Charles Sturt University, Wagga Wagga, New South Wales, Australia
| | - Claire Quilliam
- Department of Rural Health, The University of Melbourne, Shepparton, Victoria, Australia
| | - Lyndal Sheepway
- La Trobe Rural Health School, La Trobe University, Wodonga, Victoria, Australia
| | - Catherine A Hays
- Centre for Rural and Remote Health, James Cook University, Mount Isa, Queensland, Australia
| | - Leigh Moore
- Rural and Remote Health, Flinders University, Darwin, Northern Territory, Australia
| | - Rohan L Rasiah
- Western Australian Centre for Rural Health, The University of Western Australia, Karratha, Western Australia, Australia
| | - Jodie Bailie
- University Centre for Rural Health, The University of Sydney, Lismore, New South Wales, Australia
| | - Christine Howard
- Three Rivers University Department of Rural Health, Charles Sturt University, Wagga Wagga, New South Wales, Australia
| | - Sarah Hyde
- Joint Program in Medicine School of Rural Medicine, Charles Sturt University, Orange, New South Wales, Australia
| | - Imo Inyang
- Centre for Rural Health, University of Tasmania, Launceston, Tasmania, Australia
| | - Kylie Matthews
- Majarlin Kimberley Centre for Remote Health, The University of Notre Dame, Broome, Western Australia, Australia
| | - Jane Ferns
- Department of Rural Health, The University of Newcastle, Taree, New South Wales, Australia
| | - Leanne J Brown
- Department of Rural Health, The University of Newcastle, Taree, New South Wales, Australia
| | - Sara Jones
- Department of Rural Health, University of South Australia, Whyalla, South Australia, Australia
| | - Marjorie Collett
- Western Australian Centre for Rural Health, The University of Western Australia, Geraldton, Western Australia, Australia
| |
Collapse
|
5
|
Rogers C. Supporting health students on rural placements: A scoping review. Aust J Rural Health 2021; 29:319-331. [PMID: 34145681 DOI: 10.1111/ajr.12701] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Revised: 11/22/2020] [Accepted: 11/23/2020] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE To review Australian literature on initiatives used to provide support for pre-registration health students undertaking a rural placement. DESIGN A scoping literature review. SETTING Rural, regional and remote areas of Australia. PARTICIPANTS Publications were sourced from scientific databases including Ebscohost and CINAHL. Grey literature and journal citations were searched to identify other relevant articles. MAIN OUTCOME MEASURE Identification of the various initiatives used to support students, evaluation of the success of these initiatives, and the feasibility and sustainability of implementing these initiatives. RESULTS There were 36 articles included in the final analysis. The findings identified support initiatives specific to individual professions, not on supporting health students as a whole cohort. The key findings were grouped into identification of support initiatives and the alignment of these to students feeling a sense satisfaction, belonging and connectedness. Constraints to support health students undertaking rural placements identified disparity and inequity of support initiatives available for health students with medical students provided more support than other health students. CONCLUSION This review highlights the importance of students developing a sense of belonging and building connections to community, which are strongly aligned with rural placements and student satisfaction. The need for socio-cultural, organisational and institutional support is linked to higher student satisfaction and intention to practice rurally. A centralised collation of support initiatives would benefit students, higher education institutions and stakeholders in their efforts to attract students to undertake rural placements and be immersed in these unique learning experiences.
Collapse
Affiliation(s)
- Cathy Rogers
- Three Rivers University Department of Rural Health, Charles Sturt University, Dubbo, NSW, Australia
| |
Collapse
|
6
|
Smith T, Sutton K, Beauchamp A, Depczynski J, Brown L, Fisher K, Waller S, Wakely L, Maybery D, Versace VL. Profile and rural exposure for nursing and allied health students at two Australian Universities: A retrospective cohort study. Aust J Rural Health 2021; 29:21-33. [PMID: 33567159 PMCID: PMC7986835 DOI: 10.1111/ajr.12689] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 09/27/2020] [Accepted: 10/29/2020] [Indexed: 12/04/2022] Open
Abstract
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
Collapse
Affiliation(s)
- Tony Smith
- Department of Rural Health, The University of Newcastle, Taree, NSW, Australia
| | | | | | - Julie Depczynski
- Department of Rural Health, The University of Newcastle, Moree, NSW, Australia
| | - Leanne Brown
- Department of Rural Health, The University of Newcastle, Tamworth, NSW, Australia
| | - Karin Fisher
- Department of Rural Health, The University of Newcastle, Tamworth, NSW, Australia
| | - Susan Waller
- Monash Rural Health, Latrobe Regional Hospital, Traralgon, Vic., Australia
| | - Luke Wakely
- Department of Rural Health, The University of Newcastle, Tamworth, NSW, Australia
| | | | - Vincent L Versace
- School of Medicine, Deakin Rural Health, Warrnambool, Vic., Australia
| |
Collapse
|
7
|
Moran A, Nancarrow S, Cosgrave C, Griffith A, Memery R. What works, why and how? A scoping review and logic model of rural clinical placements for allied health students. BMC Health Serv Res 2020; 20:866. [PMID: 32928199 PMCID: PMC7489211 DOI: 10.1186/s12913-020-05669-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Accepted: 08/18/2020] [Indexed: 12/03/2022] Open
Abstract
Background Allied health services are core to the improvement in health outcomes for remote and rural residents. Substantial infrastructure has been put into place to facilitate rural work-ready allied health practitioners, yet it is difficult to understand or measure how successful this is and how it is facilitated. Methods A scoping review and thematic synthesis of the literature using program logic was undertaken to identify and describe the contexts, mechanisms and outcomes of successful models of rural clinical placements for allied health students. This involved all empirical literature examining models of regional, rural and remote clinical placements for allied health students between 1995 and 2019. Results A total of 292 articles were identified; however, after removal of duplicates and article screening, 18 were included in the final synthesis. Australian papers dominated the evidence base (n = 11). Drivers for rural allied health clinical placements include: attracting allied health students to the rural workforce; increasing the number of allied health clinical placements available; exposing students to and providing skills in rural and interprofessional practice; and improving access to allied health services in rural areas. Depending on the placement model, a number of key mechanisms were identified that facilitated realisation of these drivers and therefore the success of the model. These included: support for students; engagement, consultation and partnership with key stakeholders and organisations; and regional coordination, infrastructure and support. Placement success was measured in terms of student, rural, community and/or program outcomes. Although the strength and quality of the evidence was found to be low, there is a trend for placements to be more successful when the driver for the placement is specifically reflected in the structure of the placement model and outcomes measured. This was seen most effectively in placement models that were driven by the need to meet rural community needs and upskill students in interprofessional rural practice. Conclusion This study identifies the factors that can be manipulated to ensure more successful models of allied health rural clinical placements and provides an evidence based framework for improved planning and evaluation.
Collapse
Affiliation(s)
- Anna Moran
- Department of Rural Health, 49 Graham St, Shepparton, VIC, 3630, Australia. .,Albury Wodonga Health, Borella Road, Albury, NSW, 2640, Australia. .,Services for Austalian Rural and Remote Allied Health (SARRAH), Unit 4/17 Napier Close, Deakin, ACT, 2600, Australia.
| | - Susan Nancarrow
- Southern Cross University, Gold Coast Airport, Terminal Dr, Bilinga, QLD, 4225, Australia
| | - Catherine Cosgrave
- Department of Rural Health, 49 Graham St, Shepparton, VIC, 3630, Australia
| | - Anna Griffith
- Albury Wodonga Health, Borella Road, Albury, NSW, 2640, Australia
| | - Rhiannon Memery
- Services for Austalian Rural and Remote Allied Health (SARRAH), Unit 4/17 Napier Close, Deakin, ACT, 2600, Australia
| |
Collapse
|