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Jessup B, Proudfoot F, Cross M, Barnett T. Are recent health, welfare and care graduates part of a rural and remote workforce solution? Evidence from Tasmania, Australia. BMC Health Serv Res 2024; 24:652. [PMID: 38773454 PMCID: PMC11110370 DOI: 10.1186/s12913-024-11087-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Accepted: 05/07/2024] [Indexed: 05/23/2024] Open
Abstract
BACKGROUND Strong growth in graduate supply from health, welfare and care courses across Australia may bode well for easing rural workforce shortages. However, little is known about the employment opportunities available for recent graduates in non-metropolitan areas. This study aimed to quantify and describe advertised job vacancies for health, welfare and care professions in Tasmania, a largely rural and geographically isolated island state of Australia. Further, it aimed to examine those job vacancies specifying that recent graduates were suitable to apply. METHODS Job advertisements for health, welfare and care professionals were collected weekly throughout 2018 from six online job vacancy websites. Data were extracted on 25 variables pertaining to type of profession, number of positions, location, and graduate suitability. Location of positions were recoded into a Modified Monash Model (MM) category, the Australian geographic standard used to classify rurality. Positions advertised in MM2 areas were considered regional and MM3-7 areas rural to very remote. Data were analysed using descriptive and inferential statistics. RESULTS Over the twelve-month period, 3967 advertisements were identified, recruiting for more than 4700 positions across 49 different health, welfare and care professions in Tasmania. Most vacancies were in the non-government sector (58.5%) and located in regional areas (71.7%) of the state. Professions most frequently advertised were registered nurse (24.4%) and welfare worker (11.4%). Eleven professions, including physiotherapist and occupational therapist, recorded a disproportionate number of advertisements relative to workforce size, suggesting discipline specific workforce shortages. Only 4.6% of collected advertisements specified that a recent graduate would be suitable to apply. Of these, most were for the non-government sector (70.1%) and located in regional areas (73.4%). The professions of physiotherapist (26.6%) and occupational therapist (11.4%) were most frequently represented in advertised graduate suitable positions. CONCLUSIONS Despite a range of advertised employment opportunities for health, welfare and care professionals across Tasmania, few specified vacancies as suitable for recent graduates and most were located in regional areas of the state. Health, welfare and care services in non-metropolitan locations may need to develop more employment opportunities for recent graduates and explicitly advertise these to job-seeking graduates to help grow and sustain the rural and remote health workforce into the future.
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Affiliation(s)
- Belinda Jessup
- Centre for Rural Health, College of Health and Medicine, University of Tasmania, Launceston, Australia.
| | - Fiona Proudfoot
- Wicking Dementia Research and Education Centre, College of Health and Medicine, University of Tasmania, Hobart, Australia
| | - Merylin Cross
- Centre for Rural Health, College of Health and Medicine, University of Tasmania, Launceston, Australia
| | - Tony Barnett
- Centre for Rural Health, College of Health and Medicine, University of Tasmania, Launceston, Australia
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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.
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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
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Glenister KM, McNeil R, Thorpe T, Bourke L. Positive change in intent to practice rurally is strongly associated with nursing and allied health students of metropolitan origin after rural clinical placement. Aust J Rural Health 2024; 32:377-387. [PMID: 38456241 DOI: 10.1111/ajr.13099] [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: 10/18/2023] [Revised: 02/22/2024] [Accepted: 02/27/2024] [Indexed: 03/09/2024] Open
Abstract
OBJECTIVE To: (1) assess whether rural clinical placements influence change in intention to practice rurally for nursing and allied health students, (2) to assess whether residential origin (metropolitan or rural) or university location (metropolitan or non-metropolitan) influence this change, and (3) assess residential origin of health professionals practicing rurally after graduation. DESIGN Cross-sectional survey (2014-2022) conducted in Northern/Northeastern Victoria and Grampians region by nursing and allied health students completing rural clinical placements. Survey explored student placement satisfaction, intention to practice rurally and demographic information, with a follow-up two years' post-placement. FINDINGS Experience of a rural placement increased students' intention of practicing rurally. Importantly, 57% of metropolitan origin students studying at metropolitan campuses exhibited positive change. Logistic regression analysis suggested that after controlling for age, gender and satisfaction with placement and supervision, students of metropolitan origin at metropolitan campuses were 6.4 times more likely to report positive change in intent to practice rurally after placement than students of rural origin studying at non-metropolitan campuses.Follow-up data suggested that a substantial proportion of health professionals providing services in rural areas were of metropolitan origin. RESULTS These findings concur that rural origin and rural training are important predictors of working rurally. Additionally, metropolitan students can change their intention to practice rurally after a rural placement. CONCLUSIONS This study supports strategies to enhance intention to practice rurally that are not restricted to rural origin students to build rural workforce.
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Affiliation(s)
- Kristen M Glenister
- Department of Rural Health, University of Melbourne, Wangaratta, Victoria, Australia
| | - Robyn McNeil
- Department of Rural Health, University of Melbourne, Ballarat, Victoria, Australia
| | - Trish Thorpe
- Department of Rural Health, University of Melbourne, Ballarat, Victoria, Australia
| | - Lisa Bourke
- Department of Rural Health, University of Melbourne, Shepparton, Victoria, Australia
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Jessup B, Tran N, Stevens T, Barnett T. Rural origin student representation in health courses at the University of Tasmania: 2011-2020. Aust J Rural Health 2023; 31:944-956. [PMID: 37545396 DOI: 10.1111/ajr.13027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 06/08/2023] [Accepted: 07/10/2023] [Indexed: 08/08/2023] Open
Abstract
OBJECTIVE To describe longitudinal trends in the admission and completion of domestic Tasmanian rural origin students in health courses at the University of Tasmania (UTAS). METHODS A retrospective audit of records for all domestic Tasmanian students admitted to, or who completed a health course offered by UTAS between 2011 and 2020 was conducted. Data extracted from student records included gender, age, Indigenous background, rural origin (based on residential address outside of Launceston or Hobart at the time of application), health discipline, year of admission and/or completion. Data were analysed in STATA. RESULTS Between 2011 and 2020, 7516 domestic Tasmanian students were admitted to health courses at UTAS, of which 22.6% were rural origin (vs. a rural population of 36.7%). Students admitted were mostly female (77.0%) and studying nursing (51.1%). Rural origin students were more likely to study at the regional campus in Launceston than in Hobart, the capital city (OR, 3.79 [3.4-4.3, p < 0.00]). Over this same period, 5086 students completed a health course. There was little difference in completion rates among regional vs. rural origin students (OR, 1.04 [1.0-1.1, p < 0.00]); however, completion rates decreased with increasing remoteness. Indigenous and male students were less likely to complete than non-Indigenous (OR, 0.73 [0.7-0.8, p < 0.05]) and female students (OR, 0.97 [1.0-1.0, p < 0.05]) respectively. CONCLUSIONS Tasmanian rural origin students are admitted to a range of health courses at UTAS and many complete. However, additional measures are needed to attract a greater number of local rural origin students to study health courses and to support them through to course completion.
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Affiliation(s)
- Belinda Jessup
- Centre for Rural Health, College of Health and Medicine, University of Tasmania, Launceston, Tasmania, Australia
| | - Nga Tran
- Centre for Rural Health, College of Health and Medicine, University of Tasmania, Launceston, Tasmania, Australia
| | - Terri Stevens
- Centre for Rural Health, College of Health and Medicine, University of Tasmania, Launceston, Tasmania, Australia
| | - Tony Barnett
- Centre for Rural Health, College of Health and Medicine, University of Tasmania, Launceston, Tasmania, Australia
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Puah LS, Gillam M, Walsh S, Jones M, Yisma E. Do undertaking rural placements and place of origin inform where allied health graduates work in South Australia? Aust J Rural Health 2023. [PMID: 36852747 DOI: 10.1111/ajr.12974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 02/07/2023] [Accepted: 02/15/2023] [Indexed: 03/01/2023] Open
Abstract
OBJECTIVE To examine the principal place of practice after graduation of students who participated in the Rural Health Multidisciplinary Training (RHMT) program and allied health students' place of origin. DESIGN Cross-sectional study. PARTICIPANTS Graduates who completed their degree in podiatry, occupational therapy and physiotherapy in 2019. MAIN OUTCOME MEASURES Principal place of practice at first and third years after graduation. RESULTS In 2020, 40 allied health professionals (AHPs) who graduated from the University of South Australia in 2019 were practising in rural areas but only 26 of them remained in the rural practice in 2022. The retention rate for rural practice was 65% within 2 years. However, in 2022, 25 allied health professionals left their metropolitan employment location and transitioned to rural practice. Of the 25 allied health graduates who joined the rural practice in 2022, most of them (80%, 20/25) had either rural exposure through the RMHT program or were from rural origin. CONCLUSIONS Rural exposure via the RHMT program and allied health students' rural place of origin have an important role for rural principal place of practice at first and third years after graduation.
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Affiliation(s)
- Lee San Puah
- Department of Rural Health, University of South Australia, Whyalla Norrie and Mount Barker, South Australia, Australia.,IIMPACT in Health, University of South Australia, Adelaide, South Australia, Australia
| | - Marianne Gillam
- Department of Rural Health, University of South Australia, Whyalla Norrie and Mount Barker, South Australia, Australia.,IIMPACT in Health, University of South Australia, Adelaide, South Australia, Australia
| | - Sandra Walsh
- Department of Rural Health, University of South Australia, Whyalla Norrie and Mount Barker, South Australia, Australia.,IIMPACT in Health, University of South Australia, Adelaide, South Australia, Australia
| | - Martin Jones
- Department of Rural Health, University of South Australia, Whyalla Norrie and Mount Barker, South Australia, Australia.,IIMPACT in Health, University of South Australia, Adelaide, South Australia, Australia
| | - Engida Yisma
- Department of Rural Health, University of South Australia, Whyalla Norrie and Mount Barker, South Australia, Australia.,IIMPACT in Health, University of South Australia, Adelaide, South Australia, Australia
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Williams M. Rural health careers for rural students: The entry-level degree stepping-stone challenge. Aust J Rural Health 2022; 30:426-427. [PMID: 35754177 DOI: 10.1111/ajr.12892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Seaman CE, Green E, Freire K. Effect of Rural Clinical Placements on Intention to Practice and Employment in Rural Australia: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:5363. [PMID: 35564758 PMCID: PMC9099894 DOI: 10.3390/ijerph19095363] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 04/14/2022] [Accepted: 04/22/2022] [Indexed: 02/06/2023]
Abstract
BACKGROUND Supporting the provision of clinical placement (CP) experiences in rural areas is a strategy used worldwide to promote the rural health workforce. While there is international evidence for this intervention in medicine, there is limited understanding of the influence of rural CP for nursing, midwifery, allied health, and dentistry health professions in Australia, which have received substantial federal investment. This review examined the relationship between rural CP and non-medicine health students' future rural practice intentions and workforce outcomes. METHODS Four databases were systematically searched; papers were screened using defined criteria and appraised using the mixed-methods appraisal tool (MMAT). Findings were synthesized using a critical narrative approach. RESULTS The methodological quality of the 29 eligible studies (13 quantitative non-randomized, 10 mixed method, 4 qualitative, 2 quantitative description) was appraised. Ten high-quality studies were identified. The review found that positive CP experiences may influence intention to practice rurally amongst undecided students and serve as a reinforcing experience for those students already interested in rural practice. There were mixed findings regarding the influence of CP length. The review also found that there is currently only evidence for the short-term effects of CP on students' future practice outcomes in rural areas with focus thus far on early practice outcomes. CONCLUSIONS Those looking to use rural CP to promote the rural health workforce should focus on supporting the quality of a large number of CP experiences that are undertaken in rural areas, as there are currently differing findings on the role of rural CP length. Future studies of rural CP should consider greater use of social and educational theories to guide them.
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Affiliation(s)
- Claire Ellen Seaman
- Three Rivers Department of Rural Health, Charles Sturt University, Wagga Wagga, NSW 2678, Australia; (E.G.); (K.F.)
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