Exploration of the factors that influence new Australian dental graduates to work rurally and their perspectives of rural versus metropolitan employment

Learning on the country: Motivating dental students to attend a rural placement

PURPOSE/OBJECTIVES

This research aimed to identify factors that affect dental students' attitudes toward participation in rural clinical outplacements (RCOP) in Australia, and to suggest strategies that will increase students' desire to attend RCOP in the future.

METHODS

Dental students from the nine dental schools in Australia were invited to an online survey on their willingness to participate in an RCOP and the factors that influence this willingness. These factors were grouped into themes of education, personal and health, social, financial, and information-related.

RESULTS

The study had an estimated response rate of 10% with 202 responses. More than two-thirds (68%) of students were willing to participate in an RCOP. Students who grew up in a rural area were significantly more likely to be willing to attend an RCOP, compared to those from urban settings. Attitudes toward the anticipated educational experience of RCOP were positive, while factors related to finances and pre-existing information were of concern to students. Educational, personal/health-related, and social factors had significant impacts on participants' willingness to attend RCOP.

CONCLUSION

Overall, despite students holding negative opinions on certain social and financial factors, their positive attitudes toward other factors outweighed these. Universities should aim to further promote the educational benefits of RCOP to improve students' attitudes prior to attending RCOP. In-depth qualitative analysis is required to explore students' concerns regarding RCOP and longitudinal research is warranted to monitor students' attitudes toward RCOP and rural work over time.

Positive impacts of oral health services provision by a student-led primary care clinic to an Australian rural indigenous community

BACKGROUND

This study aimed to determine whether oral health services provision by a dental student clinical outplacement embedded within a Community Controlled Health Service positively impacted a rural Indigenous community and to explore the nature of these benefits.

METHODS

Aggregated and de-identified 2017, 2018 and 2019 student-led clinic services provision data were retrospectively analysed. The change in services mix over time was measured. Rural outplacement clinic operational costs to the university were estimated. Government-funded local public dental clinic waiting list and services provision data were used to identify any student clinic establishment effect.

RESULTS

The student-led clinic services mix shifted over time from mainly acute care for toothache towards prevention of disease and tooth restoration, indicating an improvement in patient oral health and correspondingly reduced system costs. Imputed value of 2017-2019 student-led clinic services provision totalled almost AUD$1 million. Government public clinic waiting list times decreased after full establishment of the student-led clinic, indicating decreased pressure on the public system.

CONCLUSION

The Community Controlled Health Service and university partnership improved community oral health care access, its timely delivery and simultaneously provided valuable human capital development from the student training experience. The student-led clinic's targeted Indigenous community showed oral health improvement over time. © 2023 Australian Dental Association.

Motivations and experiences among dentists in rural private practice: A qualitative study

OBJECTIVES

Despite the critical importance of access to dental care for rural residents and concerns about a shrinking rural dentist workforce, few studies have examined rural dentist motivations to practice in rural areas. The aim of this study was to explore practicing rural dentists' motivations and experiences qualitatively through semi-structured interviews to help inform and guide recruitment and retention efforts in rural areas.

METHODS

Dentists were included in the sample frame if they were general dentists in private practice and had a primary practice located in a rural Iowa county. Rural dentists with publicly available email addresses were contacted by email to participate. Semi-structured interviews were administered to 16 private practice general dentists. All interviews were audio recorded, transcribed, and coded using pre-set and emergent codes.

RESULTS

Participants were most commonly male (75%), under age 35 (44%), white (88%), and practiced in a partnership arrangement (44%). The main codes regarding dentists' experiences and motivations to practice in a rural area included familiarity with a rural area, community, financial factors, and clinical care delivery. Having been raised in a rural area was a major influence in most dentists' decisions about where to locate.

CONCLUSIONS

The importance of rural upbringing in this study underscores the need to consider rural upbringing in dental student admissions. Additional findings, such as financial benefits of a rural practice and other practice-related factors can be used to inform recruitment efforts.

Recruitment and retention of the rural podiatry workforce in Aotearoa New Zealand: a qualitative descriptive study of podiatrist perceptions

Background

Past research into the Aotearoa New Zealand (NZ) podiatry workforce has indicated a shortage of podiatrists, particularly in rural NZ. However, there has been no research investigating the characteristics of the NZ rural podiatry workforce. This study aimed to explore the factors which contribute to recruitment and retention of primary care podiatrists in rural NZ.

Methods

A qualitative descriptive approach was implemented for data collection and analysis. Semi-structured interviews were conducted with 15 podiatrists who currently, or previously, worked in a rural podiatry practice. Manifest content analysis was used to analyse participant’s responses. A deductive approach was used where data were identified and coded according to predetermined themes from the literature.

Results

Four themes that influenced recruitment and retention were derived from the interviews: (1) professional factors, (2) economic factors, (3) social factors, and (4) external factors. Interviews revealed that clinical inexperience, a sole practice environment, professional and social isolation, and workload pressures combined to affect recruitment and retention. Strong community bonds, family ties, and a rural background were crucial to thrive in the rural setting.

Conclusion

A sustainable rural podiatry workforce is required to reduce health disparities that exist in NZ rural communities. The study identified that most practitioners entered the rural workforce into self-employed positions, often shortly following graduation from university. They soon reported feelings of professional isolation due to limited support networks. Practitioners established in the rural workforce noted significant workload stresses. Stresses stemming from an inability to source locums, take time away from work, or recruit new staff to fill vacant positions. Research examining support mechanisms for inexperienced practitioners and targeted strategies to grow the rural workforce and reduce attrition is required.

Importance of attachment to place in growing a sustainable Australian Rural Health Workforce: A rapid review

INTRODUCTION

Personal, community, and environmental factors can influence the attraction and retention of regional, rural, and remote health workers. However, the concept of place attachment needs further attention as a factor affecting the sustainability of the rural health workforce.

OBJECTIVE

The purpose of this rapid review was to explore the influence of a sense of place in attracting and retaining health professionals in rural and remote areas.

DESIGN

A systematic rapid review was conducted based on an empirical model using four dimensions: place dependence, place identity, social bonding and nature bonding. English-language publications between 2011 and 2021 were sought from academic databases, including studies relevant to Australian health professionals.

FINDINGS

A total of 348 articles were screened and 52 included in the review. Place attachment factors varied across disciplines and included (a) intrinsic place-based personal factors; (b) learning experiences enhancing self-efficacy and rural health work interest; (c) relational, social and community integration; and (d) connection to place with lifestyle aspirations.

DISCUSSION

This rapid review provides insight into the role of relational connections in building a health workforce and suggests that community factors are important in building attachment through social bonding and place identity. Results indicate that future health workforce research should focus on career decision-making and psychological appraisals including place attachment.

CONCLUSION

An attachment to place might develop through placement experiences or from a strong rural upbringing. The importance of the relational interactions within a work community and the broader community is seen as an important factor in attracting, recruiting, and sustaining a rural health workforce.