Background: There are ongoing health workforce shortages in rural Australia with nurses a major component of the provision of health care. Training for nursing students in rural areas is one strategy to overcome this. Aim: To explore possibilities for nursing student rural clinical placements, with a view to increase the length of placements and strengthen the future rural nursing workforce. Methods: A Nursing Roundtable was held in regional Western Australia (WA) with representatives from five Western Australian universities, tertiary providers and service clinical stakeholders. Participants attended site visits to local facilities which included primary, community and hospital-based facilities. Findings: Major issues identified included short length of nursing placements; inflexibility of bookings via centralised placement databases; financial and family responsibilities inhibiting students taking up placements; quality of on-site supervision; and the availability of graduate programs after qualifying. Participants agreed longer student clinical placements reduced workload for academic and clinical staff allowing students to settle and be industry ready. Discussion: There was a strengthening of goodwill and willingness of university and clinical stakeholders to work collaboratively to lengthen student placements and consider placements in non-traditional settings to expand student understanding of career possibilities, rural and Indigenous communities, and the underpinning determinants of health. Conclusion: Back-to-back practicums or potential to share placements between different organisations were recognised as opportunities for further development. Efforts to increase placement length, broaden experiences and overcome financial barriers need to be addressed. Production of a marketing video to include job potential post-graduating was suggested to attract students.

ObjectivesTo explore and synthesise the evidence relating to features of quality in rural health student placements.DesignScoping review.Data sourcesMEDLINE, CINAHL, Embase, ProQuest, Informit, Scopus, ERIC and several grey literature data sources (1 January 2005 to 13 October 2020).Study selectionThe 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 extractionData 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.ResultsOf 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.ConclusionThe 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.

The nursing workforce is the backbone of healthcare provision in rural and remote Australia. Introducing student nurses to rural clinical placements is one strategy used to address the shortfall of healthcare workers outside of major cities, with the goal of improving the training, recruitment and retention of nurses in rural areas. The aim of this qualitative, longitudinal study was to better understand personal and professional decision-making around rural nursing practice intentions and subsequent rural employment and retention. The study methodology consisted of repeated semi-structured interviews with student nurses who had completed at least one rural placement and following them on their journey to becoming graduate nurses over a 6-year period. Thematic longitudinal analysis was undertaken, with three main themes developing, each with further subthemes: (1) participants’ satisfaction with rural placements; (2) their challenges with gaining employment; and (3) considerations regarding ‘going rural’ for work. The participants engaged in both prospective and retrospective reflection around several professional, personal, and wider systemic barriers and enablers to rural practice, which are discussed in detail in this paper. The insights from this longitudinal study have the potential to assist the development of a sustainable rural nursing workforce through informing rural workforce programs, strategies and policies.