Experiences of working as early career allied health professionals and doctors in rural and remote environments: a qualitative systematic review

Abstract

Background: Maintaining a health professional workforce in rural and remote areas pose a significant challenge internationally. A range of strategies have been used to improve recruitment and retention with varying levels of success. To date, strategies are generally developed based on the collective experience of all health professions, rather than targeted to professional groups with differing educational and support contexts. This review sought to explore, compare and synthesise the evidence examining the experience of early career rural and remote allied health professionals and doctors to better understand both the profession specific, and common factors that influence their experience. The results of this review will generate relevant workforce recommendations. Methods: This review considered qualitative studies that include early career allied health professionals’ or doctors' experiences of working in rural or remote areas and the personal and professional factors that impact on this experience. A systematic search was completed (CINAHL (EBSCO), Embase, MEDLINE (Ovid), Web of Science, Informit, ProQuest Dissertations and Theses, Google Scholar, and WorldWideScience.org) to identify published and unpublished studies. Studies published since 2000 in English were considered for the review. Identified studies were screened for inclusion and critically appraised by two independent reviewers. Data was extracted and assigned a level of credibility. Data synthesis adhered to the JBI meta-aggregative approach.Results: Of the 1408 identified articles, 32 papers were eligible for inclusion. One study was rated as low in quality and all other studies moderate or high quality. A total of 24 categories and 334 findings and associated illustrations were aggregated into three synthesised findings for both professional groups including: making a difference through professional and organisational factors, working in rural areas can offer unique and rewarding opportunities for early career allied health professionals and doctors, acknowledging personal and community influences that make a difference. The synthesised findings illustrate a range of similar and different experiences for early career allied health professionals and doctors in rural and remote areas. Conclusions: Strategies to enhance the experience of both allied health professionals and doctors in rural and remote areas include enabling career paths through structured training programs, hands on learning opportunities, quality supervision and community involvement. Systematic review registration number: PROSPERO CRD42021223187