Immersive Place-Based Attachments in Rural Australia: An Overview of an Allied Health Program and Its Outcomes

Abstract

This paper describes a rural immersive attachment program for allied health students at an Australian University Department of Rural Health and its workforce outcomes. A mixed methods longitudinal cohort study, with data collected via end-of-placement and post-graduation surveys. Over 13 years, 311 allied health ‘year-long’ immersive rural attachments, as well as short-term placements, were supported. Pre- and post-placement rural practice intention ratings were paired (from 572 end of placement surveys) for 553 (96.7%) students. Students from metropolitan (49.4%, n = 273, p < 0.001), and rural origin (50.6%, n = 280, p < 0.001) showed a significant increase in rural practice intention. At 1 year post-graduation, 40.3% (n = 145) of graduates had worked in a rural or remote location in Australia, 39.9% at 3 years (n = 87) and 36.5% (n = 42) at 5 years. Longer-term rural attachments were found to be associated with rural practice location, independent of rural background. Those who had undertaken a longer rural attachment (≥18-weeks) were twice as likely to be working in a rural or remote area than those <18 weeks at 1 year (OR 2.018 95% CI 1.204–3.382) and 2.7 times as likely at 3 years (OR 2.727, 95% CI (1.325–5.614). Supporting students to undertake rural immersive attachments appears to be associated with greater rural practice intention and later rural practice.

Factors influencing nursing and allied health recent graduates' rural versus urban preferred principal place of practice: A cross‐sectional data linkage study

“…That points to the desirability of rural employers being proactive in choosing future employees, be that during students' undergraduate studies or even prior to enrolment, perhaps by offering scholarships. It is noted that the influence of graduates who had a previous professional placement in a rural location appeared to have less of an influence than suggested by previous studies 32,33 …”

“…Total (n = 666) is noted that the influence of graduates who had a previous professional placement in a rural location appeared to have less of an influence than suggested by previous studies. 32,33 In the logistic regression analysis, both lifestyle and professional factors did not appear to be as influential as perhaps expected on choosing rural over major city practice. Professional factors included access to professional supervision and mentoring, career advancement and professional development, and opportunities for clinical specialisation.…”

Positive change in intent to practice rurally is strongly associated with nursing and allied health students of metropolitan origin after rural clinical placement

“…Rural university centres facilitate these placements and an independent evaluation described this as relatively successful. 5 Other evidence also suggests that rural clinical placements encourage health professionals to practice in rural and remote areas in the short to medium term, [6][7][8] particularly in the medical field. 8 Research has found that students of rural-origin and students who undertook longer clinical training in a rural or remote setting were more likely to practice in rural or remote regions, particularly in medicine.…”

“…Rural university centres facilitate these placements and an independent evaluation described this as relatively successful 5 . Other evidence also suggests that rural clinical placements encourage health professionals to practice in rural and remote areas in the short to medium term, 6–8 particularly in the medical field 8 …”

An integrative review of the impact of allied health student placements on current staff’s knowledge and procedural skills in acute and primary care settings

“…For example, in 2018–19, only 29% of Australians used allied health services [ 7 ]. An additional challenge to upskilling healthcare staff is a lack of professional development opportunities [ 8 , 9 ]. Student placements have been identified as a potential approach for health workforce capacity building and support of health services delivery, especially in rural areas [ 9 – 11 ].…”