Learning from follow-up of student placements in a remote community: a small qualitative study highlights personal and workforce benefits and opportunities

Abstract

Background The maldistribution of the Australian health workforce contributes to restricted accessibility and poorer health outcomes for rural and remote populations, especially Aboriginal and Torres Strait Islander Australians. Student exposure to rural and remote settings is a long-term strategy that aims to reduce workforce shortages by encouraging rural career uptake, with well-supervised, positive placement experiences associated with rural practice intentions. Furthermore, placements can build students’ cultural capabilities and foster interest in working with disadvantaged and underserved Aboriginal communities. However, little is known about the translation of rural practice intentions to career paths, and the factors influencing employment decision-making and application of clinical and cultural content to professional practice. This in-depth study reports on the second stage of an investigation into the longer-term impact of remote placements. Stage One identified factors that contributed to students’ learning experiences and highlighted challenges encountered; Stage Two explored the impact on professional practice and employment decision-making amongst a subset of the original cohort. Methods Of 12 interviews with participants who completed a remote placement in 2013/4 (Stage One), eight graduates were located four years later and seven were re-interviewed. Telephone interviews used a semi-structured schedule; each interview was recorded, transcribed and analysed for recurring themes and meanings. Results At the time of interview, all participants were employed as health professionals and worked in Australia. The follow-up highlighted the enduring legacy of the student placement in terms of participants’ personal and professional growth. The majority were employed in rural settings; some were attracted by a rural lifestyle and employment opportunities while others were drawn by a desire to reduce rural health disparities. Regardless of setting, all actively applied clinical and cultural learnings acquired on placement to their professional practice. Rural job security, professional support and opportunities for professional development were all influences on continuing rural practice. Conclusions Despite the challenges of qualitative longitudinal follow-up, the findings of this study provide valuable information, which can inform scaled-up investigations into the role of placements in developing an expanded, more stable and culturally respectful rural workforce.

Identifying features of quality in rural placements for health students: scoping review

“…As shown in the data chart (online supplemental appendix B) and summary of included literature (table 2), most of the literature is based in the Australian context (n=77) 8 22 27–101. There is variability in the sites in which student placements were undertaken, and the length of placement varied from 6 days to 52 weeks.…”

“…Placing students in rural, regional and remote (referred to collectively as rural herein) settings exposes them to skills and experiences unique to this area of practice and embedded within the social complexities of a rural community 5 6. In addition to providing relevant learning opportunities, rural student placements can enhance delivery of health services, foster rural identity, encourage future clinicians to practice rurally and promote cultural safety by developing skills required to effectively work with clients and peers from culturally diverse backgrounds 1 7 8. There are elements of rural practice that differ from metropolitan settings.…”

Characteristics of nursing and allied health student placements in the Northern Territory over time (2017‐2019) and placement satisfaction

“…While not statistically significant in the multivariate regression models, it was statistically associated with placement satisfaction in the univariate models. It is very plausible that the students opting for a placement in the NT are interested in Aboriginal and Torres Strait Islander culture and keen to learn more about it 17 . Given the very high proportion of Aboriginal and Torres Strait Islander people in NT communities, and high use of primary health services, appropriate cultural awareness and safety training is essential for delivering culturally safe high‐quality health care in these contexts 18 …”

Factors influencing medical radiation science graduates’ early career principal place of practice: a retrospective cohort study

“…The Australian health workforce is geographically maldistributed, with fewer allied health professionals, including medical radiation science (MRS) practitioners, in rural locations compared to major cities 1–5 . ‘Rural’ areas are classified according to their size, distance from major cities and access to services into categories that include inner and outer regional through to remote and very remote 6,7 .…”

“…‘Rural’ areas are classified according to their size, distance from major cities and access to services into categories that include inner and outer regional through to remote and very remote 6,7 . Typically, those locations have smaller populations, restricted access to healthcare, a higher proportion of Aboriginal and Torres Strait Islander people, and relatively poorer health outcomes compared to major cities, including higher rates of preventable diseases and a shorter life expectancy 2,4,6 . Rural areas characteristically have difficulty attracting and retaining health professionals, with metropolitan practice perceived to be more socially and professional desirable, with better career options 2,3 …”