Understanding rural practice: implications for occupational therapy education in Canada

Abstract

Introduction: Currently Canadians living in rural communities tend to have a poorer health status than those living in urban settings. This is contributed to by the shortage of health professionals choosing work in rural and remote areas. Over the past decade there has been much research into the recruitment and retention of rural health professionals. However little has been done to identify the actual nature of rural practice and whether graduates have been adequately prepared for the diversity of rural work.The present study sought to identify the rewards and challenges of rural occupational therapy practice in western Canada. Participants' were also asked about their preparedness for rural practice after graduation, and specifically about the usefulness of course work and practical skills taught as undergraduates.Methods: Participants were occupational therapists working in rural communities in the Canadian provinces of Alberta and Saskatchewan. The quantitative approach employed a self-administered survey with closed-and open-ended questions. Data were entered into SPSS v14 (www.spss.com.au) for frequency data and percentages. Results:The participants (n = 59) worked mainly in full-time community healthcare positions with clients who had physical health issues. More than half worked in sole therapy positions. The average length of time in their current position was 5 years.Most participants reported that they were receiving informal professional support, with some receiving a formal support as well.Participants more frequently identified the rewards of rural practice (n = 214) than its challenges (n = 112). Perceived rewards included team work, autonomy, diversity and flexible work schedule, increased client contact, job satisfaction, experiences gained and the rural lifestyle. The most frequently mentioned challenges included staff shortages, the generalist nature of rural occupational therapy practice, excess time spent travelling, coping with inappropriate referrals and the need for more professional support. Regarding participants' perceptions about the course work and practical skills taught during their training that best © PM Wielandt, E Taylor, 2010. A licence to publish this material has been given to James Cook University, http://www.rrh.org.au 2 prepared them for actual practice, some highlighted additional valuable resources such as actual hands-on experience during rural fieldwork placement, personal characteristics, working in an urban setting prior to embarking on a rural career, coming from a rural background and locating a mentor prior to working rurally. Some recommended increasing management and organisational skills content in the curriculum because these were considered essential skills for effective rural practice. The return of unanswered questionnaires by participants who did not consider themselves to be rural therapists because of access to online and telehealth resources suggests further research is warranted into the changing nature of rural practice. Conclusion:Characteristics of...

What does it mean to be an allied health professional working in rural Aotearoa New Zealand? A qualitative study

“…Similar to the findings of this study, rural allied health professionals are recognised as working across an extended scope of practice that is responsive to addressing the diverse community needs 17–20 . In addition to this, it has been reported that rural allied health professionals are often expected to work in high‐demand services across large catchments and multiple sites, requiring additional skills in service prioritisation and networking 18,20–23 . Despite the importance of established local and wider professional networks being highlighted in the international literature, 20 this study found that allied health professionals in rural Aotearoa New Zealand remain disconnected professionally.…”

“…[17][18][19][20] In addition to this, it has been reported that rural allied health professionals are often expected to work in high-demand services across large catchments and multiple sites, requiring additional skills in service prioritisation and networking. 18,[20][21][22][23] Despite the importance of established local and wider professional networks being highlighted in the international literature, 20 this study found that allied health professionals in rural Aotearoa New Zealand remain disconnected professionally. The local, less traditional and interprofessional teams identified are also recognised in the international literature as important components of successful rural practice.…”

Occupational therapy and rural environment: a scoping review

“…The lack of occupational therapists working in rural areas is well documented in several studies (Millsteed, 2000;Peterson et al, 2003;Lannin & Longland, 2003;Bateman, 2012;Merrit et al, 2013). In the same clipping, professionals and undergraduate students report that this isolation from other professionals in the area demands some specific skills (Polatajko & Quintyn, 1986;Markewitz, 1992;Daly et al, 1997;Mills & Millsteed, 2002;Lee & Mackenzie, 2003;Steenbergen & Mackenzie, 2004;Devine, 2006;McAuliffe & Barnett, 2009;Wielandt & Taylor, 2010;McAuliffe & Barnett, 2010;Van Rensburg & Toit, 2016;Naidoo et al, 2017b), also ponctuating the need for a generalist professional reasoning and continuing professional training aimed at the demands of various natures in the rural environment, which leads to the description of these professionals as "general specialists" (Mills & Millsteed, 2002).…”

Terapia ocupacional e meio rural: uma revisão de escopo

“…A falta de terapeutas ocupacionais atuantes no meio rural está bem documentada em diversos estudos (Millsteed, 2000;Peterson et al, 2003;Lannin & Longland, 2003;Bateman, 2012;Merrit et al, 2013). No mesmo recorte, profissionais e estudantes de graduação relatam que esse isolamento de outros profissionais da área demanda algumas habilidades específicas (Polatajko & Quintyn, 1986;Markewitz, 1992;Daly et al, 1997;Mills & Millsteed, 2002;Lee & Mackenzie, 2003;Steenbergen & Mackenzie, 2004;Devine, 2006;McAuliffe & Barnett, 2009;Wielandt & Taylor, 2010;McAuliffe & Barnett, 2010;Van Rensburg & Toit, 2016;Naidoo et al, 2017b), sendo pontuado, igualmente, a necessidade de um raciocínio profissional de cunho generalista e uma formação profissional continuada direcionada às demandas de diversas naturezas do meio rural, o que leva à descrição desses profissionais como "especialistas generalistas" (Mills & Millsteed, 2002).…”