Determinants of rural Australian primary health care worker retention: A synthesis of key evidence and implications for policymaking

Russell, Deborah; McGrail, Matthew Richard; Humphreys, John Stirling

doi:10.1111/ajr.12294

Cited by 33 publications

(47 citation statements)

References 22 publications

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“…Attempts to increase the rural health workforce have included; recruitment of qualified doctors from overseas [18, 19], workplace reform [18], improved rural working conditions [18], loan repayment schemes [5, 20], and financial incentives [18, 21]. However, these strategies have achieved mixed results, and over the last two decades there has been a focus on clinical training and education in rural areas, to encourage health professionals to work permanently in rural locations [22–24].…”

Section: Introductionmentioning

confidence: 99%

The impact of rural outreach programs on medical students’ future rural intentions and working locations: a systematic review

2018

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BackgroundSignificant investment has been undertaken by many countries into ‘Rural Clinical Training Placement Schemes’ for medical students in order to deal with shortages of trained health care professionals in rural and remote locations. This systematic review examines the evidence base of rural educational programs within medical education and focusses on workforce intentions and employment outcomes. The study provides a detailed description of the methodological characteristics of the literature, thematic workforce outcomes and key related factors are identified, study quality is assessed, and the findings are compared within an international context.MethodsA systematic review looking at international literature of rural placement programs within medical education between January 2005 to January 2017 from databases including; Medline, Embase, NursingOVID, PubMed and Cochrane. The study adopted the PRISMA protocol. A quality assessment of the literature was conducted based on the Health Gains Notation Framework.ResultsSixty two papers met the inclusion criteria. The review identified three program classifications; Rural Clinical Placement Programs, Rural Clinical Placement Programs combined with a rural health educational curriculum component and Rural Clinical School Programs. The studies included were from Australia, United States, Canada, New Zealand, Thailand and Africa.Questionnaires and tracking or medical registry databases were the most commonly reported research tools and the majority were volunteer programs. Most studies identified potential rural predictors/confounders, however a number did not apply control groups and most programs were based on a single site. There was a clear discrepancy in the ideal rural clinical placement length. Outcomes themes were identified related to rural workforce outcomes. Most studies reported that an organised, well-funded, rural placement or rural clinical school program produced positive associations with increased rural intentions and actual graduate rural employment.ConclusionsFuture research should focus on large scale methodologically rigorous multi-site rural program studies, with longitudinal follow up of graduates working locations. Studies should apply pre-and post-intervention surveys to measure change in attitudes and control for predictive confounders, control groups should be applied; and in-depth qualitative research should be considered to explore the specific factors of programs that are associated with encouraging rural employment.Electronic supplementary materialThe online version of this article (10.1186/s12909-018-1287-y) contains supplementary material, which is available to authorized users.

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Section: Introductionmentioning

confidence: 99%

The impact of rural outreach programs on medical students’ future rural intentions and working locations: a systematic review

2018

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“…remotas, y seis revisiones posteriores (21)(22)(23)(24)(25)(26). En total, se analizaron 20 RS: 14 identificadas en la revisión de Mbemba -una se excluyó por tratarse de estudiantes-y 6 RS identificadas a través de la revisión rápida (cuadro 1).…”

Section: Resultsunclassified

“…en el año 2015 (20) sobre factores que influencian la captación y retención de trabajadores de salud en áreas rurales y negativo), independientemente del indicador empleado en cada caso. 2) Factores familiares: cinco RS jerarquizaron las oportunidades laborales de la pareja o las facilidades para acceder a la educación de sus hijos/as como factores que inciden en la captación (23,24) y en la retención de trabajadores/as en áreas RRD (10,23,25,26). 3) Factores vinculados con la exposición o entrenamiento durante la formación de grado: además del origen o la crianza rural, la "identidad rural" puede lograrse a través de exposiciones repetidas a estos ámbitos, que permiten conocer la cultura, las formas en las que las personas se relacionan, y las características de la práctica rural (24).…”

Section: Extracción Y Síntesis De Los Datosunclassified

“…4) Factores vinculados con la exposición o entrenamiento en la formación de posgrado: tanto la realización de una residencia en especialidades vinculadas a la APS (23,24,26) como una rotación en ámbitos rurales se asociaron positivamente con la captación (7-9,14,18,19,22,23) y en menor medida, con la retención de RHS en ámbitos rurales (21). 5) Factores financieros: incluyen la deuda asumida durante el período de formación a cambio de servicios postgraduación en determinados ámbitos, e incentivos financieros y el salario, que se asociaron a mejoras en la captación y retención de RHS en 8 revisiones (9)(10)(11)(12)18,23,24,25).…”

Section: Extracción Y Síntesis De Los Datosunclassified

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Factores e intervenciones que inciden en las condiciones y medio ambiente de trabajo para incrementar la atracción, captación y retención de recursos humanos en salud en el primer nivel de atención de áreas rurales, remotas o desatendidas

Esandi

Antonietti

Ortiz

et al. 2020

Revista Panamericana De Salud Pública

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Objetivo. Identificar y sistematizar la evidencia empírica disponible sobre factores e intervenciones que inciden en las condiciones y medio ambiente de trabajo para incrementar la atracción, captación y retención de recursos humanos en salud en el primer nivel de atención de áreas rurales, remotas o desatendidas. Métodos. Revisión rápida de revisiones, seleccionadas según criterios de pertinencia, elegibilidad e inclusión con búsquedas en bases de datos electrónicas, de literatura gris y manual. Se empleó el AMSTAR I para evaluar la calidad de revisiones sistemáticas y un análisis temático para síntesis de resultados. Resultados. Se incluyeron 16 revisiones, una de las cuales contenía a su vez 14 revisiones. Del total, 20 revisiones analizaron factores y 9 evaluaron efectividad de intervenciones. La evidencia sobre factores es abundante, pero de limitada calidad. Los factores individuales, familiares y la “exposición rural previa” se asociaron a mayor captación; factores organizacionales y del contexto externo fueron gravitantes en la retención. El trabajo en red y el apoyo profesional incidieron en la captación y retención. La evidencia sobre efectividad de intervenciones fue limitada, en cantidad y calidad. El tipo de intervención más frecuentemente empleada fueron los incentivos. Conclusiones. La evidencia sobre factores que se relacionan positivamente con la captación y retención de trabajadores en el primer nivel de atención de áreas rurales, remotas o desatendidas es suficiente y debería ser tenida en cuenta al diseñar intervenciones. La evidencia de calidad sobre la efectividad de intervenciones es escasa. Se requieren más estudios controlados con rigurosidad metodológica, particularmente en las Américas.

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“…Many researchers have noted the difficulties encountered in seeking to attract nurses to work in a range of community settings (Efendi, Purwaningsih, Kurniati, & Bushy, ; Njuguna, Mwangi, & Kamau, ; Onnis & Pryce, ) as well as the difficulties in actually recruiting nurses who are suitably equipped to engage fully in community‐based initiatives (Jaskiewicz & Deussom, ). Equally challenging is the retention of nurses in community settings, with rates of attrition high, especially in areas that are geographically remote or rural (Fadi El‐Jardali et al., ; Keane, Lincoln, Rolfe, & Smith, ; Russell, McGrail, & Humphreys, ). Often nurses working in such contexts cite geographical locations and related factors, such as poor transportation and lack of supportive infrastructure, as reasons for seeking to leave community‐based nursing (AbuAlRub, El‐Jardali, Jamal, Iblasi, & Murray, ; El‐Jardali et al., ; Nowrouzi et al., ).…”

Section: Introductionmentioning

confidence: 99%

Expertise in action: Insights into the dynamic nature of expertise in community‐based nursing

Dickson

McVittie

Kapilashrami

2018

Journal of Clinical Nursing

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Determinants of rural Australian primary health care worker retention: A synthesis of key evidence and implications for policymaking

Cited by 33 publications

References 22 publications

The impact of rural outreach programs on medical students’ future rural intentions and working locations: a systematic review

The impact of rural outreach programs on medical students’ future rural intentions and working locations: a systematic review

Factores e intervenciones que inciden en las condiciones y medio ambiente de trabajo para incrementar la atracción, captación y retención de recursos humanos en salud en el primer nivel de atención de áreas rurales, remotas o desatendidas

Expertise in action: Insights into the dynamic nature of expertise in community‐based nursing

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