A final-year nursing student survey: rural attitudes, perceived competencies and intention to work across five Asian countries

Abstract

BackgroundShortages and maldistribution of nurses remain significant problems in many countries. Having appropriate intervention strategies to retain nurses in underserved areas, where they are most needed, are crucial for health system strengthening. This study aimed to quantify attitudes to working in rural areas, perceived competencies, and intention to work among final-year nursing students, and to analyze the associations between those factors and their background characteristics across five countries in the Asia-Pacific Network for Health Professional Education Reforms (ANHER), namely Bangladesh, China, India, Thailand, and Vietnam.MethodsA descriptive comparative cross-sectional survey was conducted between July 2012 and July 2013, using a self-administered questionnaire to assess students’ attitudes towards working in rural areas, their perceived competencies, and their intended job choices. A total of 10,169 final-year nursing students in five countries were selected. Bivariate models were constructed to compare students’ characteristics. Statistically significant variables were further analyzed using multivariate models.ResultsMost nursing students in five countries had rural backgrounds. Students in India (67.1%) and Thailand (65.1%) held more positive attitudes towards working in rural areas. Students in Bangladesh (78.8%) and India (62.6%) believed that their schools prepared them well, and inspired them, to work in rural areas. The ‘Lifelong learning’ competency was ranked highest by students in all five countries, ranging from 76.2 to 91.7%. Their perceived competencies were significantly related to their background of having graduated from rural high schools and being admitted to study through rural recruitment. Rural upbringing and rural recruitment were significantly associated with more positive attitudes towards rural areas (p-value < 0.5). A majority of students in China (83.8%), Thailand (67.7%) and Vietnam (86.5%) intended to work in the public sector immediately after graduation.ConclusionsThese findings from five Asian countries confirm that nursing students with rural upbringing and recruitment had more positive attitudes toward rural areas and were more likely to choose working in rural areas after graduation. This study provides additional evidence from country implementation to support the value of WHO recommendations of effective strategies to address issues of rural retention by focusing on the recruitment of students with a rural background.

The Effect of Patient Safety Education on Undergraduate Nursing Students’ Patient Safety Competencies

“…Their results showed that "working in teams" gained the highest score after the dimension "effective communication with other members of the healthcare team". 16 This result may be due to the mediating role of nurses in health care system; nurses learn and experience teamwork skills from the outset. Gaupp et al added that the students' participation increased after PS education.…”

“…5 In the present study, the lowest mean score difference was related to "managing safety" because our participants included first-year nursing students with no clinical experiences and could not manage safety competencies effectively. 16,18 As a result, students need to acquire theoretical and practical safety management skills to manage other positions. 19 VanDenKerkh of et al demonstrated that the score of "managing safety" was higher among the clinically educated nurses than the theoretically-educated nurses.…”

“…5,21 Ginsburg et al also showed that students' attitudes toward safety education were significant in the clinical setting. 16 Moreover, safety education becomes institutionalized in students in the clinical settings. 25 Therefore, PS education should be involved in the students' curriculum, and nursing school administrators and faculty members are recommended to continue safety training to enhance the students' PS competencies.…”

“…Furthermore, assessment of the students' self-perceived competencies after an educational program can help adjust curricula to students' needs. 16 Therefore, the current study aimed to investigate the effectiveness of PS education on PS competencies of the undergraduate nursing students in Iran.…”

Factors influencing the intention of Indonesian nursing students to work in rural areas

“…Most of the studies focused on other health students such as medical,10 18optometry9 and midwifery,11or including nurses but mixed in with the others 8 19–2122 and final-year students 23. Several rural health-related studies conducted in Indonesia had different subjects and aims to the current study, such as identifying the medical students’ rural preferences,18 assessing the rural health programmes and not the students’ preferences24 25 and concerning only the attracting factors 21.…”