Darlow Ben, Brown Melanie, McKinlay Eileen, Gray Lesley, Purdie Gordon, Pullon Sue (2023) Influence of a rural interprofessional education placement on the rural health workforce: working in primary care, rural settings, and with Māori. Journal of Primary Health Care 15, 78-83.

OPEN ACCESS https://www-publish-csiro-au.ezproxy.otago.ac.nz/hc/HC22136

Rural workforce outcomes:

“Our study suggests that short rural immersion placements do not increase rural workforce participation during early healthcare careers.”

Although a little disheartening, the authors’ findings are not that surprising given the design of their study. By only including data to 3 years after graduation we don’t really know what influence it has had on actual workforce outcomes. If we look at doctors, it’s essentially impossible to work in a rural area within the first 2 years of graduation. However the authors’ conclusion probably does align with overseas research that short rural placements have minimal impact on workforce outcomes.

Although probably not so important given the “negative” result, an issue with this study was it used self-reported geographic location. It will be great to see any future research like this to be linked to the Geographic Classification for Health (GCH)

Working with Māori outcomes:

There wasn’t anything “measurable” here. However, the free text thematic analysis showed participant’s attitudes towards working with Māori were really positive. Some “before” data might have been useful too though for comparison and to see what changes were linked to the programme.

A new research area to explore?:
The free text comments from this study show some positive attitude shifts towards rural health. It would be really interesting to see some more research into the benefits of the “rurally attuned” urban medical professional. It might not fix our rural health workforce crisis but there would hopefully still be some benefits to our communities!

(Katelyn Costello)

 

ABSTRACT

Introduction

Pre-registration interprofessional rural immersion programmes provide students with first-hand insight into challenges faced in rural clinical practice and can influence future practice intentions. The impact of short rural and hauora Māori interdisciplinary placements on early healthcare careers is unknown.

Aim

Explore whether a 5-week rural interprofessional education programme influenced graduates’ choices to work in primary care, rurally, and with Māori patients.

Methods

We conducted a survey-based, non-randomised trial of graduates from eight healthcare disciplines who did (n = 132) and did not (n = 479) attend the Tairāwhiti interprofessional education rural programme with hauora Māori placements. Participants were surveyed at 1-, 2-, and 3-years’ post-registration. Self-reported practice location and vocation were analysed with mixed-model logistic regression. Free-text comments were analysed with Template Analysis.

Results

We did not identify any measurable impact on rural or community workforce participation at 3-years’ post-registration. Free-text analysis indicated that a short rural interprofessional immersion placement had long-term self-perceived impacts on desire and skills to work in rural locations, and on desire and ability to work with Māori and embrace Māori models of health.

Discussion

Our study suggests that short rural immersion placements do not increase rural workforce participation during early healthcare careers. Three-years’ post-graduation may be too early to determine whether rural placements help to address rural health workforce needs. Reports from rural placement participants of increased ability to care for people from rural backgrounds, even when encountered in a city, suggest that assessment of practice location may not adequately capture the benefits of rural placement programmes.