World first study reveals nurses, allied health workers more likely to take rural jobs if they study there

The initial results of a world-first, 10-year study of more than 1100 nursing and allied health graduates has found the more time students spend in rural placements, the more likely they will stay once they have graduated.

While there has been much focus on where medical students choose to study and practice with emphasis on increasing the number of rural doctors, the tracking of graduate rural allied health workers and nurses has lagged behind.

The Nursing and Allied Health Graduate Outcome Tracking (NAHGOT) study tracked nursing graduates from Monash and Newcastle universities, looking at what influenced nursing and allied health students to study in rural and regional areas and to continue their practice there.

The study, published in The Australian Journal of Rural Health, is the first to reliably track allied health and nurses in rural Australia. It shows that addressing rural health workforce shortages is a key strategy to overcoming the health inequities across rural Australia, and emphasises the need to increase rural placements in this cohort of healthcare students.

Funded under the Rural Health Multidisciplinary Training Program, the study began in 2019 tracking graduates who completed their degrees in 2017 across seven disciplines.

Of the 1130 graduates, 51% were nurses, 81% females, 62% under 21 years at enrollment, 23% of rural origin, 62% had experienced at least one rural placement and 23% had over 40 cumulative days spent in rural placement.

Using data on principal place of practice from the Australian Health Practitioner Regulation Agency, the research team led by Dr Keith Sutton, from the Monash School of Rural Health, nurses and allied health workers who were originally from a rural or regional area were 4.45 times more likely than urban graduates to practice in a rural area.

According to Dr Sutton, the findings provide important evidence for what many have long thought:

“The more time a student – whether in medicine, nursing or allied health – spends working in a rural setting the more likely they will remain once they graduate”.

“There is a clear imperative for universities to ensure that the rural allied health and nursing shortage is addressed through appropriate student selection and training, with sufficient rural placement for a student to get a feel, and a love, for working in regional areas,” Dr Sutton said.

Associate Professor Shane Bullock, Acting Director of the Monash School of Rural Health said the NAHGOT study is important because “there is an urgent need to increase the number of nurses and allied health workers in regional areas”.

The study will continue to survey the 2017 graduates to follow their career trajectory, whether they are from a rural background, where they intended to practice and their expectations of the course. They were re-surveyed at the end of their course in between 3 and 4 years depending on the course as well as being followed for a further decade using the data to track outcomes including where they end up practicing, how often they move practices and what proportion end up in rural areas.

Dr Sutton said the results of the long-term study will produce evidence to inform government programs and policies related to rural education and workforce planning, university selection strategies and curriculum design, in the same way, that there have been tracking studies of rural medical students for some time.