Rural, mature-aged nursing and allied health student supports: a novel workforce approach.

Abstract

Background: Urgent action is required to address the undersupply of health professionals in regional, rural and remote Australia. The nursing and allied health fields have received minimal attention in the rural health workforce literature in comparison to medicine. Most attention has focused on student placements and strategies to retain metro-origin rural health professionals in rural communities. The notion of ‘home grown training’, where university health courses are delivered in non-metropolitan areas to educate and recruit health professionals from rural communities, is steadily gaining recognition as a sustainable workforce approach. However, this approach is more prominent in medicine and has generally targeted rural school-leaver university students. A ‘grow your own’ approach to addressing nursing and allied health workforce shortages could harness the potential of mature-aged people embedded in rural communities. This approach requires understanding optimal support strategies for rural, mature-aged nursing and allied health (RMANAH) students. Aim: To identify evidence gaps regarding supports for RMANAH students to participate and succeed in higher education. Methods: Arksey and O’Malley’s scoping review methodology and refinements by Levac et al were used to guide the review. Five electronic databases (CINAHL, MEDLINE, Education Resources Information Center [ERIC], Embase and Education Research Complete), key peer-reviewed journals and Australian grey literature were searched between November 2020 and January 2021. The literature was screened and reviewed, and data were extracted using the Covidence review electronic platform. Themes surrounding sources of supports for students within micro-, meso- and macro-levels were developed via thematic analysis techniques. Results: Of the 590 eligible citations, 14 articles were included. Study barriers reported included managing study workloads with non-university commitments, social isolation, poor access to university information communication and technology systems, career disincentives and financial pressures. Seven study supports were identified. Four micro-level supports related to sources close to the student, including student maturity and life experiences, partner support and motivation to demonstrate success to children. Two meso-level supports related to university-wide offerings, including peer support and a university wellbeing program. One support at the macro-level identified financial supports via Australian Government initiatives. Conclusions: The scoping review demonstrated a significant gap in evidence regarding supports for RMANAH students to successfully complete higher education. Future research is required to develop further evidence, particularly to increase understanding of meso- and macro-level student barriers and supports, to enable rural, mature-aged people to become a significant component of the rural health workforce.