Abstract of the research

Many health professionals work outside of traditional large hospital settings that are staffed by a variety of specialist health professionals. Health professionals who work in rural/remote, industrial, tourism and justice roles require more extensive knowledge and skills to meet demands of these contexts, that includes a lack of specialised health services. Rural knowledge and skills are largely not provided by traditional, standardised education. This can make working rurally overwhelming and deter staff from working in these contexts.

An international review of literature confirmed beliefs that there is little teaching specifically related to knowledge and skills to work in rural/remote health settings. Although medicine seems to be preparing doctors to work rurally, there is very little research published from any health professional group that shows what teaching methods are being used, or are proving successful. Tertiary preparation to work in rural/remote locations seems heavily reliant upon student placement experiences.

What is the purpose of the research?

This research aims to draw attention to the need for students to be taught specifically for rural/remote practice so that they can be competent and confident to work in rural/remote areas. The disparity in health outcomes between rural/remote and urban populations, requires health professionals to apply an understanding of health determinants and of their role in influencing health outcomes for rural/remote populations. To achieve this, rural/remote health professionals need specific knowledge and skills that differ from those required to work in metropolitan contexts.

Health professional educators could consider how and why rural/remote concepts are missing from health professional education and instead, develop rural content, particular teaching methodologies, assessment and relevant theoretical perspectives. Attention is drawn to possible ways that rural practice is being presented that may inadvertently deter students from considering a career in rural practice.

What did the researchers do?

The researchers explored reasons why there appears to be so little specific preparation of health professionals to work in rural/remote locations even though these locations are acknowledged as having considerable practice differences, have populations heavily affected by poor health outcomes and difficulties recruiting and retaining health professionals.

The researchers presented Mezirow’s theory of transformative learning as one framework that could be used to guide student learning about a complex and diverse context of practice. Transformative learning aims to develop a thorough understanding of rural practice that goes beyond simply being exposed to rural environments. Transformative learning can be used to maximise the usefulness of rural/remote placement experiences.

What did the researchers find?

The researchers found a complex mix of urban-dominant policy, regulatory activity, teaching practices, professional boundaries and institutional rigidities that do not align with rural practice.

Education research is mostly descriptive and focused on recruitment/ retention strategies rather than research and evaluation of teaching and learning strategies and specific design that caters to rural education.

Transformative learning was identified and explored as an appropriate tool for application to rural placements and other learning opportunities that challenge students’ existing understanding of health care.

How can the research be used?

Although Australia has experienced approximately 30 years of evolving research aimed at recruiting health professionals for rural/remote locations, this aim has not been achieved, nor are there improved health outcomes for rural/remote populations. While medicine is now focusing on teaching strategies specific to rural practice, other health professions are not, even though they are often present in greater numbers than medicine in rural/remote locations.

This research can contribute to greater capacity for inclusion of rural content in curriculum, and evaluation of teaching methods and outcomes. This research will raise the profile of rural education and contribute to the capability of health professionals for confident and effective practice in rural/remote areas that is informed by appropriate learning experiences.

Read the full research report published in the Health Education in Practice Journal - Vol. 7 | No. 1 | 2024