Gorton, Susan M. (2012) The shortage of health professionals in rural and remote Australia: creating pathways between students living in rural and remote Australia and health professional careers. PhD thesis, James Cook University.

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Abstract

Rural and remote Australia suffers a severe, chronic shortage of a diverse range of health professionals. This is of major concern, because the people living in rural and remote Australia have worse health in several health outcome areas than their metropolitan peers. Australian and overseas studies have reported that health professionals who grew up in a rural or remote area are more likely than those from urban environments to return to work in a rural area after graduation. Career development theories indicate that children begin to shape ideas about careers in early childhood, and emphasise the importance of career exposure, including occupational role models, in shaping career choice. However, the severe chronic shortage of health professionals in rural and remote Australia means there is also a severe chronic shortage of health professional role models to which children in these areas can aspire. According to career development theories, career education should start long before high school if it is to make up for the absence of visible occupational role models. Any health career information in rural and remote Australia has focused on mid to late high school students. Career information provided to mid to late high school students is also too late for many students and their families to overcome the educational, cultural, social, family and financial barriers between them and participation in tertiary education for a health professional career at a distant university.

This project explored the health professional careers with a small number of predominantly primary students living in rural and remote Australia and studying by distance education, as well as their teachers, parents and governesses. Issues around the knowledge, perceptions and aspirations of students in relation to these careers, before and after health professional career education, were central to this research. The aims were to contribute to long-term solutions to the severe health professional shortage in rural and remote areas, and to widen the career choices of these students. No previous documented research in Australia had explored the health professional careers with primary students or with distance education students living remotely.

This project drew broadly on an action research framework, fundamental to which was a suite of activities aimed at informing the students about health professional careers. The research component involved initial qualitative interviews with parent, teacher, governess and student volunteers from two schools of distance education. The action component occurred over one school year and involved only one school, which serviced an area greater than 500,000 square kilometres. The action component was negotiated with the school community, and explored a diverse range of health careers. Follow-up interviews with volunteers from this school occurred at the end of the year. Observations, informal communications and curriculum review completed the data collection.

These students had little opportunity to learn about professional careers, including the health professional careers, either in their daily lives or from the school. In contrast, they had rich opportunities to learn about working on the land. With few exceptions, students on initial interview showed very limited knowledge and few positive perceptions of, or aspirations towards, health professional careers. This contrasted with their knowledge, perceptions and aspirations in relation to these careers on follow-up by year's end.

Interviews with parents, teachers and governesses unveiled factors contributing to the initial limited knowledge, perceptions and aspirations of these students in relation to health professional careers which suggested a recursive nature to the health professional shortage. This generation's students may have greater difficulty imagining themselves as health professionals than previous generations. These students, in general, have far less opportunity to become health professionals than to work on the land in the beef cattle industry. They also have far less opportunity to participate in tertiary education than many students living in university cities.

This study explored how health professional career information can be disseminated to rural and remote students—in this case, students living in highly inaccessible areas, and serviced by distance education—as part of their education. The study also reports on participants' overall positive response to the program to which they were exposed. The data tentatively suggests that programs to address the shortage of health professionals in rural and remote Australia should include carefully planned integration of health professional career information in the school curriculum from an early age. The data also recognises the complexity of the shortage of health professionals in rural and remote Australia reported in previous studies. Finally, this research highlights the self perpetuating nature of the shortage of health professionals in rural and remote Australia, and the need for wide, sweeping changes to achieve a long-term stable health workforce in these areas.

Item ID:	31130
Item Type:	Thesis (PhD)
Keywords:	career choice; career education; distance education; health professional careers; health resources; remote Australia; rural Australia
Date Deposited:	26 Feb 2014 23:55
FoR Codes:	13 EDUCATION > 1399 Other Education > 139999 Education not elsewhere classified @ 100%
SEO Codes:	92 HEALTH > 9202 Health and Support Services > 920206 Health Policy Economic Outcomes @ 80% 92 HEALTH > 9205 Specific Population Health (excl. Indigenous Health) > 920506 Rural Health @ 20%
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