Why did they leave and what can they tell us? Allied health professionals leaving rural settings

The aim of this paper is to explore the lack of retention of allied health professionals in rural areas in Victoria, Australia. A structured telephone interview was used to elicit responses from 32 allied health professionals from south-west, central-west and north-east Victoria about their working experiences and reasons for resignation. The data revealed that work experiences in rural areas can be summarised within three domains: organisational, professional and personal/community. Under the organisational domain the participants were mainly focussed on the way in which their work arrangements require them to be both more generalist in their approach to day-to-day work, and more expansive in shouldering management style functions in the workplace. Under the professional domain there were three major issues; clinical, career and education/training. The personal/community domain focussed on issues to do with their affinity for their workplace as well as their location in a rural place. The attempts by government to address some of the leading factors for retention of allied health professionals are perhaps too narrowly focussed on the public sector and could encompass a wider approach.

What is known about the topic? Although recruitment and retention of allied health professionals in rural areas is widely discussed, the professionals have not been interviewed about their experiences once they have left rural employment.

What does this paper add? This paper provides detailed insights into the reasons why allied health professionals leave their positions in rural areas and the positive and negative aspects of living and working in a rural area. The results of this study contribute to the development of better policy models for recruitment and retention of allied health professionals in rural areas.

What are the implications for practitioners? The factors that influence whether allied health professionals stay or leave rural areas is of concern for health policy makers at state and federal levels. This paper provides information for the extension and development of programs to attenuate rural leakage of professionals.

Leaving the bush : why did they do it?

The demand for allied health professionals (AHPs) in rural areas is increasing due to changes in lifestyle, disease and disability of the population. Recruitment and retention of AHPs in rural Australia is an issue that continues to challenge policy makers. However, recent initiatives from the Commonwealth Government have focused on boosting the rural health workforce through grants that support education and training, expand health services and increase the number of rural and remote clinical placements. In addition to this funding, suggested restructure of the current allied health service delivery model is gaining much attention. Although this funding and organisational reform is much needed and welcomed, the changing nature of allied health work, increasing demand, and shortages across most rural areas highlight the need for research to address the complexities associated with recruitment and retention of these professionals.

Gaining insight into the experiences of rural AHPs can assist with enhancing government funded recruitment and retention programs and developing sustainable and efficient workforce policies. This study hopes to build on our previous research that implies recruitment is enhanced when retention is optimal, since AHPs are willing to recommend their workplace. Therefore, the factors that influence retention are just as valid and important as the factors that influence recruitment, but many of the existing workforce models have solely focused on recruitment.4 Additionally, these models do not adequately address issues regarding rural employment, they are difficult to implement, and costly to sustain.

In order to make policy recommendations on recruitment and retention in Australia, this paper aims to explore the experiences of AHPs who resigned from rural employment

Pre-cursors to physical employment standards for rural tanker-based bushfire suppression work

This thesis quantified the physical demands of Australian rural bushfire suppression and developed a controlled bushfire simulation suitable for ongoing bushfire research. The findings of this thesis will be used to develop physical employment standards and OH&S strategies to protect the 200,000 volunteer firefighters Australia wide.

An assessment of riparian restoration outcomes in two rural catchments in south-western Victoria: Focusing on tree and shrub species richness, structure and recruitment characteristics

Riparian ecosystems are among the most degraded systems in the landscape,and there has been substantial investment in their restoration. Consequently, monitoring restoration interventions offers opportunities to further develop the science of riparian restoration, particularly how to move from small-scale implementation to a broader landscape scale. Here, we report on a broad range of riparian revegetation projects in two regions of south-western Victoria, the Corangamite and Glenelg-Hopkins Catchment Management Areas. The objectives of restoration interventions in these regions have been stated quite broadly, for example, to reinstate terrestrial habitat and biodiversity, control erosion and improve water quality. This study reports on tree and shrub composition, structure and recruitment after restoration works compared with remnant vegetation found regionally. Within each catchment, a total of 57 sites from six subcatchments were identified, representing three age-classes: <4, 4–8 and >8–12 years after treatment, as well as untreated (control) sites. Treatments comprised fencing to exclude stock, spraying or slashing to reduce weed cover, followed by planting with tube stock. Across the six subcatchments, 12 reference (remnant) sites were used to provide a benchmark for species richness, structural and recruitment characteristics and to aid interpretation of the effects of the restoration intervention. Vegetation structure was well developed in the treated sites by 4–8 years after treatment. However, structural complexity was higher at remnant sites than at treated or untreated sites due to a higher richness of small shrubs. Tree and shrub recruitment occurred in all remnant sites and at 64% of sites treated >4 years ago. Most seedling recruitment at treatment sites was by Acacia spp. This assessment provides data on species richness, structure and recruitment characteristics following restoration interventions. Data from this study will contribute to longitudinal studies of vegetation processes in riparian landscapes of south-western Victoria.

Economic edifice, urbanisation and rural education in developing countries

The nexus between economic edifice, urbanisation and education is a somewhat understudied area in the academic literature. This applies especially to the urban-rural nexus and its impact on transition in economic edifice, which are especially pronounced in developing countries. This article addresses some selected consequences of urbanisation on education in developing countries within a context of transition in economic edifice. It is argued that transitions in economic edifice are for rural populations at times unrestrained and precipitous. It is further argued that the transition economic edifice impacts on social, economic and personal interests of not only the school-aged population, but also of the working and retired population. Against this background, this article discusses factors relating to effects of urbanization within a context of urbanisation and urbanisation theories, including transition in economic edifice, globalization, employment and employability, and vocationalisation of education. In conclusion opportunities and challenges for education in the context of transforming an economic structure in rural areas in a contemporary context is brought to the fore.

Outsourcing and benchmarking in a rural public hospital : does economic theory provide the complete answer?

INTRODUCTION: The ideology and pronouncements of the Australian Government in introducing 'competitive neutrality' to the public sector has improved efficiency and resource usage. In the health sector, the Human Services Department directed that non-clinical and clinical areas be market tested through benchmarking services against the private sector, with the possibility of outsourcing. These services included car parking, computing, laundry, engineering, cleaning, catering, medical imaging (radiology), pathology, pharmacy, allied health and general practice. Managers, when they choose between outsourcing, and internal servicing and production, would thus ideally base their decision on economic principles. Williamson's transaction cost theory studies the governance mechanisms that can be used to achieve economic efficiency and proposes that the optimal organisation structure is that which minimises transaction costs or the costs of exchange. Williamson proposes that four variables will affect such costs, namely: (i) frequency of exchange; (ii) asset specificity; (iii) environmental uncertainty; and (iv) threat of opportunism. This paper provides evidence from a rural public hospital and examines whether Williamson's transaction cost theory is applicable. d into an analysis that relies solely on transaction

Pathways from rural schools : does school VET make a difference?

This paper reports results from an NREC funded study of the medium term outcomes for youth and their communities of VET programs delivered by rural schools. The key findings relate to the outcomes of school VET programs in terms of education and training, employment, and community outcomes such as rural youth retention, and to the features that contribute to successful outcomes. Rural school VET students are less likely to continue with post school education and training in general, but more likely to go onto further vocational education and training than school non-VET students. The study reports strong links between industry area of school VET course, and further education and training, or employment, in the same industry area. It also indicates that school VET students are more likely to live in a rural area at some time during their working life. The features of rural school VET programs that influence outcomes include the purpose of the school VET program and work placements. Student motivation and gender also influence outcomes for individual students. Rural school VET courses represent pathways to related education and training for students who intend to live in a rural area during their working life, and for those who do not.

Pathways from rural schools : does VET make a difference?

This paper reports findings from a survey of former students from six Australian rural school clusters. It compares the experiences and outcomes of students who had participated in a school vocational education and training (VET) program with those who had not. School VET courses intended to provide a pathway to local employment appear to be successful in retaining students who otherwise may have left school before completing Year 12, and in assisting their transition from school to work. For all school VET students, the work placement component of the program aids the transition to local jobs and apprenticeships, and increases youth retention in the community. As the findings indicate that school VET students are predisposed to live in a rural area at some time during their working life, the paper concludes that VET programs in rural areas have special potential to develop skills and pathways for the future workforce of rural Australia.

Skill shortages in health : innovative solutions using vocational education and training

Introduction: This article reports findings of a project funded by the Australian National Council for Vocational Education Research. The project explores solutions to current and projected skills shortages within the health and community services sector, from a vocational education and training perspective. Its purpose is to locate, analyse and disseminate information about innovative models of health training and service delivery that have been developed in response to skill shortages.

Methods: The article begins with a brief overview of Australian statistics and literature on the structure of the national health workforce and perceived skill shortages. The impact of location (state and rurality), demographics of the workforce, and other relevant factors, on health skill shortages is examined. Drawing on a synthesis of the Australian and international literature on innovative and effective models for addressing health skill shortages and nominations by key stakeholders within the health sector, over 70 models were identified. The models represent a mixture of innovative service delivery models and training solutions from Australia, as well as international examples that could be transposed to the Australian context. They include the skill ecosystem approach facilitated by the Australian National Training Authority Skill Ecosystem Project. Models were selected to represent diversity in terms of the nature of skill shortage addressed, barriers overcome in development of the model, healthcare specialisations, and different customer groups.

Results: Key barriers to the development of innovative solutions to skills shortages identified were: policy that is not sufficiently flexible to accommodate changing workplace needs; unwillingness to risk take in order to develop new models; delays in gaining endorsement/accreditation; current vocational education and training (VET) monitoring and reporting systems; issues related to working in partnership, including different cultures, ways of operating, priorities and timelines; workplace culture that is resistant to change; and organisational boundaries. For training-only models, additional barriers were: technology; low educational levels of trainees; lack of health professionals to provide training and/or supervision; and cost of training. Key enhancers for the development of models were identified as: commitment by all partners and co-location of partners; or effective communication channels. Key enhancers for model effectiveness were: first considering work tasks, competencies and job (re)design; high profile of the model within the community; community-based models; cultural fit; and evidence of direct link between skills development and employment, for example VET trained aged care workers upskilling for other health jobs. For training only models, additional enhancers were flexibility of partners in accommodating needs of trainees; low training costs; experienced clinical supervisors; and the provision of professional development to trainers.

Conclusions: There needs to be a balance between short-term solutions to current skill shortages (training only), and medium to longer term solutions (job redesign, holistic approaches) that also address projected skills shortages. Models that focus on addressing skills shortages in aged care can provide a broad pathway to careers in health. Characteristics of models likely to be effective in addressing skill shortages are: responsibility for addressing skills shortage is shared between the health sector, education and training organisations and government, with employers taking a proactive role; the training component is complemented by a focus on retention of workers; models are either targeted at existing employees or identify a target group(s) who may not otherwise have considered a career in health.

Interactional infrastructure in rural communities : matching training needs and provision

This paper reports some of the main lessons learnt from a collaborative project titled Generating jobs in regional Tasmania: a social capital approach investigating how two small rural Tasmanian communities could better match local training needs with training provision. The project was conducted within the context of the wider social, economic and demographic changes affecting the two rural communities and their ongoing efforts to manage such change. The paper provides a profile of the two communities with particular attention to their local education, training and employment infrastructure. Three research questions in terms of improving the contributions of leadership, partnerships and social capital are addressed. Development and utilisation of social capital, particularly in the form of interactional infrastructure (defined as opportunities and structures for interaction in a community) that brought together the range of stakeholders, appeared the key to successfully matching needs with provision.

Study of the Geelong Local Learning and Employment Network

In common with many Western nations, Australian governments, both state and federal, have increasingly embraced network-based approaches in responding to the effects of globalisation. Since 2001, thirty one Local Learning and Employment Networks (LLEN) have been established across all areas of Victoria, Australia in line with recommendations of a Ministerial Review into Post Compulsory Education and Training Pathways. That review reported that, in the globalised context, youth in transition from schooling to independence faced persistent and severe difficulties unknown to previous generations; it also found problems were frequently concentrated in particular groups and regions. LLEN bring together the expertise and experience of local education providers, industry, community organisations, individuals and government organisations. As a result of their local decisions, collaboration and community building efforts it is intended that opportunities for young people will be enhanced. My research was conducted within an Australian Research Council Linkage Project awarded to Deakin University Faculty of Education in partnership with the Smart Geelong Region LLEN (SGR LLEN). The Linkage Project included two separate research components one of which forms my thesis: a case study of SGR LLEN. My data was generated through participant observation in SGR LLEN throughout 2004 and 2005 and through interviews, reflective writing and archival review. In undertaking my analysis and presenting my thesis I have chosen to weave a series of panels whose orientation is poststructural. This approach was based in my acceptance that all knowledge is partial and fragmentary and, accordingly, researchers need to find ways that highlight the intersections in and indeterminacy of their empirical data. The LLEN is -by its nature as a network -more than the contractual entity that gains funding from government, acts as the administrative core and occupies the LLEN office. As such I have woven firstly the formation and operational structure of the bounded entity that is SGR LLEN before weaving a series of six images that portray the unbounded LLEN as an instance-in-action. The thesis draws its theoretical inspiration from the work of Deleuze and Guattari (1987). Despite increased use of notions of networks, local decision-making and community building by governments there had been little empirical research that explored stakeholder understandings of networks and their role in community building as well as a lack of theorisation of how networks actually ‘work.’ My research addresses this lack and suggests an instituted network can function as a learning community capable of fostering systemic change in the post compulsory education training and employment sector and thereby contributing to better opportunities for young people. However the full potential of the policy is undermined by the reluctance of governments to follow through on the implications of their policies and, in particular, to confront the limiting effects of performativity at all levels.

Comparison of the work of psychologists in rural and urban settings : implications for professional training

To compare the work practices and training needs of rural and urban psychologists, 774 surveys were sent to psychologists throughout Australia. The psychologists were selected from the Australian Psychological Society (APS) Directory of Psychologists, 1992- 1993. A total of 86 rural psychologists and 282 urban psychologists responded to the survey. The survey comprised of four sections with questions asking respondents their demographic and employment background, past and current training activities, work experience, and relations with community. Results showed that the decision to practice and remain in a rural area was influenced by psychologists’ childhood experience and professional training in a rural setting, A substantial proportion of rural psychologists (28%) had been working in rural practice for five years or less. These rural psychologists were identified as a group that had a demographic and training profile more similar to urban psychologists than their rural colleagues. The employment conditions and training background of rural and urban psychologists were similar, though rural psychologists were more likely to be working in private practice and have undertaken their studies in a rural setting. Rural and urban psychologists rated their undergraduate and postgraduate training in psychology as only somewhat adequate. Training in rural health and community issues received the lowest ratings from both groups of psychologists. The work practices of rural and urban psychologists were also similar. There were some differences in the demographic profile of the client groups seen by the two groups. Rural psychologists reported the type of relations with their communities that are conducive to rural practice. The main evidence of this was that rural psychologists were collaborating with the natural helpers of their communities, and expressed willingness to formally train natural helpers to assist in the provision of psychological services. There were several conclusions drawn from this study. The first conclusion was that rural psychologists with urban demographic and training backgrounds are a group that is likely to migrate from rural practice to urban practice, Secondly, training needs to be specialised for rural practice if there is to be an improvement in the number of psychologists practicing in rural settings. Thirdly, rural psychologists were conducting the type of relations with their communities that are important to the requirements of rural practice.