- Title
- Recruiting and retaining rural general practitioners : A mismatch between research evidence and current initiatives?
- Creator
- McDonald, John; Bibby, Louise; Carroll, Steve
- Date
- 2003
- Type
- Text; Conference paper
- Identifier
- http://researchonline.federation.edu.au/vital/access/HandleResolver/1959.17/45062
- Identifier
- vital:1470
- Abstract
- This paper investigates the possible mismatch between current initiatives to attract and retain general practitioners (GPs) to rural areas, and Australian research evidence about the most significant factors affecting recruitment and retention. The results reported here are part of a broader project that aims to use evidence-based research to enhance rural GP workforce planning and management. This phase of the project analysed research reports evaluating the outcome of programs and services aimed at improving rural recruitment and retention. The search strategies for this review included: key word searches of electronic database publications over the last 15 years; hand searching of relevant journals; trawling websites of relevant organisations; and direct contact with relevant organisations to request copies of “grey” literature such as unpublished reports. A total of 22 Australian studies were identified that met these criteria. (It is acknowledged that many other initiatives have been tried, but evaluation reports for these do not exist or were not obtainable. Similarly, many other studies have examined recruitment or retention without evaluating workforce initiatives.) The 22 studies evaluated nine major recruitment and retention initiatives including: medical course admission criteria (2 studies); rural placements (7); student scholarships (1); financial incentives (2); continuing medical education (5); universitylinked rural practices (1); case management (1); and overseas-trained doctors (2); an community capacity-building (1). Demonstrating “causation” requires strong internal and external validity. Overall, however, there is not yet strong empirical evidence for the efficacy of the any of these initiatives. The methodological problems consistently identified in our analysis were: no use of comparison or control groups; an overreliance on surveys of GPs’ attitudes or intentions rather than actual behaviours; inconsistent definitions of key variables including “rural” and “retention”; inadequate sample sizes or unrepresentative samples and selection biases; inconsistent use of definitions of key variables including “rural” and “retention”; cross-sectional and retrospective designs; insufficient information on statistical analyses; and qualitative studies that did not formally and systematically apply techniques for strengthening credibility and transferability. Moreover, many of these initiatives do not appear to be closely aligned with the factors usually thought to influence recruitment or retention. The learnings from this project support the strategic and accessible use of evidencebased health care for rural workforce issues. Government departments and agencies should invest in rigorous evaluations that are then made publicly available. Policy and program development can benefit by drawing upon sound research knowledge. Rural communities can also become more informed and discerning consumers of this information.; E1
- Publisher
- Hobart : National Rural Health Alliance
- Relation
- Paper presented at Seventh National Rural Health Conference, Hobart : 1st - 4th March , 2003
- Rights
- Open Access
- Rights
- Copyright National Rural Health Alliance
- Rights
- This metadata is freely available under a CCO license
- Subject
- Evidence-based practice; Practitioners; Rural work
- Full Text
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