Lived experiences and insights into the advantages important to rural recruitment and retention of general practitioners
- Terry, Daniel, Nguyen, Hoang, Schmitz, David, Baker, Ed
- Authors: Terry, Daniel , Nguyen, Hoang , Schmitz, David , Baker, Ed
- Date: 2018
- Type: Text , Journal article
- Relation: Rural and remote health Vol. 18, no. 3 (2018), p. 1-16
- Full Text:
- Reviewed:
- Description: INTRODUCTION: Despite existing studies in this field, community factors behind recruiting and retaining rural general practitioners (GPs) are not fully understood. To address this issue, the Community Apgar Questionnaire (CAQ) was developed to extend the understanding of communities' assets and capabilities that impact GP recruitment and retention. However, more in-depth insights are vital to develop a comprehensive approach. METHODS: This mixed methods study was administered using face-to-face structured interviews with a total of 40 health service representatives. All interviews lasted 35-40 minutes and were audio-taped. Qualitative data were generated from the extended responses to the structured questions of the CAQ and later transcribed. Thematic analysis was conducted in relation to explanations, elaborations, and relevant strategic approaches to improving workforce retention. RESULTS: The qualitative findings illuminated the most important advantages of recruiting and retaining GPs were linked to medical support, hospital and community support, and economic factors, while the challenges were related to geographic factors. The underlying reasons for and nature of those advantages and challenges reinforce that health professionals' decisions to stay or leave are complex and multifactorial. CONCLUSION: The originality of the study rests on the administration of the CAQ accompanied by the opportunity for participants to provide extended responses, which gives critical insights into the complexities of rural recruitment and retention. As such, the results confirm the need for a flexible multifaceted response to improving rural GP workforce and informs decision-making in terms of addressing workforce issues within the scope of available resources and capacity.
- Authors: Terry, Daniel , Nguyen, Hoang , Schmitz, David , Baker, Ed
- Date: 2018
- Type: Text , Journal article
- Relation: Rural and remote health Vol. 18, no. 3 (2018), p. 1-16
- Full Text:
- Reviewed:
- Description: INTRODUCTION: Despite existing studies in this field, community factors behind recruiting and retaining rural general practitioners (GPs) are not fully understood. To address this issue, the Community Apgar Questionnaire (CAQ) was developed to extend the understanding of communities' assets and capabilities that impact GP recruitment and retention. However, more in-depth insights are vital to develop a comprehensive approach. METHODS: This mixed methods study was administered using face-to-face structured interviews with a total of 40 health service representatives. All interviews lasted 35-40 minutes and were audio-taped. Qualitative data were generated from the extended responses to the structured questions of the CAQ and later transcribed. Thematic analysis was conducted in relation to explanations, elaborations, and relevant strategic approaches to improving workforce retention. RESULTS: The qualitative findings illuminated the most important advantages of recruiting and retaining GPs were linked to medical support, hospital and community support, and economic factors, while the challenges were related to geographic factors. The underlying reasons for and nature of those advantages and challenges reinforce that health professionals' decisions to stay or leave are complex and multifactorial. CONCLUSION: The originality of the study rests on the administration of the CAQ accompanied by the opportunity for participants to provide extended responses, which gives critical insights into the complexities of rural recruitment and retention. As such, the results confirm the need for a flexible multifaceted response to improving rural GP workforce and informs decision-making in terms of addressing workforce issues within the scope of available resources and capacity.
The rural nursing workforce hierarchy of needs : decision-making concerning future rural healthcare employment
- Terry, Daniel, Peck, Blake, Baker, Ed, Schmitz, David
- Authors: Terry, Daniel , Peck, Blake , Baker, Ed , Schmitz, David
- Date: 2021
- Type: Text , Journal article
- Relation: Healthcare (Switzerland) Vol. 9, no. 9 (2021), p.
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- Description: Addressing nursing shortages in rural areas remains essential, and attracting nursing graduates is one solution. However, understanding what factors are most important or prioritized among nursing students contemplating rural employment remains essential. The study sought to understand nursing student decision-making and what aspects of a rural career need to be satisfied before other factors are then considered. A cross-sectional study over three years at an Australian university was conducted. All nursing students were invited to complete a Nursing Community Apgar Questionnaire to examine their rural practice intentions. Data were analyzed using principal component analysis, and mean scores for each component were calculated and ranked. Overall, six components encompassed a total of 35 items that students felt were important to undertake rural practice after graduating. Clinical related factors were ranked the highest, followed by managerial, practical, fiscal, familial, and geographical factors. Maslow’s Hierarchy of Needs provided a lens to examine nursing student decision-making and guided the development of the Rural Nursing Workforce Hierarchy of Needs model. Each element of the model grouped key factors that students considered to be important in order to undertake rural employment. In culmination, these factors provide a conceptual model of the hierarchy of needs that must be met in order to contemplate a rural career. © 2021 by the authors. Licensee MDPI, Basel, Switzerland.
- Authors: Terry, Daniel , Peck, Blake , Baker, Ed , Schmitz, David
- Date: 2021
- Type: Text , Journal article
- Relation: Healthcare (Switzerland) Vol. 9, no. 9 (2021), p.
- Full Text:
- Reviewed:
- Description: Addressing nursing shortages in rural areas remains essential, and attracting nursing graduates is one solution. However, understanding what factors are most important or prioritized among nursing students contemplating rural employment remains essential. The study sought to understand nursing student decision-making and what aspects of a rural career need to be satisfied before other factors are then considered. A cross-sectional study over three years at an Australian university was conducted. All nursing students were invited to complete a Nursing Community Apgar Questionnaire to examine their rural practice intentions. Data were analyzed using principal component analysis, and mean scores for each component were calculated and ranked. Overall, six components encompassed a total of 35 items that students felt were important to undertake rural practice after graduating. Clinical related factors were ranked the highest, followed by managerial, practical, fiscal, familial, and geographical factors. Maslow’s Hierarchy of Needs provided a lens to examine nursing student decision-making and guided the development of the Rural Nursing Workforce Hierarchy of Needs model. Each element of the model grouped key factors that students considered to be important in order to undertake rural employment. In culmination, these factors provide a conceptual model of the hierarchy of needs that must be met in order to contemplate a rural career. © 2021 by the authors. Licensee MDPI, Basel, Switzerland.
Community assets and capabilities to recruit and retain GPs : the community apgar questionnaire in rural Victoria
- Terry, Daniel, Baker, Ed, Schmitz, David
- Authors: Terry, Daniel , Baker, Ed , Schmitz, David
- Date: 2016
- Type: Text , Journal article
- Relation: Rural and Remote Health Vol. 16, no. 4 (2016), p.
- Full Text:
- Reviewed:
- Description: Introduction: Rural communities continue to experience significant challenges recruiting and retaining physicians. The Community Apgar Questionnaire (CAQ) was developed in Idaho in the USA to comprehensively assess the characteristics associated with successful recruitment and retention of rural physicians. The CAQ has been utilised and validated across the USA; however, its value in rural Australia has not been examined. The objective of this study was to use the CAQ in rural Australia to examine its utility and develop a greater understanding of the community factors that impact general practitioner (GP) recruitment and retention. Method: The project conducted structured face-to-face interviews with hospital chief executive officers (CEOs) and directors of clinical services (DCSs) from 14 of the 21 (76%) health services that agreed to participate in rural north-eastern Victoria, Australia. The interviews were undertaken to complete the CAQ, which contains 50 questions centred on factors that influence physician recruitment and retention. Once completed, CAQs were scored by assigning quantitative values to a community's strengths and challenges including the level of importance placed on each factor. As such, the most important factors in physician recruitment, whether they are advantages or challenges for that community, were then weighed for their relative importance. Scores were then combined to create a CAQ score. To ensure reliability and validity of the results, three additional CAQs were purposefully administered to key general practices within the region. Results: The 14 rural communities exhibited cumulative CAQ scores ranging from a high of 387 to a low score of 61. This suggests the tool was sensitive enough to differentiate between communities that were high and low performers in terms of physician recruitment. The groups of factors that had the greatest impact on recruitment and retention were ranked highest to lowest and included medical support, hospital/community support, economic, scope of practice and geographic factors. Overall, the highest individual factors to impact recruitment and retention were perception of quality, hospital leadership, nursing workforce and transfer arrangements. Conversely, the lowest factors and challenges to recruitment and retention were family related, specifically spousal satisfaction and access to schools. Conclusions: Hume, in rural Victoria, was the first international site to implement the CAQ to differentially diagnose a community's relative strengths and challenges in recruiting and retaining GPs, while supporting health facilities to prioritise achievable goals to improve long-term retention strategies. It provided each community with a tailored gap analysis, while confidentially sharing best practices of other health facilities. Within Hume, open communication and trust between GPs and health facility leadership and nursing staff ensures that GPs can feel valued and supported. Possible solutions for GP recruitment and retention must consider the social, employment and educational opportunities that are available for spouses and children. Participation in the program was useful as it helped health facilities ascertain how they were performing while highlighting areas for improvement. © James Cook University 2016.
- Authors: Terry, Daniel , Baker, Ed , Schmitz, David
- Date: 2016
- Type: Text , Journal article
- Relation: Rural and Remote Health Vol. 16, no. 4 (2016), p.
- Full Text:
- Reviewed:
- Description: Introduction: Rural communities continue to experience significant challenges recruiting and retaining physicians. The Community Apgar Questionnaire (CAQ) was developed in Idaho in the USA to comprehensively assess the characteristics associated with successful recruitment and retention of rural physicians. The CAQ has been utilised and validated across the USA; however, its value in rural Australia has not been examined. The objective of this study was to use the CAQ in rural Australia to examine its utility and develop a greater understanding of the community factors that impact general practitioner (GP) recruitment and retention. Method: The project conducted structured face-to-face interviews with hospital chief executive officers (CEOs) and directors of clinical services (DCSs) from 14 of the 21 (76%) health services that agreed to participate in rural north-eastern Victoria, Australia. The interviews were undertaken to complete the CAQ, which contains 50 questions centred on factors that influence physician recruitment and retention. Once completed, CAQs were scored by assigning quantitative values to a community's strengths and challenges including the level of importance placed on each factor. As such, the most important factors in physician recruitment, whether they are advantages or challenges for that community, were then weighed for their relative importance. Scores were then combined to create a CAQ score. To ensure reliability and validity of the results, three additional CAQs were purposefully administered to key general practices within the region. Results: The 14 rural communities exhibited cumulative CAQ scores ranging from a high of 387 to a low score of 61. This suggests the tool was sensitive enough to differentiate between communities that were high and low performers in terms of physician recruitment. The groups of factors that had the greatest impact on recruitment and retention were ranked highest to lowest and included medical support, hospital/community support, economic, scope of practice and geographic factors. Overall, the highest individual factors to impact recruitment and retention were perception of quality, hospital leadership, nursing workforce and transfer arrangements. Conversely, the lowest factors and challenges to recruitment and retention were family related, specifically spousal satisfaction and access to schools. Conclusions: Hume, in rural Victoria, was the first international site to implement the CAQ to differentially diagnose a community's relative strengths and challenges in recruiting and retaining GPs, while supporting health facilities to prioritise achievable goals to improve long-term retention strategies. It provided each community with a tailored gap analysis, while confidentially sharing best practices of other health facilities. Within Hume, open communication and trust between GPs and health facility leadership and nursing staff ensures that GPs can feel valued and supported. Possible solutions for GP recruitment and retention must consider the social, employment and educational opportunities that are available for spouses and children. Participation in the program was useful as it helped health facilities ascertain how they were performing while highlighting areas for improvement. © James Cook University 2016.
The nursing community apgar questionnaire in rural Australia : an evidence based approach to recruiting and retaining nurses
- Prengaman, Molly, Terry, Daniel, Schmitz, David, Baker, Ed
- Authors: Prengaman, Molly , Terry, Daniel , Schmitz, David , Baker, Ed
- Date: 2017
- Type: Text , Journal article
- Relation: Online Journal of Rural Nursing & Health Care Vol. 17, no. 2 (2017), p. 148
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- Description: Purpose: To date, the Nursing Community Apgar Questionnaire (NCAQ) has been effectively utilized to quantify resources and capabilities of a rural Idaho communities to recruit and retain nurses. As such, the NCAQ was used in a rural Australian context to examine its efficacy as an evidence-based tool to better inform nursing recruitment and retention. Sample: The sample included nursing administrators, senior nurses and other nurses from six health facilities who were familiar with the community and knowledgeable with health facility recruitment and retention history. Participants were registered nurses and/or directly involved in nursing recruitment. Method: The 50 factor NCAQ was administered online. Data were cleaned, checked, and analyzed by assigning quantitative values to the four-point scale of community advantages or challenges for each factor and then weighted according to the participant's perceived importance to create a community asset and capability measure. Higher scores represented more developed community assets and capabilities relating to nursing recruitment and retention. Findings: The findings demonstrate that lifestyle, emphasis on patient safety and high quality care, availability of necessary materials and equipment, perception of quality were among the highest scoring factors and considered to have the most impact on recruiting and retaining nurses. The lowest factors impacting recruitment and retention included spousal satisfaction, access to larger communities, and opportunities for social networking within communities. Conclusions: The implementation of the NCAQ has the capacity to offer health facilities and managers to examine what is appealing about the health service and community, while highlighting key challenges impacting recruitment and retention. The NCAQ assists health services to develop strategic plans tailored specifically to enhance recruitment and retention of nursing staff. Its use has the capacity to provide health services with greater evidence as they seek to address site specific or regional recruitment and retention issues. Keywords: Rural, nursing, Workforce, Recruitment, Retention, Community apgar
- Authors: Prengaman, Molly , Terry, Daniel , Schmitz, David , Baker, Ed
- Date: 2017
- Type: Text , Journal article
- Relation: Online Journal of Rural Nursing & Health Care Vol. 17, no. 2 (2017), p. 148
- Full Text:
- Reviewed:
- Description: Purpose: To date, the Nursing Community Apgar Questionnaire (NCAQ) has been effectively utilized to quantify resources and capabilities of a rural Idaho communities to recruit and retain nurses. As such, the NCAQ was used in a rural Australian context to examine its efficacy as an evidence-based tool to better inform nursing recruitment and retention. Sample: The sample included nursing administrators, senior nurses and other nurses from six health facilities who were familiar with the community and knowledgeable with health facility recruitment and retention history. Participants were registered nurses and/or directly involved in nursing recruitment. Method: The 50 factor NCAQ was administered online. Data were cleaned, checked, and analyzed by assigning quantitative values to the four-point scale of community advantages or challenges for each factor and then weighted according to the participant's perceived importance to create a community asset and capability measure. Higher scores represented more developed community assets and capabilities relating to nursing recruitment and retention. Findings: The findings demonstrate that lifestyle, emphasis on patient safety and high quality care, availability of necessary materials and equipment, perception of quality were among the highest scoring factors and considered to have the most impact on recruiting and retaining nurses. The lowest factors impacting recruitment and retention included spousal satisfaction, access to larger communities, and opportunities for social networking within communities. Conclusions: The implementation of the NCAQ has the capacity to offer health facilities and managers to examine what is appealing about the health service and community, while highlighting key challenges impacting recruitment and retention. The NCAQ assists health services to develop strategic plans tailored specifically to enhance recruitment and retention of nursing staff. Its use has the capacity to provide health services with greater evidence as they seek to address site specific or regional recruitment and retention issues. Keywords: Rural, nursing, Workforce, Recruitment, Retention, Community apgar
Is nursing student personality important for considering a rural career?
- Terry, Daniel, Peck, Blake, Smith, Andrew, Stevenson, Tyrin, Baker, Ed
- Authors: Terry, Daniel , Peck, Blake , Smith, Andrew , Stevenson, Tyrin , Baker, Ed
- Date: 2019
- Type: Text , Journal article
- Relation: Journal of Health Organization and Management Vol. 33, no. 5 (2019), p. 617-634
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- Description: Purpose: Identifying and measuring personality traits assists to understanding professional career choices, however, what impact personality traits have on nursing student rural career choice remains absent. The purpose of this paper is to identify personality traits among nursing students that may be predictive of pursuing a rural career. Design/methodology/approach: A cross-sectional design was used to examine the importance Bachelor of Nursing students place on undertaking rural careers. All nursing students (n=1,982) studying a three-year bachelor’s degree were invited to complete a questionnaire examining personality traits and rural practice intentions. Findings: Students who saw themselves working rurally after graduation had higher levels of conscientiousness than those who wanted metropolitan careers. Students with higher levels of agreeableness or open-mindedness were more likely to consider rural practice when individual community factors were carefully considered. Finally, students with higher levels of neuroticism were less likely to consider rural practice as a future career pathway. Research limitations/implications: The cohort had high numbers of student from rural and regional settings, which may limit the ability to generalise the findings. In addition, student respondents of the survey may not be representative of the whole student cohort given the low response rate. Originality/value: Key personality traits are identifying factors that contribute to nursing student decision making regarding rural practice. Students who displayed higher levels of agreeableness and conscientiousness and open-mindedness have traits that are most likely to impact the consideration of rural practice across their nursing career, which gives additional insight into targeted recruitment strategies. © 2019, Emerald Publishing Limited.
- Authors: Terry, Daniel , Peck, Blake , Smith, Andrew , Stevenson, Tyrin , Baker, Ed
- Date: 2019
- Type: Text , Journal article
- Relation: Journal of Health Organization and Management Vol. 33, no. 5 (2019), p. 617-634
- Full Text:
- Reviewed:
- Description: Purpose: Identifying and measuring personality traits assists to understanding professional career choices, however, what impact personality traits have on nursing student rural career choice remains absent. The purpose of this paper is to identify personality traits among nursing students that may be predictive of pursuing a rural career. Design/methodology/approach: A cross-sectional design was used to examine the importance Bachelor of Nursing students place on undertaking rural careers. All nursing students (n=1,982) studying a three-year bachelor’s degree were invited to complete a questionnaire examining personality traits and rural practice intentions. Findings: Students who saw themselves working rurally after graduation had higher levels of conscientiousness than those who wanted metropolitan careers. Students with higher levels of agreeableness or open-mindedness were more likely to consider rural practice when individual community factors were carefully considered. Finally, students with higher levels of neuroticism were less likely to consider rural practice as a future career pathway. Research limitations/implications: The cohort had high numbers of student from rural and regional settings, which may limit the ability to generalise the findings. In addition, student respondents of the survey may not be representative of the whole student cohort given the low response rate. Originality/value: Key personality traits are identifying factors that contribute to nursing student decision making regarding rural practice. Students who displayed higher levels of agreeableness and conscientiousness and open-mindedness have traits that are most likely to impact the consideration of rural practice across their nursing career, which gives additional insight into targeted recruitment strategies. © 2019, Emerald Publishing Limited.
Factors contributing to the recruitment and retention of rural pharmacist workforce: a systematic review
- Terry, Daniel, Peck, Blake, Hills, Danny, Baker, Ed, Schmitz, David
- Authors: Terry, Daniel , Peck, Blake , Hills, Danny , Baker, Ed , Schmitz, David
- Date: 2021
- Type: Text , Journal article
- Relation: BMC Health Services Research Vol. 21, no. 1 (2021), p.
- Full Text:
- Reviewed:
- Description: Background: Recruiting and retaining medical, nursing, and allied health professionals in rural and remote areas is a worldwide challenge, compromising continuity of care and population health outcomes in these locations. Specifically, pharmacists play an essential and accessible frontline healthcare role, and are often the first point of contact for health concerns. Despite several incentives, there remains a maldistribution and undersupply of pharmacists in rural and remote areas across many parts of the world. Although current systematic reviews have focussed on factors affecting pharmacists’ retention generally, literature specifically focused on rural pharmacist workforce in a global context remains limited. The aim of this systematic review is to identify factors associated with recruitment and retention of the pharmacist workforce in rural and remote settings. Better understanding of these contributors will inform more effective interventional strategies to resolve pharmacist workforce shortages. Methods: A systematic search of primary studies was conducted in online databases, including Medline, Embase, CINAHL, Scopus, Web of Science and PsycINFO, and by hand-searching of reference lists. Eligible studies were identified based on predefined inclusion/exclusion criteria and methodological quality criteria, utilising the Critical Appraisal Skills Programme (CASP) and Good Reporting of A Mixed Methods Study (GRAMMS) checklists. Results: The final review included 13 studies, with quantitative, qualitative, or mixed methods research design. Study-specific factors associated with recruitment and retention of pharmacists in rural practice were identified and grouped into five main themes: geographic and family-related, economic and resources, scope of practice or skills development, the practice environment, and community and practice support factors. Conclusions: The results provide critical insights into the complexities of rural recruitment and retention of pharmacists and confirms the need for flexible yet multifaceted responses to overcoming rural pharmacist workforce challenges. Overall, the results provide an opportunity for rural communities and health services to better identify key strengths and challenges unique to the rural and remote pharmacist workforce that may be augmented to guide more focussed recruitment and retention endeavours. © 2021, The Author(s). **Please note that there are multiple authors for this article therefore only the name of the Federation University Australia affiliates “Daniel Terry, Blake Peck, Danny Hills, Ed Baker and David Schmitz” are provided in this record** Correction to: Factors contributing to the recruitment and retention of rural pharmacist workforce: a systematic review (BMC Health Services Research, (2021), 21, 1, (1052), 10.1186/s12913-021-07072-1)
- Authors: Terry, Daniel , Peck, Blake , Hills, Danny , Baker, Ed , Schmitz, David
- Date: 2021
- Type: Text , Journal article
- Relation: BMC Health Services Research Vol. 21, no. 1 (2021), p.
- Full Text:
- Reviewed:
- Description: Background: Recruiting and retaining medical, nursing, and allied health professionals in rural and remote areas is a worldwide challenge, compromising continuity of care and population health outcomes in these locations. Specifically, pharmacists play an essential and accessible frontline healthcare role, and are often the first point of contact for health concerns. Despite several incentives, there remains a maldistribution and undersupply of pharmacists in rural and remote areas across many parts of the world. Although current systematic reviews have focussed on factors affecting pharmacists’ retention generally, literature specifically focused on rural pharmacist workforce in a global context remains limited. The aim of this systematic review is to identify factors associated with recruitment and retention of the pharmacist workforce in rural and remote settings. Better understanding of these contributors will inform more effective interventional strategies to resolve pharmacist workforce shortages. Methods: A systematic search of primary studies was conducted in online databases, including Medline, Embase, CINAHL, Scopus, Web of Science and PsycINFO, and by hand-searching of reference lists. Eligible studies were identified based on predefined inclusion/exclusion criteria and methodological quality criteria, utilising the Critical Appraisal Skills Programme (CASP) and Good Reporting of A Mixed Methods Study (GRAMMS) checklists. Results: The final review included 13 studies, with quantitative, qualitative, or mixed methods research design. Study-specific factors associated with recruitment and retention of pharmacists in rural practice were identified and grouped into five main themes: geographic and family-related, economic and resources, scope of practice or skills development, the practice environment, and community and practice support factors. Conclusions: The results provide critical insights into the complexities of rural recruitment and retention of pharmacists and confirms the need for flexible yet multifaceted responses to overcoming rural pharmacist workforce challenges. Overall, the results provide an opportunity for rural communities and health services to better identify key strengths and challenges unique to the rural and remote pharmacist workforce that may be augmented to guide more focussed recruitment and retention endeavours. © 2021, The Author(s). **Please note that there are multiple authors for this article therefore only the name of the Federation University Australia affiliates “Daniel Terry, Blake Peck, Danny Hills, Ed Baker and David Schmitz” are provided in this record** Correction to: Factors contributing to the recruitment and retention of rural pharmacist workforce: a systematic review (BMC Health Services Research, (2021), 21, 1, (1052), 10.1186/s12913-021-07072-1)
The pharmacy community apgar questionnaire : a modified Delphi technique to develop a rural pharmacist recruitment and retention tool
- Terry, Daniel, Peck, Blake, Hills, Danny, Bishop, Jaclyn, Kirschbaum, Mark, Obamiro, Kehinde, Phan, Hoang, Baker, Ed, Schmitz, David
- Authors: Terry, Daniel , Peck, Blake , Hills, Danny , Bishop, Jaclyn , Kirschbaum, Mark , Obamiro, Kehinde , Phan, Hoang , Baker, Ed , Schmitz, David
- Date: 2022
- Type: Text , Journal article
- Relation: Rural and remote health Vol. 22, no. 4 (2022), p. 7347
- Full Text:
- Reviewed:
- Description: INTRODUCTION: An adequate healthcare workforce remains essential for the health of rural communities. Strategies to address rural health workforce challenges have often centred on the medical and nursing workforce; however, addressing the rural pharmacist workforce also remains critical as they are often the first point of contact for health advice. Initiatives have increased pharmacist supply; however, key issues such as poor attraction, recruitment, and retention to rural areas remain. The aim of this study was to support the recruitment and retention of pharmacists in rural areas of Australia through the development of the Pharmacy Community Apgar Questionnaire (PharmCAQ). METHODS: A modified Delphi technique was employed to develop the PharmCAQ. A panel of experts were purposively selected. Eight representatives were from organisations with rural experience relevant to the study including the Society of Hospital Pharmacists of Australia, the Pharmaceutical Society of Australia, the Pharmacy Guild of Australia, the Pharmacy Board of Australia, and a representative of a government health agency, who also leads a hospital pharmacy. Three additional participants included local and international academics with health policy and rural health workforce expertise. All participants participated in three separate focus groups of 45-60 minutes duration, where the review and refinement of factors that drive recruitment and retention of pharmacist were discussed. Face and content validity was achieved through the representatives, while internal consistency was achieved when the tool was piloted among 10 rural pharmacists in rural Victoria. RESULTS: Fifty key factors that impact the recruitment and retention of pharmacists were identified, developed and succinctly described. All factors were grouped into five classifications: (1) geographic, (2) economic and resources, (3) practice and scope of practice, (4) practice environment and (5) community practice support. After final consensus, the factors and their definitions formed the final questionnaire. Lastly, the reliability of PharmCAQ was determined, with a Cronbach's alpha coefficient of 0.852. CONCLUSION: While the development and use of the Apgar questionnaire for the recruitment and retention of health professionals is not a novel idea, seeking to specifically focus on pharmacists is unique. However, 10 factors were similar to factors associated with rural recruitment and retention of both physicians and nurses; they encompassed geographic, community support, and economic and resource factors. Regardless of similarities or differences between health professions in terms of recruitment and retention, as a mechanism for addressing the worsening health professional shortage currently experienced in rural areas, the PharmCAQ was developed to support the recruitment and retention of the pharmacist workforce in rural areas.
- Authors: Terry, Daniel , Peck, Blake , Hills, Danny , Bishop, Jaclyn , Kirschbaum, Mark , Obamiro, Kehinde , Phan, Hoang , Baker, Ed , Schmitz, David
- Date: 2022
- Type: Text , Journal article
- Relation: Rural and remote health Vol. 22, no. 4 (2022), p. 7347
- Full Text:
- Reviewed:
- Description: INTRODUCTION: An adequate healthcare workforce remains essential for the health of rural communities. Strategies to address rural health workforce challenges have often centred on the medical and nursing workforce; however, addressing the rural pharmacist workforce also remains critical as they are often the first point of contact for health advice. Initiatives have increased pharmacist supply; however, key issues such as poor attraction, recruitment, and retention to rural areas remain. The aim of this study was to support the recruitment and retention of pharmacists in rural areas of Australia through the development of the Pharmacy Community Apgar Questionnaire (PharmCAQ). METHODS: A modified Delphi technique was employed to develop the PharmCAQ. A panel of experts were purposively selected. Eight representatives were from organisations with rural experience relevant to the study including the Society of Hospital Pharmacists of Australia, the Pharmaceutical Society of Australia, the Pharmacy Guild of Australia, the Pharmacy Board of Australia, and a representative of a government health agency, who also leads a hospital pharmacy. Three additional participants included local and international academics with health policy and rural health workforce expertise. All participants participated in three separate focus groups of 45-60 minutes duration, where the review and refinement of factors that drive recruitment and retention of pharmacist were discussed. Face and content validity was achieved through the representatives, while internal consistency was achieved when the tool was piloted among 10 rural pharmacists in rural Victoria. RESULTS: Fifty key factors that impact the recruitment and retention of pharmacists were identified, developed and succinctly described. All factors were grouped into five classifications: (1) geographic, (2) economic and resources, (3) practice and scope of practice, (4) practice environment and (5) community practice support. After final consensus, the factors and their definitions formed the final questionnaire. Lastly, the reliability of PharmCAQ was determined, with a Cronbach's alpha coefficient of 0.852. CONCLUSION: While the development and use of the Apgar questionnaire for the recruitment and retention of health professionals is not a novel idea, seeking to specifically focus on pharmacists is unique. However, 10 factors were similar to factors associated with rural recruitment and retention of both physicians and nurses; they encompassed geographic, community support, and economic and resource factors. Regardless of similarities or differences between health professions in terms of recruitment and retention, as a mechanism for addressing the worsening health professional shortage currently experienced in rural areas, the PharmCAQ was developed to support the recruitment and retention of the pharmacist workforce in rural areas.
Self-efficacy, grit and perceptions of rural employment : what changes occur after graduation?
- Terry, Daniel, Peck, Blake, Baker, Ed
- Authors: Terry, Daniel , Peck, Blake , Baker, Ed
- Date: 2021
- Type: Text , Journal article
- Relation: Online journal of rural nursing and health care Vol. 21, no. 2 (2021), p. 44-68
- Full Text:
- Reviewed:
- Description: Purpose: General self-efficacy, occupational self-efficacy, and grit have a correlation with academic and practical success amongst nursing students. The role of these same characteristics during the first 18-24 months following the transition from student to nurse is poorly understood. In addition, when a nursing graduate begins to consider a career in a rural area is also remains unclear. This study sought to understand the change, if any, in general self-efficacy, occupational self-efficacy, grit, and rural employment importance that occurred during this transition period. Sample: Nurses after graduating from a three-year Bachelor of Nursing degree (n=28). Method: A follow-up study of a larger longitudinal mixed-methods cohort design used a survey to examine general self-efficacy, occupational self-efficacy, grit, and rural employment importance among novice nurses. Participants had agreed when completing the initial study as students to participate in a follow-up study 18-24-months after graduating. Findings: Occupational self-efficacy increased as the cohort transitioned from student to professional nurse, while grit was remarkably lower between final year students and novice nurses. No change in earlier measures of general self-efficacy or importance placed on rural careers were detected. Conclusions: Following graduation, new clinicians are focused on building professional identity and the development of foundational skills for practice. Clinical agencies have an opportunity to shift the balance between autonomy and support in order to harness these key characteristics in an effort to improve the longevity and progression of nursing graduates within the nursing profession.
- Authors: Terry, Daniel , Peck, Blake , Baker, Ed
- Date: 2021
- Type: Text , Journal article
- Relation: Online journal of rural nursing and health care Vol. 21, no. 2 (2021), p. 44-68
- Full Text:
- Reviewed:
- Description: Purpose: General self-efficacy, occupational self-efficacy, and grit have a correlation with academic and practical success amongst nursing students. The role of these same characteristics during the first 18-24 months following the transition from student to nurse is poorly understood. In addition, when a nursing graduate begins to consider a career in a rural area is also remains unclear. This study sought to understand the change, if any, in general self-efficacy, occupational self-efficacy, grit, and rural employment importance that occurred during this transition period. Sample: Nurses after graduating from a three-year Bachelor of Nursing degree (n=28). Method: A follow-up study of a larger longitudinal mixed-methods cohort design used a survey to examine general self-efficacy, occupational self-efficacy, grit, and rural employment importance among novice nurses. Participants had agreed when completing the initial study as students to participate in a follow-up study 18-24-months after graduating. Findings: Occupational self-efficacy increased as the cohort transitioned from student to professional nurse, while grit was remarkably lower between final year students and novice nurses. No change in earlier measures of general self-efficacy or importance placed on rural careers were detected. Conclusions: Following graduation, new clinicians are focused on building professional identity and the development of foundational skills for practice. Clinical agencies have an opportunity to shift the balance between autonomy and support in order to harness these key characteristics in an effort to improve the longevity and progression of nursing graduates within the nursing profession.
The threshold of rural placement frequency and duration : a repeated cross-sectional study examining rural career aspirations among student nurses
- Terry, Daniel, Peck, Blake, Elliott, Jessica, East, Leah, Ryan, Liz, Baker, Ed, Schmitz, David
- Authors: Terry, Daniel , Peck, Blake , Elliott, Jessica , East, Leah , Ryan, Liz , Baker, Ed , Schmitz, David
- Date: 2024
- Type: Text , Journal article
- Relation: Nurse Education in Practice Vol. 77, no. (2024), p.
- Full Text:
- Reviewed:
- Description: Aim: This study aimed to explore what changes rural placement had on the perceptions of nursing students and the impact of placement frequency and duration on student considerations for rural practice. Background: A strong rural healthcare workforce is a global concern and has led countries to look for creative ways to address this challenge. One approach is to train more health professionals, however, nursing students who grew up or lived in metropolitan or urbanised areas are suggested to be less inclined to pursue a rural career. As such it is posited that recurrent exposure to rural settings may exert a positive impact on future intention for rural practice. However, there is a need to explore the specific thresholds related to both the frequency and duration of rural placement exposure, as well as the cumulative impact multiple rural placements may have on the intention to engage in rural practice. Design: A repeated cross-sectional design. Methods: All nursing students from an Australian regional university were invited to complete an online questionnaire between 2019 and 2023. Demographic and placement specific questions were included. A modified version of the Nursing Community Apgar tool also measured the importance of key variables in rural career decision-making. Data were analysed using independent sample t-tests and one-way ANOVAs. Significance was determined at two-tailed p
- Authors: Terry, Daniel , Peck, Blake , Elliott, Jessica , East, Leah , Ryan, Liz , Baker, Ed , Schmitz, David
- Date: 2024
- Type: Text , Journal article
- Relation: Nurse Education in Practice Vol. 77, no. (2024), p.
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- Reviewed:
- Description: Aim: This study aimed to explore what changes rural placement had on the perceptions of nursing students and the impact of placement frequency and duration on student considerations for rural practice. Background: A strong rural healthcare workforce is a global concern and has led countries to look for creative ways to address this challenge. One approach is to train more health professionals, however, nursing students who grew up or lived in metropolitan or urbanised areas are suggested to be less inclined to pursue a rural career. As such it is posited that recurrent exposure to rural settings may exert a positive impact on future intention for rural practice. However, there is a need to explore the specific thresholds related to both the frequency and duration of rural placement exposure, as well as the cumulative impact multiple rural placements may have on the intention to engage in rural practice. Design: A repeated cross-sectional design. Methods: All nursing students from an Australian regional university were invited to complete an online questionnaire between 2019 and 2023. Demographic and placement specific questions were included. A modified version of the Nursing Community Apgar tool also measured the importance of key variables in rural career decision-making. Data were analysed using independent sample t-tests and one-way ANOVAs. Significance was determined at two-tailed p
Sustaining rural pharmacy workforce understanding key attributes for enhanced retention and recruitment
- Terry, Daniel, Peck, Blake, Hills, Danny, Bishop, Jaclyn, Kirschbaum, Mark, Obamiro, Kehinde, Phan, Hoang, Baker, Ed, Schmitz, David
- Authors: Terry, Daniel , Peck, Blake , Hills, Danny , Bishop, Jaclyn , Kirschbaum, Mark , Obamiro, Kehinde , Phan, Hoang , Baker, Ed , Schmitz, David
- Date: 2023
- Type: Text , Journal article
- Relation: Australian Journal of Rural Health Vol. 31, no. 2 (2023), p. 218-229
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- Description: Objective: To pilot the Pharmacist Community Apgar Questionnaire (PharmCAQ) and evaluate its usability and capacity to develop a greater understanding of the unique factors that impact the rural recruitment and retention of pharmacists. Design: Cross-sectional design involving face-to-face, telephone or video conferencing interviews. Setting: Twelve rural communities across Tasmania and Western Victoria, Australia. Participants: Participants (n = 24) included pharmacists, a Director of Clinical Services, pharmacy practice managers and senior pharmacy assistants. Main Outcome Measures: Interviews enabled the completion of the PharmCAQ, which assigns quantitative values to 50 key factors to ascertain a community's strengths and challenges associated with recruitment and retention and their relative importance to the pharmacist workforce. Results: The cumulative PharmCAQ scores indicated the tool was sensitive enough to differentiate high- and low-performing communities. Overall, the highest-rated factors considered most vital to pharmacist recruitment and retention were the reputation of the pharmacy, the ability of the pharmacist to be independent and autonomous, the loyalty of the community to the pharmacy, the level and stability of monetary compensation and the breadth of tasks available to a pharmacist. Conclusions: This study identified the strengths and challenges of participating communities and provided an insight into the shared factors to consider in recruiting and retaining pharmacists. Further, each community has unique strengths that can further be promoted in recruitment, flagging where limited resources are best used to address site specific challenges. This is more likely to ensure the matching of the right candidate with the right community. © 2022 The Authors. Australian Journal of Rural Health published by John Wiley & Sons Australia, Ltd on behalf of National Rural Health Alliance Ltd.
- Authors: Terry, Daniel , Peck, Blake , Hills, Danny , Bishop, Jaclyn , Kirschbaum, Mark , Obamiro, Kehinde , Phan, Hoang , Baker, Ed , Schmitz, David
- Date: 2023
- Type: Text , Journal article
- Relation: Australian Journal of Rural Health Vol. 31, no. 2 (2023), p. 218-229
- Full Text:
- Reviewed:
- Description: Objective: To pilot the Pharmacist Community Apgar Questionnaire (PharmCAQ) and evaluate its usability and capacity to develop a greater understanding of the unique factors that impact the rural recruitment and retention of pharmacists. Design: Cross-sectional design involving face-to-face, telephone or video conferencing interviews. Setting: Twelve rural communities across Tasmania and Western Victoria, Australia. Participants: Participants (n = 24) included pharmacists, a Director of Clinical Services, pharmacy practice managers and senior pharmacy assistants. Main Outcome Measures: Interviews enabled the completion of the PharmCAQ, which assigns quantitative values to 50 key factors to ascertain a community's strengths and challenges associated with recruitment and retention and their relative importance to the pharmacist workforce. Results: The cumulative PharmCAQ scores indicated the tool was sensitive enough to differentiate high- and low-performing communities. Overall, the highest-rated factors considered most vital to pharmacist recruitment and retention were the reputation of the pharmacy, the ability of the pharmacist to be independent and autonomous, the loyalty of the community to the pharmacy, the level and stability of monetary compensation and the breadth of tasks available to a pharmacist. Conclusions: This study identified the strengths and challenges of participating communities and provided an insight into the shared factors to consider in recruiting and retaining pharmacists. Further, each community has unique strengths that can further be promoted in recruitment, flagging where limited resources are best used to address site specific challenges. This is more likely to ensure the matching of the right candidate with the right community. © 2022 The Authors. Australian Journal of Rural Health published by John Wiley & Sons Australia, Ltd on behalf of National Rural Health Alliance Ltd.
Understanding rural pharmacists' perspectives : lived experiences and insights associated with rural recruitment and retention
- Terry, Daniel, Peck, Blake, Phan, Hoang, Hills, Danny, Bishop, Jaclyn, Kirschbaum, Mark, Obamiro, Kehinde, Baker, Ed, Schmitz, David
- Authors: Terry, Daniel , Peck, Blake , Phan, Hoang , Hills, Danny , Bishop, Jaclyn , Kirschbaum, Mark , Obamiro, Kehinde , Baker, Ed , Schmitz, David
- Date: 2024
- Type: Text , Journal article
- Relation: Rural and remote health Vol. 24, no. 1 (2024), p. 8687
- Full Text:
- Description: INTRODUCTION: Pharmacists serve an important role in rural communities, and in some cases they may be the only health professional available. Their recruitment and retention is a major concern for rural communities and health services; however, a deeper understanding regarding the advantages and challenges of sustaining a rural pharmacy workforce is somewhat limited. The aim of this study was to develop a deeper understanding of pharmacists' perspectives about factors influencing pharmacist recruitment and retention to rural and remote communities. METHODS: The exploratory study, carried out in rural Tasmania and rural Western Victoria, used a qualitative descriptive design. Structured interviews, lasting between 30-60 minutes, were conducted by a single researcher using the Pharmacist Community Apgar Questionnaire via face-to-face, telephone or videoconferencing technology. Data were analysed thematically using verbatim transcription, extraction of significant statements and identification of similarities in formulated meanings, grouping the similar meanings and significant statements that pertained to the phenomena of interest. Specifically, qualitative data were used to provide a deeper understanding of factors identified as key assets, capabilities, or those most challenging for pharmacist recruitment and retention. RESULTS: The advantages and disadvantages rural communities face in recruiting and retaining pharmacists are presented. These insights are linked to the advantages of financial income, incentives and moving allowance. Further advantages include the degree of practice autonomy, breadth of tasks, the perception of the community, loyalty to the pharmacy and its pharmacists, along with community recognition. Challenges associated with the recruitment and retention of pharmacists centred on the need for spousal or partner employment opportunities, having greater proximity to schools, access to social or cultural opportunities, along with good transport connections. Further challenges included housing, the cost of schooling for children, having adequate locum or peer coverage and opportunities to host interns. DISCUSSION: The study provides a deeper exploration of the meaning and experiences of factors that previous research has shown are considered advantageous or challenging to the recruitment and retention of pharmacists in rural areas. Through the voices of pharmacists living and working in a rural area, the findings further enlighten our understanding regarding how the multifaceted and complex nature of health workforce planning may be addressed. As such, greater pharmacist recruitment and retention is enabled through adequate financial compensation and incentives, along with additional tax incentives for business and health services. Further, innovation is required to enhance economic sustainability. Locum coverage and intern opportunities also require innovative approaches to address concerns among potential candidates. Lastly, efforts to enable and support social connections such as schooling and spousal employment, while building community connection and a sense of rural community belonging, remain essential to recruit and retain pharmacists. CONCLUSION: Rural pharmacist recruitment and retention is complex, requiring a multi-pronged approach to implement practical solutions. Given this complexity and the unique features of each rural community, solutions require whole-of-community ownership to create innovative solutions. Recognition of specific advantages and challenges can address key driving factors for pharmacist recruitment and retention in rural communities.
- Authors: Terry, Daniel , Peck, Blake , Phan, Hoang , Hills, Danny , Bishop, Jaclyn , Kirschbaum, Mark , Obamiro, Kehinde , Baker, Ed , Schmitz, David
- Date: 2024
- Type: Text , Journal article
- Relation: Rural and remote health Vol. 24, no. 1 (2024), p. 8687
- Full Text:
- Description: INTRODUCTION: Pharmacists serve an important role in rural communities, and in some cases they may be the only health professional available. Their recruitment and retention is a major concern for rural communities and health services; however, a deeper understanding regarding the advantages and challenges of sustaining a rural pharmacy workforce is somewhat limited. The aim of this study was to develop a deeper understanding of pharmacists' perspectives about factors influencing pharmacist recruitment and retention to rural and remote communities. METHODS: The exploratory study, carried out in rural Tasmania and rural Western Victoria, used a qualitative descriptive design. Structured interviews, lasting between 30-60 minutes, were conducted by a single researcher using the Pharmacist Community Apgar Questionnaire via face-to-face, telephone or videoconferencing technology. Data were analysed thematically using verbatim transcription, extraction of significant statements and identification of similarities in formulated meanings, grouping the similar meanings and significant statements that pertained to the phenomena of interest. Specifically, qualitative data were used to provide a deeper understanding of factors identified as key assets, capabilities, or those most challenging for pharmacist recruitment and retention. RESULTS: The advantages and disadvantages rural communities face in recruiting and retaining pharmacists are presented. These insights are linked to the advantages of financial income, incentives and moving allowance. Further advantages include the degree of practice autonomy, breadth of tasks, the perception of the community, loyalty to the pharmacy and its pharmacists, along with community recognition. Challenges associated with the recruitment and retention of pharmacists centred on the need for spousal or partner employment opportunities, having greater proximity to schools, access to social or cultural opportunities, along with good transport connections. Further challenges included housing, the cost of schooling for children, having adequate locum or peer coverage and opportunities to host interns. DISCUSSION: The study provides a deeper exploration of the meaning and experiences of factors that previous research has shown are considered advantageous or challenging to the recruitment and retention of pharmacists in rural areas. Through the voices of pharmacists living and working in a rural area, the findings further enlighten our understanding regarding how the multifaceted and complex nature of health workforce planning may be addressed. As such, greater pharmacist recruitment and retention is enabled through adequate financial compensation and incentives, along with additional tax incentives for business and health services. Further, innovation is required to enhance economic sustainability. Locum coverage and intern opportunities also require innovative approaches to address concerns among potential candidates. Lastly, efforts to enable and support social connections such as schooling and spousal employment, while building community connection and a sense of rural community belonging, remain essential to recruit and retain pharmacists. CONCLUSION: Rural pharmacist recruitment and retention is complex, requiring a multi-pronged approach to implement practical solutions. Given this complexity and the unique features of each rural community, solutions require whole-of-community ownership to create innovative solutions. Recognition of specific advantages and challenges can address key driving factors for pharmacist recruitment and retention in rural communities.
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