Data analysisWhat do the numbers tell us?
WP 2
The questions
• • why health care workers are reluctant to consider
working in a remote rural area
• why health care workers are pleased to be working
in a remote rural area
• what health care workers require to start working
in a remote rural area
• what health care workers require to continue
working in a remote rural area
• why health care workers leave a position in a
remote rural area
Differences urban-rural
• The reasons for commencing current job
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–
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Jobs suits education u+r
Job security u+r
Education possibilities u > r
Career possibilities seem to interest rural less
Clinical placement and upbringing only relevant to rural in
younger groups
– Financial remuneration more attractive to rural workers and in
small ways leisure activities
– Rural workers do not put as much weight on working close to
family
The age issue
• Young workers are willing to work more for extra salary
and shifts
• Young workers are more mobile
• Social, recreational and leisure activities is important
when leaving post in rural area
• Career possibilities is less important with decreasing age
• Mentoring is important for younger workers
• Younger workers want to live close to family and spouse
position has more influence
• Child care
The gender question
• 45% of female workers have never worked in rural area
though higher percentage had rural education
• Fewer female health care training in rural areas (profession
orientated)
• Female workers experience less isolation
• When leaving rural work family reasons are more important
for female workers
• Female workers work more part time
• Need job security and accredited funding and developmental
activities
J Am Board Fam Med. 2011 Nov-Dec;24(6):740-4. doi: 10.3122/jabfm.2011.06.110037.
Increasing the supply of women physicians in rural areas: outcomes of
a medical school rural program.
Rabinowitz HK, Diamond JJ, Markham FW, Santana AJ.
The professional issue
• Rural workers experience professional isolation.
Large issue in all partners countries
• Of those who have left a post ; limited professional
support and career possibilities
• Those working in rural seem to have think less
important “research and development access”
• Locum cover more important rural but education and
mentoring possibilities less so
The education issue
• There is a clear trend towards working in a rural area if majority of school
education is in a rural area.
• Health care training is also a factor with increased likelihood of working in
rural if training has been rural.
• The crucial factor seems to be early exposure and motivation of
stakeholders
JAMA. 2001 Sep 5;286(9):1041-8.
Critical factors for designing programs to increase the supply and retention of rural primary care physicians.
Rabinowitz HK, Diamond JJ, Markham FW, Paynter NP
.
“Medical educators and policy makers can have the greatest impact on the supply and
retention of rural primary care physicians by developing programs to increase the
number of medical school matriculants with background and career plans that make
them most likely to pursue these career goals. ”
OBS high % nurse and dental students rural in survey
Summary to recruit and retain
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Focus on professional continual education.
Increase focus on women
Focus on younger generation
Early and “correct” exposure
Questions?
Recommendations
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•
•
•
Younger age professionals
Rural background
Training experiences in rural environment
Professional development opportunities for rural
professionals
• Support services for families and spouses
• Positive elements of "rural lifestyle" (which is still
a bit hard to define but people who feel attached
to the community or lifestyle are more likely to
be retained)
Recommendations – Retention
factors (Physicians)
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•
•
•
Favorable working conditions
Possibility for career advancement
Job security
Older respondents more likely to stay in their
current position
Clinical Faculty and
Residents Survey Results:
Canadian Sample
•
•
•
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n=306; 52% female
μ=46.5, σ=11.6
74% of sample are physicians
58% self-reported living in urban
areas and 42% in rural areas
• 56 % self-reported being of a rural
background
Thesis
• Examination of QWL among obstetrical
nurses in northeastern Ontario
– Stratified sample of 111 RNs (cross-trained vs.
non-cross-trained)
– Explanatory sequential mixed methods design
• Quantitative (NSS, WAI and WRQLS)
• Qualitative (semi-structured Interviews)
• Results:
– QWL predicted by cross-training and stress
– Home-work interface, cross-training and hospital
type explained greatest variance in WAI scores
• Behdin Nowrouzi:
bx_nowrouzi@laurentian.ca