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Supporting rural, mature-aged nursing & allied health students

An interdisciplinary collaboration to build the rural health workforce

Dr Nicole Crawford, NCSEHE
Dr Claire Quilliam, Department of Rural Health, University of Melbourne
Associate Professor Carol McKinstry, La Trobe Rural Health School, La Trobe University

There is an undersupply of medical, nursing and allied health professionals in regional, rural and remote Australia and, as a result, there is an urgency for action to address rural health workforce shortages. Despite implementing strategies to mitigate the issue, the maldistribution of the health workforce in rural areas persists. Literature exploring initiatives to improve rural health workforce recruitment and retention has tended to focus on medicine, particularly evaluating strategies to select students from rural origins and educating them in regional areas in the later years of their course. The rural workforce development of nursing and allied health disciplines has received less attention.

In mid 2020, we (Claire, Carol and Nicole) initiated an interdisciplinary collaboration between Victorian University Departments of Rural Health and the National Centre for Student Equity in Higher Education (NCSEHE). This collaboration has seen the exchange of ideas between the disciplines of rural health and equity in higher education. We’re focusing on the support needs of mature-aged, nursing and allied health students who live, work and study in rural communities. We’re interested in this older cohort of students because they are potentially an “untapped” cohort of students in rural areas, and are likely to remain in their rural communities due to family and work commitments.

We’re taking a long-term approach to our project on the wicked problem of improving the rural health workforce and have planned several stages of research. Our first stage was a deep dive into the literature to find out what is known about our area of interest. After fine-tuning our research question, scoping review protocol and search strategy, we screened 4,170 journal articles and reviewed 583 articles in full. It was a lot of work — more than we had anticipated! Although, this was the result of having three key population concepts: mature-aged students, rural students, and nursing and allied health students. Unsurprisingly, we did not find many articles that focused on the intersection of these three areas. Fourteen articles met the inclusion criteria.

What did we find?

  • There is limited evidence to guide higher education providers in attracting, supporting and retaining rural, mature-aged nursing and allied health students.
  • The existing literature suggests that these students are manifesting their own supports—which is great—but university level or broader supports for this cohort are missing.

These findings highlight the need to take a “rural” standpoint — a rurally-focused perspective on what works and what rural students need to support them in their tertiary studies in rural areas in order to, ultimately, build the rural health workforces required.

We’re now working on Stage 2, which has three parts: i) analysis of the national student participation data, ii) mapping of the university health courses across regional, rural and remote Australia, and iii) a mixed-methods study, “Understanding supports for rural, mature-aged nursing and allied health students” using three case study sites, interviews and a survey.

For more information, check out our systematic scoping review, in The Australian Journal of Rural Health and please get in touch with the project lead, Dr Claire Quilliam, for further details (email: or telephone: 03 5823 4576).

Posted 6 April 2022 Posted in General, Mature age, Regional, rural and remote