Data analysis-What 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– 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

activitiesJ 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

• Focus on professional continual education.• Increase focus on women• Focus on younger generation • Early and “correct” exposure

Questions?

Recommendations

• 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)

• 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• 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