Investigating the motivation and personal traits of allied health professionals working in remote and rural Australia: the Remote and Rural Allied Health Motivation and Personality (RRAHMP) study

Abstract

Background: Allied health (AH) workforce shortages in remote and rural Australia contribute to poorer health outcomes for residents in those areas. This gap in health workforce has long been recognised as problematic and persists despite strategies for improving recruitment and retention of AH professionals. This thesis reports on a new approach to addressing the recruitment to, and retention in, remote areas of AH professionals by investigating the personal traits and motivation characteristics of AH professionals with and without remote area work experience. Recent research has shown that the nursing and medical professions can be differentiated by personality traits, but little is known about the personality traits of AH professionals. Therefore, this research aimed to address that knowledge gap. The aim of the study was to identify the personality traits and motivation characteristics that might assist an individual to ‘thrive’ rather than ‘survive’ in the remote work environment. It did this by asking two research questions. First, what are the personal traits exhibited by novice and experienced AH professionals? The question sought in particular to identify traits associated with remote work experience. Second, how is working in remote areas construed, or perceived, in terms of the personal and motivation characteristics that contribute to success? Methods: The convergent parallel mixed methods design comprised two strands of data collection (QUAN+QUAL/QUAN). Strand 1 used a biopsychosocial trait model of personality, operationalised through the Temperament and Character Inventory – Revised 140 (TCI). Data were collected using an online survey. Snowball sampling through Services for Australian Rural and Remote Allied Health achieved a sample size of 562 AH professionals, with full demographic data and a completed TCI. Dependent variables were the TCI dimensions, while independent variables were remote experience, gender, age, profession and grouping of the professions as either person- or technique-oriented. Analysis was descriptive of the whole sample and comparative between groups using independent samples t-test, ANOVA and subsequent two-way ANOVA with 95% confidence level. Strand 2 used Personal Construct Psychology’s key technique, the repertory grid interview, to understand how AH professionals construed working in remote areas, in terms of the personal traits and motivation that contribute to success. Participants (n=34) were a purposively selected subset of Strand 1. The repertory grid interviews produced both qualitative and quantitative data. These were analysed qualitatively to identify the personal and motivation characteristics, and quantitatively using singular value decomposition and Euclidean distance to compare differences construed by participants between remote and other AH work situations. Results: The following key findings were determined from personality trait results, together with the repertory grid results: • The AH professionals appear to have mature personality characteristics, i.e. high or very high levels of Reward Dependence, Persistence, Self-directedness and Cooperativeness. • The AH professionals with remote experience had higher Novelty Seeking and average Harm Avoidance levels compared with AH professionals without remote experience. • Younger AH professionals tended towards higher Harm Avoidance levels. • No single combination of temperament and character traits was prescriptive of successful recruitment to, and long-term retention in, remote work. While higher Novelty Seeking and average Harm Avoidance appeared to be a trait combination suited to working in remote environments, interaction between traits in conjunction with the context of the individual is paramount. This interaction ultimately determines behaviour, decisions and fit with the demands of the work environment. • The context of the individual included self-assessed suitability to remote work; life-stage; personal construing about ideal career and work role; and previous familiarity with remote work. • The trait levels exhibited by the Strand 1 remote AH professionals were reflected in the Strand 2 sample’s construing about the personal attributes of a successful remote AH professional, suggesting congruence between the empirical trait measurement and the sample’s perceptions about ‘what it takes’ to work in remote areas. Discussion: This research created new in-depth knowledge about personal and motivation characteristics of AH professionals suited to remote work. The thesis has made an important and novel contribution, including a range of evidence-based policy recommendations regarding recruitment to, and retention of, AH professionals in remote Australia. For recruitment, these recommendations include understanding the insights of individual AH professionals into their suitability for remote work and what it means to them to work in remote areas. This approach facilitates tailoring appropriate supervision and support, clarifying expectations about the role before employment, and developing career opportunities. Enhancing retention requires remote workplaces to develop strategies for novices that may look different from strategies for experienced AH professionals. In particular, higher Harm Avoidance in younger professionals requires same-profession support and supervision, strategies that facilitate personal engagement with the community, and overt career opportunities. Proper recognition and valuing of the expertise developed by remote generalist AH professionals via career pathways is important for retention of experienced AH professionals.