Abstract
One strategy aimed at resolving ongoing health workforce shortages in rural and remote settings has been to implement workforce development initiatives involving the early activation and development of health career aspirations and intentions among young people in these settings. This strategy aligns with the considerable evidence showing that rural background is a strong predictor of rural practice intentions and preferences. The Broken Hill Regional Health Career Academy Program (BHRHCAP) is an initiative aimed at addressing local health workforce challenges by helping young people in the region develop and further their health career aspirations and goals. This article reports the factors impacting on rural and remote youths' health career decision-making within the context of a health workforce development program. Data were collected using interviews and focus groups with a range of stakeholders involved in the BHRHCAP including local secondary school students, secondary school teachers, career advisors, school principals, parents, and pre-graduate health students undertaking a clinical placement in Broken Hill, and local clinicians. Data interpretation was informed by the theoretical constructs articulated within socio cognitive career theory. Young people's career decision-making in the context of a local health workforce development program was influenced by a range of personal, contextual and experiential factors. These included personal factors related to young people's career goals and motivations and their confidence to engage in career decision-making, contextual factors related to BHRHCAP program design and structure as well as the visibility and accessibility of health career pathways in a rural setting, and experiential factors related to the interaction and engagement between young people and role models or influential others in the health and education sectors. This study provided theoretical insight into the broader range of interrelating and complex personal, contextual and experiential factors impacting on rural and remote youths' career decision-making within a health workforce development initiative.
Highlights
One strategy aimed at resolving ongoing health workforce shortages in rural and remote settings has been to implement workforce development initiatives involving the early activation and development of health career aspirations and intentions among young people in these settings
This strategy aligns with the empirical evidence, which has established that rural origin is a positive predictor of rural practice intentions, with health students from rural and remote backgrounds being more likely to return to their communities of origin or similar settings to practice after graduation[3,4,5,6,7,8]
Formally classified as an outer regional centre according to the Australian Standard Geographical Classification (ASGC) Remoteness Areas index[17], Broken Hill is considered to be 'remote' due to its geographical location and distance from other centres
Summary
One strategy aimed at resolving ongoing health workforce shortages in rural and remote settings has been to implement workforce development initiatives involving the early activation and development of health career aspirations and intentions among young people in these settings. It attempts to address some of the cultural and structural barriers faced by young people in rural and remote settings in developing and pursuing career aspirations, including geographical isolation, financial cost, lack of information and lack of visibility of career pathways[9,10] This bodes well for rural and remote communities experiencing complex and persistent health workforce challenges. Longitudinal programs in particular were shown to enhance participants’ self-esteem and confidence[13] and were associated with positive long-term impact[12] This literature has demonstrated that health career development programs are effective, what has been lacking is a more nuanced and theoretically informed understanding of the complex and interrelating elements that impact on young people’s career decision-making in rural and remote communities. The authors aim to theoretically illustrate the factors shaping rural and remote youths’ career decisionmaking in the context of a health workforce development program
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