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People living in rural areas of Australia have long faced health disparities compared to their metropolitan counterparts, primarily due to an uneven distribution of the health workforce and limited access to essential healthcare services. Addressing this issue is urgent, as a stronger rural health workforce is essential for improving health outcomes in these regions.
Efforts to attract and retain healthcare professionals in rural and remote areas have been ongoing for decades. Recent reforms under the Australian Universities Accord Final Report are set to play a pivotal role in developing the rural health workforce by making tertiary education more accessible and equitable. The report emphasizes the importance of lifelong learning, especially in regional, rural, and remote communities, and advocates for increasing participation in higher education from people in these areas.
A key aspect of these reforms is recognizing the importance of mature-aged students (aged 21 or older) in contributing to the rural workforce. Research shows that mature-aged students make up a significant portion of the higher education cohort in rural areas, which positions them as an essential group for the future of the rural health workforce.
Mature-aged people in rural communities often have strong ties to their local areas, which can be an asset for retaining health professionals in these regions. These individuals may be more likely to stay in their communities long-term, strengthening the continuity of care and fostering a sense of belonging in the rural health sector.
A recent study led by researchers from the University of Victoria explored the experiences of rural, mature-aged students in nursing and allied health courses. The research, conducted across three rural campuses in Victoria, involved interviews, surveys, and focus groups with 36 participants, including students, academics, and staff. The findings, published in BMC Medical Education, highlighted several key issues affecting mature-aged students in these areas.
One of the most striking findings was that mature-aged students made up over 50% of nursing and allied health students across the campuses surveyed. This is a significant proportion of students who could play a crucial role in addressing rural health workforce shortages. However, the study also found that no formal study support systems were in place for these students. Many rural, mature-aged nursing and allied health students face a complex set of challenges, including managing family responsibilities, financial pressures, and balancing work with their studies.
Mrs. Armstrong, a mature-aged student from Shepparton studying a Bachelor of Nursing, described her experience as a balancing act between her academic obligations, family responsibilities, and work. She pointed out that the lack of flexibility in placements, combined with the added pressures of parenting, often led to overwhelming stress. The absence of formal support systems, particularly in rural areas, made her return to study more difficult.
While some support is provided through online services, many students like Mrs. Armstrong found these resources inadequate, especially given their unique rural challenges. The study also found that support for mature-aged students often relied on the informal knowledge of staff, leading to unequal access to resources and services. This reliance on informal support is beneficial in some cases but highlights the need for more structured and universally accessible support systems.
The study underscores the importance of tailoring support to the unique needs of rural communities. For example, some rural campuses may have local scholarship opportunities, while others may not. The differences between rural communities suggest that a one-size-fits-all approach is not feasible; instead, support systems need to be flexible and contextually appropriate to ensure that all rural, mature-aged students can succeed.
Despite the challenges, Mrs. Armstrong and other students have found support in the form of peer networks and engaging lecturers. Many students benefit from shared experiences with others in similar situations, as well as the motivation and guidance provided by experienced teaching staff.
The experience of rural mature-aged students like Mrs. Armstrong highlights the critical need for universities to provide adequate, context-specific support systems to foster success. This includes improving accessibility, offering flexible placements, and recognizing the unique contributions that rural mature-aged students bring to the workforce.
With continued focus on structural changes in higher education and targeted support for rural mature-aged students, Australia can build a stronger, more sustainable health workforce in regional, rural, and remote communities. Such efforts will not only address the health disparities faced by these communities but also ensure the long-term resilience of the rural health workforce.
For more information: Claire Quilliam et al, Study supports for rural mature-aged university health students: a Stakian multicase study, BMC Medical Education (2024). DOI: 10.1186/s12909-024-05128-4.
