Growing our own: enhancing the transition from Rural Physiotherapy Clinical School student to new graduate

Background
The “grow your own” approach to boosting the rural health workforce is a well-known strategy, particularly in medicine. Little is known about the motivation of physiotherapy students choosing to apply to a Rural Physiotherapy Clinical School (RPCS), or their intentions to work rurally following a RPCS placement. The perspectives of university workplace learning academics, physiotherapy
clinical supervisors and physiotherapy students were explored in relation to converting intention to practice rurally into a workforce reality following a RPCS placement.

Methods
A mixed-methods approach was implemented using on-line surveys and focus groups. 14 physiotherapy students completed the survey, six were 4th year students currently on RPCS placement and eight had completed their placement the previous year. 15 clinical supervisors or co-ordinators of the RPCS in Western NSW LHD and Murrumbidgee LHD completed the survey. Three online
focus groups were run with six clinical supervisors/co-ordinators and four university workplace learning academics. Survey data were analysed descriptively. Focus groups were audio recorded, transcribed verbatim, and analysed to identify key themes.

Results
Several themes emerged in the student responses to survey questions. The most common reasons given for choosing to apply to a RPCS were wanting to complete their placement in a location close to home, to do placement in a rural location, affordability, being of rural background, intention to work rurally post-graduation, the opportunity to work in the area post-graduation, ease of
organisation, and the opportunity to gain rural competencies and assist local communities.85% of students reported intending to work rurally after graduation, but students and clinical supervisors identified that the pathway to employment was unclear.
Strategies such as early advertising of new graduate positions and offering students the opportunity to apply for allied health assistant positions during their final year, could optimise recruitment. Extending placement experiences to include private practice and outreach to more rural communities may enhance the student experience and create stronger sense of community engagement. Strategies to strengthen the rural pipeline such as participating in local sporting and community events were discussed.

Implications
There is a positive attitude regarding implementation of the RPCS model, which offers students a quality rural experience and influences students’ attitudes towards working rurally. Our shared recommendations could be considered by local health districts and universities in future planning.