National Centre for Remote and Rural Health and Care: Information Hub

Plan, recruit, retain: a framework for local healthcare organizations to achieve a stable remote rural workforce | Human Resources for Health | Full Text

This international study presents a practical, evidence-informed framework to support the recruitment and retention of healthcare professionals in remote and rural areas. Drawing on a decade-long collaboration across Sweden, Norway, Canada, Iceland, and Scotland, the authors developed the Framework for Remote Rural Workforce Stability through literature reviews, stakeholder input, and five national case studies. The framework consists of nine strategic elements grouped into three main tasks: plan (e.g. assessing service needs), recruit (e.g. supporting families), and retain (e.g. enabling professional development). Implementation is supported by five conditions for success, including active community engagement and targeted investment.

The paper offers a flexible, real-world tool that can be adapted to different local contexts. It provides valuable guidance for local health organisations, policymakers, and planners aiming to stabilise the rural workforce through holistic and context-specific strategies. The framework has already informed practice and policy initiatives in countries beyond the study group, demonstrating its relevance and applicability.

‘Moving to the countryside and staying’? Exploring doctors’ migration choices to rural areas - ScienceDirect 

This paper examines the complex factors influencing doctors' decisions to both move to, and remain in, rural areas. The research integrates health services, rural studies, and migration research, emphasising the need to understand doctors’ lives holistically, beyond their professional roles. By focusing on the reasons doctors choose to stay in rural areas, the study contributes to a broader understanding of rural migration and the sustainability of rural healthcare services. This comprehensive perspective urges a shift from traditional "recruitment and retention" strategies to more place-based, interdisciplinary approaches to addressing the healthcare workforce challenges in rural communities.

For Scotland, where recruitment and retention of doctors in rural areas is a significant challenge, this research emphasises the need to look beyond salary and working conditions to understand the personal motivations behind doctors’ migration choices. It provides valuable insights into the experiences of rural doctors and offers a more comprehensive understanding of how to support sustainable healthcare services in remote communities.

RRH: Rural and Remote Health article: 8557 - The allied health rural generalist pathway: a cost consequence analysis 

This paper evaluates the Allied Health Rural Generalist Pathway (AHRGP) introduced in South Australia in 2019, aiming to address recruitment and retention challenges in rural and remote allied health services. The study offers insights into the cost-effectiveness of this workforce initiative by measuring both financial inputs (such as tuition and supervision costs) and key outcomes (such as workforce retention, career progression, and service development). Over three years, the program demonstrated positive outcomes, including reduced turnover, increased tenure intentions, and enhanced confidence and competence among trainees.

The findings suggest that initiatives like the AHRGP can be a sustainable and cost-effective strategy to address workforce shortages, making this relevant for Scotland, where similar rural health workforce challenges persist. It highlights the potential benefits of structured support systems for rural health professionals, offering valuable insights for policymakers and health organisations looking to improve rural workforce retention and service delivery.

The threshold of rural placement frequency and duration: A repeated cross-sectional study examining rural career aspirations among student nurses - ScienceDirect 

This study examines the impact of rural clinical placements on nursing students' aspirations to pursue careers in rural areas, focusing on how the frequency and duration of these placements influence decision-making. Conducted at an Australian regional university, the study found that nursing students from metropolitan backgrounds who had three or more rural placements, or a total of over 16 weeks of rural placement, were significantly more likely to consider rural employment post-graduation. The study highlights that beyond professional and clinical factors, social and environmental aspects of rural placements—such as community integration—are crucial in influencing students' rural career aspirations.

For Scotland, these findings are relevant as they point to the importance of structured and extended rural placement experiences in addressing workforce shortages in rural health settings. By understanding the thresholds that positively impact rural practice decisions, education providers and policymakers can design better programs to encourage nursing students to consider rural careers, helping mitigate recruitment and retention challenges.

For the rural curious: mixed methods evaluation of a rural pharmacy practice elective | BMC Medical Education | Full Text (biomedcentral.com)

The paper explores the impact of a specialized elective course at the University of Minnesota College of Pharmacy, designed to introduce pharmacy students to rural healthcare practice. The course employs a combination of lectures, guest presentations, student interviews with rural pharmacists, and reflective assignments to enhance student understanding of rural healthcare challenges and opportunities. Findings indicate that the elective increased students' cultural responsiveness and practical knowledge of rural pharmacy, though it did not significantly shift their intentions to practice in rural settings. Nevertheless, students valued the exposure to rural culture and the unique role pharmacists play as primary healthcare providers in remote areas, especially where traditional healthcare resources are limited.

This paper highlights the importance of incorporating rural-specific education into healthcare training programs. Given the parallels between rural healthcare challenges in the United States and Scotland, this study provides insights into how rural-focused electives might help bridge healthcare service gaps by equipping future pharmacists with an understanding of rural needs and cultural nuances.