Rural nursing and allied health placements during the latter stage of the COVID-19 public health emergency: A national study

Objective: To explore changes to rural nursing and allied health placements during the latter stage of the COVID-19 public health emergency. Setting: Regional, rural and remote Australia. Participants: Nursing and allied health students with a scheduled University Department of Rural Health (UDRH) facilitated rural placement between 1 January 2022 and 31 October 2022. Design: Cross-sectional online survey (n = 333), followed by semi-structured interviews (n = 21). Results: Almost all students surveyed (98.5%) were able to undertake their placement, although 13.1% reported changes to the setting, timing or delivery of training. Placement tasks (47.3%), experience of the local community (39.0%) and connection with other students (39.6%) were the placement aspects most commonly reported to have changed. However, most students were satisfied with their placement (86.0%), agreed their placement provided quality clinical training (79.3%) and wanted to work rurally after their experience (73.2%). Nursing students had lower odds of reporting satisfaction with placement (OR, 0.49 [95% CI 0.24-0.99, p = 0.03]), while placements longer than 4 weeks had almost twice the odds of promoting rural intention (OR, 1.84 [95% CI 1.09-3.15, p = 0.02]). Placement changes were associated with: fear of contracting COVID-19; circulating illness; health workforce shortages; and health and safety compliance. Conclusions: Despite changes, most students found rural placements undertaken during 2022 to be quality learning experiences which left them satisfied and wanting to work rurally. UDRHs should advocate for longer placements, improve remote supervision and accommodation infrastructure, and help prepare and support students for challenging learning environments to promote positive rural training experiences during public health emergencies.