Cooperative knowledge-making with female and male rural doctors.
BACKGROUND
It is becoming increasingly difficult to engage rural doctors in survey-based research. Rural doctors in Australia are time-poor and overworked, yet it is vital that researchers find ways to engage them because they are the holders of information that is critical to effective workforce policy and planning.


OBJECTIVE
To establish a cooperative research outcome with rural General Practitioners at a time when they were subject to many competing requests for contributions to various data gathering exercises. To develop and apply a knowledge-instrument for researching the practice of female doctors.


METHODS
The research project began with the intention of locating a partially hidden voice, that of female rural GPs, and bringing it to the forefront. This grew out of 6 years' work with doctors which identified that women had their own relationship with rural practice and that this was not widely recognised in the professional and policy context. Each step of the research process was negotiated with the doctors to ensure that their solutions were the basis of the work, and their language was the vehicle of investigation. Dephi rounds were used to develop content for a national survey of rural GPs. Thirty-five female rural and remote GPs contributed to 3 Delphi rounds to construct the central section of the questionnaire. The work of the expert panel contributed the unique questions at the heart of a questionnaire that was sent to 2000 rural GPs in Rural Remote and Metropolitan Areas (RRMA) 4-7. The sample was stratified by RRMA and randomised for women, with a matching sample of men to provide a control group, test whether issues identified by women are relevant to men too, and allow a gender analysis.


RESULTS
Sixty-three percent of the women returned usable surveys and 54% of the men. This was a comparatively high response rate, especially for a complex, 16 page questionnaire with 79 questions, administered at a time when rural doctors had become resistant to mail surveys. Fifty-six doctors commented on the questionnaire itself, most of them appreciating the topics raised.


CONCLUSIONS
It was possible to develop a cooperative relationship with rural doctors that resulted in high rates of participation in the research, particularly from women. What women do can be researched and included in knowledge about rural practice, and men will respond to female-designed data collection instruments. Careful attention to questions of voice, presentation, communication and purpose can assist in bringing the experience of women as well as men into the research frame.
Wainer
J
J
Monash University School of Rural Health, Victoria, Australia. jo.wainer@med.monash.edu.au