title: Studying nursing in a rural setting: are students adequately supported and prepared for rural practice? A pilot study.
abstract: BACKGROUND
  A rural nursing program has a vital role in improving the recruitment and retention of nurses in rural and remote settings. A small pilot study was conducted to explore the views and experiences of the first cohort of undergraduate nursing students who completed a rurally based bachelor of nursing program which commenced in 2002 in Renmark, South Australia. The participants were eight current undergraduate nursing students who were part of the first cohort of nursing students nearing completion of the program. The pilot study set out to explore support provided to rural nursing students studying in a rural setting; to investigate whether rural nursing students feel adequately prepared for rural clinical practice near completion of the nursing program; to identify the challenges and highlights of studying rurally; and to explore the probability of retention and recruitment of future nursing graduates in a rural setting.
  
  
  METHODS
  The method used was a descriptive, exploratory, web-based survey. Quantitative data were limited to descriptive statistics of demographic characteristics, career goals, graduate nurse program and future employment intentions, level of support, preparation for practice, challenges and highlights of rural study and clinical placements. Qualitative responses to open-ended questions were content analysed to identify common themes.
  
  
  RESULTS
  This study found between two and four participants indicated they received no support from academic, administrative staff and clinical facilitators from the city campus. Five participants (63%) indicated they received no financial support during their studies. Seven of the participants (88%) surveyed, indicated an intention to undertake a graduate nurse program and the same number indicated they would be living in a rural or remote area in 5 years time. Six participants (75%) indicated they were prepared with regard to their 'attitude' towards their future practice as a registered nurse. The study identified some of the challenging issues of a rurally based program, such as 'realising that if you miss a day you are actually missing a whole week's worth of lectures', as well as the positive and unique aspects of rural study, 'not having to leave the family to travel to the city'.
  
  
  CONCLUSIONS
  This study indicates the rural placement of the bachelor of nursing program has been of benefit to this particular community and is a positive outcome for the South Australian rural nursing workforce. The study shows that students actively sought nursing employment in a rural setting, and identifies highlights experienced by students and the advantages associated with remaining at home (as opposed to relocating) while enjoying the benefits of smaller class sizes. The challenges of rural study were issues such as limited lecture times, compared with the city campus, which often caused a disproportionate workload for rural students on alternate weeks during the study term. The quality of the delivery of some lectures was also an issue for some students. This study determined that a lack of support was encountered by students, and that further investigation is warranted. Greater consideration will be required to address the delivery of the program together with the future availability and accessibility of further university rurally based nursing programs.
authors.affiliation: Flinders University, School of Nursing and Midwifery, Flinders Rural Clinical School, Renmark, South Australia, Australia. lyn.gum@flinders.edu.au
authors.forename: L F
authors.initials: LF
authors.lastname: Gum
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D002321:Career Choice; D004508:Education, Nursing, Baccalaureate / Q000592:standards*; D004651:Employment; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015402:Nursing Education Research; D010563:Personnel Turnover / Q000706:statistics & numerical data*; D010865:Pilot Projects; D015397:Program Evaluation; D019035:Rural Health Services; D012424:Rural Population; D012924:Social Conditions; D013021:South Australia; D013338:Students, Nursing / Q000523:psychology*; D011795:Surveys and Questionnaires; D000078329:Workforce