title: Recruitment and retention of occupational therapists and physiotherapists in rural regions: a meta-synthesis.
abstract: BACKGROUND
  Significant efforts have been made to address the shortage of health professionals in rural communities. In the face of increasing demand for rehabilitation services, strategies for recruiting and retaining occupational therapists (OTs) and physiotherapists (PTs) have yielded limited success. This study aims to broaden the understanding of factors associated with recruitment and retention of OTs and PTs in rural regions, through a synthesis of evidence from qualitative studies found in the literature.
  
  
  METHODS
  A systematic search of three databases was conducted for studies published between 1980 - 2009 specific to the recruitment and retention of OTs and PTs to rural areas. Studies deemed eligible were appraised using the McMaster Critical Review Form. Employing an iterative process, we conducted a thematic analysis of studies and developed second order interpretations to gain new insight into factors that influence rural recruitment and retention.
  
  
  RESULTS
  Of the 615 articles retrieved, 12 qualitative studies met the eligibility criteria. Our synthesis revealed that therapists' decision to locate, stay or leave rural communities was influenced to a greater degree by the availability of and access to practice supports, opportunities for professional growth and understanding the context of rural practice, than by location. The second-order analysis revealed the benefits of a strength-based inquiry in determining recruitment and retention factors. The themes that emerged were 1) support from the organization influences retention, 2) with support, challenges can become rewards and assets, and 3) an understanding of the challenges associated with rural practice prior to arrival influences retention.
  
  
  CONCLUSIONS
  This meta-synthesis illustrates how universally important practice supports are in the recruitment and retention of rehabilitation professionals in rural practice. While not unique to rural practice, the findings of this synthesis provide employers and health service planners with information necessary to make evidence-informed decisions regarding recruitment and retention to improve availability of health services for rural residents.
authors: Department of Physical Therapy, University of British Columbia, Vancouver, BC V6T 1Z3, Canada.
authors: Robin K
authors: RK
authors: Roots
authors: Linda C
authors: LC
authors: Li
mesh_terms: D005260:Female; D006801:Humans; D008297:Male; D009788:Occupational Therapy; D010558:Personnel Loyalty; D010560:Personnel Selection; D059825:Physical Therapists / Q000600:supply & distribution*; D012424:Rural Population
references: J Rural Health. 2007 Winter;23(1):62-71
references: 17300480
references: Rural Remote Health. 2009 Oct-Dec;9(4):1238
references: 19842780
references: Aust J Rural Health. 2008 Oct;16(5):255-61
references: 18808482
references: Can J Occup Ther. 2008 Dec;75(5):301-8
references: 19382512
references: Aust J Rural Health. 2004 Oct;12(5):181-6
references: 15588259
references: Can J Occup Ther. 2002 Dec;69(5):261-80
references: 12501452
references: Can J Nurs Res. 2005 Mar;37(1):163-8
references: 15887771
references: J Rural Health. 2001 Summer;17(3):278-85
references: 11765892
references: Rural Remote Health. 2009 Apr-Jun;9(2):1060
references: 19530891
references: Aust J Physiother. 1999;45(1):23-31
references: 11676750
references: Aust J Rural Health. 2007 Oct;15(5):313-20
references: 17760915
references: Aust J Physiother. 1996;42(1):47-52
references: 11676635
references: J Adv Nurs. 2009 Jan;65(1):11-9
references: 19120580
references: Physiother Can. 1991 Apr;43(2):15-21
references: 10110595
references: Rural Remote Health. 2009 Jan-Mar;9(1):1078
references: 19335059
references: Qual Health Res. 1998 May;8(3):341-51
references: 10558335
references: Aust J Rural Health. 2003 Jan;11(1):36-43
references: 12603445
references: Arthritis Rheum. 2005 Apr 15;53(2):314-6
references: 15818641
references: Bull World Health Organ. 2010 May;88(5):379-85
references: 20461133
references: Aust J Rural Health. 2004 Aug;12(4):160-5
references: 15315545
references: Rural Remote Health. 2008 Oct-Dec;8(4):1062
references: 19182858
references: Cochrane Database Syst Rev. 2009 Jan 21;(1):CD005314
references: 19160251
references: Res Nurs Health. 1997 Aug;20(4):365-71
references: 9256882
references: J Allied Health. 2006 Winter;35(4):226-32
references: 17243438
references: Qual Health Res. 2003 Sep;13(7):905-23
references: 14502957
references: BMC Health Serv Res. 2008 Jan 23;8:19
references: 18215313
references: Aust J Rural Health. 2004 Feb;12(1):28-9
references: 14723778
references: Am J Occup Ther. 1993 Aug;47(8):731-7
references: 8352333
references: J Health Serv Res Policy. 2007 Jan;12(1):42-7
references: 17244397
references: Aust J Rural Health. 2008 Jul;16(4):187-8
references: 18652604
references: Aust J Physiother. 1999;45(3):203-212
references: 11676768
references: J Health Serv Res Policy. 2005 Jul;10 Suppl 1:6-20
references: 16053580
references: Health Serv Res. 2007 Aug;42(4):1758-72
references: 17286625
references: Hum Resour Health. 2006 May 27;4:12
references: 16729892