Positive placement experience and future rural practice intentions: findings from a repeated cross-sectional study.

Objective: To identify the constituents of positive placement experience and explore the association between positive placement experiences and rural and remote practice intentions.

Methods: A repeated cross-sectional study was conducted between January 2014 and December 2017. Medical, nursing, dentistry, and allied health students who completed a rural/remote placement were invited to complete a survey questionnaire on placement experience. Information on students' sociodemographic factors, discipline, placement experience, placement satisfaction, and rural/remote practice intentions was collected. Modified Poisson regression was performed to determine the relationships between placement satisfaction and future rural practice intentions. Qualitative data were analyzed by thematic analysis.

Results: A total of 873 students responded. The majority of the survey respondents were females (70.06%), with a median age of 22 years (IQR 21-25 years), and 44.46% of respondents were medical students. Students satisfied with their placement were 2.10 times more likely to have rural/remote practice intention than their counterparts. Of all components of rural/remote placement experience, satisfaction with the placement supervision had the highest impact on changing students' rural/remote practice intentions from negative to positive. The major themes from qualitative analysis were as follows: "wide variety of experience and hands-on learning opportunities," "multidisciplinary exposure at home and workplace," "support from the local University Department of Rural Health (UDRH)," "learning of indigenous culture," and "experiencing challenges of rural health care services."

Conclusion: There is a strong association between positive placement experience and future rural/remote practice intentions. Therefore, facilitation of positive placement experiences in remote and rural locations could be a key strategy in addressing rural health workforce maldistribution.