Abstract: University Departments of Rural Health (UDRHs) facilitate clinical placements in rural and remote settings throughout Australia for students enrolled in tertiary health courses. UDRHs support students to travel to rural and remote regions, provide accommodation, and ensure clinical learning needs are met for students to complete these placements. In 2019, the 16 UDRHs across Australia supported over 16,500 placements (mostly in nursing, midwifery and allied health). Similar numbers of UDRH-facilitated placements were planned in 2020. However due to the risks of COVID-19, associated travel restrictions, biosecurity zones and the constraints within health services, many of these placements were altered, postponed or cancelled. This had repercussions for student progress through their university courses and the types of placements that were offered. As student responses to these placement changes were not well understood, UDRHs were interested in student experiences of their UDRH-facilitated rural or remote placement during 2020. All 16 UDRHs agreed to participate in a study of student perspectives among students who had a placement organised by a UDRH. The aims of the study were to: 1) identify student perspectives of impacts to UDRH-facilitated placements due to COVID-19; 2) identify student perspectives of UDRH-facilitated placements during COVID-19; 3) understand student experiences of UDRH-facilitated placements during COVID-19. A core project team of researchers from eight UDRHs lead the project, with involvement from all 16 UDRHs asking their students to participate. All students with a planned placement facilitated by any UDRH (regardless of whether or not the placement went ahead) between February and October, 2020 were invited by email to complete an online questionnaire. A total of 1,505 students completed the questionnaire. Of these, 84% identified as female, 4% as Aboriginal and/or Torres Strait Islander and 62% were under 25 years of age. Half were studying nursing or midwifery and half were studying medicine (9%) or one of19differentallied health disciplines. At the end of the questionnaire, all participants were asked if they were willing to be interviewed. Of those willing, 29 were randomly selected and interviewed. Interviewees included students who planned to undertake placements in all states and the NT. Of the1,505questionnaire participants, 20% did not complete their placement. Of students completing their placement, 60% indicated their placement was impacted by COVID-19 while 20%suggested their placement was not impacted. Where placements were impacted, students talked about their placement being changed to another service, another town, starting and completing the placement from ‘home,’ or the placement being undertaken from a metropolitan area via telehealth or in the form of a project relevant to a rural or remote location or service. Allied health students were more likely to report that their placement had been cancelled or changed to an online formator a placement model with less direct client contact than nursing students. The decision to cancel or postpone these placements was said to be made mostly by either the health service or the university where the student studied, rather than students choosing not to go rural. Importantly, 80% of respondents indicated they had completed a UDRH facilitated placement, of which 84% were satisfied with their placement. Given the travel restrictions in all states, UDRHs have, therefore, continued to provide placements in difficult times. While financial and mental health issues were identified, the key issues raised by students were concerns for their clinical learning and development of their skills involving direct patient care. Stemming from this, students were also concerned about graduating on time and securing employment in their area of study after graduation. The interviewees outlined the complexity of UDRH-facilitated rural and remote placements during 2020. Students who did not complete their placement talked about the cost of cancelled flights and travel. The students who did complete their rural or remote placement talked about restrictions preventing them from moving around the rural/remote area, being alone in student accommodation, and the restricted duties and activities during placement due to COVID-19 related issues (e.g., lack of personal protective equipment, changes in student tasks, etc.). The many changes and uncertainty of placements also contributed to students’ worry about their placement, progress through their course and clinical learning. Similar to the questionnaire respondents, interviewees also raised financial concerns, worries about graduation, fears about finding employment after graduation, mental health and resilience issues, and the many difficulties of juggling work, family, travel and uncertainty during the pandemic. Overall, most students wanted to go on their UDRH-facilitated rural or remote placement to gain experience and to progress through their course, and the majority of these students completed their UDRH-facilitated placement. While there were changes in placements, locations, accommodation and the types of placement, most students were grateful to complete their planned placement. The cancellation of, and changes to, placements appears to have contributed to student concerns about clinical learning and progression through their course. Many of these concerns are not likely to be specific to UDRH-facilitated placements, but to all placements required in their course. What was clear from this study was the complexity of students’ lives throughout COVID-19due to juggling financial issues, family concerns, seeking clinical experience, worrying about graduation and feeling insecure about future employment. This suggests that significant student support and flexibility is required for current and future cohorts of nursing and allied health students.
Lisa Bourke, Barbara Hellwege, Belinda Jessup, Susan Heaney, Lyndal Sheepway, Ha Hoang, Tegan Podubinski, Annie Farthing, Rohan Rasiah, Robyn Fitzroy, Kehinde Obamiro, Santosh Jatrana, Geoff Argus, Sabina Knight, 2021, The impact of COVID-19 on student placements facilitated by University Departments of Rural Health, Report, viewed 24 January 2022, https://www.nintione.com.au/?p=23788.