• Candice M Manahan, Cindy L Hardy, and Martha L P MacLeod.
• University of Northern British Columbia, Prince George, British Columbia, Canada. manac000@unbc.ca.
• Rural Remote Health. 2009 Oct 1; 9 (4): 1238.

IntroductionHealth sciences programs are being designed to attract students who are likely to stay and practice in rural and northern Canada. Consequently, student recruitment and screening are increasingly including assessment of suitability for rural practice. Although retention factors among rural physicians and nurses have been investigated, little is known about factors that contribute to the retention of other healthcare professionals who work in rural areas. The primary objective of this project was to identify the personal characteristics and experiences of allied health professionals who have worked long term in northern British Columbia (BC), Canada.MethodsThe study used a qualitative descriptive approach. Six speech language pathologists, four psychologists, four occupational therapists, eight social workers, and four physiotherapists practicing long term in northern BC were recruited, using a convenience sample and the snowball technique, to participate in semi-structured telephone interviews. The interviews were audiotaped and transcribed verbatim. A thematic content analysis identified the motivations for their decision to begin or stay working in northern communities, the reasons for choosing rural or northern education and key themes concerning personal characteristics and experiences. A process of member checking and an external audit validated the analysis and findings.ResultsThere were two major themes for choosing rural and northern education. For some, selection of rural or northern training was based on accessibility to health education programs; all participants who chose rural and northern education had already decided that they were going to practice rurally. Generally, participants identified past positive experiences and rural background as influencing their practice location decision. Participants named the community's need for healthcare professionals, career advancement opportunities, welcoming employers, peer support, as well as promises of continuing education and interprofessional teamwork as key to their decision. Professional preferences for variety, challenges, and trying new aspects of the job such as teaching also impacted their decision. Also identified were individual factors and personal preferences such as the need for adventure, wilderness, and outdoor recreation, and community factors (eg people's friendliness and the slow pace). Such factors also influenced retention; however, retention was also affected by factors such as job satisfaction, and some community factors were only associated with retention. The analysis revealed a number of personal characteristics and experiences shared by long-term healthcare professionals, and that there is not one particular factor that determines duration of practice in rural and northern communities.ConclusionThe findings imply a combination of varying personal values impact the decision to come or stay in rural and northern communities. Personal characteristics and experiences help to shape these personal values. Over time and depending on stage of life, personal values change. Age and stage of life, rural background, and location of family members also have bearing on personal values, which in turn impact recruitment and retention. An explicit identification of values that have emerged out of personal characteristics and experiences may be useful in the selection of students for rural health education programs, as well as the recruitment and retention of healthcare professionals in rural and northern areas.

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