A qualitative exploration of factors that influence physiotherapy students’ preferences of location and type of post-graduation employment in Scotland

ABSTRACT

Keywords Undergraduate Physiotherapists;Career choice;Rural practice Purpose: Sub-optimal distribution of physiotherapists in Scotland between urban and rural settings in Scotland have lead to problematic staff shortages. There are well documented difficulties in recruiting and retaining NHS staff within rural and remote areas. As a result of COVID-19 we have witnessed the workforce pressures and capacity challenges within our NHS, exacerbating this issue. Despite deployment of healthcare students to support workforce capacity during this time, there remains a preference for employment in metropolitan areas, making recruitment to more remote locations challenging. Brexit through its influence on immigration has further magnified such pressures. Measures to increase domestic training capacity have been implemented within Scotland and there is an urgent need to explore influences on job preferences for undergraduate physiotherapy students entering the workforce. The main purpose in undertaking this research recognises that it is crucial to recruit and retain health workers within rural areas. Aim: To identify factors which influence physiotherapy students’ preferences of location and type of post-graduation employment in Scotland. Objectives: • To describe reasons why physiotherapy students choose their profession. • To explore preferred choices of location for employment post-graduation. • To explore influences on preferences for type of post graduate employment. Methods: Participants (n = 22) were final year pre-registration physiotherapy students from Queen Margaret University (QMU) 4th year BSc (Hons) and 2nd year Masters (MSc). A phenomenological qualitative approach was employed, with data collected through three focus groups (face-to-face). A semi-structured interview format was facilitated by the researcher. Interview transcripts were subjected to thematic analysis. Results: Five themes emerged from the analysis relating to influences on participants’ preferences for location and type of work. These themes were (1) Previous exposure to physiotherapy, (2) One's upbringing, (3) Clinical placement, (4) Job characteristics, (5) Desirable work/life environment. Themes 1, 4 and 5 appeared to influence student's preference for location, whereas themes 2 and 3 were influencers of the preferred type of physiotherapy practice. These themes were comprised of associated subthemes. Urban practice was the location preferred overall. Clinical placement experiences had the ability to overpower influential factors prior to studying and change one's preferences for type of physiotherapy practice. Conclusion(s) A combination of factors influenced preferences for post-graduation employment and these varied based on individual experiences. Interestingly, some of the largest influences were modifiable characteristics which may well be of significance to managers if incentive policies are to be developed to attract more employees to underserviced areas and combat the previously mentioned spatial maldistribution of employment. For example, recruiting physiotherapy students from rural areas, developing supportive mentoring and or developmental structures may be an effective way. Impact Policymakers can design strategies to attract more physiotherapy students to remote and rural areas, such as better targeting and promotion of such jobs to students from rural areas and promoting supportive work environments. Funding acknowledgements This work was not funded.