On being a rural origin health care professional: lives, learnings and practice.
Ross, Andrew John.
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Rural origin health care professionals (HCPs) have been identified as those who are most likely to work in rural areas after graduation. However, there are significant challenges of access, selection and throughput for South African rural students wanting to train as HCPs. Many studies have focused on strategies for staffing rural healthcare facilities. However a life history approach has not previously been used to study the educational experiences of rural origin HCPs in South Africa, and there is a paucity of data about the lived personal and professional educational experiences of rural origin HCPs and their experiences of returning to work in rural areas after graduation. A deeper understanding of these issues using a life history approach may help in supporting rural origin students and contribute to improved staffing levels at rural healthcare institutions. Social identity theory and a generative understanding of rurality provided the theoretical framing for this study. A life history approach complemented by arts-based methods generated stories through which to gain an understanding of the complex, multidimensional, multi-layered lives of HCPs who grew up in rural areas, their personal lives in relation to others, and the context in which they grew up (time, person and place). Their developing identity is seen in their performances through the choices they make in response to everyday situations. Their learning experiences are complex and reveal that as active and critical thinkers they adopted a range of strategies to succeed at institutions of higher learning, and found platforms and communities to develop as those with knowledge and agency to change/challenge dominant and stereotypical ways of being. They demonstrate their willingness and ability to work in rural contexts, leading transformation in the healthcare setting. The findings of this study point to a new understanding of rurality – that of home and a sense of belonging where the possibility for better healthcare services exists. A junctional hub is presented as a theoretical ‘model’ to frame lived experiences and to understand rural origin HCPs’ personal and professional identity and work in a complex, interconnected, negotiated space where different forces are negotiated. This provides a platform to open up the opportunity for other ways of being, knowing and practising.