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Are midwives interested in rural practice?
"The long-term tracking study of the students and graduates of the Bachelor of Health Science Program in Midwifery (henceforth referred to as the Midwifery Education Program) has been conducted by the Centre for Rural and Northern Health Research (CRaNHR) , in cooperation with the Midwifery Education Program at Laurentian, McMaster and Ryerson Polytechnic Universities. The objective of this study is to monitor and examine midwifery human resources trends and educational issues. Several surveys are used to track the students and graduates of the program. All students are asked to complete an entry survey when they begin the program. The midway survey, originally conducted between the second and third year of the program, was discontinued because the survey did not yield useful information. Upon completion of the program, the graduates complete an exit survey and, contingent upon future research funding, they will also receive follow-up surveys over a number of years....
"This report summarizes the results of the 1997 exit survey, completed by the second cohort of graduates of the Midwifery Education Program. A cohort in this report is defined as a group of students that either begins or graduates from the program at the same time. It focuses on their assessment of the program, career plans and views on midwifery practice and the Canadian health care system....
"The revised exit survey questionnaire was mailed to all 1997 graduates of the Midwifery Education Program in September of 1997. Two follow-up letters, with replacement copies of the questionnaire, were sent to those that had not returned their completed questionnaires. Data were collected over a three-month period. Sixteen of the 21 graduates completed the exit survey, yielding a response rate of 76.2 per cent....
"Table 9 shows the regions in which the graduates would like to practise as a midwife during their initial year of practice ('initial year of practice' refers to the first year after graduation, during which the graduates have to be supervised by a registered midwife for a period of one year) and one year after. All regions in Ontario were mentioned except northwestern Ontario. Although one graduate plans to practise in Québec during the initial year of practice, no graduates planned to work in another province or country the year after the initial year of practice.
Table 9
Regions Where Graduates Intended to Practise
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Region
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Initial Year
(n=16)
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One Year After
(n=16)
|
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Northwestern Ontario
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0
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0
|
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Northeastern Ontario
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0
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1
|
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Eastern Ontario
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3
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0
|
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Central East Ontario
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3
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3
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Central West Ontario
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6
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4
|
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Southwestern Ontario
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3
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3
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In another province
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1
|
1
|
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In another country
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0
|
0
|
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Don't know
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0
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4
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"Table 10 shows the size of communities in which they planned to practise during their initial year of practice and one year after. Their plans were similar for both time frames. Like the 1996 cohort of graduates, most wished to practise in cities with a population of over 100,000. No respondent chose a community with a population of less than 10,000 and four didn't know where they would practise one year after.
Table 10
Size of Communities Where Graduates Planned to Practise
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Size of Community
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Initial Year
(n = 16)
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One Year After
(n = 16)
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City with 500,001 or more
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4
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2
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City with 250,001-500,000
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7
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5
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City with 100,001-250,000
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2
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2
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City with 50,001-100,000
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2
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2
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City with 25,001-50,000
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0
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0
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City with 10,001-25,000
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1
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1
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Town with 5,001-10,000
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0
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0
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Town with 5,000 or less
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0
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0
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"Don't know"
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0
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4
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"Seven respondents planned to practise in both an urban and rural setting during the initial year of practice and six one year after. Eight wanted to work in an urban setting during the initial year of practice and five one year after. Four were not sure in which type of setting they would work after their initial year of practice. It is of interest to note that only one graduate planned to work in a rural setting during the initial year of practice and no graduate preferred a rural practice setting one year after. These results are similar to those from the 1996 exit survey.
"Most graduates planned to work in a practice with 4 or more midwives during their initial year of practice and one year after. The mean group practice size was 4.69 for the initial year of practice and 4.80 for one year after. Nine graduates planned to practise with the same group after their initial year of practice, one did not and six were not sure. One graduate had made a two-year commitment with a group practice and then hoped to practise in a rural setting. Two respondents planned to practise in northern Ontario one year after the initial year of practice.
"....The most influential factors (that would influence their future practice location) were midwifery needs in the community, proximity to family and/or friends and availability of group practice. Quality of the physical environment and educational facilities for children were also important factors. The factors with the least influence on future practice location were proximity to post-secondary educational institutions and size of community. Other factors that would influence practice location included French environment and commitment to health care development in northern Ontario. These results differ from the 1996 exit survey. The most influential factor for the 1996 cohort was availability of group practice. Also, career opportunities for spouse/partner had more influence on the 1996 graduates than on the 1997 cohort."
From: Raymond W. Pong and Dianne Stewart (1998). Summary Report of the 1997 Cohort of Graduates of the Midwifery Education Program. Sudbury, Ontario: Centre for Rural and Northern Health Research, Laurentian University.
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