Undergraduate pre-registration nursing education in Australia: a longitudinal examination of enrollment and completion numbers with a focus on students from rural and remote campus locations.
INTRODUCTION: There is much evidence to indicate a shortage of Registered Nurses (RNs) in Australia and to suggest that the shortage may be more pronounced in rural and remote locations. Attracting RNs to work in rural and remote areas may not be as simple as increasing the intake of students into university undergraduate pre-registration nursing courses. There is some evidence indicating that student nurses may be more likely to enter the nursing workforce in rural and remote locations if they have existing associations with rural and remote areas and/or their undergraduate education provides opportunities to undertake supported placements in rural and remote settings. Two important difficulties have been associated with measuring outcomes in relation to rural and remote pre-registration nursing students. One is defining what constitutes a rural or remote location and the other is suspect data on the number of nursing students enrolled in, and completing, nursing courses. The aims of this study were to provide a longitudinal profile of the number of domestic students studying and completing undergraduate pre-registration nursing courses in Australia, with a particular emphasis on identifying those at rural and remote university campuses, and to compare results across States and Territories. METHODS: This study presents the combined findings from two investigative reports. Data on undergraduate pre-registration nursing student numbers were collected via electronic survey instruments completed by staff at all Australian educational institutions offering undergraduate pre-registration nursing education programs in 2001 and 2002. Australian domestic students were the focus of this study. Data included the total number of domestic students enrolled in undergraduate pre-registration nursing courses in 2001 and 2002, the number of domestic students who successfully completed courses in 1999, 2000 and 2001, and estimates for the number expected to complete in 2002. Surveys were sent to course coordinators or other staff nominated by heads of divisions of nursing at each institution. RESULTS: There was a 100% response rate. Twenty-four rural and remote campus locations were identified using an adjusted form of the Rural, Remote and Metropolitan Areas (RRMA) classification system. The Australian Capital Territory and the Northern Territory did not have any rural or remote campus locations. In contrast, undergraduate pre-registration nursing in Tasmania was offered at a rural campus only (for the first 2 years). From 2001 to 2002, there was an increase of just over 5% in the total number of domestic students enrolled in undergraduate pre-registration nursing courses in Australia (2002 total = 22,811 students). Rural and remote location students accounted for slightly more than 25% of these students in 2001, and almost 27% in 2002. The States Victoria, New South Wales and Queensland had the highest percentage of students enrolled at rural and remote campus locations, greater than the Australian average for both years. In contrast, South Australia and Western Australia had less than 11% of students enrolled at rural and remote campus locations for each year. Total undergraduate pre-registration course completions increased by approximately 16% across Australia between 1999 (n = 4868) and 2002 (n = 5667), although for 2002, the figure was projected. Of these total course completions, the percentage of students completing at rural and remote campus locations increased from almost 23% to nearly 28% during the same period. Of the States/Territories with both metropolitan and rural/remote campus locations, only Victoria and Queensland had more than 25% of their total student completions consisting of students enrolled at rural and remote campus locations for each year. In contrast, South Australia and Western Australia had approximately 6% of student completions consisting of students enrolled at rural and remote campus locations in 1999, increasing to approximately 12% projected for 2002. CONCLUSIONS: In this study, the authors attempted to improve the accuracy of data collection in relation to the number of domestic undergraduate pre-registration nursing students in Australia, which is representative of the potentially new Australian domestic RN workforce. There was a trend towards an increasing number of students being enrolled in undergraduate pre-registration nursing courses, and also toward an increasing number of course completions. From the perspective of the rural and remote RN workforce, the percentage of students enrolled and completing courses at rural and remote campus locations was found to be increasing. However, there may be some areas of concern for education and workforce planners in States and Territories that are providing a smaller percentage of their undergraduate pre-registration nursing courses in rural and remote areas. Several study limitations are discussed and suggestions made for future research.