Beyond enrolments: a systematic review exploring the factors affecting the retention of Aboriginal and Torres Strait Islander health students in the tertiary education system

Research output: Contribution to journalReview article

Abstract

Background
Indigenous Australians are under-represented in the health workforce, with large disparities between rates of Indigenous and non-Indigenous people in every health profession, including nurses, medical practitioners and all allied health professionals. Yet Indigenous people have long requested to have Indigenous practitioners involved in their health care, with this increasing the likelihood of culturally safe care. To address the shortage of Indigenous health professionals, it is important to not only recruit more Indigenous people into health courses, but also to support them throughout their studies so that they graduate as qualified health professionals.

The aim of this systematic literature review was two-fold: to identify the factors affecting the retention of Indigenous students across all tertiary health disciplines, and to identify strategies that support Indigenous students to remain with, and successfully complete, their studies.

Methods
Eight electronic databases were systematically searched between July and September 2018. Articles were screened for inclusion using pre-defined criteria and assessed for quality using the Mixed Methods Assessment Tool and the Joanna Briggs Institute Checklist for Text and Opinion.

Results
Twenty-six articles met the criteria for inclusion. Key factors reported by students as affecting retention were: family and peer support; competing obligations; academic preparation and prior educational experiences; access to the Indigenous Student Support Centre; financial hardship; and racism and discrimination. The most successful strategies implemented by nursing, health and medical science faculties to improve retention were multi-layered and included: culturally appropriate recruitment and selection processes; comprehensive orientation and pre-entry programs; building a supportive and enabling school culture; appointing Indigenous academics; embedding Indigenous content throughout the curriculum; developing mentoring and tutoring programs; flexible delivery of content; partnerships with the Indigenous Student Support Centre; providing social and financial support; and ‘leaving the university door open’ for students who leave before graduation to return.

Conclusions
Universities have an important role to play in addressing inequities in the Indigenous health workforce. A suite of measures implemented concurrently to provide support, starting with recruitment and pre-entry preparation programs, then continuing throughout the student’s time at university, can enable talented Indigenous people to overcome adversities and graduate as health professionals.
Original languageEnglish
Article number136
JournalInternational Journal for Equity in Health
Volume18
Issue number1
DOIs
Publication statusPublished - 2 Sep 2019

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Students
Education
Health
Health Manpower
Financial Support
Racism
Medical Faculties
Allied Health Personnel
Health Occupations
Nurse Practitioners
Checklist
Social Support
Curriculum
Nursing
Databases
Delivery of Health Care

Cite this

@article{25a26b8a0e77495c8c774f3a3c47a928,
title = "Beyond enrolments: a systematic review exploring the factors affecting the retention of Aboriginal and Torres Strait Islander health students in the tertiary education system",
abstract = "BackgroundIndigenous Australians are under-represented in the health workforce, with large disparities between rates of Indigenous and non-Indigenous people in every health profession, including nurses, medical practitioners and all allied health professionals. Yet Indigenous people have long requested to have Indigenous practitioners involved in their health care, with this increasing the likelihood of culturally safe care. To address the shortage of Indigenous health professionals, it is important to not only recruit more Indigenous people into health courses, but also to support them throughout their studies so that they graduate as qualified health professionals.The aim of this systematic literature review was two-fold: to identify the factors affecting the retention of Indigenous students across all tertiary health disciplines, and to identify strategies that support Indigenous students to remain with, and successfully complete, their studies.MethodsEight electronic databases were systematically searched between July and September 2018. Articles were screened for inclusion using pre-defined criteria and assessed for quality using the Mixed Methods Assessment Tool and the Joanna Briggs Institute Checklist for Text and Opinion.ResultsTwenty-six articles met the criteria for inclusion. Key factors reported by students as affecting retention were: family and peer support; competing obligations; academic preparation and prior educational experiences; access to the Indigenous Student Support Centre; financial hardship; and racism and discrimination. The most successful strategies implemented by nursing, health and medical science faculties to improve retention were multi-layered and included: culturally appropriate recruitment and selection processes; comprehensive orientation and pre-entry programs; building a supportive and enabling school culture; appointing Indigenous academics; embedding Indigenous content throughout the curriculum; developing mentoring and tutoring programs; flexible delivery of content; partnerships with the Indigenous Student Support Centre; providing social and financial support; and ‘leaving the university door open’ for students who leave before graduation to return.ConclusionsUniversities have an important role to play in addressing inequities in the Indigenous health workforce. A suite of measures implemented concurrently to provide support, starting with recruitment and pre-entry preparation programs, then continuing throughout the student’s time at university, can enable talented Indigenous people to overcome adversities and graduate as health professionals.",
author = "Emma Taylor and Alex Lalovic and Sandra Thompson",
year = "2019",
month = "9",
day = "2",
doi = "10.1186/s12939-019-1038-7",
language = "English",
volume = "18",
journal = "International Journal for Equity in Health",
issn = "1475-9276",
publisher = "BioMed Central",
number = "1",

}

TY - JOUR

T1 - Beyond enrolments

T2 - a systematic review exploring the factors affecting the retention of Aboriginal and Torres Strait Islander health students in the tertiary education system

AU - Taylor, Emma

AU - Lalovic, Alex

AU - Thompson, Sandra

PY - 2019/9/2

Y1 - 2019/9/2

N2 - BackgroundIndigenous Australians are under-represented in the health workforce, with large disparities between rates of Indigenous and non-Indigenous people in every health profession, including nurses, medical practitioners and all allied health professionals. Yet Indigenous people have long requested to have Indigenous practitioners involved in their health care, with this increasing the likelihood of culturally safe care. To address the shortage of Indigenous health professionals, it is important to not only recruit more Indigenous people into health courses, but also to support them throughout their studies so that they graduate as qualified health professionals.The aim of this systematic literature review was two-fold: to identify the factors affecting the retention of Indigenous students across all tertiary health disciplines, and to identify strategies that support Indigenous students to remain with, and successfully complete, their studies.MethodsEight electronic databases were systematically searched between July and September 2018. Articles were screened for inclusion using pre-defined criteria and assessed for quality using the Mixed Methods Assessment Tool and the Joanna Briggs Institute Checklist for Text and Opinion.ResultsTwenty-six articles met the criteria for inclusion. Key factors reported by students as affecting retention were: family and peer support; competing obligations; academic preparation and prior educational experiences; access to the Indigenous Student Support Centre; financial hardship; and racism and discrimination. The most successful strategies implemented by nursing, health and medical science faculties to improve retention were multi-layered and included: culturally appropriate recruitment and selection processes; comprehensive orientation and pre-entry programs; building a supportive and enabling school culture; appointing Indigenous academics; embedding Indigenous content throughout the curriculum; developing mentoring and tutoring programs; flexible delivery of content; partnerships with the Indigenous Student Support Centre; providing social and financial support; and ‘leaving the university door open’ for students who leave before graduation to return.ConclusionsUniversities have an important role to play in addressing inequities in the Indigenous health workforce. A suite of measures implemented concurrently to provide support, starting with recruitment and pre-entry preparation programs, then continuing throughout the student’s time at university, can enable talented Indigenous people to overcome adversities and graduate as health professionals.

AB - BackgroundIndigenous Australians are under-represented in the health workforce, with large disparities between rates of Indigenous and non-Indigenous people in every health profession, including nurses, medical practitioners and all allied health professionals. Yet Indigenous people have long requested to have Indigenous practitioners involved in their health care, with this increasing the likelihood of culturally safe care. To address the shortage of Indigenous health professionals, it is important to not only recruit more Indigenous people into health courses, but also to support them throughout their studies so that they graduate as qualified health professionals.The aim of this systematic literature review was two-fold: to identify the factors affecting the retention of Indigenous students across all tertiary health disciplines, and to identify strategies that support Indigenous students to remain with, and successfully complete, their studies.MethodsEight electronic databases were systematically searched between July and September 2018. Articles were screened for inclusion using pre-defined criteria and assessed for quality using the Mixed Methods Assessment Tool and the Joanna Briggs Institute Checklist for Text and Opinion.ResultsTwenty-six articles met the criteria for inclusion. Key factors reported by students as affecting retention were: family and peer support; competing obligations; academic preparation and prior educational experiences; access to the Indigenous Student Support Centre; financial hardship; and racism and discrimination. The most successful strategies implemented by nursing, health and medical science faculties to improve retention were multi-layered and included: culturally appropriate recruitment and selection processes; comprehensive orientation and pre-entry programs; building a supportive and enabling school culture; appointing Indigenous academics; embedding Indigenous content throughout the curriculum; developing mentoring and tutoring programs; flexible delivery of content; partnerships with the Indigenous Student Support Centre; providing social and financial support; and ‘leaving the university door open’ for students who leave before graduation to return.ConclusionsUniversities have an important role to play in addressing inequities in the Indigenous health workforce. A suite of measures implemented concurrently to provide support, starting with recruitment and pre-entry preparation programs, then continuing throughout the student’s time at university, can enable talented Indigenous people to overcome adversities and graduate as health professionals.

U2 - 10.1186/s12939-019-1038-7

DO - 10.1186/s12939-019-1038-7

M3 - Review article

VL - 18

JO - International Journal for Equity in Health

JF - International Journal for Equity in Health

SN - 1475-9276

IS - 1

M1 - 136

ER -