Factors Influencing Retention among Regional, Rural and Remote Undergraduate Nursing Students in Australia: A Systematic Review of Current Research Evidence

Abstract

Background: This systematic review aimed to explore the factors influencing retention among regional, rural, and remote undergraduate nursing students who were enrolled in Australian universities. Methods: Mixed-methods systematic review. A+ Education, CINAHL, Education Resources Information Center (ERIC), Education Research Complete, JBI EBP database, Journals@Ovid, Medline, PsycINFO, PubMed, and Web of Science were systematically searched from September 2017 to September 2022 to identify eligible English-language studies. The methodological quality of the included studies was critically assessed using the Joanna Briggs Institute’s critical appraisal tools. Descriptive analysis with a convergent segregated approach was conducted to synthesize and integrate the results from the included studies. Results: Two quantitative and four qualitative studies were included in this systematic review. Both the quantitative and qualitative findings demonstrated that additional academic and personal support was essential for improving retention among undergraduate nursing students from regional, rural, and remote areas in Australia. The qualitative synthesis also highlighted many internal (e.g., personal qualities, stress, ability to engage with classes and institutions, time management, lack of confidence, cultural well-being, and Indigenous identity) and external factors (e.g., technical difficulties, casual tutors, different competing demands, study facilities, and financial and logistical barriers) that influenced retention among undergraduate nursing students from regional, rural, and remote areas in Australia. Conclusions: This systematic review demonstrates that identifying potentially modifiable factors could be the focus of retention support programs for undergraduate nursing students. The findings of this systematic review provide a direction for the development of retention support strategies and programs for undergraduate nursing students from regional, rural and remote areas in Australia.