Rural and Remote Continuing Nursing Education: An Integrative Literature Review

Background:  Rural and remote nursing has unique practice requirements that create a need for distinct education and practice preparation.  Preparing registered nurses (RNs) to work in rural and remote communities is essential for the support and advancement of rural and remote health, as there is a shortage of rural and remote health care providers. Purpose:  An integrative literature review was conducted to identify the current continuing education needs of rural and remote RNs internationally. Sample: Eight studies were included in the integrative review of the literature.  Countries reported in the literature included Canada (n = 2), Australia (n = 2), Sweden (n = 1) and the United States (n = 3). Method:  An integrative literature review on rural and remote nursing practice continuing education was conducted using Torraco’s (2005) guidelines, in addition to Whittemore and Knafl’s (2005) methodological strategies.  A search strategy was created, tested, and approved by the research team.Themes were extracted, collated, analyzed, and knowledge synthesized. Findings:  Rural and remote RNs identified areas requiring enhanced ongoing training.  The identified training areas were summarized into the following four themes: 1) Comprehensive specialized nursing practice for direct patient care, 2) Unanticipated events, 3) Non-direct patient care, and 4) Advanced specialty courses. Conclusion:  The autonomy, competency, and expertise that is expected of RNs working in rural and remote locations requires educational supports. Rural and remote nursing continuing education is required in the areas of: comprehensive specialized nursing practice for direct patient care, unanticipated events, non-direct patient care, and advanced specialty courses.     Keywords: continuing education, integrative review, registered nurse(s), remote, rural Acknowledgements: The authors thank Saskatchewan Polytechnic for partial funding of this review through the Seed Applied Research Program.  The authors also thank their research team member Chau Ha and research assistant Devendrakumar Kanani for their contributions to this integrative review.