Background: Despite the fact that public and private nursing schools have contributed significantly to the Thai\nhealth system, it is not clear whether and to what extent there was difference in job preferences between types\nof training institutions.\nThis study aimed to examine attitudes towards rural practice, intention to work in public service after\ngraduation, and factors affecting workplace selection among nursing students in both public and private\ninstitutions.\nMethods: A descriptive comparative cross-sectional survey was conducted among 3349 students from 36\nnursing schools (26 public and 10 private) during February-March 2012, using a questionnaire to assess the\nassociation between training institution characteristics and students� attitudes, job choices, and intention to\nwork in the public sector upon graduation. Comparisons between school types were done using ANOVA, and\nBonferroni-adjusted multiple comparisons tests. Principal component analysis (PCA) was used to construct a\ncomposite rural attitude index (14 questions). Cronbach�s alpha was used to examine the internal consistency\nof the scales, and ANOVA was then used to determine the differences. These relationships were further\ninvestigated through multiple regression.\nResults: A higher proportion of public nursing students (86.4% from the Ministry of Public Health and 74.1%\nfrom the Ministry of Education) preferred working in the public sector, compared to 32.4% of students from\nthe private sector (p = <0.001). Rural upbringing and entering a nursing education program by local recruitment were\npositively associated with rural attitude. Students who were trained in public nursing schools were less motivated by\nfinancial incentive regarding workplace choices relative to students trained by private institutions.\nConclusions: To increase nursing workforce in the public sector, the following policy options should be promoted: 1)\nrecruiting more students with a rural upbringing, 2) nurturing good attitudes towards working in rural areas through\nappropriate training at schools, 3) providing government scholarships for private students in exchange for compulsory\nwork in rural areas, and 4) providing a non-financial incentive package (e.g. increased social benefits) in addition to\nfinancial incentives for subsequent years of work.
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