La ruta m´as corta en una gr´ afica

A review of the literature has indicated previous IMG studies have focused primarily on acculturation and retention issues within the workplace, such as IMG satisfaction and practice support (Alexander & Fraser, 2007; Carlier et al., 2005; Durey, 2005b; Han & Humphreys, 2005; Han & Humphreys, 2006; Hawthorne et al., 2003; Heal & Jacobs, 2005; RHWA, 2011a). Only a small number of these studies recognised quality of life and psychosocial needs of IMGs and their families as significant factors impacting rural acculturation and retention (Alexander, 1998; Colic-Peisker, 2009; Stanley & Bennett, 2005). Alexander and Fraser (2007) said IMGs’ non- professional needs in rural contexts required further research. While Klein, et al. (2009) have said there is a need to undertake further qualitative research to understand what motivates IMGs to stay in a particular place.

In addition, within the literature, prior IMG research has focused on employment satisfaction as a measure of integration and settlement success. This research focus follows the viewthat obtaining “employment is universally considered – among scholars, settlement service providers and policy makers – to be the single most important aspect of migrant integration” (Colic-Peisker, 2009, p. 176). Migrants obtaining employment is viewed as a central indicator of successful settlement in Australia (Richardson et al., 2004). This focus on integration and settlement success remains detached from the additional social and psychological indicators of

successful integration, settlement and life satisfaction. The social and psychological indicators include establishing social networks within communities, quality of life,

wellbeing, happiness and acculturation of migrants (Colic-Peisker, 2009; McGrail et al., 2010; Mpofu, 2008).

In addition, Kilpatrick et al. (2011, p. 183) has said the factors of successful acculturation for skilled migrants are defined by:

job opportunities for partners, perceptions of rural life, lifecycle, place identity and social networks, education and training, infrastructure, housing and health provision. Supportive partners have been identified… as a key factor in recruitment, satisfaction and retention of workers in rural areas.

Furthermore, acculturation of IMGs and their families may be achieved through a supportive community environment. This assists IMGs and their families to reside, integrate and acculturate in rural contexts. This had been observed and achieved in some degree throughout the identified IMG studies, by providing a number of key strategies that made the transition easier and less confusing for IMGs and families (Carlier et al., 2005; Durey, 2005b; Gilles et al., 2008; Han & Humphreys, 2005; Hancock et al., 2009; McGrath et al., 2009). These strategies can be divided into two groups and include:

Those carried out by IMGs

• Develop local acquaintances before arriving;

• Seek assistance from medical colleagues and their families; and • Gain more information on the community and its facilities.

Those by the host community

• Provide transport at arrival or assisting with car hire; • Provide information regarding spouse employment; • Help familiarise the family to the community;

• Involve the family in community events and participation; • Assist with temporary furnished housing and loans; and • Meet the specific social and cultural needs of IMGs.

3.6 Conclusion

An overview of both international and Australian IMG literature has highlighted the challenges encountered by IMGs as they live and work in rural communities. These challenges include employment integration, satisfaction and practice support in addition to the quality of life and psychosocial needs of IMGs and their families. A number of key findings remain unanswered; however, these questions to a certain extent will be answered in the current research as it aims to explore the

experiences and challenges of IMGs living and working in rural and remote Tasmania, and how this informs the acculturation process.

A number of key theoretical concepts and frameworks are required to address the study’s aims. The next chapter introduces internationalisation and globalisation of health workforce and acculturation. The chapter is then followed by a discussion regarding the theoretical standpoints which are employed as the framework and lens to guide the study. These theoretical standpoints include human and social capital of migrants in new social and workplace environments. These theories draw attention to the acculturation and identity challenges, which migrants in the health workforce, particularly IMGs, encounter in new cultural and healthcare contexts.

4

Chapter four: Theoretical framework

underpinning the study

4.1 Introduction

Chapter three has provided an overview of both international and Australian IMG studies and highlighted the challenges faced by IMGs as they live and work in rural communities. These challenges include employment integration, satisfaction and practice support in addition to the quality of life and psychosocial needs of IMGs and their families. A number of key theoretical concepts and frameworks underpin this study to address the study’s aims. Chapter four introduces the

internationalisation and globalisation of health workforce and acculturation followed by a discussion regarding the framework to guide the study that uses a number of theoretical standpoints. These theoretical standpoints include human and social capital of migrants in new social and workplace environments. These theories draw attention to the challenges of acculturation and identity, which migrants in the health workforce, particularly IMGs, encounter in new cultural and healthcare contexts.