Rural health care workforce retention measures: A rapid scoping review.

PURPOSE: Rural Veterans face persistent barriers to care, often exacerbated by health care workforce shortages. Although recruitment initiatives are important, retaining providers in rural areas is equally critical to sustaining access and continuity of care. This rapid scoping review examined how "rural workforce retention" is defined and measured in the peer-reviewed literature and synthesized recommended reporting elements to improve clarity and comparability.

METHODS

Six bibliographic databases were searched (2014-2025) for English-language studies of rural health care in the United States, Canada, the United Kingdom, and Australia using terms related to rural workforce retention. Data were extracted on definitions of retention, time frames, and measurement approaches.

FINDINGS: Of 2392 abstracts screened, 268 met inclusion criteria. Among these, 172 (64%) lacked a retention definition. Of the remaining 96, nearly half (45%) measured retention using providers' intentions to stay or leave; others relied on turnover or continued rural practice. More than half (61%) specified a retention timeframe, most often retrospectively (41/59; 69%). Substantial heterogeneity across definitions, time horizons, and data sources led to the development of a reporting checklist outlining key conceptual, temporal, and methodological elements for retention research.

CONCLUSIONS

Inconsistent and incompletely reported measures of rural workforce retention limit evaluation and scalability of effective strategies. Research should explicitly define retention, specify a measurable time frame, and clearly report key conceptual and methodological elements to enable comparison across settings. For the Veterans Health Administration (VHA) and other rural systems, clear retention metrics are essential to ensure workforce stability and sustain access to high-quality care for rural Veterans.