{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T08:13:46Z","timestamp":1782893626520,"version":"3.54.5"},"reference-count":94,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T00:00:00Z","timestamp":1778198400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"vor","delay-in-days":54,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Nurs"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Rural\u2013urban maldistribution of health professionals continues to widen health inequities, particularly in low- and middle-income countries (LMICs). In Nepal, nurses are central to frontline care in remote communities, yet \u201curban pull\u201d forces and structural constraints undermine rural recruitment and retention. This study examined how training at a rural-embedded institution\u2014Karnali Academy of Health Sciences (KAHS)\u2014may shape final-year nursing students\u2019 intentions for rural\/remote practice and the barriers they anticipate.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We used a two-site qualitative descriptive design with an exploratory orientation. Semi-structured interviews were conducted with 22 final-year female nursing students: 11 from an urban tertiary institution and 11 from KAHS. A codebook-style applied thematic analysis was undertaken. Ajzen\u2019s Theory of Planned Behaviour and a structural intervention lens guided interpretation of how institutional context may influence beliefs underpinning rural-practice intentions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Five themes captured students\u2019 accounts: (1) rural immersion and emerging rural commitment; (2) experiential learning beyond the books; (3) the relational pull of community-centred care; (4) perceived urban\u2013rural inequities and curriculum gaps; and (5) gendered and professional barriers to rural practice. Most KAHS participants\u2014including several of urban origin\u2014described strong intentions to begin their careers in rural\/remote settings, whereas most urban-site participants anticipated urban employment. However, anticipated constraints\u2014especially safety concerns, social isolation, professional\/academic isolation, and limited career development pathways\u2014were repeatedly described as factors that could weaken the feasibility and sustainability of rural practice.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Rural-embedded education may strengthen intentions to serve in rural areas by reshaping how students evaluate rural work (attitudes), social expectations (subjective norms), and the feasibility of rural service (perceived behavioural control). Yet intention formation occurs alongside persistent gendered and structural barriers. Longitudinal research is needed to track post-graduation trajectories and to identify multi-component strategies that translate rural intention into durable rural retention.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical trial number<\/jats:title>\n                    <jats:p>Not applicable.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12912-026-04722-9","type":"journal-article","created":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T11:36:03Z","timestamp":1778240163000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Cultivating a rural nursing workforce: the impact of rural vs. urban education on nursing students\u2019 intentions for rural practice in Nepal"],"prefix":"10.1186","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2167-5771","authenticated-orcid":false,"given":"Animesh","family":"Ghimire","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-4408-198X","authenticated-orcid":false,"given":"Mamata Sharma","family":"Neupane","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,5,8]]},"reference":[{"issue":"2","key":"4722_CR1","doi-asserted-by":"publisher","first-page":"390","DOI":"10.1002\/hec.3556","volume":"27","author":"M Gersovitz","year":"2018","unstructured":"Gersovitz M. 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