Research highlights 27 years of retaining Ontario’s nurse practitioners

Primary Healthcare Nurse Practitioners (NPs) deliver care across Ontario in a variety of settings. Where student NPs study and then begin practice post-graduation can provide a snapshot about regional retention. A study by nursing leaders across Ontario, including Vice Dean in McMaster University’s Faculty of Health Sciences and Executive Director of the School of Nursing, Sandra Carroll, examined the results of a long-standing nine-university Ontario Primary Health Care Nurse Practitioner (PHCNP) consortium education program. 

The study tracked nearly 3,000 PHCNP graduates from 1996 to 2022, using data from the College of Nurses of Ontario. The four main research questions included: what percentage of PHCNP graduates are practicing in Ontario, what percentage of PHCNP graduates practicing in the university region where they graduated, the geographic distribution, and the percentage working in rural or remote communities. 

• Retention Rates: Nearly 87% of NP graduates from 1996 to 2022 have practiced or continue to practice as NPs in Ontario. Retention rates varied by university, with McMaster University and Toronto Metropolitan University having the highest retention at 90.2% and 90.8%, respectively. French graduates had slightly lower retention rates, with Laurentian University at 78.4% and University of Ottawa at 77.9%. 

• Graduate Retention within Region: Retention within the university region was high, especially in northern regions, such as Lakehead University and Laurentian University, with 72% and 66%, respectively. The Greater Toronto Area (GTA) universities, such as York and Toronto Metropolitan, also had high retention rates at 79% and 78%. Windsor had a 71% retention rate within its region. 

• Geographic Distribution: Graduates were well-distributed across Ontario, with significant clustering in their home regions and spill over into other regions. Northern graduates often stayed in the north, while southern graduates sometimes moved to northern regions. French graduates from Ottawa and Laurentian supported rural, remote, and Indigenous communities in the north and moved to the GTA and Quebec. 

• Percentage of NPs Practicing in Rural Communities: On average, 17.2% of NP graduates worked in rural or remote communities. Laurentian had the highest percentage at 38.9%, followed by Lakehead at 28.6%. French graduates from Laurentian had an exceptionally high rurality rate at 55.6%, highlighting the importance of the distributed and bilingual education model. 

The results show that the consortium’s distributed education model supported NP retention post-graduation in their region of study. Job opportunities in all regions are essential for meeting primary healthcare needs across Ontario, especially in northern and rural communities. With an expanding scope of practice, NPs can fill a critical role of meeting primary healthcare needs. For the full study, visit Research Square.