Literature Review
1. Global Aged Care Workforce Challenges
A substantial body of literature highlights the growing global crisis in the aged care workforce, driven by population ageing, increased care complexity, and insufficient workforce supply. Evidence from international reports and empirical studies consistently demonstrates high levels of workforce shortages, turnover, and burnout across aged care settings [3,17,19,20]. A rapid review of workforce interventions identified persistent challenges in recruitment and retention, alongside fragmented training systems and limited career pathways [3].
Recent workforce surveys further confirm that nursing shortages remain a critical constraint on aged care service delivery, with increasing demand projected over the coming decades [19,20]. These shortages are compounded by inadequate staffing models and skill mix imbalances, which negatively impact quality of care and patient outcomes.
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2. Nursing Education and Workforce Preparedness
The relationship between nursing education and workforce preparedness has been widely examined. A systematic scoping review by King et al. (2022) identified significant gaps in research education and training for nurses, particularly in translating theoretical knowledge into clinical practice .
Similarly, Henderson et al. (2018) found that nursing students often report insufficient preparedness for real-world clinical environments, particularly in complex care settings such as aged care. This lack of preparedness contributes to transition shock and reduced confidence among new graduates [7].
Emerging evidence also suggests that postgraduate and specialty nursing education programs lack standardisation, leading to variability in competency outcomes and workforce readiness . These inconsistencies highlight the need for structured, competency-based education frameworks aligned with workforce demands.
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3. Aged Care-Specific Education Gaps
A growing number of studies focus specifically on aged care education within nursing curricula. Research indicates that aged care is often underrepresented in undergraduate programs, limiting students’ exposure and reducing their interest in pursuing careers in this field [8].
Recent research on innovative educational interventions, such as the “Aged Care Classroom,” demonstrates that targeted curriculum design can significantly improve student perceptions and engagement with aged care nursing . This suggests that curriculum reform plays a critical role in addressing workforce shortages.
However, clinical placement experiences in aged care remain inconsistent. Studies have identified challenges including inadequate supervision, limited learning opportunities, and insufficient educator preparation, all of which hinder competency development .
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4. Training Systems and Workforce Development
Training systems across healthcare sectors are often fragmented and lack alignment with workforce needs. Frenk et al. (2010) argue that health professional education systems must undergo transformative reform to better respond to evolving healthcare demands [6].
A recent integrative review of specialised nursing career frameworks found a significant lack of structured career pathways in aged care nursing, highlighting a critical gap in workforce development strategies .
Furthermore, evidence suggests that education and training interventions can improve workforce retention and performance, particularly when combined with supportive organisational environments and career progression opportunities [3].
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5. Simulation and Innovative Education Approaches
Simulation-based learning has emerged as a key strategy for enhancing clinical competency in nursing education. Evidence demonstrates that simulation can improve decision-making, confidence, and clinical performance, particularly in complex care scenarios [12].
Recent studies also highlight the potential for innovative technologies, including digital and hybrid learning approaches, to support workforce training and scalability in education programs . These approaches are particularly relevant for resource-limited settings, where traditional clinical training opportunities may be constrained.
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6. Transition-to-Practice and Workforce Retention
The transition from student to practicing nurse is widely recognised as a critical period influencing workforce retention. Studies consistently show that structured transition programs, including mentorship and preceptorship, improve job satisfaction and reduce attrition rates [10].
However, such programs are inconsistently implemented across aged care settings, contributing to ongoing workforce instability. This gap is particularly pronounced in resource-limited settings, where formal support systems may be absent.
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7. Synthesis of Key Gaps
Across the literature, several consistent gaps emerge:
- Insufficient emphasis on aged care in nursing curricula
- Lack of standardised competency-based education frameworks
- Poor quality and variability of clinical placements
- Limited access to simulation and innovative training methods
- Weak transition-to-practice support systems
- Absence of clear career pathways in aged care nursing
These gaps collectively contribute to workforce shortages, reduced clinical competency, and challenges in delivering high-quality aged care services.
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8. Implications for Future Research
The literature highlights the need for further research in several key areas:
- Development and evaluation of competency-based aged care curricula
- Effectiveness of simulation and digital learning in aged care education
- Workforce retention strategies specific to aged care settings
- Comparative studies between high-income and resource-limited contexts
Addressing these research gaps is essential for strengthening nursing education systems and improving workforce sustainability in aged care globally.
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Summary
The existing body of literature demonstrates that workforce challenges in aged care are closely linked to deficiencies in nursing education and training systems. While evidence supports the effectiveness of competency-based education, simulation, and structured transition programs, these approaches are not consistently implemented.
Strengthening education systems, aligning training with workforce needs, and investing in innovative learning models are critical to addressing the aged care workforce crisis.
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