Table 1.

Reported additional challenges for rural researchers.

Themes and Issues	Example of Issues Raised
1. Governance and site-specific approvals Delays blow out budgets and timelines Time-consuming governance processes including documenting and costing staff time to the minute High staff turnover in regions; Repetitive processes; Poorly designed systems; Poorly trained support staff; Gatekeeping; Adversarial “us and them” culture.	We were on a pretty tight timeframe. Initially, we wanted to get the ethics done within six months and because we were going through the new RGS, it had already taken us so much time. We foresaw that two more months was going to blow it out. And the other person who was starting was a registrar, and she was only with us for another six months, and it became completely unacceptable for that kind of time delay. (P8) I’d describe the experience as terrible and unnecessarily complicated. My research associate described the people she was dealing with (in the RGO) as ‘almost militant’. Like they have the power over us, that kind of attitude. That is absolutely unacceptable in medical research and it just has to change. And it seems to me that governance believes they are above everyone else and they control everything. If they say ‘no’ then you can’t do anything. And it cannot be like that in research…(P13)
2. Multi-site approvals and reporting Process of nationally certified ECs appear not well understood by the certified committees themselves; Reciprocal processes uneven between committees and regions/jurisdictions; Onerous reporting to multiple committees on different time schedules; Complexity of the process discourages ambitious projects that deliver more generalisable results. Processes change without this being clear to rural researchers.	(In the future) I wouldn’t try to engage with so many sites. I’d encourage smaller, less ambitious projects…You could do a small one in one community and have something to give back to that community. But it’s a bit more ambitious to have input into health planning more generally. Multiple sites make more sense from that perspective. When you’re talking about regional Australia, you can’t generalise from one area so you need more diversity in what you’re looking at…it’s all about diversity and small projects just don’t deliver on that. They can have good insights but service level projects need a broader brush. (P15)
3. Service evaluations and quality assurance Committees don’t understand the nature of the research, especially qualitative studies and evaluation research; Forms and systems unsuitable for service research.	The software (RGS) needs to be more intuitive. The fields don’t match with research that’s not clinical trials or drug interventions. So that immediately puts qualitative researchers, social science researchers…all of which seem to be more prominent in rural areas—at a disadvantage. It’s not fit for purpose for rural researchers. (P4)
4. Aboriginal research approval processes Individuals can dominate the process; No low-risk pathway.	The moment you mention “Aboriginal” research, the level of caution escalates. I can understand why but it’s ironical that in the service of improving health care for Aboriginal people, you can experience so many barriers. Of course, you want ethical processes and due diligence but I’m not sure that this process encourages good research. (P12)