Career Practice Research Articles

PPE for your mind: a peer support initiative for health care workers.

PPE for your mind: a peer support initiative for health care workers.

Medical students\u2019 attitudes towards careers in primary care in Singapore

BackgroundSingapore needs more family doctors to care for its ageing population and their chronic conditions. While there is a shifting of care from acute care settings to more community care, this has not been reflected in the primary care training in local medical schools. Furthermore, no research has explored how different aspects of the medical school curricula in Singapore influence students’ perceptions of careers in General Practice and Family Medicine- a gap that is filled by this study.MethodsSix focus groups involving 54 students from all three medical schools in Singapore were conducted. Discussions focused on their primary care experience, their professional and career aspirations, and perceptions towards the opportunities and challenges of primary care careers. Qualitative content analysis was used to interpret the data.ResultsThe respondents shared eight key concerns of pursuing primary care careers including limited professional opportunities, emphasis on lifestyle benefits rather than professional characteristics, need for business acumen, conflicts created by business in clinical care, mundane case mix, lack of continuity of care, limited consultation time, and specialists’ negative attitudes towards family doctors. The positive views articulated included the opportunities for entrepreneurialism and a portfolio career, breadth of clinical problems presented, and an improved future for primary care.ConclusionsImproving students’ perceptions of careers in primary care in Singapore would benefit from a concerted effort from multiple stakeholders; medical schools, healthcare providers, professional and regulatory bodies, and government.

Longitudinal GP placements – inspiring tomorrow's doctors?

ABSTRACT General practice worldwide is facing a severe recruitment crisis, with significantly fewer medical students choosing to pursue careers in primary care than are required to meet society’s growing demands. The role of GP placements and GP tutors has been highlighted as having a significantly positive influence on medical students’ perceptions of general practice. However, how students perceive these experiences to have influenced their subsequent career preferences remains poorly understood. We sought to explore how a longitudinal GP placement influences medical students’ preferences regarding a career in general practice, in order to gain a deeper understanding of the significance of such placements. Semi-structured interviews were undertaken with five fourth-year medical students using Interpretive Phenomenological Analysis methodology. Four overarching concepts were identified, with nine superordinate themes, to describe how a longitudinal placement had influenced medical students’ preference regarding a career in general practice. There appears to have been a matching process between an expanding knowledge of the realities of being a GP and an increasing understanding of self. The GP tutor and ‘authentic’ experiences to consult patients themselves developed a growing sense of self-efficacy within students, all of which resulted in a significant internal desire to become future GPs.

Immigrant Neurologists in the United States: The Path of Most Resistance.

International medical graduates (IMGs), individuals who graduated from medical school outside of the United States or Canada, constitute 31.3% of active neurologists and one-third of current neurology trainees. Although three-fourths of IMG neurology trainees are not US citizens, they are an integral part of our trainee and practice workforce. IMGs play a vital role in providing greater access to health care for millions of patients, particularly in traditionally underserved regions and in the face of a current global health care crisis. With this article, we outline some of the unique challenges faced by immigrant, US-trained neurologists as they seek to provide neurologic care across the country, including preparing and applying for residency, securing authorization to remain in the United States to practice, and positioning themselves for successful careers in academic and private practice. We also call for advocacy and legislation to help reduce these barriers as a means to address the increasing physician workforce gap.

Newly qualified nurse: choosing to work as a GPN

In this new column, newly qualified nurse Mark Gourlay explains what attracted him to a career in general practice

For a postcolonial turn in career guidance: the dialectic between universalisms and localisms

ABSTRACT This paper draws on the fund of regional knowledge about career guidance that comparative research has generated in the “global South”. The goal of the paper is to add another voice to the challenge to the universalising language that characterises career guidance theory and practice, and to further highlight the serious attention that needs to be given to “localisms” and “particularisms” so that responses that are sensitive to context can emerge. While several authors make a case for attention to context, few explicitly link epistemological and ontological concerns to the issue of political power. In contrast, in this paper I argue that inductive theorising is more likely to not only generate relevant and useful knowledge and practices: it is also more likely to serve the interests of social justice.

Impact of early direct patient care introductory pharmacy practice experiences on student pharmacists' career exploration

Background and purposeThe University of Kentucky College of Pharmacy piloted a novel longitudinal introductory experiential program to provide second (P2) and third (P3) year professional students early exposure to pharmacist-provided direct patient care, opportunity to develop professionally expected behaviors, and ability to explore contemporary pharmacy career options. This paper describes the influence of the pilot on pre-advanced pharmacy practice experiences (APPEs) career interests and professional development. Educational activity and settingForty P2 and P3 students participated in the longitudinal experiential pilot course. Students were assigned to 32 pharmacist preceptors in a variety of direct patient care practices. Students completed 16 onsite hours over the fall semester. Influence of the pilot experience on APPE plans and future career interests was assessed by an end of experience reflective assignment and survey. FindingsThe pilot course served as the initial exposure for the majority of students to both direct patient care and specialized areas of pharmacy practice. Nearly half of students indicated the experience advanced their knowledge of pharmacists' scope of practice and potential career opportunities. Most students (85%) reported the experience influenced future career plans, with half indicating increased interest in their specific practice specialty. Over 75% planned to pursue an APPE in that practice area. Nearly all students reported making professional contacts through this experience. SummaryEarly exposure to direct patient care and specialized pharmacy practice areas through this IPPE provided students opportunity to inform career interest and develop professional contacts with preceptors in specialized practice areas.

A critique of the Capability Approach\u2019s potential for application to career guidance

In this article, we provide a balanced critique of Sen’s Capability Approach (CA) with reference to its potential to inform career guidance theory and practice. There are varying understandings and interpretations of the CA. Some see capabilities as universal, whilst others favour a more relativist view. The CA is also vulnerable to misunderstanding. Critiques based on misunderstanding are easily dismissed, so our focus is on substantive conceptual and practical critiques. Three main challenges are explored: conceptual debates about the nature of freedom and justice; limitations arising from the disciplinary origins of the CA; and challenges in operationalising the CA.

“We learnt it, then we lived it”: Influencing medical students’ intentions toward rural practice and generalist careers via a socially-accountable curriculum

Objective The James Cook University (JCU) medical school has a mission to produce graduates committed to practising with underserved populations. This study explores the views of final-year students regarding the influence of the JCU medical curriculum on their self-reported commitment to socially-accountable practice, intentions for rural practice, and desired postgraduate training pathway. Methods Cross-sectional survey of final year JCU medical students (n = 113; response rate = 65%) to determine whether their future career directions (intentions for future practice rurality and postgraduate specialty training pathway) are driven more by altruism (commitment to socially accountable practice/community service) or by financial reward and/or prestige. Results Overall, 96% of responding students reported their JCU medical course experiences had cultivated a greater commitment towards 'socially-accountable' practice. A commitment to socially-accountable practice over financial reward and/or prestige was also significantly associated with preferring to practise Medicine in non-metropolitan areas (p = 0.036) and intending to choose a ‘generalist’ medical discipline (p = 0.003). Conclusions The findings suggest the JCU medical curriculum has positively influenced the commitment of its graduating students towards more socially accountable practice. This influence is a likely result of pre-clinical teachings around health inequalities and socially-accountable medical practice in combination with real-world, immersive experiences on rural and international placements.

THE IMPACT OF THE EXPECTATIONS OF PROFESSIONAL PRACTICE ON CAREER MOTIVATION: A STUDY ON THE STUDENTS OF HEALTH MANAGEMENT DEPARTMENT

Üniversitelerdeki teorik eğitimlerin kalıcı olması ve bu eğitimin gerçek iş yaşamında uygulanabilmesi için mesleki uygulama, öğrencilerin eğitim hayatında önemli bir yer tutmaktadır. Bu nedenle çalışma, mesleki uygulama yapan sağlık yönetimi bölümü öğrencilerinin mesleki uygulama beklentilerini karşılama derecesinin, kariyer motivasyonları üzerindeki etkisini incelemek amacıyla gerçekleştirilmiştir. Araştırmada, 5 üniversitenin mesleki uygulamaya katılan 305 sağlık yönetimi bölümü öğrencisine tanımlayıcı sorular, mesleki uygulama beklentilerini karşılama derecesi ile ilgili sorular ve Kariyer Motivasyonu Ölçeği’nin yer aldığı anket formu uygulanmıştır. Çalışmada örneklem seçimine gidilmeyip çalışma evrenine ulaşılmaya çalışılmıştır. Verilerin analizinde; ortalama, standart sapma, t ve ANOVA testi, faktör analizi, korelasyon ve regresyon analizinden yararlanılmıştır. Mesleki uygulama beklentilerini karşılama derecesi ile cinsiyet, yaş ve öğrenim görülen üniversite değişkenleri karşılaştırıldığında aralarında anlamlı bir fark bulunmuştur (p<0,05). Kariyer motivasyonunun kimlik alt boyutu ile cinsiyet grupları arasında da anlamlı bir fark bulunmuştur (p<0,05). Mesleki uygulama beklentilerini karşılama derecesi ile kariyer motivasyonu arasında “orta düzeyde” (r=0,373; p<0,01) anlamlı ve pozitif bir ilişki saptanmıştır. Mesleki uygulama beklentilerini karşılama derecesi, kariyer motivasyonundaki değişimin %14’ünü açıklamaktadır. Sonuç olarak, öğrencilerin eğitim sürecinde yapmış olduğu mesleki uygulama ile mesleği konusunda bilgi, beceri ve tecrübe kazanımları ve mesleki bakış açısı, onların kariyer hedeflerini ve kariyer planları yapabilmeleri için gereken kariyer motivasyonunu sağlamaktadır.

CAREER STRATEGIES FOR MODERN WOMEN

In this article, the author focuses on the formation of career practices of modern women. In recent decades, there has been a change in the labor market, the entry of women into those sectors of the economy that were traditionally considered male. Due to the changing professional status of women, their career aspirations have expanded. They are no longer confined to traditional feminine areas such as education or nursing. They have joined the global workforce as doctors, lawyers, teachers, designers, truck drivers and many other professions. Discrimination against women still exists in various forms, especially in the workplace.

Progression of Citation-Based Scholarly Activity from Postgraduate Year One to Postgraduate Year Two in a Current Radiation Oncology Resident Class

Recent work has demonstrated multiple measures of citation-based scholarly activity. Measures including Hirsch index (h-index), h-index limited to first-author manuscripts (hf), h-index limited to first or second-author only manuscripts (hs), and g-index have been associated with radiation oncology resident choice of academic versus private practice career. To date, there has been no evaluation of the progression of citation-based scholarly activity during residency. A list of radiation oncology residents from the graduating class of 2022 (PGY-2 academic year of 2018-2019) was obtained through internet investigation. Citation-based scholarly activity was collected and calculated from searches of the SCOPUS bibliometric citation database for h-index, hf, hs, and g-indices for each resident as previously described. Calculations were derived in June 2018 for the PGY-1 year, and in June 2019 for the PGY-2 year. Fisher’s exact test was used for statistical analysis. Analysis of 195 residents from the 2022 class revealed that the citation-based scholarly activity significantly increased from PGY-1 to PGY-2 for h-index (2.59 to 3.23; p=0.047) and g-index (4.03 to 5.13; p=0.045), but not for hf (1.03 to 1.28; p=0.169) or hs (1.48 to 1.88; p=0.0654). From the PGY-1 to PGY-2 year, the proportion of residents with hf of zero (no cited articles as first author) decreased from 43.6% to 38.5%, as did the proportion of residents with hs of zero (no cited articles as first or second author) from 32.3% to 26.7%. Underrepresented minority race/ethnicity (African-American/Hispanic) did not impact the significance of the h-index and g-index findings. From the PGY-1 to PGY-2 academic year, radiation oncology residents significantly increased in citation-based academic productivity, with an increase in the proportion of residents with a cited first-or-second author manuscript. Further study is necessary to determine how this trend persists in future years.

Factors associated with the entry to general practice training: A multicentre study

Background Despite recent studies regarding general practice (GP) career decision-making, the impact of primary care exposure during undergraduate study on career-decision-making remain unclear. Purpose To examine the association between primary care exposure with the entry to GP training. Methods An unmatched case–control study design was employed. A total of 130 trainees in GP training and 260 trainees in other speciality training were randomly selected from speciality training registration. Questionnaires were used to identify primary care exposure and factors associated with career-decision making. Odds ratios (OR) and logistic regression were used to examine the association between the entry to GP training and those factors. Results The response rate was 66.4%. Three variables were found associated with entering GP training, including timetabled primary care sessions in all three clinical years (adjusted OR = 2.91; 95% CI = 1.23 − 6.88), enrolling in rural medical student recruitment schemes (adjusted OR = 3.07; 95% CI = 1.05 − 8.99) and valuing core values of GP (adjusted OR = 8.46; 95% CI = 3.27 − 21.88). Conclusion Our findings suggest that timetabled primary care sessions in all three clinical years has a positive influence on entering GP training. This research extends our knowledge of primary care exposure regarding continuity of the exposure.

Medical Students’ Career Choice and Attitudes towards Family Medicine in Morocco

Background. The motivation of this work is driven on the one hand from the need to understand the medical students’ attitude towards medical training in the context of the reform in Morocco and the creation of “family medicine” as a specialty. This study aims to explore the expectations of medical students regarding family medicine and to identify the factors that may influence setting their choices after graduation. Methods. We conducted a cross-sectional study among Moroccan medical students from public faculties during the month of August 2019. The data collection was based on an online self-administered electronic questionnaire. The quantitative data were analyzed by SPSS version 16. The analyses were descriptive univariate (Fisher’s test) and multivariate (binary logistic regression) with a P value of 5%. The qualitative data were synthesized according to a thematic analysis grid. Results. The medical students in Morocco have a positive perception of family medicine as an important specialty but low interest in it as a future career. Only 6.4% had the intention to choose it as a future career. However, 27.5% chose to become a general practitioner if it is a specialty (family medicine, as part of the new medical reform). The factors associated with the choice of career in general practice were mainly the ambition for career development (OR = 4.8; 95% CI [2.46; 9.51]), income (OR = 2.6; 95% CI [1.11; 6.29]), or the personal experience as a student or patient in contact with a general practitioner (OR = 0.48; 95% CI [0.25; 0.92]). Conclusion. The practical experience with family medicine seems to have an important influence on being attracted to family medicine careerwise. The study findings will inform future planning to introduce the residency program.

Women in Medicine: Dr. Danielle Martin

Dr. Danielle Martin is an Associate Professor at the University of Toronto and Executive Vice President and Chief Medical Executive at Women’s College Hospital in Toronto, where she is also a practicing family physician. Her career epitomizes an idea that is often discussed in medical training, but rarely manifests in practice: physicians are both advocates for individual patients and stewards of public health equity at a systems level. Dr. Martin has dedicated her career to improving and strengthening Canada’s universal health care system. She is a public leader in the ongoing debate about health care privatization and founded the organization Canadian Doctors for Medicare. Notably, Dr. Martin spoke about Canadian health care and advocated for single-payer health care in a widely publicized US Senate hearing led by Senator Bernie Sanders. She has also published a book titled, Better Now: Six Big Ideas to Improve Health Care for All Canadians, which breaks down complex health policy into six actionable steps in order to improve the health care system for all Canadians. She continuously advocates for public involvement in health policy through research and public outreach and is a role model for young physicians aspiring to leadership roles in health and health care policy, while simultaneously pursuing a career in clinical practice. In fact, doing both provides a unique framework for improving the individual wellbeing and health of Canadians. Dr. Martin believes that advocacy is a skill that requires practice and training; she advises young trainees that the time to start is now.

Familial Support as a Determinant of Women Career Development: A Qualitative Study

Although women’s participation in the workforce has increased remarkably in recent times but women are still lagging behind because of the traditional thinking and attitudes of their families in the context of Bangladesh. The purpose of the current study was to explore the role of the family in shaping women’s career development. The study was conducted in a qualitative approach and it was exploratory in nature. The study was conducted during November-December, 2019 in Khulna division, Bangladesh. The purposive sampling procedure was used to select the 25 respondents of the study. The respondents constituted of working women from different professions. Primary data was collected through semi-structured in-depth interviews extending from 35 to 45 minutes. The collected data were analyzed using thematic analysis method and nine themes emerged from the transcripts. The emerged themes were acceptance and aspiration from family, spousal support, being a mother, grown-up children as helping hands, family and work balance, family as a social network, family as a barrier, family as a lever, and gender inequality. This research highlighted the fact that women’s career practices and its development depended highly on familial roles. The family possesses the ability to affect women’s career success both positively and negatively. The study revealed that women who received positive support from their families were more motivated and achieved greater success in their professional life. Family can serve both as a lever as well as a barrier in shaping a woman’s career.

67 Airway Skills in Paediatrics: Infants are Not Just Little Children

Abstract Background Airway skills such as intubation and bag-valve-mask ventilation (BVM) have historically been considered necessary skills for all general paediatricians. Recently, evidence has driven practice toward goals of reduced invasive respiratory intervention and support. While patient outcomes have improved, implications include reduced airway skill training opportunities for paediatric residents, and possibly challenges in maintaining proficiency for practicing paediatricians. From postgraduate and continuing professional educational perspectives, the specific airway skill needs for Canadian paediatricians in contemporary practice are unclear. Objectives Identify those airway skills that are critical to general paediatric practice in Canada, and whether the skill needs differ by patient age. Design/Methods Data on general paediatric procedural practice was collected in 2018 via a one-time survey through the Canadian Paediatric Surveillance Program. A database was created from the 938 collected responses. The survey asked paediatricians to indicate the frequency of performance, opinion of importance, and challenges in maintaining proficiency of various airway procedures. Data was analyzed descriptively, and questions discriminating infant (age < 2y) vs. child (age ≥ 2y) were compared by chi-square or Fisher’s exact test, as appropriate. Results In total, 481 (51.3%) respondents worked ≥ 50% in general paediatrics and formed the main analysis group. Responses represented broad ranges of career duration, national geography, and practice settings. BVM of infants was the most commonly performed procedure, with 196 (40.8%) performing this monthly. Infant intubation was performed monthly by 58 (12.1%). A total of 355 (73.8%) and 402 (83.6%) reported never performing laryngeal-mask airway insertion and tracheostomy tube exchange respectively. Both BVM and intubation were performed significantly more frequently in infants than in children (p < 0.001). While many respondents considered BVM and intubation of children as essential skills, significantly more rated performing these skills on infants as essential to their practice (p < 0.001). Of those paediatricians that performed procedures as part of their practice, 68/309 (22.0%) and 192/304 (63.2%) reported difficulty in maintaining proficiency in the skills of infant BVM and intubation respectively. Conclusion Although variably utilized, airway skills in infants and children remain a core aspect of practice for many general paediatricians. Specifically, skills related to infants were performed more frequently and were more often rated as essential. Most respondents felt it was challenging to maintain proficiency in several airway skills. Accordingly, airway skills, especially those involving infants, should be emphasized in paediatric residency programs and continuing professional development activities.

What factors influence medical students to enter a career in general practice? A scoping review.

Internationally, healthcare systems are providing more community-based care. Consequently, there is an increasing demand for GPs and other healthcare professionals to work in primary care and this has implications for undergraduate medical education. In this scoping review, we aim to examine 'What factors positively influence medical students to pursue a career in general practice?' The five-stage framework developed by Arksey and O'Malley (2005) was utilized to review the extant literature. Fourteen records were included in the review. Medical students are influenced to pursue a career in general practice due to curriculum factors such as exposure, positive clinical rotation experiences, positive GP role models and maintaining a positive view of the profession at an early stage of their time as a medical student. Intrinsic factors such as student attributes, the influence of family, friends and the community where people live and having a strong orientation to social concerns were factors that make students more likely to pursue a career in the specialty. There is a shortage of literature from an Irish context examining the career intentions of medical students specifically. However, those studies which were conducted in Ireland reported similar findings to those conducted elsewhere. Curriculum and personal factors have a key role in influencing students to pursue a career in general practice. As much of the existing research involves cross-sectional designs involving small numbers of participants, further research adopting prospective, quasi-experimental designs involving larger cohorts is a priority.

Effects of professional identity on turnover intention in China's hotel employees: The mediating role of employee engagement and job satisfaction

This study investigated the relationships among professional identity, employee engagement, job satisfaction, and turnover intention of hotel employees in China based on the conservation of resources theory. The research was operationalized using empirical data collected from 1312 hotel employees in China. By leveraging the structural equation modeling technique, the findings confirmed that the professional identity of hotel employees is a second-order structure consisting of four dimensions: career practice, career affirmation, identification with commitment, and reconsideration of commitment. Further, the results showed that professional identity has a positive impact on employee engagement and satisfaction and a negative impact on turnover intention. Meanwhile, employee engagement and job satisfaction have negative effects on turnover intention. In addition, we further explained the mediating role of the two variables, namely, employee engagement and job satisfaction, between professional identity and turnover intention. This study contributes by investigating the research field of professional identity in the hospitality workplace and evaluating its impacts on various work performance metrics. Hospitality practitioners and scholars may find many useful insights based on the study findings.

Analysis on the Whole Process Approach of Career Planning Guidance for College Students

With the introduction of the policy of expanding enrollment in colleges and universities, many colleges and universities in the country have added specialties and increased enrollment scale. In the past 20 years, the number of college graduates in China has increased rapidly. The employment situation of many college graduates is not optimistic because of the shortage of professional skills and fierce competition. Although many colleges and universities now have the courses of career planning and employment guidance, to give college students the psychological guidance of employment , vocational training and planning, to help college students improve their competitiveness in employment. However, these guidance can help students to carry out career planning, targeted learning and practice, but in practice, because of different grades, different periods of students' personal needs, psychological characteristics, employer needs and so on, the original guidance can not meet the needs of students' employment competitiveness and growth, talent. Based on this, this paper discusses how to carry out the guidance of career planning for college students more effectively from the perspective of effectiveness and whole process.