Critical Workforce Research Articles

Nature-Based Feasibility Intervention to Influence Mitigation Strategies for Perceived Stress.

Burnout, compassion fatigue, and perceived stress among undergraduate nursing students are significant factors leading to a poorer quality of life, decreased job satisfaction, and adversely impact patient outcomes. Burnout among undergraduate nursing students is a critical individual and workforce issue with contributing factors including a relentless schedule, academically challenging and rigorous programs, pressure to perform, and the completion of clinical hours caring for patients. This paper describes our feasibility study of a nature-based intervention (NBI) to reduce perceived stress and quality of life as it relates to burnout, and compassion fatigue. Quantitative data was collected through demographics, surveys, and electronic sensor data. The project’s aim was to determine the feasibility of NBI monitored by NatureDoseTM to decrease perceived stress burnout and compassion fatigue among undergraduate nursing students.

Public Health in the Public Eye: Experiences of Ohio's Public Health Workforce During COVID-19.

The COVID-19 pandemic was uniquely challenging for public health workers charged with enforcing recommendations. In the United States, media reports highlight frequent outbursts and threats from community members and elected officials regarding masking protocols, vaccine mandates, and other public health measures such as isolation/quarantining recommendations. Given this backdrop, the purpose of this study was to better understand the lived experiences of this critical workforce in the context of COVID-19. We conducted in-depth phone interviews with public health workers in Ohio (N = 11). Questions were designed to illicit workers' experiences and sense-making of the pandemic experience. We analyzed results using the techniques of interpretive phenomenological analysis. Five major themes focused on how workers experienced public perceptions of COVID-19 and the public health response. Three themes highlight the role of media and social media in polarizing public perceptions. These we note as: Dealing with Deadlock, Feeling Misunderstood and Misrepresented, and The Rollercoaster of Public Opinion. Getting on With the Work reveals strategies used to navigate public perceptions and misperceptions. This ranged from aggressive education and information sharing, to setting boundaries around the controversial or disputed aspects of the pandemic. Finally, After the Dust Settles comments on hopes for postpandemic transformations of public health and public perceptions thereof. These results can inform new pathways for public health. Paramount among these are effective strategies that address public knowledge, values, and worldviews. Such messaging must promote nuanced understanding and customized approaches for local realities, rather than relying on rigid dichotomies that further polarization and distrust.

Grouping Public Health Skills to Facilitate Workforce Development: A Factor Analysis of PH WINS.

This study examined whether distinct factors exist among public health skills, measured through the Public Health Workforce Interests and Needs Survey (PH WINS). Understanding how workforce training needs group is important for developing targeted and appropriate public health workforce training sessions. Exploratory factor analysis was used to examine public health skills among tier 1 staff (nonmanagers) and a combined group of tier 2 and 3 staff (managers and executives). Data for this study come from the 2017 PH WINS, which assessed public health workforce perceptions of training needs, workplace environment, job satisfaction, perceptions about national trends, and demographics. The analysis included 22 items. All public health staff in participating agencies were eligible to complete the survey. The national data set included participants from 47 state health agencies, 26 large local health departments (LHDs), and 71 mid-sized LHDs across all 10 Health and Human Services regions in the United States (including LHDs from all states). The analytic sample was n = 9630 in tier 1, n = 4829 in tier 2, and n = 714 in tier 3 staff. Three factors were identified within the skills portion of PH WINS, using exploratory factor analysis. To interpret retained factors, the following parameters were used: factor loadings greater than 0.4, factor cross-loadings less than 0.4 or higher than loadings on other factors, and communalities greater than 0.5. Factors included (1) data and systems thinking, (2) planning and management, and (3) community collaboration, with slight variation in item loadings between tier 1 and tier 2 and 3 staff analyses. This study was the first known factor analysis of the training needs and workforce skills portion of PH WINS in the published literature. This study advances our conceptualization of public health workforce skills and has the potential to shape future critical workforce training development.

HRSA's Investment in Public Health Training Centers.

HRSA's Investment in Public Health Training Centers.

Regional Public Health Training Centers: An Essential Partner in Workforce Development.

Regional Public Health Training Centers: An Essential Partner in Workforce Development.

Public Health Training Centers' Support for Community Health Workers: Case Studies of Needs Assessment, Training, and Student Field Placement Initiatives.

Community health workers (CHWs) are vital frontline public health workers. Given their trusted roles and connection to and understanding of the communities they serve, CHWs are able to link underserved communities to resources and public health agencies. With CHWs' increased prominence in the public health workforce, calls have been made for expanding and supporting CHW training and career development opportunities. Public health training centers (PHTCs) are mandated to assess public health workforce needs, provide evidence-based professional development trainings, and increase students' aptitude for working with underserved and underresourced communities through applied practice experiences. Public health training centers can support CHWs in each of these areas. Case studies from 3 PHTCs are provided to exemplify how PHTCs are well positioned to support the critical CHW workforce via assessment, training, and student field placements. A regional needs assessment survey with a designated section for CHWs, the provision of accessible and relevant CHW training, and CHW-focused student field placements were implemented in PHTC Regions 6/South Central, 1/New England, and 5/Great Lakes, respectively. The Region 6 needs assessment found that CHWs in Oklahoma had multiple core roles and training interests. A crosswalk of needs and available training in the region guided the creation of tailored CHW trainings. Across 35 CHW-targeted trainings in Region 1, 88.5% of trainees were satisfied with the trainings and identified actions they could take to apply information they learned to their work. Significant improvements ( P < .001) in knowledge occurred across the 13 trainings that had pre-/posttests. In Region 5, students engaged with CHW-based organizations in Wisconsin to inform statewide CHW priority action items and deliverables and found the field placements meaningful for their academic experience. Public health training centers' strengths in workforce development can complement and extend existing efforts to support the CHW workforce.

The Digital Engineering Competency Framework (DECF): Critical Skillsets to Support Digital Transformation

ABSTRACTIn the US, the Department of Defense (DoD) is engaging in major digital transformation efforts to modernize the defense workforce, particularly the engineering acquisition workforce to ensure that the workforce remains technically competent. This effort was kicked off with the publication of its Digital Engineering Strategy in 2018. Digital engineering is necessary to update and support systems engineering practices to maintain a competitive advantage in data analytics, data science, computation technology, modeling, and simulation. The DoD envisions successful digital engineering transformation through the modernization of the way the Department designs, develops, delivers, operates, maintains, and sustains systems. One of the key aspects of this transformation is developing a digital engineering competency model to develop and sustain the workforce. In 2019, the DoD tasked the Systems Engineering Research Center (SERC) with the creation of a “Digital Engineering Competency Framework (DECF)” as part of its critical digital transformation and workforce development modernization efforts. Though created in the context of the US DoD, the DECF is not intended to be a defense‐ or US‐centric and instead provides a foundation for any individual or organization looking to embark on digital transformation. This paper provides an overview of the DECF and its potential relationships with other competency frameworks.

Admitting what is needed: How the health system and society can reduce hospitalizations for children with medical complexity.

Admitting what is needed: How the health system and society can reduce hospitalizations for children with medical complexity.

Surgeons’ perspectives on facilitators and barriers to fellowship training in hospice and palliative medicine (575)

<b>Objectives:</b> While there is a national shortage of Hospice and Palliative Medicine Providers (HPM), surgeons comprise only 2% of the HPM workforce. The current study sought to explore facilitators and barriers to HPM fellowship training from the perspective of surgeons with training in HPM and a surgical specialty. <b>Methods:</b> We conducted a qualitative study utilizing semi-structured interviews with HPM fellowship-trained surgeons. Data were recorded, transcribed, and coded. Descriptive statistics were used to summarize demographic data, and thematic analysis was used to identify themes in participant responses. <b>Results:</b> There were 17 participants, including general surgeons (<i>n</i>=5), surgical specialists (<i>n</i>=5), general obstetrician/gynecologists (<i>n</i>=3), and obstetrics/gynecology specialists (<i>n</i>=4). All participants described having pivotal experiences that highlighted deficits in patient care, their clinical skillset, and/or their personal or professional development. Participants or their mentors recognized that practicing through a palliative care lens aligned with the participant's personal and professional identity and could fill self-identified deficits in their skillsets. These pivotal experiences and the participants' internal alignment with the HPM practice ultimately drove their decision to pursue an HPM fellowship. Many participants experienced bias when considering HPM, which was either internal bias and doubt or external bias or discouragement that they experienced during conversations with their mentors, faculty, and peers. Additionally, many participants had to overcome logistical barriers to pursue an HPM fellowship, including financial concerns, moving with spouses/families, coordinating an additional surgical fellowship, and navigating an uncertain job market post-fellowship. Ultimately, all participants found solutions to these barriers (JB1) and felt satisfied with their decision to pursue HPM training. <b>Conclusions:</b> Our participants emphasized the importance of mentorship and exposure to HPM as key facilitators to pursuing HPM training. While many participants had to navigate bias and logistical barriers, they felt HPM fellowship was feasible for surgeons and ultimately led to more satisfying careers in their current practice. Highlighting the experiences of HPM-trained surgeons who have navigated this underrepresented career path may empower other surgeons to consider HPM fellowship training and expand surgeon representation in the HPM workforce. HPM and surgical specialty organizations should work to mitigate the cultural and structural barriers to HPM surgical training identified by our participants to facilitate the growth of this critical healthcare resource, the HPM trained surgeon. This will add value to surgical and HPM care for patients, improve primary and specialty palliative care education in surgery and HPM, and foster HPM-oriented research within the surgical specialties while simultaneously addressing a critical HPM workforce shortage.

Future Directions for Global Clinical Neurosurgical Training: Challenges and Opportunities

Expanded access to training opportunities is necessary to address 5 million essential neurosurgical cases not performed annually, nearly all in low- and middle-income countries. To target this critical neurosurgical workforce issue and advance positive collaborations, a summit (Global Neurosurgery 2019: A Practical Symposium) was designed to assemble stakeholders in global neurosurgical clinical education to discuss innovative platforms for clinical neurosurgery fellowships. The Global Neurosurgery Education Summit was held in November 2021, with 30 presentations from directors and trainees in existing global neurosurgical clinical fellowships. Presenters were selected based on chain referral sampling from suggestions made primarily from young neurosurgeons in low- and middle-income countries. Presentations focused on the perspectives of hosts, local champions, and trainees on clinical global neurosurgery fellowships and virtual learning resources. This conference sought to identify factors for success in overcoming barriers to improving access, equity, throughput, and quality of clinical global neurosurgery fellowships. A preconference survey was disseminated to attendees. Presentations included in-country training courses, twinning programs, provision of surgical laboratories and resources, existing virtual educational resources, and virtual teaching technologies, with reference to their applicability to hybrid training fellowships. Virtual learning resources developed during the coronavirus disease 2019 pandemic and high-fidelity surgical simulators were presented, some for the first time to this audience. The summit provided a forum for discussion of challenges and opportunities for developing a collaborative consortium capable of designing a pilot program for efficient, sustainable, accessible, and affordable clinical neurosurgery fellowship models for the future.

Mixed-Methods Assessment Of A Pilot Decentralized Surgical Training Program For House Officers In Ghana

Introduction : There is a critical surgical workforce gap in low- and middle-income countries, particularly at first-level referral (i.e. district) hospitals. To address this gap we piloted a decentralized surgical training program for house officers at a district hospital in Ghana.Methods : Six house officers took part in the pilot program. Trainees participated in : i) didactic, videobased, and practical modules ; ii) intensive surgical immersion at a district hospital with consultant surgeon oversight ; and iii) a 12-month supervised rotation as asurgical care provider at a district hospital. Case mix and volume, complications, and perioperative mortality rate during the program were tracked. Anonymous feedback from the trainees was analysed with a content analysis framework.Results : In the 12-month pilot training program, 6 trainees were actively involved in carrying out 606 procedures either independently, under supervision or as assistant (mean : 101 procedures/trainee). The most frequent pre-operative diagnoses were hernia and complications of labour (432, 71.3%), followed by acute abdomen requiring laparotomy (85, 14.0%), soft tissue mass (21, 3.5%), hemopneumothorax or plearal effusion (19, 3.1%), hydrocele (16, 2.6%), abscess (12, 2.0%) and other (47, 7.8%). Twenty-three (3.8%) patients experienced complications, with the most common being surgical site infections (superficial : 8, 1.3% ; deep : 3, 0.5%). The perioperative mortality rate was 1.2%. Feedback from trainees was generally positive, but revealed several unmet challenges.Conclusion : Through the decentralized surgical training program Ghanaian trainees gained useful experience with essential surgical care at a first-level hospital and provided timely surgical care to patients.

NASEM Report to Improve Nursing Home Quality Makes Recommendations to Address Critical Workforce Issues.

NASEM Report to Improve Nursing Home Quality Makes Recommendations to Address Critical Workforce Issues.

COVID-19 Booster Uptake among First Responders and Their Household Members May Be Lower than Anticipated.

(1) Background: COVID-19 vaccination status varies widely among law enforcement and emergency medical services professionals. Though at high risk of exposure, these first responders have demonstrated significant vaccine hesitancy, with only 70% reportedly vaccinated. We sought to understand whether similar vaccine hesitancy exists for first responders and their household contacts around COVID-19 boosters. (2) Methods: In a prospective longitudinal cohort of first responders and their household contacts, survey data was collected, including demographics, medical history, COVID-19 exposure risks, and vaccination and/or booster status. The statistical analysis focused on primary vaccination and booster rates of both the first responders and their household contacts. (3) Results: Across 119 study participants, 73% reported having received some combination of vaccine and/or booster, and 26% were unvaccinated. Vaccinated individuals were older, reported less prior exposure to COVID-19 and had more comorbidities. Only 23% reported having received a COVID-19 booster. Pairing of the data for household contacts demonstrated a 60% agreement to receive primary vaccination but only a 20% agreement for boosters within households. (4) Conclusions: This study provides insight into the vaccination and booster rates of first responders and household contacts. Focused efforts to enhance vaccinations is essential for the protection and maintenance of this critical workforce.

Motivating and Critical Success Factors in the ISO 9001:2015 Implementa-tion of the Provincial Government of Bulacan

Quality is an essential performance measure in both the private and public sector. The adoption of a Quality Management System (QMS)/ISO 9001:2015 standard is a strategic decision that can help improve an organization’s overall performance. This study aimed to assess the ISO 9001:2015 implementation of the Provincial Government of Bulacan in terms of the selected critical success factors and workforce level of motivation and be able to provide recommendations for improvement. This study used the quantitative, non-experimental, descriptive research design, employing survey and correlational approaches. A qualitative approach through qualitative interview was also utilized to capture the implementation strategies. The overall analysis revealed that 8 motivating factors obtained a low level of relationship with all of the selected critical success factors while the 9th motivating factor, Recognition and Feedback Received obtained a high level of relationship with 7 critical success factors indicating that Recognition and Feedback Received can affect the implementation of QMS tasks in terms of the critical success factors. Findings also showed that there is an opportunity in trainings. Leaders can identify training needs to support a more effective QMS implementation. Furthermore, the Provincial Government of Bulacan can revisit and strengthen the performance evaluation process as this can help meet the upper-level self-actualization needs of employees. A quality program with the suggested action plan has also been recommended towards overall performance improvement.

An interdisciplinary and multi-level review of resilience to inform training of human resources for critical infrastructure

Following the broad application of the concept of resilience, the interdisciplinary and multi-level formulations have been blurred, calling for further research to explore the commonalities and differences of the concept across disciplines and organizational levels of analysis. In this research, we studied interdisciplinary formulations of the concept of resilience to explore how critical infrastructure workforce training to build resilience can be incorporated across individual employee (micro-level), team (meso-level) and organization (macro-level) levels. Informed by a systematic literature review and content analysis, an interdisciplinary and multi-level framework for resilience in the workplace was developed to guide organization-wide resilience training of critical infrastructure employees. This research can be used to inform practice by directing the focus of resilience training initiatives at each level. The paper's recommendations highlight the need for resilience training to focus on capacities and traits associated with anticipation in organizations to ensure the protection and resilience of critical infrastructure.

Active learning strategies in business education: using the law to build critical workforce skills

PurposeIn today’s global business environment, business learners and employees must adapt to ever-changing challenges. Active learning strategies like case-based learning and think-pair-share may be used in any business course, as they engage learners, may meet Association to Advance Collegiate Schools of Business standards and assist with employer needs through knowledge and skill enhancement in critical thinking, decision-making, problem-solving and collaboration. The purpose of this paper is to provide business instructors with three activities that are easily modified. The activities promote workforce skills and encourage reflection activities as an assessment. The intent of each scenario is to present solution-driven methods by which business challenges may be assessed and resolved.Design/methodology/approachSection 2 offers a literature review on case-based learning and think-pair-share. Section 3 includes three case-based activities that instructors may implement. Section 4 sets forth student assessment findings and a conclusion.FindingsThe findings demonstrated that learners reported positive benefits of case scenarios and think-pair-share on their ability to make business decisions, critically analyze, solve business problems and collaborate. Reflective observation was an insightful tool in assessing comprehension and skill-building for 68 learners in two sections of fall 2019 Legal Environment of Business courses. The contribution to literature is primarily practical. The activities foster educational effectiveness by stimulating learners to practice critical employment skills. The results also show that satisfaction, intensifying students’ engagement, enhances the educational effectiveness of the courses.Originality/valueThis study provides three original case-based activities with suggested content, handouts that may be copied for class use, instructor preparation, learning outcomes, objectives and assignment procedures.

ANCC Pathway to Excellence® now included in the Leapfrog Hospital Survey

ANCC Pathway to Excellence® now included in the Leapfrog Hospital Survey

Teaching the care of older people in Australian nursing schools: Survey findings

BackgroundMeeting the complex health needs of an increasing number of older people is a critical workforce challenge for the Australian health and aged care sectors. Nurses are the largest group of registered health care professionals and fundamental to delivering health and aged care in Australia. However, while nursing students encounter increasing numbers of older people in all health and aged care settings, little is known about how they are educationally prepared to care for them. AimTo investigate the curriculum content and method of teaching the care of older people in Australian Bachelor of Nursing degrees. MethodsA population sample of all Australian nursing schools offering Bachelor of Nursing degrees. Nurse academics involved in subject coordination or curriculum development were recruited. A telephone-assisted survey explored ‘the care of older people’ in Australian undergraduate nursing curricula. Descriptive statistical analyses were undertaken. ResultsThe response rate was 100%. Curricula were acute care focused with content specific to the care of older people scaffolded across curricula. A variety of teaching and learning methods were reported. Clinical experiences with older people occurred in residential aged care settings, generally in the first year of the degree. ConclusionsPreparation of pre-registration nurses for the care of older people requires improvement in curricula content and clinical experience to equip graduates to provide safe, person-centred care that meets the needs of older Australians.

An Inclusive Approach to Geriatric Specialization: The Society for Post-Acute and LTC Medicine AMDA Certified Medical Director Program as a Model for Association-based Training

This symposium addresses a critical need to grow the field of geriatric expertise by creating multiple learning options that reach clinicians at all phases of practice. The AAGP Strategic Planning meeting of September 2019 articulated several future goals including 1) Develop our own competency-based certificate program and 2) Offering a pathway to clinical expertise for clinicians (Tampi R, et al 2020). The strategic plan also strongly emphasized partnerships with like-minded organizations. This symposium highlights the success of the AMDA Certified Medical Director (CMD) Program. Dr Meenakshi Patel will discuss how AMDA developed the certification; she will review the core curriculum, the development of the initial certification and the subsequent recertification procedures. She will also discuss the advantages of the certification for other providers (e.g., PCPs, NPs). Discussion will address how new geriatric certification programs may supplement training conducted in traditional post-graduate settings and allow for critical workforce growth. Association-based certifications permit inclusivity for providers who are not able to avail themselves of post-graduate fellowships but wish to gain geriatric expertise. The value of “clinical pathways” to expertise will be discussed and stakeholders will be invited to explore ways for the AAGP to help create more diverse learning pathways in geriatric psychiatrySpeaker Meenakshi Patel will discuss the AMDA CMD certification program. She will review the core curriculum, development of the initial certification and subsequent recertification program.Panelists: Dr. Amita Patel will review an AAGP-based geriatric certification that was in development several years ago under her leadership and may be ready for a revitalized effort.Dr. Schultz will discuss possible targeted certifications (e.g., Geriatric Psychopharmacology) and models such as the AACP Board Certification In Community & Public Psychiatry, endorsed by the APA. Other training models (NIH T32, HRSA-based) will be noted.Dr. Lantz: Will address how an AAGP-sponsored certification may complement traditional post-residency fellowship programs in a productive way that meets growing workforce needs.Dr. Padala will discuss new VA programs to share geriatric expertise in case-based “Ask the Expert” and other on-line training formats. Growth in training programs offered by the VA and other healthcare systems will be discussed.The symposium will include audience discussion to begin a planning process that may include stakeholder input from clinicians, educators, association leaders and staff.

Expanding Our Capacity to Train Vascular Surgeons: Results of a National Initiative

In 2018, the Society for Vascular Surgery and the Association for Program Directors in Vascular Surgery formed a task force to address the critical workforce shortage facing our specialty. A key aim was to assess and mitigate the barriers to creating new vascular training programs.