Health Workforce Development Research Articles

Evaluation of postgraduate rural medical training programs and implications for rural workforce development: a systematic review.

Providing postgraduate rural training programs has been recognised as central for successful recruitment and retention of medical workforce. While there have been many documented cases of rural training program development, documented program outcome evaluations are few. This review investigated how postgraduate training and educational programs for rural and remote medicine are evaluated worldwide. Through the use of a systematic review, the study explored three questions: 'What are the outcomes of postgraduate rural and remote training programs worldwide?', 'How are the program evaluations conducted?' and 'What evaluation models and approaches are used in evaluating the effectiveness of these training programs?' A qualitative synthesis was undertaken of evaluations of postgraduate rural training programs published in the English language in medical education journals. The study involved pooling quantitative and mixed-methods research data and findings from qualitative studies, which were aggregated, integrated and interpreted. PubMed, PsycINFO, ERIC and Web of Science databases were searched to identify studies that satisfy the search criteria. Of the 1297 articles identified through the database search, 26 studies were included in the analysis. Most of the evidence from the studies consists of descriptive studies with some longitudinal tracking programs and cohort studies. Nine themes were identified: practice location after training completion; training location and decentralised model; educational aspects; incentives, political contexts and regulations; personal, social and cultural issues; professional development; rural orientation and community engagement; support system; and gender and racial issues. Key outcomes were analysed and cross-validated against the 2020 WHO guideline on health workforce development, attraction, recruitment and retention in rural and remote areas. These studies' most frequent evaluation methods were surveys, followed by interviews, questionnaires and secondary data from existing databases. Methodological characteristics, the relationship between rural background and program outcomes, and implications for decentralised training, telehealth and tele-assessment during the COVID-19 pandemic are discussed. Analysis from the key outcomes suggests evaluation as a strategy to uncover outcomes in postgraduate rural and remote training and medical education. Regardless of the similar outcomes, the program evaluations implemented and the robustness of evidence vary across programs and medical schools. The absence of solid evaluation designs and their alignment to the program objectives will lessen the strengths of evidence. Better quality research and evaluation design, objective settings, qualitative inquiry to uncover the contexts, and developing appropriate indicators and benchmarks for monitoring and evaluating strategies must be considered during program development and implementation.

Supporting Success: ASTHO's Strategies for Reducing Maternal Mortality and Morbidity.

Supporting Success: ASTHO's Strategies for Reducing Maternal Mortality and Morbidity.

Insights from the national maternal and Child Health Workforce Development Center on Title V Teams’ collaborative readiness and goal accomplishment

PurposeState Title V programs collaborate with diverse partners to improve maternal and child health. Since 2014, the National Maternal and Child Health Workforce Development Center has trained Title V leaders in facilitating system change. This article describes aspects of initial collaborative readiness differentiating state and jurisdiction teams that later reported meeting their goals to greater or lesser degrees.DescriptionWe used quantitative data from initial team leader reports to characterize readiness to collaborate with external partners, and their responses twelve months later to a prompt about how fully they had accomplished their goals. In addition, we coded excerpts from team leader accounts six and twelve months into their work with the Center, and retrospective coach perspectives, to identify collaborative readiness patterns.AssessmentTeams whose leaders reported higher goal accomplishment twelve months after beginning work with the Center had initially reported higher levels of collaboration with key partners. Our analyses suggest that such teams were also better able to use their cohort experience with the Center to improve collaboration, including information sharing with external stakeholders. Challenges working with Medicaid were reported both by teams with more and less goal accomplishment.ConclusionsTitle V teams with lower levels of initial collaborative readiness may benefit from additional support in skill development, connections to key partners, and convening power. Given the crucial and increasing role of Medicaid in maternal and child health systems, more attention may be warranted to supporting all Title V programs in partnering with this funder.

Behavioral Health Workforce Development in the era of COVID-19: Examples From a State-Funded Intermediary Organization.

Intermediary and purveyor organizations (IPOs) play a key role in disseminating and implementing behavioral health evidence-based practices. The COVID-19 pandemic created a time of crisis and disruption to behavioral health care delivery. Using the conceptual framework of basic, targeted, and intensive technical assistance (TA) from the Training and Technology Transfer Centers, case studies are used to describe how programs at The Center for Practice Innovations a state funded-intermediary organization, adapted its training and technical assistance to be delivered entirely remotely, to include content related to COVID-19 and to provide guidance on telehealth-based behavioral health care.

Public Health Workforce Development Through Virtually Interactive Training Courses.

Public Health Workforce Development Through Virtually Interactive Training Courses.

Regionalisation and general practitioner and nurse workforce development in regional northern Australia: Insights from 30 years of census migration data

The purpose of this research is to investigate the extent to which Australia's northern cities have become increasingly important mediators of migration of nurses and general practitioners (GPs) to the regional north since the 1980s. Over that period, national and provincial policy has focused on ‘regionalisation’ of health workforce development, including creating education and training infrastructure outside of metropolitan areas. This paper hypothesises that the effectiveness of regionalisation in northern Australia should be reflected in an increased net flow of GPs and nurses from northern cities (which are the hubs of education and training) to the regional north. Data from the seven Australian Census between 1986 and 2016 are used to model changing patterns of migration. Overall, there was limited evidence of substantial change in migration patterns, although for GPs there was a reduction in migration from the key metropolitan source markets (Brisbane and Adelaide) matching an increase in supply from northern cities. Northern cities have consistently been the source of about one quarter of new nurse and GP migrants to the regional north, but the regional north has become a much less favoured destination for professionals leaving northern cities as cities' populations have grown much faster than regional populations. Net flows have remained small and for nurses have favoured the cities while for GPs favoured the regional north. The paper concludes that, while there is limited evidence of increased ‘spillover’ of labour from the cities to the regional north, there is also no evidence of the cities increasingly ‘spongeing’ regional labour. Cities and regional migration systems may be increasingly disconnected as labour demands diverge, but new connections are being created with the rest of non-metropolitan Australia. The research is the first to analyse health professional migration over such a long period, and contributes to the debates about the roles of cities in sparsely populated areas in the development of their rural and remote hinterlands.

COVID-19 and Its Implications to the Assessment of Sustainable Palm Oil Supply Chain Management: An Indonesian Perspective

Motivated by the low sustainability index and pressure to meet the global demand for eco-friendly crude palm oil (CPO) in the pandemic-ridden environment, this research aims to investigate the implications of the COVID-19 pandemic to assess the drivers of sustainable supply chain management (SSCM) of the Indonesian CPO sector to tackle supply chain disruptions. To achieve this aim, the study seeks to determine the sustainability drivers to accommodate the pandemic-ridden environment and if sustainability indicators can help improve the supply chain management of the CPO sector. A methodology is divided into two interrelated parts: first, based on a careful review of extant literature of the CPO sector and sustainable supply chain in the light of pandemic. The proposed methodology is then tested using the response data of 108 oil mills' representatives collected through survey questionnaires and analyzed using statistical tools of reliability, distribution, Kaiser–Meyer–Olkin (KMO), Confirmatory Factor Analysis (CFA), and diagnostic tests of CFA. The findings designate the environmental costs, rapidity, and adaptability as core economic indicators; the social and workforce development, health, and safety workforce development and consumer issues as crucial social indicators; while energy and material efficiency, management of waste and emissions, and sustainable suppliers as the best environmental indicators. This study provides a holistic platform on the implications of the pandemic to assess the SSCM of the CPO sector. These findings are expected to aid the industrial managers in employee skills and health protocols, customer service, and environmental management. The study is also anticipated to guide the supply-chain partners and government policymakers to take initiatives on SSCM in the context of the pandemic.

Evidence assessment and narrative synthesis of the key characteristics of older people living in service-integrated housing facilities, and their ‘accommodation journey’

PurposeThis paper aims to provide an evidence assessment and narrative synthesis of literature regarding the key characteristics of older people living in service-integrated housing (SIH) facilities and their “accommodation journey”.Design/methodology/approachA rapid evidence assessment was conducted: 22 research publications met the inclusion criteria and were analysed using narrative synthesis.FindingsThe quality of studies in this area is low, but consistency across components of the results of studies included in the review is apparent. Results suggest key characteristics of older people that drive moves into SIH are a decline in health, increased dependency, increased health service use and carer burden. Suggested key characteristics of SIH residents are high levels of health problems, dependency and health service use, but high self-reported health and well-being. Results indicate that the key driver for older people leaving SIH is a lack of workforce competency to manage further declines in health and dependency status.Research limitations/implicationsCurrent policy may not realise or account for the complex health and care needs of SIH residents. Investment into integrated care, robust community health services and workforce development to facilitate a comprehensive assessment approach may be required to support residents to remain in SIH and live well. Further longitudinal studies are required to map the progression of SIH residents’ health status in detail over time to provide an understanding of preventative and enablement support, development of care pathways and workforce planning and development requirements.Originality/valueThis evidence assessment is the first to consider the accommodation journey of older people residing in SIH.

The toll of cascading crises on Lebanon's health workforce

The toll of cascading crises on Lebanon's health workforce

How are countries supporting health workers? Data from the COVID-19 Health System Response Monitor

BackgroundHealth workers have been at the forefront of treating and caring for patients with COVID-19. They were often under immense pressure to care for severely ill patients with a new disease, under strict hygiene conditions and with lockdown measures creating practical barriers to working. This study aims to explore the range of mental health, financial and other practical support measures that 36 countries in Europe and Canada have put in place to support health workers and enable them to do their job.MethodsWe use data extracted from the COVID-19 Health Systems Response Monitor (HSRM). We only consider initiatives implemented outside of clinical settings where COVID-19 patients are treated, and therefore exclude workplace provisions such as availability of personal protective equipment, working time limits or mandatory rest periods.ResultsWe show that countries have implemented a range of measures, ranging from mental health and well-being support initiatives, to providing bonuses and temporary salary increases. Practical measures such as childcare provision and free transport and accommodation have also been implemented to ensure health workers can get to their workplace and have their children looked after. Other initiatives such as offering continuing professional development credits for knowledge learnt during the crisis were also offered in some countries, albeit less frequently.ConclusionsWhile a large number of initiatives have been introduced, often as ad-hoc measures, their effectiveness in helping staff is unknown in most countries. The effectiveness of these initiatives should be evaluated to inform future crisis responses and strategies for health workforce development.

Conceptualisations of Leadership and Relevance to Health and Human Service Workforce Development: A Scoping Review.

PurposeThis scoping review was undertaken to determine leadership definitions and approaches relevant to health and human service (H&HS) workforce development. This review provides a preliminary analysis of the potential size and scope of available research literature to inform ongoing research with the ultimate aim to inform a future systematic review in relation to leadership development interventions.MethodsFollowing the methodology proposed by Arksey and O’Malley and using PRISMA-ScR, a systematic search was conducted using seven databases (PubMed, Health Business Elite, Medline, CINAHL, Ovid, Scopus, and Web of Science). Articles were screened and assessed for eligibility. From eligible studies, data were extracted to summarize, collate, and make a narrative account of the findings.ResultsEmploying pre-selected criteria, a total of 424 records were identified and 171 full-text articles were assessed. The majority of the papers were studies undertaken by researchers based in North America. Leadership in the H&HS sector was addressed in 35% of the articles. The narrow disciplinary or workforce fields of the nursing and medical professions in hospitals and acute care settings dominated the literature.ConclusionThe findings suggest that while leadership has been studied extensively in the health system, there is a paucity of leadership development research specific to the broader H&HS sector. This review emphasises the need for further research, including a more critical examination of leadership development interventions and their application to the H&HS sector.

Training a diverse workforce to address the opioid crisis

ABSTRACT This article describes an interprofessional workforce development program that aims to train current and future behavioral health professionals in culturally- and developmentally-appropriate, integrated care for adolescents and transitional-aged youth. This federally-funded program is implemented in one region in the United States because the location has a substantial shortage of providers. The program meets the local needs by training a diverse group of master-level graduate students and community partners on evidence-based practices for substance misuse, including opioid misuse, and common mental health conditions. This article includes recommendations on key aspects to include in behavioral health workforce development programs.

Our way of being: Infant and Early Childhood Mental Health workforce development in Tennessee.

The optimal relational experiences of infants and young children demand a cross-sector workforce informed by Infant and Early Childhood Mental Health (IECMH) principles and practices. A recent review by the Alliance for the Advancement of Infant Mental Health, Inc identified seven themes that help define "What makes an IECMH association strong?": (1) Identity, (2) Cross-Systems Collaborations, (3) Sound Organizational Structure, (4) Competency-Informed Training, (5) Reflective Supervision Capacity, (6) Policy, and (7) Higher Education. The present paper documents the story of the Association of Infant Mental Health in Tennessee (AIMHiTN) and the role of the Endorsement for Culturally Sensitive, Relationship-Focused Practice Promoting IECMH in that growth across those seven themes with the additional themes of (8) Funding and, (9) Diversity, Equity, Inclusion, and Belonging. First, foundational literature is reviewed to summarize IECMH-informed workforce development. Next, AIMHiTN's story of workforce development is mapped onto the nine themes and challenges and lessons learned are summarized. The article aims to serve as a roadmap for other states, provinces, territories, or nations hoping to develop their own Association for Infant Mental Health (AIMH) as well as a guide for those with existing AIMHs for promoting continued growth and sustainability.

Aligning Best Practices: A Guiding Framework as a Valuable Tool for Public Health Workforce Development with the Example of Ukraine.

Background: At present, in Ukraine, there is an insufficient capacity for up-to-date surveillance of the health status of the general population; public health (PH) promotion and disease prevention activities are scarce. Additionally, there is an urgent need to ensure, develop and support an efficient public health workforce (PHW) and appropriately address existing health issues. Ukraine currently introduces PH system reforms in line with its current burden of disease, the epidemiological profile and the Essential Public Health Services (EPHOs). This analysis aims to propose a pragmatic framework to provide guidance and recommendations related to the development, support and planning of the PHW in Ukraine. Methods: We constructed a framework based on a previously published scoping review and analyzed various policy analysis approaches. In line with the recommendations found in the literature and the best practices used elsewhere, this method enabled the construction of a framework for facilitating successful PHW development. In addition, an expert workshop was held, serving as a reality check for identifying crucial areas of the PH system in Ukraine. Results: The proposed framework includes a country’s background, the evidence and available policy options, such as the health system (including core functions, organizational resources, regulations and norms), health system capacities (including human resources; PH capacity assessment; datasets and databases; forecasting strategies; licensing, accreditation and quality assurance) and capacity building (including PH education, training, core competencies and ethical and professional codes of conduct). To facilitate and support effective implementation of the framework, we propose (1) implementing strategies to facilitate changes in attitude, behavior and practices among the citizens; (2) implementing strategies to facilitate the necessary behavioral changes in the PHW; (3) implementing strategies to facilitate the necessary organizational and institutional changes; (4) implementing strategies to facilitate system changes and (5) identification of potential barriers and obstacles for the implementation of these strategies. Conclusion: The report highlights the practical tactics and best practices for providing suggestions for PHW support and planning. The employment of prominent analytical tools and procedures in policymaking processes suggests an effective strategy for PHW development in Ukraine.

Nationalisation of Health Workforce in Saudi Arabia’s Public and Private Sectors: A Review of Issues and Challenges

Presently, Saudi Arabia depends largely on expatriate health workforce for delivery of health services. This article provides an overview of Saudization policy introduced by the Kingdom of Saudi Arabia and analyses its underlying impact on health workforce in public and private sectors. It also examines key strategic initiatives undertaken by the government for health workforce development and challenges of replacing expatriates in the country as envisaged in the Vision 2030. There are concerns about low participation of females in nursing, mainly due to a poor image attached to the profession, and further exacerbated by religious and cultural factors. There is a strong need to adopt a health workforce development policy that integrates local culture, values and social ties. Government needs to follow a multipronged approach to change the mindset of citizens to take up health care jobs, particularly nursing and pharmacist professions.

Academic partners see benefit in collaborative training

Partners in a mental health workforce development initiative in central New York believe greater collaboration among mental health disciplines can help improve quality of care to the underserved while also easing a shortage of clinical professionals in the region. An initiative funded by the federal Health Resources and Services Administration (HRSA) is establishing a multidisciplinary training program designed to improve services for high‐need populations.

University's first Ph.D. program would boost workforce development

A Florida state university that historically has responded to the mental health needs of its surrounding community is seeking to establish a doctorate program to enhance mental health workforce development and research. The doctorate program in counselor education and supervision would be the very first Ph.D. program at Florida Gulf Coast University (FGCU).

Health workforce development in rheumatology : Amapping exercise and wake-up call for health policy

Hintergrund und FragestellungFachkräftemangel in der Rheumatologie in Deutschland ist als Versorgungsproblem erkannt. Die Gesundheitspolitik hat mit neuen Planungszielen reagiert, aber es fehlen effektive Interventionsstrategien. Ziel dieser Studie ist ein systematischer berufsstruktureller Überblick, um die Grundlage für Interventionen zu verbessern und Möglichkeiten für ein effektives Fachkräftemanagement aufzuzeigen.MethodeDie WHO National Health Workforce Accounts (NHWA) dienen als konzeptioneller Rahmen. Ausgewählt werden 4 Indikatoren: Personalbestand, Arbeitsmarktbewegungen, Komposition und Weiterbildung. Die Exploration von Entwicklungstrends stützt sich auf vergleichende Analysen von Altersgruppen und Zeitreihen. Die Erhebung nutzt öffentliche Statistiken und andere Sekundärliteratur; die Auswertung erfolgt deskriptiv.ErgebnisseIn Deutschland sind 1076 Ärzt*innen mit einer Facharztqualifikation oder Schwerpunktbezeichnung in der internistischen Rheumatologie ärztlich tätig. Die absolute Zahl verdoppelte sich seit 2000 deutlich (91 %), aber mit einem demografischen Bias. Im Zeitraum 2000 bis 2019 stieg die Zahl der über 50-Jährigen deutlich, aber die der unter 50-Jährigen nur um 9 %; seit 2010 sind die Zahlen in der Gruppe 40 bis 50 Jahre rückläufig. Im Jahr 2019 waren mehr Rheumatolog*innen im Rentenalter als unter 40-Jährige ärztlich tätig. Seit 2015 schwächt sich der steigende Trend insgesamt ab, aber am stärksten im Krankenhaussektor; die Weiterbildungen lassen keine konstante Steigerung erkennen.SchlussfolgerungenBerufsstrukturelle Trends zeigen, dass die gesundheitspolitischen Planziele mit den verfügbaren Humanressourcen nicht zu erreichen sind. Gefordert ist ein besseres Fachkräftemanagement, insbesondere durch Innovation der Weiterbildung, Aufgabenverschiebung und verbesserte Geschlechtergerechtigkeit.

Job Satisfaction is Dominant Factor Influencing of Nurse Performance in X Hospital Pekanbaru

Introduction: The provision of optimal health services is determined by the quality of health workers. The research objective was to explore the factors that influence the performance of nurses in health service.Method: It was a quantitative analytic study with a cross-sectional design. A total of 58 nurses participated with a purposive random sampling technique. The data was collected by questionnaire and worksheets observation. The statistical analysis was done by Smart PLS (Partial Least Square).Result: This study showed that individual characteristics are correlated to job satisfaction (p-value 0.001) but not correlated with the performance of nurses (p-value 0.468). Organizational factors were correlated to job satisfaction (p-value 0.000) but not correlated to work performance (p-value 0.865). Job satisfaction was correlated to work performance (p-value 0.001). There was a negative correlation between individual characteristics and nurse performance (-0.466). Meanwhile, the organizational factor only has a direct effect of 0.025 on nurse performance. Only job satisfaction has a direct effect on nurse performance with an increase of 0.5 (50%) for every increase of one value of job satisfaction.Conclusion: Job satisfaction is a dominant factor that has a direct effect on nurse performance. Hospital management needs to consider health workforce planning, mapping, and development competency to optimize nurse performance.

Health Workforce Development in Health Emergency and Disaster Risk Management: The Need for Evidence-Based Recommendations.

The Sendai Framework for Disaster Risk Reduction 2015–2030 placed human health at the centre of disaster risk reduction, calling for the global community to enhance local and national health emergency and disaster risk management (Health EDRM). The Health EDRM Framework, published in 2019, describes the functions required for comprehensive disaster risk management across prevention, preparedness, readiness, response, and recovery to improve the resilience and health security of communities, countries, and health systems. Evidence-based Health EDRM workforce development is vital. However, there are still significant gaps in the evidence identifying common competencies for training and education programmes, and the clarification of strategies for workforce retention, motivation, deployment, and coordination. Initiated in June 2020, this project includes literature reviews, case studies, and an expert consensus (modified Delphi) study. Literature reviews in English, Japanese, and Chinese aim to identify research gaps and explore core competencies for Health EDRM workforce training. Thirteen Health EDRM related case studies from six WHO regions will illustrate best practices (and pitfalls) and inform the consensus study. Consensus will be sought from global experts in emergency and disaster medicine, nursing, public health and related disciplines. Recommendations for developing effective health workforce strategies for low- and middle-income countries and high-income countries will then be disseminated.