Locum Tenens in the Women's Healthcare Workforce.

Career Paths of Emergency Medicine Residents From a Tertiary Care Center in a Low-to-Middle Income Country.

Conceptualising the primary health care workforce: A meta-narrative-inspired review of stakeholder perspectives in Denmark

Unforeseen Positive Impacts of a Neonatal Encephalopathy Teleconsultation Program: Insights From Clinicians Practicing in a Rural State.

A data-driven multicriteria decision model for healthcare workforce retention strategies

BackgroundThe increasing demands of an aging population, healthcare workforce shortages, financial constraints, and a shift in care perspectives call for rethinking geriatric rehabilitation (GR). To ensure GR remains sustainable, a transition towards home-based GR is proposed, reducing the need for prolonged inpatient GR. This study assesses the outcomes, costs and feasibility of the “Better@Home” program, in which home-based GR replaces part of inpatient GR.MethodsThis multicenter cohort study is conducted in eight GR facilities in the Netherlands, implementing the Better@Home program. Core elements of this program include replacing part of inpatient GR with home-based GR, focusing on participation goals, using eHealth, promoting self-management, and fostering close collaboration among all care partners. Data is gathered through semi-structured interviews, questionnaires, group interviews, registration forms, and electronic patient files.The Better@Home study is designed as a cohort study accompanied by a mixed-methods feasibility study. The study includes an outcome-and cost assessment. Within the cohort study, two evaluations can be distinguished. The first is a comparative evaluation, comparing the multicentre prospective Better@Home cohort with a historical control group on the primary outcome measure, as well as patient, family, and healthcare-related costs, from admission to completion of GR. The primary outcome measure of the comparative evaluation is independence in activities of daily living, assessed by the Barthel Index. The second is a follow-up evaluation, to assess the course of the outcomes and costs from GR admission to three months of follow-up after GR completion, solely in the Better@Home cohort. The primary outcome measure of the follow-up evaluation is participation, assessed by the Canadian Occupational Performance Measure. The mixed-methods feasibility study incorporates both quantitative and qualitative methods. It evaluates the program’s reach, performance according to plan, active engagement of patients and informal caregivers, barriers and facilitators affecting implementation, and the opinions of patients, informal caregivers, and professionals on the program.DiscussionThis study offers insights into the potential of home-based GR. The multicentre and multilayered design enables a comprehensive evaluation of the Better@Home program’s outcomes, costs and feasibility, providing a basis for further optimization and upscaling of home-based GR.Supplementary InformationThe online version contains supplementary material available at 10.1186/s12877-025-06573-6.

ABSTRACT Academics whose research and teaching are focused on healthcare professions are essential for Australians’ access to healthcare. Academics based in regional and rural communities and universities face challenges of workforce precarity and high workloads, which threaten the sustainability of their careers and, consequently, rural health workforce training. Their careers ensure a pipeline of healthcare professionals for rural practice. The present research used the sustainable career framework and systems theory framework to explore the careers of health academics whose work predominantly occurs in regional and rural contexts. A systematic literature review following the PRISMA protocol identified nine articles which generated findings pertaining to challenges to sustainable careers, including person and place-based factors; workload, expectations, and reality; and tensions and pressures between clinical and academic activities. Future research is needed to understand the influence of regionality and place on health academics’ career trajectories.

Care transitions for people living with dementia are critical periods requiring coordinated, person-centered support. Effective transitions can reduce caregiver burden, prevent adverse outcomes, and improve care quality. However, the barriers, facilitators, and lived experiences during transitions remain poorly understood. This systematic review synthesizes evidence on these factors from the perspectives of people with dementia and their informal caregivers. A comprehensive search across MEDLINE, CINAHL, PsycINFO, ProQuest, and Web of Science identified 67 eligible English-language studies published from 2018 to 2023. Quality appraisal used Joanna Briggs Institute tools. The protocol was registered on PROSPERO: CRD42023452669. Four themes captured the barriers, facilitators, and experiences shaping care transitions for people with dementia and their caregivers. Systemic influences included fragmented governance, funding and policy inconsistencies, and structural challenges in care coordination and delivery, mitigated by proactive planning and integrated care. Health and social care workforce factors highlighted gaps in dementia training, staffing, and communication, with empathetic, informed staff improving transitions. Emotions and decision-making reflected caregiver burden, uncertainty, and advocacy, eased by early guidance and peer support. Cultural, social and situational influences showed how values, socioeconomic status, and rurality affected transition choices, underscoring the need for culturally sensitive, person-centered support. Care transitions remain complex, shaped by systemic, workforce, emotional, and cultural factors. Addressing inequities and coordination gaps is critical for more integrated transitional care. Strengthening dementia-specific training, home-based care models, and culturally responsive communication may improve continuity, person-centeredness, and caregiver support.

Purpose: This study aimed to explore the lived experiences of Saudi female nurses working in mixed-gender healthcare environments and understand how they navigate professional identity while managing cultural expectations in Saudi Arabia’s evolving healthcare landscape. Methods: A descriptive phenomenological qualitative study grounded in symbolic interactionism was conducted using in-depth semi-structured interviews with 20 Saudi female nurses working in mixed-gender healthcare settings in Riyadh. Interviews were conducted in Arabic and systematically translated using forward–backward translation protocols. Data were analyzed using Colaizzi’s phenomenological analysis framework to identify essential themes and meanings. Trustworthiness was established through credibility, dependability, confirmability, and transferability strategies, including member checking with 6 participants, peer debriefing, and comprehensive audit trails. Results: Four major themes emerged: (1) Reconciling Traditional Values with Professional Duties, (2) Negotiating Gender Dynamics in Clinical Practice, (3) Developing Professional Identity Amid Cultural Tensions, and (4) Organizational Support and Environmental Adaptation. Participants demonstrated remarkable resilience in balancing cultural expectations with professional responsibilities while developing sophisticated coping strategies. Conclusions: Saudi female nurses actively construct their professional identities while navigating complex cultural landscapes. The study reveals the need for organizational policies that support cultural sensitivity while promoting professional growth and gender equality in healthcare settings. These findings may inform healthcare workforce development in other Islamic and culturally transitioning contexts.

BackgroundChronic diseases are an increasing burden for Swiss healthcare. Demographic change aggravates the problem, with an ageing, multi-morbid population increasing the need for care while also depleting the healthcare workforce. Originally developed to assess the structural quality of and access to primary care, Potentially Avoidable Hospitalizations (PAHs) are an OECD-metric employed as an indicator of inpatient burden for various chronic diseases. So far, evidence on future PAH-burden remains limited.Aims(1) To assess the evolution of PAHs and associated resources (bed capacities, inpatient healthcare expenditures) in Switzerland for chronic obstructive pulmonary disease (COPD), asthma, congestive heart failure (CHF), hypertension and diabetes between 2012 and 2022, (2) to forecast PAHs until 2032, based on expected demographic change and (3) to explore methodologically how changes in primary care physician (PCP)-supply and countermeasures might influence future PAH-development.MethodsWe identified PAHs in retrospective routine hospital data and derived numbers of occupied hospital beds, based on cases’ length of stay, and inpatient healthcare expenditures, based on diagnosis-related group payments. We utilized population forecasts for Switzerland to extrapolate PAH-volume in the base scenario. Additionally, we predicted via linear regression how reduced ageing-induced PCP-availability might affect PAHs. Finally, we explored the potential impact of countermeasures, optimal Guideline-Directed Medical Therapy (GDMT)-implementation, for CHF and COPD.ResultsThe number of PAHs across all five chronic diseases increased from 30.1 to 40.2 thousand cases between 2012 and 2019 (+ 34%) and is projected to rise to 54.9 thousand cases until 2032 (+ 37%). We project PAH-volume to increase by an additional 11% by 2032 due to changes in PCP-supply. By 2032, optimal GDMT-implementation has the potential to reduce CHF- and COPD-related PAH-volumes by 31% (95% CI: 22.23–37.60%) and 14% (95% CI: 2.17–26.02%), respectively.ConclusionsOur study assesses cumulative PAH-trends and is the first to forecast future burden in Switzerland. A strong rise in PAHs and associated inpatient resources was registered for the last decade, with accelerating growth expected throughout the next. A depleting healthcare workforce may exacerbate burden. Optimal GDMT-implementation could potentially curb increases in PAHs. However, methods to reach optimal implementation require further research and policy efforts.Supplementary InformationThe online version contains supplementary material available at 10.1186/s12913-025-13687-5.

Nurse emigration is the process by which nurses move from their home country to another country in search of better job opportunities, higher salaries, improved working conditions, and international experience. In Kenya, nurse emigration is a growing challenge often attributed to deficits in Human Resource Standards. This high level of emigration imposes additional costs on the government and taxpayers due to repeated training cycles and disruptions in the delivery of quality healthcare services. Beyond HR-related factors, demographic, psychological, and psychosocial dimensions also play a critical role. Understanding these factors in conjunction with HR standards is essential for improving healthcare delivery and workforce stability. This study investigated nurses’ intention to migrate within the context of Nakuru County, Kenya. It involved a sample of 150 nurses employed across seventeen health facilities in the Nakuru West Sub-County. Guided by Social Cognitive theory, the study adopted a cross-sectional design to explore the effects of socio-cognitive factors on emigration intention. Results revealed that 80.7% (n=150) of nurses firmly intend to emigrate, with 74.7%(n=150) already enrolled in immigration processes. The United States was the most preferred destination, followed by the United Kingdom (18.7%, n=150), Australia (10.7%, n=150), and Canada (4.7%, n=150). Socio-cognitive factors significantly influenced emigration intention: motivation (β = 0.353, p < .05), attention (β = 0.346, p < .05), and self-efficacy (β = 0.348, p < .05). These variables explained a substantial portion of the variance in emigration intention, underscoring their predictive strength. These findings highlight the urgent need to address cognitive determinants of nurse emigration to reduce emigration intention.

BackgroundPhysician Assistant/Associate (PA) students are facing increased impairment, adverse academic experiences, and impeded performance. Despite well-documented research demonstrating the multi-factorial wellness needs of many PA students nationally, the unnecessary challenges and continuance of harm persists. Such barriers have influenced student performance, stability, outcomes, and undesirable health events. Further, evidence suggests that student learner wellness is influenced by predisposing and mitigatable factors, which can be addressed proactively at the individual and program level. Early identification of well-being needs, risk factors, and modifiable action steps can enhance student success during the intensive educational journey of the PA student pre-clinical workforce. Therefore, examining, optimizing, and integrating longitudinal wellness practices across curricular design and program operations can have a lasting impact on learners, including as the future healthcare workforce (HCW). This scoping review aims to investigate wellness practices, alignment of their terminologies and implementations for PA students in the United States (U.S.) and evaluate health profession programs’ implications of the future HCW.MethodsThe authors utilized a Joanna Briggs Institute (JBI) scoping review protocol and logic model to investigate the research query. Literature retrieval was led by the research librarian using keywords, Boolean operators, and database-specific terminology. Using a population, intervention, comparison, outcome, and setting (PICOS) framework and Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) tools, studies were vetted through a phased eligibility screening process according to inclusion/exclusion criteria (PA students, wellness practices, occurred within the U.S., original research). Data extraction occurred systematically and involved categorization of terminology (constructs, positive/negative tone), wellness practices, and student impact and outcomes. Findings were mapped to best-fit wellness dimensions using the National Wellness Institute (NWI) competency-based model and to the PA Core Competencies. Thematic and directed content analysis was performed in sequence to determine culminative study results.ResultsA total of 447 studies were retrieved from database searching (n = 439) and handsearching (n = 8). After initial screening and full-text review, 25 studies met inclusion criteria for a total of 9,628 PA student participants. Out of the 25 studies examined, 13/25 (52%) explored the didactic year, 3/25 (12%) examined the clinical year, 7/25 (28%) studied both, and 2/25 (8%) did not specify (Table 1). 28% (n = 7/25) of studies were anchored in evidence-based frameworks. Terminology, wellness practices, and implementation varied across the health professions programs. The ‘construct tone’ across studies used was nearly equivalent when examining positive (50.89%) versus negative (49.11%) terms related to ‘well-being,’ Three of 7 (42.86%) dimensions of wellness were most prevalent (EP, IM, and OA) (Fig. 2), whereas the remaining 4 of 7 (57.14%) dimensions (Ph, Sp, Soc, and OWB) had less representation (Table 2). Wellness practices were siloed or brief in nature as seen in 15/25 studies (60%), such as an isolated module or class session, and none of the studies (n = 0/25) addressed all the dimensions of wellness. Findings related to PA student positive/negative wellness experiences sourced directly from the included studies showed statistical significance (p < 0.0001 to p = 0.05), a predominance of moderate to strong correlations (r = -0.802, r = 0.762), and a range of effect sizes: odds ratios (1.04 to 2.09), Cohen’s d (0.09 to 0.38), and Pearson’s r (0.0 to 0.16).ConclusionsUnified terminology, definitions, and implementation of wellness practices are necessary to optimize PA student success as future clinicians practicing medicine. Establishing and fostering practices that promote wellness habits, work-life balance, and modernization of antiquated health professions programs is an investment in the iterative growth toward long-term well-being, resilience, and success.

Saudi Arabia’s Vision 2030 has prioritized healthcare transformation through the expansion and modernization of primary healthcare clinics (PHCs) to ensure equitable access, high-quality services, and patient-centered care. This review explores strategic approaches to developing medical clinics within this national framework. It synthesizes literature from 2016–2025 on healthcare infrastructure, digital transformation, public-private partnerships (PPPs), and workforce development in Saudi Arabia. The findings highlight that effective clinic development depends on integrating smart health technologies (EHR, telemedicine), optimizing clinic design for patient flow, and empowering multidisciplinary teams. Policy reforms under Vision 2030—such as corporatization of health clusters, privatization initiatives, and value-based healthcare—have accelerated the establishment of resilient, efficient, and technologically enabled clinics. Challenges remain in rural accessibility, data interoperability, and workforce readiness. The review concludes with strategic recommendations for sustainable clinic development through innovation, digital integration, and human capital investment.

Co-developing an inclusive interprofessional health workforce minimum data standard for enhanced planning and decision-making: A Canadian case with international relevance.

Reimagining nursing education: Leveraging competency-based education, artificial intelligence, and simulation for a diverse and practice-ready workforce.

Although India’s health outcomes have improved, progress can still be made to reduce the health burden from tuberculosis, noncommunicable diseases, and maternal and neonatal health. In order to address challenges such as healthcare workforce shortages or sub-optimal time with healthcare workers, health systems can involve family caregivers who are already playing an active, informal role to support patients. Their formal involvement to support patients has been associated with improved health outcomes in health conditions. Formal support for family caregivers aligns with other priority health strategies, such as self-care, universal healthcare, and shifting demographic trends in India. Inspiration can be drawn from existing interventions that support family caregivers: training and education delivered through the public health system, caregiver support groups, community volunteers to support palliative patients, and interventions for specific patient populations (i.e., palliative care or for children with disabilities). For India, though there are no comprehensive policies that finance informal caregiver inclusion, there are examples to draw from globally. Finally, we recommend tenets of how to best engage with family caregivers, which can lead to meaningful caregiver involvement for improved health outcomes: leveraging trusted sources, focusing on actionable skills, providing just-in-time engagement, designing for diverse contexts, and ensuring caregiver safety.

Burundi remains one of the most socioeconomically challenged countries globally, facing profound limitations in healthcare infrastructure, workforce, and access. In this context, the Italian Medical Foundation for Central Africa (FIMAC) has conducted humanitarian orthopaedic missions for over two decades in Bubanza, addressing critical musculoskeletal conditions in both paediatric and adult populations. This essay provides a comprehensive overview of the operational, clinical, and ethical dimensions of these missions. Commonly treated pathologies include chronic osteomyelitis, neglected fractures, open injuries, and congenital or acquired limb deformities-conditions frequently encountered in advanced stages due to delayed access to care. Resource-sensitive protocols guide interventions and rely heavily on collaboration with local healthcare workers, who receive targeted training in trauma management, postoperative care, and basic surgical techniques. The aim is not just to deliver urgent care but to foster sustainable improvements through capacity building and knowledge exchange. Major challenges include a lack of surgical infrastructure, limited availability of diagnostics and sterile equipment, as well as sociocultural barriers to care, such as language and traditional beliefs. Despite these constraints, the missions yield significant functional and psychosocial outcomes, particularly among paediatric patients. Ethical considerations, including informed consent, scope of practice, and cultural humility, are central to responsible practice in this setting. The personal and professional impact on participating surgeons is profound, often reshaping clinical priorities and reinforcing the humanistic foundations of the medical profession. The paper concludes by advocating for the establishment of permanent surgical facilities, structured deployments, and scalable innovations to enhance the continuity of care and address surgical inequities in low-resource settings.

Background: Faculty burnout in allied healthcare education institutions represents a significant challenge with implications for educational quality, organizational effectiveness, and healthcare workforce development. This scoping review aims to map the existing literature on the relationships between leadership approaches, faculty personality factors, and burnout within allied healthcare education, while examining digital competence as a potential moderating factor. Methods: This scoping review followed the PRISMA-ScR guidelines. Five electronic databases (MEDLINE, CINAHL, ERIC, PsycINFO, and Web of Science) were searched for relevant studies published between 2010 and 2024. Studies examining burnout among allied healthcare educators in relation to leadership, personality traits, or digital competence were included. Data extraction captured study characteristics, methodological approaches, key findings, and theoretical frameworks. Quality assessment was conducted using the Mixed Methods Appraisal Tool. Results: Sixteen studies met the inclusion criteria. Existing research indicates significant relationships between leadership styles and faculty burnout rates, with transformational leadership consistently associated with lower burnout scores. The literature reveals that individual personality traits demonstrate significant relationships with burnout vulnerability, with emotional stability and extraversion showing the strongest protective effects. Limited research has examined digital competence in relation to burnout, though emerging evidence suggests it may function as a moderating factor. Significant gaps exist in non-Western contexts and in understanding interaction effects between leadership, personality, and digital competence. Conclusions: The current literature supports the importance of leadership approaches that emphasize collaboration, faculty autonomy, recognition, and professional development opportunities in protecting against burnout in allied healthcare education settings. Digital competence represents a promising but understudied job resource that may mitigate burnout effects. Future research should explore cross-cultural variations, interaction effects between personal and organizational factors, and the effectiveness of interventions in reducing faculty burnout.

RECOMMENDATIONS 1. We recommend that PHPs identify PLWO, and initiate patient-centred, health-focused conversations with them (Level 3, Grade C).2. We recommend that PHPs ensure that they ask PLWO for their permission prior to discussing weight or taking anthropometric measurements (Level 3, Grade C). 3. Primary care interventions should be used to increase health literacy in individuals’ knowledge about and skills in weight management as an effective intervention to manage weight (Level 1a, Grade A). 4. PHPs should refer PLWO to primary care multi-component programmes with personalised obesity management strategies as an effective way to support obesity management (Level 1b, Grade B). 5. PHPs can use collaborative deliberation with motivational interviewing to tailor action plans to individuals’ life context in a way that is manageable and sustainable to support improved physical and emotional health, and weight management (Level 2b, Grade C). Features of primary care and primary healthcare community-based interventions for PHPs and developers: 6. Interventions that target a specific ethnic group should consider the diversity of psychological and social practices with regard to excess weight, food and physical activity as well as socioeconomic circumstances, as they may differ across and within different ethnic groups (Level 1b, Grade B). 7. Longitudinal primary care interventions should focus on incremental, personalised, small behaviour changes (the ‘Small Changes’ approach) to be effective in supporting people to manage their weight (Level 1b, Grade B). 8. Primary care multi-component programmes should consider personalised obesity management strategies as an effective way to support PLWO (Level 1b, Grade B). 9. Primary care interventions that are behaviour based (nutrition, exercise, lifestyle), alone or in combination with pharmacotherapy, should be utilised to manage PLWO (Level 1a, Grade A). 10. Group-based nutrition and physical activity sessions informed by the Diabetes Prevention Program and the Look AHEAD (Action for Health in Diabetes) programme should be used as an effective management option for PLWO (Level 1b, Grade A). 11. Interventions that use technology to increase reach to larger numbers of people asynchronously should be a potentially viable lower-cost method in a community-based setting (Level 1b, Grade B). Educational recommendations to support development of obesity management skills in the primary healthcare clinical workforce: 12. Educators in undergraduate, graduate and continuing education programmes for PHPs should provide courses and clinical experiences to address the gaps in skills, knowledge of the evidence, and attitudes necessary to confidently and effectively support PLWO (Level 1a, Grade A).[20]

Introduction: Over 500 interdisciplinary healthcare students from Bournemouth University’s Faculty of Health &amp; Social Sciences took part in a two-day interprofessional simulation event, simulating a major incident: an alien invasion causing organised chaos in an underground car park. Students from multiple healthcare disciplines (Adult, Mental Health, and Children’s and Young People’s Nursing, Paramedic Science, Physician Associates, and Physiotherapy) collaborated with makeup artists from Arts University Bournemouth to create high-fidelity injuries, practicing triage, emergency care and teamwork in a controlled, immersive setting. The NHS Long Term Workforce Plan highlights simulation as a key strategy to modernize healthcare education, supporting interprofessional education (IPE) and exposure to rare and complex scenarios [1]. Higher Education Institutions (HEI) play a vital role in preparing students to deliver safe, effective and innovative care. Simulation fosters essential communication, collaboration and decision-making skills, while major incident simulations enhance both technical and non-technical abilities to improve emergency readiness [2]. By promoting IPE, these experiences help build a resilient healthcare workforce equipped to handle major incident events and deliver high-quality patient care [3]. Methods: Drawing on our faculty’s interprofessional expertise, we designed clear scenarios with learning objectives, intending to integrate students’ theoretical knowledge and practical skills. Recognizing the potential for emotional responses, we integrated wellbeing staff and hot and cold debriefings. Central to the design was the establishment of a formative, psychologically safe environment, prioritizing participant growth and emotional safety. Planning involved careful consideration of learning objectives and support structures to allow learners to engage fully. This comprehensive approach facilitated reflection, iterative improvements and a supportive environment for learning from challenging experiences (Figure 1). Results: An educational evaluation, using thematic analysis of student feedback, demonstrated that this major incident simulation offered valuable realism, hands-on experience and promoted teamwork. Identified challenges, including noise and equipment issues, will inform improvements centred on scenario variety, multidisciplinary collaboration, and optimised resources. The limitation of primarily discipline-specific teams will be addressed through future focus on experiential learning to underpin and fully integrate IPE with the inclusion of the remaining disciplines in our faculty, for a more holistic, collaborative educational experience. Discussion: This evaluation demonstrates that a major incident simulation effectively builds key skills for interprofessional healthcare students. Realism was valued; noise levels and equipment access were challenges. Future improvements developed with our interprofessional partners will optimize debriefing and IPE, aligning with the NHS Long Term Workforce Plan [1]. Ethics Statement: As the submitting author, I can confirm that all relevant ethical standards of research and dissemination have been met. Additionally, I can confirm that the necessary ethical approval has been obtained, where applicable