Implications For Workforce Research Articles

Social Workers and Physical Health: Imperative Medical Issues and COVID-19.

The COVID-19 pandemic has resulted in unprecedented disruptions to the workforce, most notably necessitating a more distanced work environment, which may have negative repercussions for physical health. In our prepandemic study of licensed social workers (Straussner et al., 2015), we found that many professionals were already experiencing significant physical health problems that impacted their work; these have likely been exacerbated as a result of COVID-19. This column presents the literature on physical health among social workers, findings from our study of social workers, and COVID-related implications for the social work workforce. In a review of emerging literature related to the pandemic, Kniffin et al. (2021) found that workplace trends that were already underway, such as working from home and virtual teamwork, have accelerated as a result of the virus. It has been demonstrated that social interaction is important for physical health; virtual and socially distanced workplaces limit social interaction, which may heighten workplace problems (Mogilner et al., 2018). Recent scholarship indicates that COVID-19 is also contributing to other negative workplace shifts, such as burnout, absenteeism, bullying, job insecurity, and turnover (Bapuji et al., 2020).

Fostering Adaptability in the Future Nursing Workforce Through the Transformation of Nursing Education During the COVID-19 Pandemic

This is a reflective report on the challenges experienced at an Australian nursing school, in which there was full continuation of degree delivery throughout the national lockdown period in mid-2020 due to the COVID-19 pandemic. The authors describe the significant modifications to teaching methods and reflect on how this experience influenced learning, yet also helped develop essential nursing qualities among students. Anecdotal evidence is drawn from the authors’ academic roles as clinical education specialists, positions which involve teaching at the university as well as clinical supervision during students’ work integrated learning clinical placement periods. This unique perspective allows for insight into the impact of the pandemic on transference of student knowledge and skills to patient care in health facilities. There were indications that these modifications to teaching during the pandemic have, in some respects, impeded learning, yet have provided the benefit of fostering adaptability and resilience in these future nurses. Further analysis of modified nursing education in the context of a pandemic is needed to determine implications for the future nursing workforce, and strategies needed to address these. The authors recommend optimising this momentum of adaptability as an opportunity for innovation in tertiary nursing education for better preparedness of future nurses.

Less than full-time training (LTFT), is this the new norm? A cross-sectional study using a UK-wide online survey to evaluate trainees’ views and intentions for LTFT

ObjectivesInterest in less than full-time training (LTFT) is growing among doctors in training. LTFT applications have previously been limited to fulfilment of specific criteria such as childcare or health reasons,...

Numbers and types of neurological emergencies in England and the influence of socioeconomic deprivation: a retrospective analysis of hospital episode statistics data

ObjectivesIn this first large-scale analysis of neurological emergency admissions in England, we determine the number and types of emergency admissions with neurological emergency diagnostic codes, how many are under the...

Variation in Support for Documentation Among Primary Care Physicians by Gender.

There are known gender differences in both time spent on the electronic health record (EHR) and burnout. Previous studies have described potential benefits of staff support for documentation for physician experience and EHR time. It is not known, however, to what extent availability of staff support for documentation differs by gender in the context of primary care. METHODS: This was a cross-sectional study of primary care physicians (PCPs) using data from the 2018 and 2019 National Electronic Health Records Survey administrations. After descriptively analyzing the prevalence of staff support for documentation, we used multivariable logistic regression to identify the adjusted relationship of staff support for documentation with gender. RESULTS: Among the 813 physicians who endorsed having an EHR (92.5% of sample, representing 296,854 physicians), female PCPs were significantly less likely than male PCPs (25.1% vs 37.3%; P = .04) to report having staff support for documentation. This difference was most pronounced in practices with a single physician and practices with more than 50% of patients insured by Medicaid. Gender differences persisted in analyses adjusted for practice ownership and percent of patients insured by Medicaid. CONCLUSIONS: Given positive effects of documentation support and known gender differences in burnout and EHR use times, the differences identified have important implications for the physician workforce. Future research should focus on identifying underlying reasons and potential solutions for the gender differences described.

Implications for paediatric training and workforce from pandemic disruptions: A view from a tertiary hospital.

To understand the lived experience of paediatric trainees in relation to their educational opportunities, workforce roles and the interplay between them, during pandemic disruptions. Twenty paediatric trainees working at Australian paediatric hospitals during the time of COVID-19 restrictions were interviewed between July and November 2020. Based on a phenomenological approach, the interviews examined junior doctors' experiences in relation to medical education, adaptive education modes, learning opportunities and their workforce roles during the pandemic. Qualitative inductive thematic data analysis was used to develop a cohort narrative. Four overarching themes were identified regarding trainee perceptions of the impact of COVID-19 restrictions on learning opportunities, both positive and negative. These were: impaired rapport building, altered team role, altered care and education affordances versus access. Participants felt ill-equipped to provide optimal clinical care during virtual and stifled in-person consultations, detached from the multidisciplinary team, that changed work roles diminished their professional self-worth, and that online learnings were advantageous if rostering afforded opportunities to engage with them. To equip paediatric trainees for the next steps in their careers, we suggest the following areas of focus: the use of new tools of rapport, smart investment in clinical moments, reconnection of multidisciplinary teams and learning, the support of online learning infrastructure with protected education time and roadmaps for learning, and teaching on how to triage information sources and alongside clinical visit types.

Demographic Factors Associated With Research and Career Interests in Aspiring Academic Surgeons: What are the Implications for Tomorrow's Workforce?

To evaluate the research and career interests of aspiring academic surgeons and determine the influence of demographic factors. Cross-sectional survey SETTING: Single institution, academic general surgery residency program PARTICIPANTS: Medical students invited to interview during 2019-2020 and 2020-2021 residency cycle RESULTS: One hundred fifty-four of 160 (96%) potential respondents representing 63 medical schools completed the survey, American Association for Public Opinion Research Response Rate 6. Fifty-three percent of the study population was female. Seventeen percent identified as Black, 14% Asian, 13% Latinx, 50% white, and 6% other. Respondents were most interested in education, professional development, and surgical culture (32%) followed by basic and translational science (23%), global and community health (20%), and health services (18%). On multiple logistic regression, interest in global/community health was associated with identifying as Black (OR 5.9 [2.0, 17.8] p = 0.001) and female (OR 2.7 [1.0, 7.0] p = 0.044). A plurality of participants were undecided on future specialty (n = 63, 41%). The most common specialty interests were surgical oncology (n = 28, 18%); trauma, acute care, or surgical critical care (n = 21, 14%); pediatric and cardiothoracic surgery (n = 20 for each, 13%); and abdominal transplant (n = 15, 10%). In this cross-sectional survey of highly competitive academic general surgery applicants, respondents who were underrepresented in medicine (URiM) and women were more interested in research fields with a history of lower relative NIH funding. In light of these findings, academic programs seeking a more diverse residency workforce should consider strategies beyond recruitment to promote the scholarly achievement of women and URiM residents.

Assessing the contribution of immigrants to Canada’s nursing and health care support occupations: a multi-scalar analysis

BackgroundThe World Health Organization adopted the Global Strategy on Human Resources for Health Workforce 2030 in May 2016. It sets specific milestones for improving health workforce planning in member countries, such as developing a health workforce registry by 2020 and ensuring workforce self-sufficiency by halving dependency on foreign-trained health professionals. Canada falls short in achieving these milestones due to the absence of such a registry and a poor understanding of immigrants in the health workforce, particularly nursing and healthcare support occupations. This paper provides a multiscale (Canada, Ontario, and Ontario’s Local Health Integration Networks) overview of immigrant participation in nursing and health care support occupations, discusses associated enumeration challenges, and the implications for health workforce planning focusing on immigrants.MethodsDescriptive data analysis was performed on Canadian Institute for Health Information dataset for 2010 to 2020, and 2016 Canadian Census and other relevant data sources.ResultsThe distribution of nurses in Canada, Ontario, and Ontario’s Local Health Integration Networks reveal a growth in Nurse Practitioners and Registered/Licensed Practical Nurses, and contraction in the share of Registered Nurses. Immigrant entry into the profession was primarily through the practical nurse cadre. Mid-sized communities registered the highest growth in the share of internationally educated nurses. Data also pointed towards the underutilization of immigrants in regulated nursing and health occupations.ConclusionImmigrants comprise an important share of Canada’s nursing and health care support workforce. Immigrant pathways for entering nursing occupations are complex and difficult to accurately enumerate. This paper recommends the creation of an integrated health workforce dataset, including information about immigrant health workers, for both effective national workforce planning and for assessing Canada’s role in global health workforce distribution and utilization.

Construction Accidents in Spain: Implications for an Aging Workforce.

Construction workers are getting older. In the European Union, the percentage of workers over 50 grew from 24.7% in 2011 to 31.5% in 2018, in Spain from 20.4% to 31.2%. Objective. Identify trends and detailed patterns of accidents of older construction workers compared to other age groups. Data and Method. We analyzed construction accidents in Spain from 2011 to 2018 (N = 455,491). The number of accidents and lost working days (LWD) were broken down by occupation, seniority, company size, temporal variables (weekday, hour), trigger, and body part injured and compared for different age groups. Results. Although older worker had fewer accidents, the consequences of accidents were more serious. Those over 50 years had 84% more lost working days (LWD) than those under 24 years, 48% more than those between 25 and 39 years, and 21% more than those between 40 and 49 years. (1) Occupation: the percentage of accidents grew with age for supervisors, lorry drivers, and bricklayers. (2) Seniority: the least experienced (less than 6 months) and the most experienced (more than 6 years) had the most LWD. (3) Company size: there are 24.5% of accidents in companies of less than four workers. (4) Trigger: older workers suffered more falls, both from height and at the same level. (5) Time: the percentage of accidents in those over 50 was higher on Thursdays and Fridays, in the afternoons from 4 to 7 p.m., and after four hours of work. (6) Injury: this shows the longest absences for shoulder injuries for those over 50 years, with an average of 70 LWD.

Oncology Healthcare Professionals' Mental Health during the COVID-19 Pandemic.

The paper begins by reviewing the literature on oncology healthcare professionals’ (HCP) mental health. We summarize and present the current data on HCP mental health in order to understand the baseline state of oncology HCPs’ mental health status prior to the COVID-19 pandemic. At each juncture, we will discuss the implications of these mental health variables on the personal lives of HCPs, the healthcare system, and patient care. We follow by reviewing the literature on these parameters during the COVID-19 pandemic in order to better understand the impact of COVID-19 on the overall mental health of HCPs working in oncology. By reviewing and summarizing the data before and after the start of the pandemic, we will get a fuller picture of the pre-existing stressors facing oncology HCPs and the added burden caused by pandemic-related stresses. The second part of this review paper will discuss the implications for the oncology workforce and offer recommendations based on the research literature in order to improve the lives of HCPs, and in the process, improve patient care.

Emotional Wellbeing and The Healthcare Workforce: A Review

Healthcare systems have long recognized the impact of adverse health events on patients and families, and in recent years have gone further to identify the resulting emotional strains on the healthcare workforce. This attention to emotional health, which has been described as the overall state of one's emotions and the ability to manage and adapt to stressors, is also referred to as "emotional wellness" or "wellbeing." As this concept of wellness expands and evolves in the midst of the COVID-19 pandemic into a priority on the wellbeing of those in the helping professions, the current review explores the existing literature on the impact of compassion fatigue, compassion satisfaction, and their relationship to occupational burnout, with the conclusion that the emotional wellness of healthcare stakeholders and the health of an organization itself are not mutually exclusive. A review of these identified areas of occupational wellness is conducted, as well as a summary of findings emphasizing its significant implications for the healthcare workforce moving forward, both in relation to tangible costs to the healthcare industry and its reach to the bedside in the form of reported patient experience.

Emotional Wellbeing and The Healthcare Workforce: A Review

Healthcare systems have long recognized the impact of adverse health events on patients and families, and in recent years have gone further to identify the resulting emotional strains on the healthcare workforce. This attention to emotional health, which has been described as the overall state of one's emotions and the ability to manage and adapt to stressors, is also referred to as "emotional wellness" or "wellbeing." As this concept of wellness expands and evolves in the midst of the COVID-19 pandemic into a priority on the wellbeing of those in the helping professions, the current review explores the existing literature on the impact of compassion fatigue, compassion satisfaction, and their relationship to occupational burnout, with the conclusion that the emotional wellness of healthcare stakeholders and the health of an organization itself are not mutually exclusive. A review of these identified areas of occupational wellness is conducted, as well as a summary of findings emphasizing its significant implications for the healthcare workforce moving forward, both in relation to tangible costs to the healthcare industry and its reach to the bedside in the form of reported patient experience.

RETRACTED ARTICLE: A thematic analysis of system wide learning from first wave Covid-19 in the East of England

BackgroundThe Covid-19 pandemic has created an unprecedented challenge for health and social care systems globally. There is an urgent need for research on experiences of COVID-19 at different levels of health systems, including lessons from professional, organisational and local system responses, that can be used to inform managerial and policy responses.MethodsThis paper presents the findings from a thematic analysis of front-line staff experiences working across the Norfolk and Waveney integrated care system (ICS) in the East of England during April and October 2020 to address the question “What are the experiences and perceptions of partner organisations and practitioners at multiple levels of the health system in responding to COVID-19 during the first wave of the pandemic?” This question was posed to learn from how practitioners, interdependent partner organisations and the system experienced the pandemic and responded. 176 interview transcripts derived from one to one and focus group interviews, meeting notes and feedback from a “We Care Together” Instagram campaign were submitted for qualitative thematic analysis to an external research team at a regional University commissioned to undertake an independent evaluation. Three phases of qualitative analysis were systematically undertaken to derive the findings.FindingsThirty-one themes were distilled highlighting lessons learned from things that went well compared with those that did not; challenges compared with the celebrations and outcomes; learning and insights gained; impact on role; and system headlines. The analysis supported the ICS to inform and capitalise on system wide learning for integration, improvement and innovations in patient and care home resident safety, and staff wellbeing to deal with successive waves of the pandemic as well as prioritising workforce development priorities as part of its People Plan.ConclusionsThe findings contribute to a growing body of knowledge about what impact the pandemic has had on health and social care systems and front-line practitioners globally. It is important to understand the impact at all three levels of the system (micro, meso and macro) as it is the meso and macro system levels that ultimately impact front line staff experiences and the ability to deliver person centered safe and effective care in any context. The paper presents implications for future workforce and health services policy, practice innovation and research.

Exploring the Impact of Emerging Technologies on Business Models, Customer Behavior, and Workforce Implications

In this study, we investigate how new technologies affect traditional company structures, consumer habits, and the implications for the labor force. This research delves deeply into the potential of robots, blockchain, and AI to disrupt existing markets and pave the way for new forms of business and product development. The study used a qualitative strategy, which included a literature review and industry-specific case studies. According to the data and analysis, if you want to successfully adopt new technologies, you need to take a strategic approach that takes into account the wants and fears of your customers and employees while also opening the door to growth and innovation. This research emphasizes the value of learning about and catering to customers' individual preferences and requirements before investing in the creation of customer-centric technologies. In addition, it stresses the significance of businesses investing in retraining and development to equip their workforce with the skills necessary to adapt to new job roles, as well as working with the workforce to address concerns and meet their needs. Finally, to effectively utilize emerging technologies for growth and innovation, it is necessary to continually evaluate and adjust to the impact they are having on business models, customer behavior, and the workforce

Impact of COVID-19 on service delivery in radiology and radiotherapy

IntroductionThe COVID-19 pandemic has had a profound impact on radiography services globally. The reshaping of service delivery continues to impact patient management and the experience of the radiography workforce should be evaluated to determine how effective service delivery can be maintained in the ongoing and post-pandemic world. MethodsA mixed methods approach was adopted. Questionnaires, designed using Qualtrics (Qualtrics, Provo, UT) online survey software, were used to survey radiographers throughout Northern Ireland (NI). Semi-structured interviews were conducted with radiography service managers in the NHS and private sector in NI. All interviews were digitally recorded, transcribed and coded independently by 2 researchers. ResultsA total of 106 Radiographers completed the online survey i.e. 82 Diagnostic and 24 Therapeutic. Variations were reported regarding staff concern for contracting COVID-19 and passing it on. Clinical workload was reported to fluctuate during the early period of the pandemic, however, both diagnostic and therapeutic radiographers reported workloads which were higher than normal at the time of the data collection. Nine service managers participated in the interviews plus two band 8 superintendent radiographers. Staff faced many challenges whilst delivering services due to COVID-19. The two most frequently cited challenges included issues related to (i) Implementation of PPE and (ii) Changes to work practices. ConclusionA pre-prepared pandemic plan should be established and stress tested for the future. The plan should be devised in consultation with both the public and private sector to determine the very best use of resources. Implications for practiceThe radiography workforce has worked continuously throughout the pandemic and needs to be supported to deal with the potential increase in demand for services in the post-pandemic world.

Exploring perceived training and professional development needs of Australian dietetic students and practising dietitians in the area of eating disorders: a focus group study

BackgroundTimely diagnosis and treatment of eating disorders (EDs) are essential for achieving the best possible outcomes, and dietitians have an important role in the multidisciplinary team. ED-specific training has been shown to enhance the knowledge, mental health literacy and confidence of health professionals in providing patient treatment. However, the ED-specific training needs of dietitians have yet to be determined. This study aimed to explore the perceived readiness of dietitians and student dietitians to treat patients with EDs; to identify the key training components that would enhance their confidence in delivering ED-specific treatment; and to examine any barriers associated with engagement in ED-specific professional development.MethodsA semi-structured question guide was developed by researchers to elicit information from six virtual focus groups consisting of a purposive sample of practising dietitians and student dietitians enrolled in their final year of an Australian tertiary accredited dietetic program. Members of professional organisations were approached to participate via email; and a recruitment flyer was promoted on various social media platforms. Discussions were recorded, transcribed verbatim and analysed qualitatively using inductive thematic analysis.ResultsThirty-eight participants (26 dietitians, 12 student dietitians) were recruited, mean age of 32.5 years ± 11 SD. Three major themes emerged: (1) reluctance to practice in EDs, which was associated with limited ED-specific training at university, lack of clinical guidelines, mental health complexities of patients with an ED, ambiguity regarding the dietitian’s role, systemic complexities with ED care, and beliefs of health professionals; (2) the need for additional ED-specific training and clinical supervision both during and after university, with the focus on identification, assessment, management and treatment, mental health literacy, and counselling skills, identified as an essential component to improving professional confidence and competence; (3) limited awareness and access/supply of ED-specific training opportunities were found, which included the financial cost of training/clinical supervision, and limited access to suitable clinical supervision.ConclusionDietitians currently practising in the workplace and dietetic students perceive that enhanced ED-specific training during university and after graduation is essential to work with patients confidently and competently with EDs. This research has implications for Australian university dietetic programs and workforce development.Plain English SummaryThis study aimed to explore the perceptions and readiness of dietitians and student dietitians to treat patients with eating disorders (EDs); to identify the key training components that would enhance their confidence and competence in delivering treatment; and to examine any barriers associated with engaging in ED-specific professional development. Twenty-six dietitians and twelve dietetic students participated in six virtual focus group discussions, which identified three main themes: (1) reluctance to practice which was associated with limited ED-specific training at university, lack of clinical guidelines, mental health complexities of patients with an ED, ambiguity regarding the dietitian’s role, systemic complexities with ED care, and beliefs of health professionals; (2) the importance of engaging in ED-specific training, beyond an introductory level, during university and after graduation to confidently and competently work with patients with EDs; (3) barriers to accessing further ED-specific training and clinical supervision were found, including poor awareness of training opportunities, high financial cost of training/clinical supervision, and limited access to obtaining suitable clinical supervision. Results from this study provide insight into the ED-specific training needs of practising and student dietitians. This research has value for university programs and workforce development.

Trends in Primary Mental Health Care Service Use and Subsequent Self-Harm in Western Sydney Australia: Policy and Workforce Implications.

Background: This study investigated the trends in primary mental health care (PMHC) service use and hospital-treated self-harm in Western Sydney (Australia). Methods: A data linkage study and descriptive ecological study of PMHC referrals investigated the trends in referrals, treatment attendance, hospital-treated self-harm, and health care practitioners (HCPs) for the period of 2013−2018 (n = 19,437). Results: There was a substantial increase in referrals from 2016. The majority of referrals were females (60.9%), those aged <45 years (71.3%), and those presenting with anxiety or affective disorders (78.9%). Referrals of those at risk of suicide increased from 9.7% in 2013 to 17.8% in 2018. There were 264 (2.2%) cases of subsequent hospital-treated self-harm, with higher rates among those at risk of suicide and those who attended <6 sessions. The number of HCPs per referral also increased from 2013, as did waiting times for treatment initiation. Conclusion: Individuals presenting to PMHC services at risk of suicide, and who subsequently presented to a hospital setting following self-harm, were more likely to either not attend services following a referral or to attend fewer services. This trend occurred in the context of an increase in the number of clients per HCP, suggesting workforce capacity has not kept pace with demand.

Influence of rurality on general practitioner registrars' participation in their practice's after-hours roster: Across-sectional study.

ObjectiveTo investigate whether practice rurality and rural training pathway are associated with general practitioner registrars' participation in their practice's after‐hours care roster.DesignA cross‐sectional analysis of data (2017‐2019) from the Registrar Clinical Encounters in Training study, an ongoing inception cohort study of Australian general practitioner registrars. The principal analyses used logistic regression.SettingThree national general practitioner regional training organisations across 3 Australian states.ParticipantsGeneral practitioner registrars in training within regional training organisations.Main outcome measureInvolvement in practice after‐hours care was indicated by a dichotomous response on a 6‐monthly Registrar Clinical Encounters in Training study questionnaire item.Results1576 registrars provided 3158 observations (response rate 90.3%). Of these, 1574 (48.6% [95% confidence interval: 46.8‐50.3]) involved registrars contributing to their practice's after‐hours roster. In major cities, 40% of registrar terms involved contribution to their practice's after‐hours roster; in regional and remote practices, 62% contributed to the after‐hours roster. On multivariable analysis, both level of rurality of practice (odds ratio(OR) 1.75, P = .007; and OR 1.74, P = .026 for inner regional and outer regional/remote locations, respectively, versus major city) and rural training pathway of registrar (OR 1.65, P = .008) were significantly associated with more after‐hours roster contribution. Other associations were registrars' later training stage, larger practices and practices not routinely bulk billing. Significant regional variability in after‐hours care was identified (after adjusting for rurality).ConclusionThese findings suggest that registrars working rurally and those training on the rural pathway are more often participating in practice after‐hours rosters. This has workforce implications, and implications for the educational richness of registrars' training environment.

Evaluation of Collaborative Robot Sustainable Integration in Manufacturing Assembly by Using Process Time Savings.

Collaborative robots are enablers of flexibility in the current dynamic and uncertain manufacturing environment. Decision making on its implementation requires technical feasibility, involving productivity and workforce implications that should be faced in an integrated perspective in processes where many components of different materials are assembled in products of increasing diversity and complexity. This study introduces two new parametric models for collaborative robotics, formulated in order to evaluate the differential cost of assembly (economic dimension) and the differential income from taxes that supports short-term workforce displacement (social dimension) in cobot implementation. Updated techno-economical parameters are selected for assessing feasibility ranges of application in different production scenarios. Next, the influence curves of productivity gain for a feasible implementation of cobot establish thresholds for decision making under both criteria. The results show the need for productivity gains that are significantly lower in high-wage scenarios than in low-wage scenarios; however, in a joint approach, breakeven productivity gain is always higher for the social dimension threshold than for the economic requirement of cost-effective manufacturing, with a higher gap in low-wage cases. The detailed analysis of a real case study of cobot implementation for assembly demonstrates the practical application of models and potential for future research.

Acute Care Surgeons Spend More Time than General Surgeons on the Electronic Health Record (EHR).

The paradigm of Acute Care Surgery (ACS) emerged in response to decreasing operative opportunities for trauma surgeons and increasing need for surgical coverage in disciplines to which the expertise of trauma surgeons naturally extends. While the continued evolution of this specialty remains largely beneficial, unintended consequences may have arisen along the way. One aspect of ACS that remains to be thoroughly investigated is the impact of the electronic health record (EHR). The purpose of this study is to objectively quantify EHR usage for ACS and compare it to other general surgery specialties. EHR user data were collected for fifteen ACS attendings and thirty-seven general surgery attendings from October 2014 to September 2019. Comparative analysis was conducted using two-tailed t-tests. Subgroup analysis was conducted for subspecialties included in the general surgery group. ACS attendings opened almost 3 times as many charts as general surgery attendings per month (180 vs 64 charts/month, P < .0001), and ultimately spent more time on the EHR as a result (10 vs 6.4 hours/month, P < .0001). Documentation was the most time consuming EHR task for both groups. Although ACS attendings spent less overall time per patient chart, the proportion of time spent on certain EHR tasks was similar to that of general surgery colleagues. The EHR imposes a disproportionate burden on ACS attendings compared to their general surgery counterparts, and additional study is warranted to improve usage. EHR usage burden has workforce implications for trainees considering a career in ACS.