Workforce Outcomes Research Articles

Scenarios, Not Shortage Forecasts, Are Key to Better Workforce Policy

Abstract Current and projected shortages in the U.S. health workforce have prompted policymakers to propose reforms to Medicare Graduate Medical Education (GME) and nursing programs. However, researchers have historically faced challenges in accurately predicting workforce trends; physician and nurse supply and demand all grew faster than expected over the past two decades. These discrepancies highlight the need for scenario-based workforce planning and projection models that estimate how a policy intervention would affect the workforce outcome of interest. In addition, policy options modeled should address not only increasing provider-to-population ratios, but also improving health outcomes through innovative payment and care models.

Organizational Commitment as a Mediator: Exploring the Relationship between Job Satisfaction and Job Performance in the Ghanaian Public Sector

Public sector organizations in developing countries face significant challenges related to workforce retention, job satisfaction, and performance, particularly in Ghana, where limited resources and economic constraints exacerbate these issues. Addressing these challenges is vital for improving organizational outcomes and ensuring effective delivery of public services. This study explores the relationship between job satisfaction and job performance in Ghana’s public sector, focusing on the mediating role of organizational commitment. Understanding these dynamics is becoming increasingly important as public sector organizations grapple with the complexities of workforce management in resource-constrained environments. A sample of 300 employees was selected through purposive and convenience sampling, with 200 valid responses (66.6% response rate). Data were analyzed using SMART PLS 3.0 and SPSS 22, applying partial least squares structural equation modeling (PLS-SEM) to assess the research model and hypotheses. The findings reveal that job satisfaction significantly impacts affective, continuance, and normative commitment. Additionally, continuance and normative commitment positively influence job performance, whereas affective commitment does not. This study underscores the importance of job satisfaction in enhancing job performance through its effect on organizational commitment. To improve workforce outcomes, the study recommends targeted training programs that address skill gaps and increase job satisfaction. Public sector organizations, particularly local governments, should prioritize the implementation of effective job satisfaction strategies to boost employee performance and commitment. This research provides valuable insights into how public sector entities in developing countries like Ghana can foster employee performance through improved organizational commitment.

The Impact of Clinical Supervision on the Mental Health Nursing Workforce: A Scoping Review.

Clinical supervision is a psychologically safe practice that aims to provide support and training for workers within the healthcare industry, including mental health nurses. Over the years, clinical supervision has been cited as a practice to improve workforce outcomes for both individual mental health nurses and the organisations they work in. The aim of this scoping review is to examine the evidence exploring the relationship between clinical supervision and workforce outcomes for mental health nurses. Twenty-eight articles sourced from six databases were included in this study. The most frequently evaluated workforce outcomes were competence (n = 14), workplace culture (n = 13) and compassion (n = 7). Studies reported that the association between clinical supervision and workforce outcomes was predominantly positive, but there were mixed results for competence, workplace culture, job satisfaction and burnout. Details on the type of clinical supervision received by participants were limited, and most of the evidence included in this review included qualitative research and participants self-reporting their perceived benefits from clinical supervision, as opposed to using validated instruments in experimental and/or longitudinal study designs. Organisations should be hesitant to implement mandatory clinical supervision within workplaces, as this could have the opposite effect on workforce outcomes for mental health nurses who are already time-poor and overworked, as well as those who are indifferent or hostile to clinical supervision.

Employee learning and development, workforce outcome, and talent retention among internet of thing industries: Basis for workforce satisfaction framework

Employee learning and development, workforce outcome, and talent retention among internet of thing industries: Basis for workforce satisfaction framework

Organizational Climate Related to Patient-Perpetrated Sexual Harassment: VA Primary Care Provider Perceptions.

Patient-perpetrated sexual harassment toward health care providers is common and adversely affects provider well-being, workforce outcomes, and patient care. Organizational climate for sexual harassment-shared perceptions about an organization's practices, policies, and procedures-is one of the strongest predictors of harassment prevalence. We conducted a pilot survey assessing provider perceptions of the Veterans Health Administration (VA)'s climate related to patient-perpetrated sexual harassment. Responding providers completed a survey assessing: (1) experiences with patient-perpetrated sexual harassment, (2) beliefs about VA's responses to patient-perpetrated sexual harassment of staff, and (3) perceptions of VA's organizational climate related to sexual harassment for each of 4 perpetrator-target pairings (patient-perpetrated harassment of staff, patient-perpetrated harassment of patients, staff-perpetrated harassment of staff, and staff-perpetrated harassment of patients). Respondents included 105 primary care providers (staff physicians, nurse practitioners, and physician assistants) at 15 facilities in the VA Women's Health Practice-Based Research Network. Seventy-one percent of responding providers reported experiencing patient-perpetrated sexual harassment in the past 6 months. Respondent perceptions of VA's responses to patient-perpetrated harassment of staff were mixed (eg, indicating that VA creates an environment where harassment is safe to discuss but that it fails to offer adequate guidance for responding to harassment). Respondents rated organizational climate related to patient-perpetrated harassment of staff as significantly more negative compared with climate related to other perpetrator-target pairings. Future work with representative samples is needed to corroborate these findings, which have potential ramifications for VA's ongoing efforts to create a safe, inclusive environment of care.

Association of Federal COVID-19 Funding Distributions With Workforce and Capacity in Health Centers.

Using novel national data, we examined the association between 2020 federal COVID-related funding targeted to health centers (i.e., H8 funding) and health center workforce and operational capacity measures that may be important for preserving patient access to care and staff safety. We assigned health centers to quartiles based on federal funding distribution per patient and used adjusted linear probability models to estimate differences in workforce and operational capacity outcomes across quartiles from April 2020 to June 2022. We found a nearly 6-fold difference in 2020 H8 funding per patient when comparing health centers in the lowest versus highest quartiles. Despite this difference, health centers' outcomes improved similarly across quartiles over time, with the lowest-funded health centers having the greatest staffing and service capacity challenges. Our findings suggest that COVID-related health center funding may have contributed to stabilization of health centers' workforce and operations. Amid concerns about staff turnover, sustained investments targeted to supporting workforce retention at health centers can help to ensure ongoing delivery of critical services.

Supporting early-career teachers with external mentoring: a scoping review

ABSTRACT This article presents a scoping review addressing the pressing issue of high attrition rates among early-areer teachers (ECTs), which poses a significant challenge to the development of a robust teacher workforce and student outcomes. Focusing on the role of external mentoring programmes, our study explores their potential in retaining ECTs within the teaching profession. Through a scoping review of the literature, we identified three central themes: (a) defining the role of external mentors, (b) elucidating the benefits of external mentoring and (c) examining the impact of external mentoring on ECT identity development. Our analysis revealed a scarcity of programmes emphasising university–school partnerships. Consequently, we propose the implementation of an ECT mentoring initiative involving university mentors collaborating with ECTs in their respective school environments. This study contributes significantly to the field of teacher education by shedding light on effective strategies for ECT induction and the transformative role of mentoring in cultivating ECTs as proficient educators capable of autonomous decision-making, networking, and enhancing overall teaching quality within schools.

Describing a medical school's rural activity footprint: setting selection and workforce distribution priorities.

There is growing evidence supporting a shift towards 'grow your own' approaches to recruiting, training and retaining health professionals from and for rural communities. To achieve this, there is a need for sound methodologies by which universities can describe their area of geographic focus in a precise way that can be utilised to recruit students from their region and evaluate workforce outcomes for partner communities. In Australia, Deakin University operates a Rural Health Multidisciplinary Training (RHMT) program funded Rural Clinical School and University Department of Rural Health, with the purpose of producing a graduate health workforce through the provision of rural clinical placements in western and south-western Victoria. The desire to establish a dedicated Rural Training Stream within Deakin's Doctor of Medicine course acted as a catalyst for us to describe our 'rural footprint' in a way that could be used to prioritise local student recruitment as well as evaluate graduate workforce outcomes specifically for this region. In Australia, selection of rural students has relied on the Australian Statistical Geography Standard Remoteness Areas (ASGS-RA) or Modified Monash Model (MMM) to assign rural background status to medical course applicants, based on a standard definition provided by the RHMT program. Applicants meeting rural background criteria may be preferentially admitted to any medical school according to admission quotas or dedicated rural streams across the country. Until recently, evaluations of graduate workforce outcomes have also used these rurality classifications, but often without reference to particular geographic areas. Growing international evidence supports the importance of place-based connection and training, with medical graduates more likely to work in a region that they are from or in which they have trained. For universities to align rural student recruitment more strategically with training in specific geographic areas, there is a need to develop precise geographical definitions of areas of rural focus that can be applied during admissions processes. As we strived to describe our rural activity area precisely, we modelled the application of several geographical and other frameworks, including the MMM, ASGS-RA, Primary Healthcare Networks (PHN), Local Government Areas (LGAs), postcodes and Statistical Areas. It became evident that there was no single geographical or rural framework that (1) accurately described our area of activity, (2) accurately described our desired workforce focus, (3) was practical to apply during the admissions process. We ultimately settled on a bespoke approach using a combination of the PHN and MMM to achieve the specificity required. This report provides an example of how a rural activity footprint can be accurately described and successfully employed to prioritise students from a geographical area for course admission. Lessons learned about the strengths and limitations of available geographical measures are shared. Applications of a precise footprint definition are described including student recruitment, evaluation of workforce outcomes for a geographic region, benefits to stakeholder relationships and an opportunity for more nuanced RHMT reporting.

An integrative review of the impact of allied health student placements on current staff’s knowledge and procedural skills in acute and primary care settings

BackgroundStaff shortages limit access to health services. The bidirectional benefits of allied health clinical placements are understood in the domains of student learning, health service delivery, and future workforce development. Still, the benefits to current workforce outcomes remain unknown. This review provides insights into the effects of allied health student placements in acute and primary care settings, particularly on healthcare staff's knowledge and procedural skills.MethodsThis search was based on the integrative review process established by Whittemore and Knafl in 2005. In October 2023, the first author (MH) searched five major electronic databases: Medline-EBSCO, PubMed, CINAHL, Embase, and Scopus. The CLUSTER model was used to track additional references. The first three authors (MH, SM, and SC) were involved in screening, quality appraisal, and synthesis of the studies. Data were thematically synthesised and analysed.ResultsMeSH headings and keywords were used in key search areas: health education, health professional training, clinical placements, and allied health professions. The systematic search yielded 12 papers on allied health student placements across various healthcare settings in rural and metropolitan areas, with no high-quality methodologies measuring student placements' impact on staff knowledge and skills. Four main themes were identified from the analysis: meaningful student integration in service delivery, targeted educational support to healthcare staff, development of staff procedural skills and confidence, and the mechanisms of why student placements work in this aspect.ConclusionsThis review suggests that offering allied health student placement could be a promising approach to supporting rural healthcare staff in performing patient assessments and treatments proficiently and collaboratively. However, this requires further investigation to confirm.

The relationships between certified nursing assistants' voice behaviour and job satisfaction, work engagement and turnover intentions: A two-wave survey study.

Whereas voice behaviour has been identified as a key precursor to safe and high-quality patient care, little is known about how voice relates to key workforce outcomes. This study aimed to investigate the relationships between certified nursing assistants' perceived promotive voice behaviour (speaking up with suggestions for future improvement) and prohibitive voice behaviour (speaking up about problems or potentially harmful situations) and their self-reported levels of job satisfaction, work engagement and turnover intentions. Dutch certified nursing assistants were recruited for a two-wave survey study through non-random convenience sampling. The final sample contained 152 respondents. The data were analysed using multiple linear regression analyses. In all analyses, the dependent variable at time one was controlled for. Certified nursing assistants' promotive and prohibitive voice behaviour at time one were found to be positively related to their level of job satisfaction at time two while controlling for job satisfaction at time one. No relationships with work engagement or occupational turnover intentions were found. While previous research has found positive effects of voice on patient safety outcomes and team and organizational improvements in care organizations, we demonstrate that voice is also related to a key workforce outcome, that is, certified nursing assistants' job satisfaction. Recognizing the interplay between voice behaviour and job satisfaction underscores the importance of creating work environments where certified nursing assistants feel able and willing to make their voices heard-with ideas and suggestions, as well as information regarding problems and concerns. Three certified nursing assistants have contributed to the development of the survey.

LEVERAGING HR ANALYTICS FOR STRATEGIC DECISION MAKING: OPPORTUNITIES AND CHALLENGES

In the evolving landscape of human resources (HR), organizations are increasingly leveraging HR analytics to drive strategic decision-making. This review explores the opportunities and challenges associated with the integration of HR analytics in organizational practices. HR analytics involves the systematic analysis of HR data to inform decision-making, enhance organizational performance, and optimize workforce management strategies. By harnessing the power of data, organizations can gain valuable insights into employee behavior, performance trends, and organizational dynamics, enabling them to make more informed and strategic decisions. One of the key opportunities of leveraging HR analytics is the ability to identify and address workforce trends and issues proactively. By analyzing data on employee engagement, turnover rates, and performance metrics, organizations can identify patterns and trends that may impact their workforce and business outcomes. This proactive approach allows organizations to anticipate and mitigate potential challenges, leading to improved organizational performance and employee satisfaction. Furthermore, HR analytics can help organizations optimize their recruitment and talent management strategies. By analyzing data on candidate profiles, recruitment sources, and employee performance, organizations can identify the most effective recruitment channels and selection criteria. This data-driven approach enables organizations to attract and retain top talent, leading to a more skilled and engaged workforce. However, leveraging HR analytics also presents several challenges. One of the primary challenges is the availability and quality of HR data. Organizations must ensure that they have access to reliable and relevant data to derive meaningful insights. Additionally, organizations must overcome challenges related to data privacy and security to protect sensitive employee information. In conclusion, the integration of HR analytics presents significant opportunities for organizations to drive strategic decision-making and enhance organizational performance. By leveraging HR analytics, organizations can gain valuable insights into their workforce and business operations, enabling them to make informed decisions that drive business success. However, organizations must also address challenges related to data availability, quality, and privacy to realize the full potential of HR analytics in driving strategic decision-making. This paper will examine the use of HR analytics as a strategic tool in the management of human resources. It will cover the methodologies and technologies involved in data collection, analysis, and interpretation, and how these can be used to enhance decision making in HR. The study will also address the challenges and limitations of HR analytics, including data privacy issues and the risk of misinterpretation, and propose solutions to mitigate these risks. Keywords: Leveraging, HR Analytics, Strategic Decision making, Opportunities, Challenges.

The development and validation of a Multidimensional Perceived Work Ability Scale.

Research on the concept of existing unidimensional Perceived Work Ability scale (PWA) in organizational science has recently increased due to its prediction of important work, individual, and labor force outcomes. To date, PWA has been measured as a unidimensional construct. The present study outlines the need for the multidimensional conceptualization of PWA and its measurement. We describe the development and validation of the Multidimensional Perceived Work Ability Scale (M-PWAS), comprising four dimensions: physical, cognitive, interpersonal, and emotional. In line with Hinkin's (1998) approach to scale validation, we use four samples (total N = 1,152) to establish the M-PWAS as a reliable and valid measure of PWA. Through an iterative item generation and review process, we found evidence for content validity. Furthermore, each subscale demonstrated high internal consistency and factorial validity, and analysis of the PWA nomological network demonstrated evidence for convergent and discriminant validity. Finally, we found that the M-PWAS showed incremental validity over an existing unidimensional PWA measure in the prediction of perceived stress, emotional exhaustion, work engagement, and turnover. We discuss implications for theory, research, and workplace interventions. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

The rise of for-profit teacher preparation programmes: investigating career outcomes for novice teachers

ABSTRACT The increased privatisation of educational systems is a global trend with several important implications for teachers’ preparation and workforce outcomes. With many countries facing teacher shortages, retention for novice teachers is a key area of focus for educational leaders and policymakers – yet there is a lack of evidence related to the relationship between new alternative pathways into the profession and retention patterns. In this paper, we add to the limited literature on for-profit teacher preparation Programme outcomes. Our results extend work related to educational market deregulation and contribute to research about novice teachers. Drawing on longitudinal employment files and certification records for over 160,000 individual teachers, our results demonstrate meaningful variation in the demographic characteristics and retention outcomes of for-profit prepared novice teachers. Our findings have implications for educational leaders, preparation Programme leaders, and state/district, national, and international policymakers. The realities of for-profit Programmes may have global implications.

Impact of clinical supervision on the mental health nursing workforce: a scoping review protocol

IntroductionMental health nurses work in potentially unpredictable, stressful and complex environments that can lead to burn-out and high staff turnover. Clinical supervision is a formal and professional agreement between two...

Lessons Learned From State-Based Efforts to Leverage Medicaid Funds for Graduate Medical Education.

Total Medicaid funds invested in graduate medical education (GME) increased from $3.78 billion in 2009 to $7.39 billion in 2022. States have flexibility in designing Medicaid GME payments to address population health needs. This study assessed states' impetus for using Medicaid funds for GME, structure of state Medicaid payments, composition and charge of advisory bodies that guide these investments, and degree of transparency and accountability to track whether Medicaid GME investments achieved desired workforce outcomes. Structured interviews were conducted in 2015 to 2016 and 2020 to 2021 with subject matter experts representing 10 states. Interview transcripts were analyzed and coded in 6 thematic areas: impetus for using Medicaid funds, the structure of state Medicaid payments, the composition of advisory bodies, the degree of transparency of Medicaid investments, accountability of Medicaid investments, and challenges and changes. States used Medicaid GME funding to address maldistribution of physicians by geography, setting, and specialty, respond to population growth and undergraduate medical education expansion, offset potential loss of teaching health center program funds, and launch new programs and sustain existing ones. States leveraged Medicaid funding by modifying state plan amendments and redesigning funding formulas to meet specific health workforce needs. Many states had advisory bodies to educate legislators, reach consensus on workforce needs, recommend how to disburse funds, and navigate competing stakeholder interests. States identified a need for improved data and analytic systems to understand workforce needs and monitor the outcomes of GME investments. Determining which accountability measures to use and implementing metrics were challenges. States have much to learn from each other about strategies to best leverage Medicaid funds to develop and sustain residency programs to meet population health needs. Learning collaboratives should be developed to provide a forum for states to share best practices and strategies for overcoming challenges.

The importance of transformational leadership

Transformational leadership is a leadership style that is often compared to and contrasted with transactional leadership. Where the latter tends to be more task-orientated and has a part to play in specific managerial contexts, transformational leadership focuses on the power of relationships to inspire others to achieve a shared vision, with longer lasting effects. The benefits of transformational leadership place it as one of the most applied leadership styles in health care, with positive impacts seen on the workforce, organisational productivity, and patient outcomes. Developing transformational leaders across all levels of an organisation is strongly recommended, due to the benefits highlighted in the literature. Any organisation wishing to grow its transformational leaders must first identify intrinsic and extrinsic factors within the organisation and its culture that could act as obstacles. Authors are in agreement that the skills, knowledge and behaviours of a transformational leader can be learnt, therefore investment in such development programmes is important. This article explores the importance of transformational leadership and how staff can develop the competencies required to grow as a transformational leader in health and social care.

The Australian Health Informatics Competency Framework: Conceptual Design, Framework Development, and Certification Delivery.

The Australian Health Informatics Competency Framework (AHICF) guides the healthcare workforce in identifying the required competencies to perform as a health informatician, and more definitively defines the foundational body of knowledge on which the discipline is based. The aim of this paper is to describe the conceptual foundations in developing the AHICF v1.0, detail the methods used to revise and publish AHICF v2.0, and explore the certification and workforce outcomes achieved. This paper contributes to the competency framework and certification discourse, and knowledge of the increasing importance and recognition of health informaticians through certification. Further, implications for workforce training and education, career advancement and recruitment strategies, are also discussed.

The Effects of Health Insurance Coverage on Workforce Engagement of Family Caregivers of Children With Intellectual Disability and Autism.

For many families of children with intellectual disability and autism (ID/ASD), private health insurance and public programs, such as Medicaid and the Children's Health Insurance Program (CHIP), are critical sources of support. The purpose of this study was to examine the impact of health insurance coverage on workforce engagement of parents of children with ID/ASD. The study utilized 2014-2018 pooled National Health Interview Survey data to construct national estimates and test the effects of health insurance status on parent workforce outcomes. Primary findings indicate significantly higher odds of workforce absence (OR = 2.83, p < .0038) and unemployment (OR = 8.91, p < .0038) among parents with children with ID/ASD using public health insurance, compared to the reference group. Additionally, parents of children with ID/ASD who were uninsured were found to experience significantly higher unemployment (OR = 4.86, p < .0038) than the reference group. Findings have policy and research implications related to workforce engagement for parents, including issues impacting health insurance coverage, specifically related to Medicaid and CHIP.

Realizing Inclusion and Systemic Equity in Medicine: Upstanding in the Medical Workplace-A Curriculum Update.

Racism is a public health crisis. Bias towards patients adversely affects health outcomes 1 FitzGerald C. Hurst S. Implicit bias in healthcare professionals: a systematic review. BMC Med Ethics. 2017; 18 (Mar 1) (PMID: 28249596; PMCID: PMC5333436.): 19https://doi.org/10.1186/s12910-017-0179-8 Crossref PubMed Scopus (984) Google Scholar and access to care while structural racism in medicine has led to decreased diversity of the healthcare workforce, burnout, and negative career outcomes. 2 Filut A. Alvarez M. Carnes M. Discrimination Toward Physicians of Color: A Systematic Review. J Natl Med Assoc. 2020; 112 (Apr): 117-140https://doi.org/10.1016/j.jnma.2020.02.008 Crossref PubMed Scopus (46) Google Scholar Growing evidence shows that curricula addressing racism within medical education can increase providers’ perceived capacity to address racism and limit its impact on patients and staff. 3 Jindal M. Mistry K.B. McRae A. Unaka N. Johnson T. Thornton R.L.J. "It Makes Me a Better Person and Doctor": A Qualitative Study of Residents' Perceptions of a Curriculum Addressing Racism. Acad Pediatr. 2022; 22 (Mar): 332-341https://doi.org/10.1016/j.acap.2021.12.012 Abstract Full Text Full Text PDF PubMed Scopus (3) Google Scholar

Outcomes of rural generalist internship training in Victoria, Australia.

Victoria, Australia commenced its first Rural Community Internship Training program in 2012 to support the development of rural generalist (RG) doctors. These general practitioners have additional skills to work at a broad scope to deliver the range of primary care and additional specialist services that communities need. Unlike most internships, which are wholly hospital-based and delivered mostly within larger metropolitan and regional centres, this RG internship training model involves completing general practice experience in smaller rural communities working with RGs and visiting specialists. This study aimed to explore the characteristics and satisfaction of doctors who participate in RG internship training in Victoria and their workforce outcomes. Between October and November 2021, a retrospective 10-minute anonymous survey invitation was sent to all contactable interns (n=222) who had completed/were completing the RG internship training (2012-2021). The survey was co-designed with RG internship managers and other stakeholders of a statewide evaluation advisory group, informed by the latest evidence regarding RG medicine and rural training predictors, and outcomes of interest. Participants completed the survey using Microsoft Forms, with three invitations circulated to an up-to-date email address maintained by the internship program. Collected data were analysed descriptively, by subgroup, to explore training pathway outcomes by region, training stage and specialty choice. Workforce distribution outcomes were defined in line with objectives of the program and predetermined indicators of RG scope. Results were compared with the benchmarks of rural workforce training outcomes in Australia using recent research. There were 59 participants (27% response rate); 81% were in postgraduate years 3-7. Respondents included 54% male, 17% rurally bonded, 39% of rural origin, 34% having had more than 3 months rural undergraduate training and 48% doing RG training where they previously did undergraduate training. All were satisfied/very satisfied with the RG training and 61% were working in general practice (excluding the prevocational group). Overall, 40% were currently working in the same rural region as their internship (including three who were currently interns), 56% continued to complete some prevocational training in the same region as their RG internship, while 20% had gone on to be currently based in smaller rural communities (Modified Monash Model locations 4-7) and 44% to be working part-time in smaller rural communities. Overall, 42% self-identified as working as an RG and nearly all (97%) met at least one of the key indicators of extended (RG) scope. In all areas the RG internship outcomes were better than the national benchmarks from published evidence about rural training. This study provides evidence from doctors up to 9 years after completing their RG internship. Compared with industry benchmarks, the RG internships attract rurally intentioned and rurally experienced doctors who may be likely to remain in the same rural region as their undergraduate rural medical training and continue their postgraduate training in the same region. They were all satisfied with RG internship training, had high propensity to follow a general practice career and work at broad scope in smaller communities. Importantly, they intended to stay in the region where they trained. This suggests RG internship programs are a positive intervention for promoting an RG workforce.