Workforce Pipeline Research Articles

Will they come back? Evaluation of health student placements in remote and very remote regions of Australia

BackgroundDespite the benefits of rural placements in attracting healthcare professionals to rural areas, there remains a gap in understanding the specific impact of placements in remote and very remote areas of Australia, particularly within the unique context of the Kimberley region. There is a need to elucidate differences across geographical areas and contribute to the knowledge about the specifics of where and how student placement programs work. This research explored the impact of a remote placement program at Majarlin Kimberley Centre for Remote Health (‘Majarlin’) on educational outcomes and workforce intentions of participating students.MethodsThis research evaluated student placement data and post-placement surveys of allied health, dentistry, midwifery and nursing students who had completed remote placements in the Kimberley region between 2018 and 2024. Placement numbers and demographic data from 2018 to 2023 were descriptively analysed, while post-placement surveys collected between January 2023 and June 2024 were used to examine educational outcomes, placement satisfaction, and rural practice intention.ResultsBetween 2018 and 2023, Majarlin hosted 1111 students from 20 universities in remote and very remote regions, completing a total of 6068 weeks from 2018 to 2023. Post-placement surveys showed high levels of student satisfaction, with 96.2% also reporting improved clinical knowledge. Many students participated in voluntary positions in the community while completing their clinical placements, with 97.1% feeling that they had a positive impact on the community. All students reported that their cultural awareness and ability to engage with Aboriginal and Torres Strait Islander Peoples improved. Notably, intention to work in remote areas significantly increased post-placement (p < .001).ConclusionsThe results of this study demonstrated that the remote student placement program improved students’ self-rated clinical knowledge, cultural awareness, and community engagement skills. The program significantly influenced students’ intention to work in remote areas after graduation. These results can be used to inform the design and delivery of similar remote student placement programs which aim to improve the rural health workforce pipeline, paving the way for a more equitable and effective healthcare system across Australia.

Strengthening Academic Public Health Programs and Workforce Development Through Fieldwork: Insights From a Novel Partnership Between New Mexico's Two Major Universities.

Our collaboration to strengthen applied practice in public health training between two public universities in New Mexico has offered us insight into the types of institutional, administrative, and programmatic support beneficial for navigating work with limited resources and varying geographic considerations. We share some lessons from this burgeoning partnership between University of New Mexico's (UNM) College of Population Health and New Mexico State University's (NMSU) Department of Public Health Sciences which began in 2022. The main areas of learning focus on exchanging resources to extend relationships with fieldwork sites and site supervisors, engage and support students in their planning and implementation of their fieldwork, and identify institutional resources to maintain and grow programmatic quality. Implications from this work include efforts to reinforce the public health workforce pipeline, especially to ensure the participation and success of students from underrepresented backgrounds.

Urban-rural geographic distribution of Otorhinolaryngologist, Head and Neck surgeons in Aotearoa New Zealand.

We identified geographic distribution of Otorhinolaryngologist, Head and Neck surgeons in Aotearoa New Zealand. To identify the future workforce pipeline, we explored trainee intentions for specialist practice. A survey was distributed to all New Zealand Society of Otolaryngology, Head and Neck Surgery (NZSOHNS) members and all current New Zealand Otolaryngology, Head and Neck surgery trainees. Data were gathered on work location and patterns of work, including on-call commitments and full-time equivalent hours worked. Trainees were asked about future career plans. An 88% response rate was achieved encompassing senior medical officers (SMOs) and trainees. A total of 64.8% (68) of respondents reported primarily working in a metropolitan hospital and 26.7% (28) reported working in a regional centre. Rates of internationally trained surgeons were significantly higher in regional centres compared to metropolitan hospitals (64.3% vs 32.4%, p<0.05). Regional respondents had higher after hours on-call burden, a higher full-time equivalent (FTE) worked and higher average hours worked per week. Retirement intentions within the next 10 years were high in both groups (64% regional and 52.9% metropolitan, p<0.05). The regional workforce in ORLHNS work longer hours, are older and are reliant on internationally trained surgeons. Current training of ORLHNS surgeons is unlikely to keep pace with expected retirements.

Influence of Community Cultural Wealth on Undergraduate Hispanic and Black Women's Persistence in the STEM+C Workforce Pipeline

To promote racial and gender equity in the field of science, technology, engineering, mathematics, and computing (STEM+C), we investigated prominent influences on historically underrepresented minority (HURM) women's persistence in undergraduate education. With the underrepresentation of Black and Hispanic women in the computing workforce, this study focused on the experiences of this population as they persisted in their undergraduate education at a Hispanic Serving Institution (HSI) in Texas. This pilot study employed the ACCEYSS STEM+C Majors (ASCM) survey instrument and the counter-life herstory interview protocol to illuminate the community cultural wealth (CCW) factors and relevant lived experiences that influenced Black and Hispanic women's persistence in undergraduate computing education. To center justice and equity, we utilized a modified CCW framework (MCCW) as the theoretical framework to provide an antideficit understanding of how women of color access their strengths to persist in postsecondary education. The MCCW framework was modified to include spiritual capital as a critical source of fortitude and resilience in Black and Hispanic communities. Our findings highlight ways in which CCW factors influenced Black and Hispanic women's persistence in undergraduate computing education in response to better understand this population in their attainment and representation in STEM+C disciplines.

Factors Associated with COVID-19 Public Health Workforce Pipeline.

Public health entities nationwide conducted historic hiring to mitigate the COVID-19 pandemic. Post-pandemic recovery has seen recognition and investment in the need for public health infrastructure including workforce. This case study presents a descriptive analysis of COVID-19 case investigators and contact tracers who were part of the COVID-19 workforce in Michigan and associated factors in their ongoing interest in the field. The majority of these respondents have continued their public health career.

State-Based Evaluation of the Workforce Pipeline from Paramedic Program Enrollment to Agency Affiliation

Objectives The strength and stability of the paramedic workforce is dependent on the continual flow of EMS clinicians into the field. Workforce entry requires three distinct steps: program completion, certification attainment, and affiliation with an EMS agency. At each of these steps, future EMS clinicians may be lost to the workforce but the contribution of each is unknown. Our objective was to evaluate these inflection points using a state-based registry of EMS clinicians from their point of entry into the EMS education system to eventual EMS agency affiliation. Methods This is a retrospective cohort evaluation of paramedic students in the Commonwealth of Virginia. We included any student who enrolled in a paramedic program in 2017 or 2018. Data were provided by the Virginia Office of Emergency Medical Services, who tracks the development of EMS clinicians from the point of entry into an educational program through their affiliation with an EMS agency upon employment. Our primary outcomes include proportions of enrolled students who complete a program, graduating students who attain national/state certification, and nationally certified EMS clinicians who affiliate with an EMS agency. Proportions were calculated at each step and compared to the overall population of students enrolled. Results In 2017 and 2018, 775 and 603 students were enrolled in paramedic programs, respectively. Approximately a quarter of students did not complete their paramedic program (2017: 25% [192/775]; 2018: 28% [170/603]). Of those who graduated, the proportion of students not gaining certification was lower (2017: 11% [62/583]; 2018: 17% [75/433]). Of those who certified, those not affiliating was similarly low (2017: 15% [77/521]; 2018: 13% [46/358]). Evaluating the effect of each of these steps on the total entry into the workforce, nearly half of those who originally enrolled did not join the workforce through agency affiliation (2017: 43% [331/775]; 2018: 48% [291/603]). Conclusions There are multiple areas to enhance retention of potential EMS trainees from program enrollment to EMS agency affiliation. This analysis suggests that educational attrition has a larger impact on the availability of new paramedics than certification examinations or agency affiliation decisions, though is limited to a singular state evaluation.

Australia’s ECEC workforce pipeline: Who and how many are pursuing further qualifications?

AbstractThe significant shortfall of staff in the early childhood education and care (ECEC) workforce identifies an imperative not only to recruit educators but to support ongoing qualifications and career advancement of those within. Indeed, Shaping Our Future, Australia’s workforce strategy for 2022–2031 identifies qualifications and career development as key focus areas. Taking this imperative, we asked Who? and How many? within the Australian workforce are committed to ongoing study? Analysing a national survey (N = 1291), we examine characteristics of those studying (20.5%) intending (52.3%) or wavering about further study (18.7%). Study and study intention were associated with being younger and at early career-stage, identifying a positive message for career growth. Those who were older or working part-time were less certain about ongoing training. Those with long tenure in ECEC had higher rates of studying for non-ECEC qualifications. Implications for qualification pipeline, career pathways and workforce strategy are discussed.

Restoring flow to the Aotearoa New Zealand vascular workforce pipeline requires tangible strategic interventions.

Restoring flow to the Aotearoa New Zealand vascular workforce pipeline requires tangible strategic interventions.

Is Primary Care Adapting to Medicaid Managed Care in North Carolina? Implications for Expansion and Future Managed Care Transitions.

Realizing North Carolina's comprehensive vision for Medicaid transformation requires strengthening the state's primary care infrastructure. This can be done by build-ing upon the value-based care incentives in the Advanced Medical Home model, strengthening payor data, aligning quality measures, easing administrative burdens, investing in primary care and its workforce pipeline, and ensuring pay-ment models adequately support serving Medicaid expan-sion and the growing number of Medicaid health plans.

Institute for Foundations of Machine Learning (IFML): Advancing AI systems that will transform our world

AbstractThe Institute for Foundations of Machine Learning (IFML) focuses on core foundational tools to power the next generation of machine learning models. Its research underpins the algorithms and data sets that make generative artificial intelligence (AI) more accurate and reliable. Headquartered at The University of Texas at Austin, IFML researchers collaborate across an ecosystem that spans University of Washington, Stanford, UCLA, Microsoft Research, the Santa Fe Institute, and Wichita State University. Over the past year, we have witnessed incredible breakthroughs in AI on topics that are at the heart of IFML's agenda, such as foundation models, LLMs, fine‐tuning, and diffusion with game‐changing applications influencing almost every area of science and technology. In this article, we seek to highlight seek to highlight the application of foundational machine learning research on key use‐inspired topics: Fairness in Imaging with Deep Learning: designing the correct metrics and algorithms to make deep networks less biased. Deep proteins: using foundational machine learning techniques to advance protein engineering and launch a biomanufacturing revolution. Sounds and Space for Audio‐Visual Learning: building agents capable of audio‐visual navigation in complex 3D environments via new data augmentations. Improving Speed and Robustness of Magnetic Resonance Imaging: using deep learning algorithms to develop fast and robust MRI methods for clinical diagnostic imaging. IFML is also responding to explosive industry demand for an AI‐capable workforce. We have launched an accessible, affordable, and scalable new degree program—the MSAI—that looks to wholly reshape the AI/ML workforce pipeline.

How Nursing Home Leadership Strengthens the Workforce Pipeline Through the Teaching Nursing Home Collaborative

How Nursing Home Leadership Strengthens the Workforce Pipeline Through the Teaching Nursing Home Collaborative

"Join the team" clinical research workforce development model: A new paradigm in healthcare career opportunities.

The University of California (UC) Davis Clinical and Translational Science Center has established the "Join the Team" model, a Clinical Research Coordinator workforce pipeline utilizing a community-based approach. The model has been extensively tested at UC Davis and demonstrated to generate a viable pathway for qualified candidates for employment in clinical research. The model combines the following elements: community outreach; professional training materials created by the Association for Clinical Research Professionals and adapted to the local environment; financial support to trainees to encourage ethnic and socioeconomic diversity; and internship/shadowing opportunities. The program is tailored for academic medical centers (AMCs) in recognition of administrative barriers specific to AMCs. UC Davis's model can be replicated at other locations using information in this article, such as key program features and barriers faced and surmounted. We also discuss innovative theories for future program iterations.

Spina Bifida Global Learning Collaborative: Educating the next generation of clinicians, researchers, and advocates.

This project aimed to launch an international learning community to guide the development of a spina bifida (SB) curriculum for global health trainees. Using a descriptive study design, a convenience sample of SB curricula were identified in 2022-23 by members of the Spina Bifida World Congress Outreach Committee and evaluated during a series of monthly Zoom calls to discuss SB education in a global health context. Participants included (1) leadership from the ReachAnother Foundation, (2) invited panelists from the Spina Bifida World Congress Global Health Symposium, and (3) global health students and preceptors. Education initiatives in Ethiopia, Sweden, Argentina, Ecuador, and the United States were evaluated vis-à-vis format and content. All of the education initiatives referenced the framework of the World Health Organization International Classification of Functioning, Disability and Health. Formats varied and included both virtual and interactive workshops, print materials, videos, and guides for small group discussion. Content addressed four domains: Folate Prevention, Neurosurgical Training, After Care, and Data Collection. A multidisciplinary approach, partnerships with families, and workforce pipeline training were identified as guiding themes for educating the next generation of SB researchers and clinicians in global health settings. The Spina Bifida Global Learning Collaborative is a transnational group of advocates, clinicians, and investigators whose mission is the advancement of SB-related global health education. Lessons learned from the collaborative are being leveraged to develop a global health curriculum for learners, which may improve services for individuals with SB around the globe.

Community Health Scholars: a summer program developing a public health workforce pipeline for diverse high school students.

In response to the growing interest in public health and needs to both increase and diversify the public health workforce, opportunities to engage students early in their educational journey are essential. The University of Hawai'i at Mānoa launched the Community Health Scholars Program to provide activities for high school students to learn about and build enthusiasm for the field of public health. During the 6-week, in-person summer program, students underrepresented in higher education and who are from historically underrepresented communities completed a college course and participated in activities to enhance their successful entry into a higher education institution. The Community Health Scholars completed an introduction to public health course and gained an array of public health skills through different hands-on activities. The students gained self-confidence and expanded their social capital by attending workshops led by campus faculty, staff, and community partners. A final project highlighting what students learned about themselves and their community was part of a final program showcase. Here we share information about the process of developing the program, the components of the program curriculum, and feedback from both students of the initial cohort and program faculty, where overall satisfaction with the program was reported.

USING COLLECTIVE IMPACT TO ASSESS HOME AND COMMUNITY-BASED SERVICES WORKER TRAINING AND CREDENTIALING

Abstract Older adults and people living with disabilities receive home- and community-based services (HCBS) from approximately 120,000 often poorly paid and inadequately supported direct care workers in North Carolina (NC). The demand for these workers is increasing rapidly, with NC projected to add almost 23,000 new direct care jobs from 2020 to 2030. With the goal of optimizing the workforce pipeline to prepare for the high need for HCBS across NC, we conducted a Medicaid-funded landscape analysis of direct care training/credentialing using Collective Impact (CI). CI is used for diverse collaborations through forming a common agenda, shared measurement, mutually reinforcing activities, continuous communication, and “backbone” support (dedicated coordination team). Engaging with lived experiences is crucial in CI as it leads to sustainable decision-making informed by those affected by policy change. With input from long-term services and support agencies, licensing bodies, advocates, and those with lived experience, we characterized NC HCBS training/credentialing landscape, generating a first-of-its-kind comprehensive crosswalk resource for the state. Findings reveal the complexity of training/requirements, limited portability, lack of flexibility, and a need for more person-centered and relational core competencies. In addition, funding and incentives for additional training are lacking, which limits opportunities for professional development and career advancement. CI is an effective method to analyze direct care worker training/credentialing, it allowing researchers to harness the wisdom of community partners and incorporate lived experiences of the people most impacted by potential policy changes - workers, HCBS recipients, and families.

Using a Behavioral Health Integration Model in a Family Nurse Practitioner Residency.

Primary care serves as an entry point for many patients to access health care services, especially those who reside in medically underserved areas. Because an initiative exists for family nurse practitioners (FNPs) to fill primary care gaps in medically underserved areas, they must be included in educational strategies to provide quality behavioral health care within their scope of practice. An academic-practice partnership was used to provide FNP residents the opportunity to learn to work within their scope of practice in a behavioral health integration model. The residents noted satisfaction with the learning environment, supervisory relationship, and role of the faculty. Innovative continuing education activities are needed to prepare novice FNPs to safely practice and enter into a health care workforce pipeline focused on reducing disparities in medically underserved areas. [J Contin Educ Nurs. 2024;55(4):203-208.].

Improve the Diversity of a Nursing Workforce Using a Pipeline Development Program

The Workforce Pipeline Development Program, established at a local children’s hospital, is a quality improvement initiative to address diversity in nursing, offering career-planning opportunity to underrepresented teens and young adults. The program strategy includes targeting local schools to bring in nursing assistant and medical assistant students for pediatric clinical training with possibility for employment, thus increasing the likelihood of achieving a diverse workforce and better balancing the workforce with the patient populations served. At the children’s hospital, 87.6% of registered nurses report being White, whereas the patient population is only 58.3% White.

The Impact of the Coronavirus Disease 2019 Pandemic on the Clinical Environment.

The Nuclear Medicine Technology Certification Board performed an impact survey on the coronavirus disease 2019 pandemic to better assess the current state of nuclear medicine practice within the United States, as well as the perceptions and experiences of technologists working during the pandemic. Methods: A web-based automation platform was used to create, collect, and analyze the survey data. Results: The survey revealed many department protocol variations during the pandemic, a decrease in patient volume, and several other concerns and issues. Experiences regarding staffing and wage changes were varied. Conclusion: This research showed significant inconsistencies in practice and stresses to nuclear medicine technology during the pandemic, as well as concerns for the workforce pipeline. NMTCB decided to delay the JTA process and conduct additional research regarding the workforce.

Diversity of the US Public Health Workforce Pipeline (2016-2020): Role of Academic Institutions.

Objectives. To develop a diversity index (DI) comparing the diversity of graduates across public health schools and programs in the United States and to examine characteristics associated with institutions' graduate diversity. Methods. We analyzed longitudinal data from the Association of Schools and Programs of Public Health (ASPPH) across 5 academic years (2016-2017 to 2020-2021) for 109 ASPPH members. The outcome was the percentage of underrepresented minority (URM) students among those with bachelor's and graduate degrees in public health. The DI was constructed by dividing the percentage of URM graduates by the percentage of URM residents 20 to 35 years of age in the state where the ASPPH member was located. Results. The mean DI score increased from 0.7 in 2016 to 0.8 in 2020, but URM students remain underrepresented. A 1-percentage-point increase in the proportion of URM faculty members was associated with a 0.7-percentage-point increase in the proportion of URM graduates (P < .001). Conclusions. Although the diversity of the public health educational pipeline shows an upward trend, racial/ethnic minority students remain underrepresented in public health. We found that institutional characteristics such as faculty diversity, program degree level, and area of study were associated with student diversity. (Am J Public Health. Published online ahead of print July 13, 2023:e1-e9. https://doi.org/10.2105/AJPH.2023.307352).

The Rural Integrated Community Clerkship: a vital stretch in the Alberta rural physician workforce pipeline.

Longitudinal integrated clerkships are thought to operate synergistically with factors such as rural background and practice intent to determine medical graduates' practice types and locations-sometimes known as the pipeline effect. We examined the influence of the rural integrated community clerkship (ICC) at the University of Alberta on students choosing family medicine and rural practice. We completed a retrospective cohort analysis of graduates from 2009-2016. The cohort was cross-referenced by background, type of clerkship, practice type and practice location. We used χ2 analyses and risk ratios to measure the relative likelihood that ICC students would settle on rural practice and/or family medicine. ICC participation had more influence than rural background on students' choice of rural and/or family practice, and both factors were synergistic. Rotation-based clerkship students were least likely to enter family medicine or rural practice. The ICC is a clerkship model that influences students to become rural and/or family physicians, regardless of their rural/urban origins. The ICC diverts rural-interested students into rural practice and protects rural-origin students from ending up in urban practice. Expanding ICC infrastructure, including sustaining the rural physician workforce, will benefit rural Alberta communities by increasing the numbers of UA graduates in rural practice.