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Training and development serve as important mechanisms through which organizations can prepare employees for the future of work. This chapter outlines implications for training, including how extant research can inform future interventions and how these approaches might adapt to account for technological, demographic, and behavioral shifts in the workplace.
In order to conduct translational science, scientists must combine domain-specific expertise with knowledge on how to identify and cross translational hurdles, and insights on positioning discoveries for the next translational stage. Expert educators from the Clinical and Translational Science Awards (CTSA) Consortium identified 97 knowledge, skills, and abilities (KSAs) important to include in training programs for translational scientists. To assist educators and trainees to use these KSAs, a conceptual model called “Personalized Pathways” was developed that prioritizes KSAs based on trainee background, research area, or phenotype, and expertise on the research team.
To understand how CTSA educators prioritize specific KSAs when developing personalized training plans for different translational phenotypes and to identify areas of similarity and difference across phenotypes.
A web-based, cross-sectional survey of CTSA educators was done. For a selected phenotype, respondents recommended one of four levels of mastery for each of the 97 KSAs. Results were tabulated by frequency, weighted by importance, and divided into tertiles representing high, middle, and lower priority KSAs. Agreement across phenotypes was compared using Krippendorff’s alpha.
Ten KSAs were high training priority for Preclinical, Clinical, and Community-Engaged phenotypes. These address research methods, responsible conduct of research, team building, and communicating research results. Nine KSAs were in the next tertile for priority reflecting KSAs in biostatistics, bioinformatics, regulatory precepts, and translating implications of research findings.
A smaller set of KSAs can be prioritized for training Preclinical-, Clinical-, and Community-Engaged researchers. Future work should explore this approach for other phenotypes.
The path for Chinese firms to go global has not been easy. There have been mistakes and failures. While the global community generally accepts the trend of Chinese firms going out, the pace and extent at which Chinese firms globalise nevertheless cause concerns in some host countries. This chapter examines the major types of challenges faced by Chinese firms. They include concerns in product safety (export-related), failures in managing workforce (raw material mining-related), inexperience in making deals (mining-related), failures in obtaining/honouring contracts (infrastructure-related), gaining local support (infrastructure-related), and failures in relieving host-country security concerns (merger and acquisition-related). While some of these concerns are based on host-country perceptions and may not be ‘real’, perceptions matter and carry serious consequences for Chinese firms’ going out efforts.
In this chapter, the relationship between academic and workforce skills is explored. The ultimate goal of academic preparation is to prepare individuals to succeed in the workforce, and therefore more than just academic knowledge is required. Several factors that research has shown helps individuals succeed in higher education and in the workforce are discussed. These factors are classified into a framework called the ACT® Holistic Framework which covers four independent but highly related domains: core academic skills; cross-cutting capabilities; behavioral skills; and education and career navigation. Finally, the chapter describes environmental and technological changes that will require higher education institutions to consider more than the traditional characteristics of prospective students.
Twelve evidence-based profiles of roles across the translational workforce and two patients were made available through clinical and translational science (CTS) Personas, a project of the Clinical and Translational Science Awards (CTSA) Program National Center for Data to Health (CD2H). The persona profiles were designed and researched to demonstrate the key responsibilities, motivators, goals, software use, pain points, and professional development needs of those working across the spectrum of translation, from basic science to clinical research to public health. The project’s goal was to provide reliable documents that could be used to inform CTSA software development projects, educational resources, and communication initiatives. This paper presents the initiative to create personas for the translational workforce, including the methodology, engagement strategy, and lessons learned. Challenges faced and successes achieved by the project may serve as a roadmap for others searching for best practices in the creation of Persona profiles.
Nurses routinely provide essential and integral core functions in the field hospital environment, such as daily operational service delivery planning and management, clinical governance and scope of practice supervision, workforce management and skillmix allocation highlight the need for constant flexibility and adaptation when planning, allocating, and maintaining an effective and efficient deployed operational clinical workforce roster to ensure optimal and quality service delivery is achieved. Nurses should not only be appropriately skilled and trained, but most importantly, supported in the translation and adaptation of their nursing practice into the context of an austere and environmentally challenging setting. In addition, nursing staff need to have an awareness of the host nation’s health and societal culture, language, and potential barriers, which may impact on the abilities to effectively deliver clinical care.
Strong nursing leadership is pivotal in ensuring effective and efficient running of a deployed field hospital with limited resources in an austere and environmentally challenging setting. In the context of overwhelming demand, limited resources and a low-tech environment, there is a requirement for a flexible, adaptable, multi-skilled nursing workforce to adequately meet the needs of the population at risk.
NIH Clinical and Translational Science Awards (CTSAs) include KL2 mentored career development awards for faculty commencing clinical and translational research. A survey of KL2 leaders revealed program practices, curricular elements and compelling data about scholar characteristics and outcomes.
We conducted a literature review, framed the survey construct, and obtained input from across the CTSA consortium. A REDCap survey was emailed in fall 2016 to 61 active programs.
Fifty-five programs (90.2%) responded. Respondents had been funded from 3 to 11 years, including 22 “mature” hubs funded for ≥8 years. Program cohort sizes were 56% “small”, 22% “medium”, and 22% “large.” Hubs offer extensive competency-aligned training opportunities relevant to clinical and translational research, including graduate degrees, mentorship, and grant-writing. Seventy-two percent of hubs report parallel “KL2-equivalent” career development programs. All hubs share their training and facilitate intermingling with other early stage investigators. A total of 1,517 KL2 scholars were funded. KL2 awardees are diverse in their disciplines, research projects, and representation; 54% are female and 12% self-identified as underrepresented in biomedical research. Eighty-seven percent of scholars have 2–3 mentors and are currently supported for 2–3 years. Seventy-eight percent of alumni remain at CTSA institutions in translational science. The most common form of NIH support following scholars’ KL2 award is an individual career development award.
The KL2 is a unique career development award, shaped by competency-aligned training opportunities and interdisciplinary mentorship that inform translational research pathways. Tracking both traditional and novel outcomes of KL2 scholars is essential to capture their career trajectories and impact on health.
MD-PhD training programs train physician-scientists to pursue careers involving both clinical care and research, but decreasing numbers of physician-scientists stay engaged in clinical research. We sought to identify current clinical research training methods utilized by MD–PhD programs and to assess how effective they are in promoting self-efficacy for clinical research.
The US MD–PhD students were surveyed in April–May 2018. Students identified the clinical research training methods they participated in, and self-efficacy in clinical research was determined using a modified 12-item Clinical Research Appraisal Inventory.
Responses were received from 61 of 108 MD–PhD institutions. Responses were obtained from 647 MD–PhD students in all years of training. The primary methods of clinical research training included no clinical research training, and various combinations of didactics, mentored clinical research, and a clinical research practicum. Students with didactics plus mentored clinical research had similar self-efficacy as those with didactics plus clinical research practicum. Training activities that differentiated students who did and did not have the clinical research practicum experience and were associated with higher self-efficacy included exposure to Institutional Review Boards and participation in human subject recruitment.
A clinical research practicum was found to be an effective option for MD–PhD students conducting basic science research to gain experience in clinical research skills. Clinical research self-efficacy was correlated with the amount of clinical research training and specific clinical research tasks, which may inform curriculum development for a variety of clinical and translational research training programs, for example, MD–PhD, TL1, and KL2.
Dissemination and implementation (D&I) science is not a formal element of the Clinical Translational Science Award (CTSA) Program, and D&I science activities across the CTSA Consortium are largely unknown.
The CTSA Dissemination, Implementation, and Knowledge Translation Working Group surveyed CTSA leaders to explore D&I science-related activities, barriers, and needed supports, then conducted univariate and qualitative analyses of the data.
Out of 67 CTSA leaders, 55.2% responded. CTSAs reported directly funding D&I programs (54.1%), training (51.4%), and projects (59.5%). Indirect support (e.g., promoted by CTSA without direct funding) for D&I activities was higher – programs (70.3%), training (64.9%), and projects (54.1%). Top barriers included funding (39.4%), limited D&I science faculty (30.3%), and lack of D&I science understanding (27.3%). Respondents (63.4%) noted the importance of D&I training and recommended coordination of D&I activities across CTSAs hubs (33.3%).
These findings should guide CTSA leadership in efforts to raise awareness and advance the role of D&I science in improving population health.
This study aimed to explore the extent to which health visitors who trained and qualified in both Greater London and the South West of England between September 2011 and January 2016 were employed in health visiting posts and have remained in the profession.
In 2011, the UK Government launched the Health Visitor Implementation Plan ‘A Call to Action’ (Department of Health, 2011) to develop the health visitor workforce by training 4200 health visitors over a four-year period. By April 2015, 4000 additional health visitors were trained, but the total workforce has since fallen back to pre-Implementation Plan size.
Data were collected using a survey, completed online by participants. All participants had undertaken a health visitor education programme at one of two participating universities. The survey was distributed in January 2017 and completed by 180 individuals. Quantitative data were analysed using SPSS; association was assessed using individual chi-square tests or Fisher’s exact test. Free-text responses were thematically analysed.
Most (153; 87%) participants were still working as health visitors. Length of time spent working in the community prior to completing health visitor training was associated with staying in the role ( χ2 (with Fisher’s exact test = 7.998, P = .027). Current pay was associated with attrition from the health visitor workforce ( χ2 (with Fisher’s exact test) = 67.559, P < .001.). The majority who had left the health visitor role were on higher pay bands in their new post compared to those that had stayed (12; 60%). Bronfenbrenner’s (1979) theory of socio-ecological development was used as a framework to interpret the results. While participants made an active choice to join the profession, leaving was influenced more by factors outside their control. To influence health visitor retention, both local and strategic changes are required.
As a result of multiple waves of administrative reforms in the past three decades, China's civil service has become more professionalized. Yet public employees appear to have become increasingly dissatisfied in recent years. Based on questionnaire surveys and interviews with environmental enforcement officials in a southern city, this paper traces changes in the job satisfaction levels of these officials between 2000 and 2014. It shows that satisfaction with the extrinsic rewards received and overall job satisfaction declined during this period. These downward trends partly reflected the increasingly challenging institutional environments faced by the officials: rising political and societal demands, inadequate fiscal and personnel resources, and limited enforcement authority. In addition, as the officials became more highly educated and professionalized, mission match became a stronger antecedent of job satisfaction. These findings suggest the importance of meeting the motivational needs of a more professionalized workforce.
Formal mentoring programs are increasingly recognized as critical for faculty career development. We describe a mentoring academy (MA) developed for faculty across tracks (i.e., researchers, clinicians, educators) within a “school of health” encompassing schools of medicine and nursing. The program is anchored dually in a clinical and translational science center and a school of health. The structure includes the involvement of departmental and center mentoring directors to achieve widespread uptake and oversight. A fundamental resource provided by the MA includes providing workshops to enhance mentoring skills. Initiatives for junior faculty emphasize establishing and maintaining strong mentoring relationships and implementing individual development plans (IDPs) for career planning. We present self-report data on competency improvement from mentor workshops and data on resources and barriers identified by junior faculty (n = 222) in their IDPs. Mentors reported statistically significantly improved mentoring competency after workshop participation. Junior faculty most frequently identified mentors (61%) and collaborators (23%) as resources for goal attainment. Top barriers included insufficient time and time-management issues (57%), funding limitations (18%), work–life balance issues (18%), including inadequate time for self-care and career development activities. Our MA can serve as a model and roadmap for providing resources to faculty across traditional tracks within medical schools.
In 2013, a task force was developed to discuss the future of the Canadian pediatric neurology workforce. The consensus was that there was no indication to reduce the number of training positions, but that the issue required continued surveillance. The current study provides a 5-year update on Canadian pediatric neurology workforce data.
Names, practice types, number of weekly outpatient clinics, and dates of certification of all physicians currently practicing pediatric neurology in Canada were obtained. International data were used to compute comparisons between countries. National data sets were used to provide information about the number of residency positions available and the number of Canadian graduates per year. Models for future projections were developed based on published projected population data and trends from the past decade.
The number of pediatric neurologists practicing in Canada has increased 165% since 1994. During this period, wait times have not significantly shortened. There are regional discrepancies in access to child neurologists. The Canadian pediatric neurology workforce available to see outpatient consultations is proportionally less than that of USA. After accounting for retirements and emigrations, the number of child neurologists being added to the workforce each year is 4.9. This will result in an expected 10-year increase in Canadian pediatric neurologists from 151 to 200.
Despite an increase in the number of Canadian child neurologists over the last two decades, we do not predict that there will be problems with underemployment over the next decade.
Workforce shortages in psychiatry are common worldwide. The international literature provides insights into factors influencing decisions to train in psychiatry but is predominately survey based. This national cohort study aimed to identify the characteristics of doctors who were most likely to apply to psychiatry training programmes. The sample comprised doctors who entered UK medical schools in 2007/8 and who made first-time specialty training applications in 2015. The association between application to psychiatry and doctors' sociodemographic and educational characteristics was examined using multivariable logistic regression.
Those most likely to apply were White, privately educated older doctors with below average performance at medical school.
To reduce workforce shortages, psychiatry must make itself more attractive to all doctors, especially those from underrepresented groups such as state-educated Black and minority ethnic individuals. Otherwise, national policies to widen participation in the study of medicine by such groups may exacerbate the current recruitment crisis.
This study’s objective was to explore the disaster management knowledge, attitude, behavior, willingness, and assistance among Nigerian dentists.
This cross-sectional, questionnaire-based study was conducted in Edo State (Nigeria) among selected Nigerian dentists that attended the Annual Scientific Conference of School of Dentistry, University of Benin (Benin City, Nigeria) between 2016 and 2017. The 54-item, modified Chhabra, et al disaster management questionnaire, which elicited information on demographic characteristics, disaster management knowledge, attitude, preparedness, and willingness, was the data collection tool.
A total of 126 dentists participated in the study, giving a 68.1% retrieval rate. The willingness to render assistance in the case of disaster among the participants was 95.2%. More than three-quarters (81.0%) reported that they had not received any disaster management training and 92.9% reported that they were not familiar with any government paper on response to disaster. The mean disaster management knowledge and attitude scores were 16.95 (SD = 0.40) and 34.62 (SD = 0.56), respectively. Disaster management knowledge had positive significant correlation with attitude and behavior. The disaster management attitude had positive significant correlation with behavior and negative significant correlation with preparedness. Disaster management behavior had positive significant correlation with preparedness and willingness to render assistance. Willingness to render assistance had significant correlation with preparedness.
Data from this study revealed high-level of willingness to render assistance in disaster, high disaster management attitude, but with low disaster management knowledge, behavior, and preparedness. The significant correlation between knowledge, attitude, behavior, and preparedness implies that training will offer immense benefit.
Odai ED, Azodo CC, Chhabra KG. Disaster management: knowledge, attitude, behavior, willingness, and preparedness among Nigerian dentists. Prehosp Disaster Med. 2019;34(2):132–136
Little is known about what shapes the choice of employment location in a competitive surgical specialty like otolaryngology – head and neck surgery. This study aimed to identify factors important in determining practice location among Canadian otolaryngologists
An online survey was distributed nationally to active members of the Canadian Society of Otolaryngology – Head and Neck Surgery. The survey collected data on general demographics, current practice description, training location, factors deemed important in practice location decisions, and job satisfaction.
A total of 122 survey responses were collected, with a similar proportion of participants in academic versus community practice. The majority of respondents (73 per cent) practised in the same province as their residency training. Participants identified job vacancy, colleague interaction, spouse opinion and hospital services as important in the decision of practice location.
Key determinants of practice location among Canadian otolaryngologists include job vacancies, spouse opinion, and colleague interactions. Overall, Canadian otolaryngologists report high satisfaction with current employment.
Registered nurses (RNs) and licensed practical nurses (LPNs) provide the skilled component of nursing care in Canadian residential long-term care facilities, yet we know little about this important workforce. We surveyed 309 RNs and 448 LPNs from 91 nursing homes across Western Canada and report descriptively on their demographics and work and health-related outcomes. LPNs were significantly younger than RNs, worked more hours, and had less nursing experience. LPNs also experienced significantly more dementia-related responsive behaviours from residents compared to RNs. Younger LPNs and RNs reported significantly worse burnout (emotional exhaustion) and poorer mental health compared to older age groups. Significant differences in demographics and work- and health-related outcomes were also found within the LPN and RN samples by province, region, and owner-operator model. These findings can be used to inform important policy decisions and workplace planning to improve quality of work life for nurses in residential long-term care facilities.
The need to diversify the biomedical research workforce is well documented. The importance of fostering the careers of fledgling underrepresented background (URB) biomedical researchers is evident in light of the national and local scarcity of URB scientists in biomedical research. The Career Education and Enhancement for Health Care Research Diversity (CEED) program at the University of Pittsburgh Institute for Clinical Research Education (ICRE) was designed to promote career success and help seal the “leaky pipeline” for URB researchers. In this study, we aimed to quantify CEED’s effect on several key outcomes by comparing CEED Scholars to a matched set of URB ICRE trainees not enrolled in CEED using data collected over 10 years.
We collected survey data on CEED Scholars from 2007 to 2017 and created a matched set of URB trainees not enrolled in CEED using propensity score matching in a 1:1 ratio. Poisson regression was used to compare the rate of publications between CEED and non-CEED URB trainees after adjusting for baseline number of publications.
CEED has 45 graduates. Seventy-six percent are women, 78% are non-White, and 33% are Hispanic/Latino. Twenty-four CEED Scholars were matched to non-CEED URB trainees. Compared to matched URB trainees, CEED graduates had more peer-reviewed publications (p=0.0261) and were more likely to be an assistant professor (p=0.0145).
Programs that support URB researchers can help expand and diversify the biomedical research workforce. CEED has been successful despite the challenges of a small demographic pool.
This paper examines retirement saving policy for independent – or contingent – workers, a growing segment of the workforce. Because few of these workers are covered by employer-sponsored retirement plans, they often do not benefit from payroll deduction, employer matching contributions, automatic enrollment, and other provisions that encourage retirement saving. Better use of fintech, judicious changes to tax policy, and expanded Automatic IRAs would help independent workers save for retirement. In addition, we propose the creation of retirement saving accounts that attach to the worker as a supplement to, and possible replacement for, the current system of employer-sponsored accounts.