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Bunch JL, Gedney-Lose A, Perkhounkova Y, Sharp B, Groves PS. Nurse Managers' Professional Quality of Life During the COVID-19 Pandemic. West J Nurs Res 2024; 46:183-191. [PMID: 38268463 DOI: 10.1177/01939459241227264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2024]
Abstract
BACKGROUND Health systems cannot effectively support nurse managers without understanding psychosocial effects of the COVID-19 pandemic. OBJECTIVE The objective of this study was to describe the professional quality of life of frontline nursing management during the COVID-19 pandemic. METHODS A cross-sectional online survey of 54 nurses in management positions at a large Midwest academic medical center during 2022 was conducted. Participants completed an electronic survey including demographics, Professional Quality of Life Measure Version 5, and items assessing past consideration of and future intent to leave their position, organization, or profession. RESULTS Most participants had previously considered changing roles (80%) or leaving the organization during the pandemic (76%). Fewer respondents reported that changing role (24%) or organization (20%) was likely during the upcoming 6-12 months. Most participants scored in moderate ranges of Compassion Satisfaction, Burnout, and Secondary Traumatic Stress scales (85%, 89%, and 74%, respectively). Higher Compassion Satisfaction was associated with extreme unlikelihood of leaving for an internal non-management role. Higher Burnout scores were associated with more time working and past consideration or future likelihood of leaving for an external non-nursing position. Secondary Traumatic Stress scores were higher for nurse managers and house operation managers than assistant nurse managers and associated with past consideration of moving to an internal non-management role or external non-nursing position and future likelihood of moving to an external non-nursing position. CONCLUSIONS Nurse management occupies a demanding position between frontline staff needs and administrative requirements, profoundly impacted by COVID-19. Health care researchers, administration, and policymakers must learn how to support, retain, and sustain nursing management in a post-pandemic world.
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Affiliation(s)
| | | | | | - Brittaney Sharp
- College of Nursing, University of Iowa, Iowa City, IA, USA
- University of Iowa Hospitals & Clinics, Iowa City, IA, USA
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Iyer PH. Corona Virus Disease (COVID-19): Lessons Learned Impact on the Education of Health Professionals. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2024; 1458:233-246. [PMID: 39102200 DOI: 10.1007/978-3-031-61943-4_15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/06/2024]
Abstract
The coronavirus disease (COVID-19) had a tremendous impact on the education of health professionals globally because of the lack of continuity in the medical education process. After it was declared a pandemic, stay-at-home orders forced students to learn virtually, to mitigate the spread of infection. While didactic courses transitioned easily to a virtual format, using platforms like Webex, Zoom, Google Classroom, etc. preclinical and clinical teaching suffered immensely. Patient care was halted for the safety of the patients, students and faculty, and staff involved. Uncertainty about clinical care and isolation during quarantine due to infections caused poor mental health among students. Most health professions innovated their teaching with simulations, role-play, educational videos, etc. but dental education suffered due to the need for psychomotor skill development. As the COVID-19 protocols evolved, and vaccinations became available, the teaching slowly transformed to Flipped Classrooms, Blended Learning, and Hybrid formats, and patient care was allowed with screening, triaging, and testing before scheduling for aerosol-causing procedures in dentistry. This new normal was accepted and silver linings in the pedagogies were appreciated by faculty and institutions alike as outcomes were analyzed. This chapter examines lessons learned on pandemic awareness, effective teaching pedagogies, and challenges of health professionals. An analysis of the lessons based on the framework of the Community of Inquiry is provided as guidelines to educate Gen Z for the future.
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Affiliation(s)
- Parvati H Iyer
- Department of Diagnostic Sciences, Arthur A. Dugoni School of Dentistry, University of the Pacific, 155, 5th Street, San Francisco, CA, 94103, USA.
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Walvoord EC, Howenstine MS, Allen BL, Ribera AK, Nabhan ZM, Tori AJ, Eichholtz RD, Dankoski ME. Engaging All Stakeholders to Create a Trusted, Data-Driven, Process Improvement Approach to Addressing Learner Mistreatment. TEACHING AND LEARNING IN MEDICINE 2024; 36:61-71. [PMID: 36106412 DOI: 10.1080/10401334.2022.2122979] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 08/19/2022] [Indexed: 06/15/2023]
Abstract
Problem: Learner mistreatment has remained an ongoing challenge in academic medicine despite accreditation requirements mandating that every program has systems in place to prevent and respond to mistreatment. While efforts vary across institutions, much remains unanswered in the literature about best practices. Additionally, for the foreseeable future, challenges in the learning environment will likely continue and potentially worsen, given the confluence of multiple external stressors including the COVID-19 pandemic, faculty burnout and general political divisiveness in the nation. It is essential, therefore, to focus on indicators of improvement via process metrics such as knowledge and awareness of mistreatment policies and procedures, willingness to report, reasons for not reporting, and satisfaction with having made a report, while simultaneously focusing on the more complex challenge of eliminating mistreatment occurrences. Intervention: We describe the aspects of our mistreatment prevention and response system first implemented in 2017 along with process and outcome measures. The interventions included expanding our policy outlining appropriate conduct in the teacher-learner relationship; a graduated response protocol to allegations of mistreatment with a clear escalation approach; an online reporting system; a graduate medical education exit survey which mirrors the AAMC Graduation Questionnaire on mistreatment; a robust communication and professional development campaign; a comprehensive data dashboard; and a comprehensive summary report dissemination plan. Context: The interventions were implemented at the largest allopathic medical school in the U.S., with nine campuses across the state. The system is available to all learners, including medical students, graduate students, residents, and fellows. Impact: Both institutional and national data sources have informed the continuous improvement strategies. Data from internal reporting systems, institutional surveys, and national data are presented from 2017 to 2021. Findings include an increasing number of incidents reported each year, including confidential reports from students who include their contact information rather than report anonymously, which we view as an indicator of learner trust in the system. Our data also show consistent improvements in learners' awareness of the policy and procedures and satisfaction with having made a report. We also include other data such as the nature of complaints submitted and timeliness of our institutional response. Lessons Learned: We present several lessons learned that may guide other institutions looking to similarly improve their mistreatment systems, such as a close partnership between faculty affairs, diversity affairs, and educational affairs leadership; communication, professional development, and training through multiple venues and with all stakeholders; easily accessible reporting with anonymous and confidential options and the ability to report on behalf of others; policy development guidance; data transparency and dissemination; and trust-building activities and ongoing feedback from learners.
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Affiliation(s)
- Emily C Walvoord
- Medical Student Affairs and Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Michelle S Howenstine
- Graduate Medical Education, Continuing Medical Education and Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Bradley L Allen
- Medical Student Education and Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Amy K Ribera
- Research and Evaluation, Faculty Affairs, Professional Development and Diversity, and Department of Anatomy, Cell Biology, and Physiology, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Zeina M Nabhan
- Graduate Medical Education and Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Alvaro J Tori
- Diversity Affairs and Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Rebekah D Eichholtz
- Faculty Affairs, Professional Development, and Diversity, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Mary E Dankoski
- Faculty Affairs, Professional Development, and Diversity and Department of Family Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA
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Butaney B, Hoover EB, Coplan B, Bernard K. Impact of COVID-19 on student perceived stress, life satisfaction, and psychological flexibility: examination of gender differences. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023:1-7. [PMID: 37773729 DOI: 10.1080/07448481.2023.2258411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 09/07/2023] [Indexed: 10/01/2023]
Abstract
Objective: To identify stress management practices and examine the impact of the COVID-19 pandemic on well-being among male and female physician assistant (PA) students. Participants: Participants included 1,239 students from nine PA programs who matriculated pre-pandemic, acute pandemic, or post-acute pandemic. Methods: Measures included questions about stress management practices and validated instruments assessing perceived stress, life satisfaction, and psychological flexibility. Data were analyzed for differences based on year and gender. Results: Exercise (91.6%), yoga (54.6%), meditation (34.3%), and journaling (32.5%) were commonly reported stress reduction practices. Newly matriculated PA students adjusted to the COVID-19 pandemic differently based on gender. Pre-pandemic, men and women reported similar levels of perceived stress and psychological flexibility, but female students reported higher life satisfaction. Post-acute pandemic, however, female students reported higher perceived stress and lower psychological flexibility. Conclusions: Wellness resources may be strengthened by approaches that account for differences based on gender.
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Affiliation(s)
- Bhupin Butaney
- Clinical Psychology Program, Midwestern University, Glendale, Arizona, USA
| | - Eve B Hoover
- Physician Assistant Program, Midwestern University, Glendale, Arizona, USA
| | - Bettie Coplan
- Physician Assistant Program, Northern Arizona University, Phoenix, Arizona, USA
| | - Kari Bernard
- Alaska Native Medical Center in Anchorage, Alaska, USA
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Taylor EJ, Ada HM, Dupée C, Jordan M, Radovich P, Boyd KC, Dehom S. Tragedy or transformation? Online survey of nurse spirituality during the COVID pandemic. J Clin Nurs 2023; 32:6287-6297. [PMID: 36869620 DOI: 10.1111/jocn.16668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 11/02/2022] [Accepted: 02/15/2023] [Indexed: 03/05/2023]
Abstract
AIM To describe positive and negative spiritual responses to providing COVID-related nursing care among nurses working in hospitals. BACKGROUND The COVID pandemic has intensified and publicised the threats to nurse well-being. Absent from the recommendations for promoting nurse well-being is recognition of how nurses' spirituality and/or religiosity is affected by the strain of COVID caring or how it may be affecting their well-being. DESIGN Cross-sectional, descriptive observational, mixed methods study. METHODS Data were collected from 523 registered nurses employed in three Southern California hospitals during March-May, 2022 when these hospitals' COVID case counts were <15%. Using Online survey methods, data were obtained using the Religious/Spiritual Struggles Scale-Short Form, Moral Injury Symptom Scale-Healthcare Professionals, Post-traumatic Growth Inventory and demographic and work-related items. STROBE guidelines for cross-sectional observational studies were observed. RESULTS The mean for religious/spiritual struggles was 1.98 (range of 1-5, comparable to a little bit). Although roughly half of the sample reported the struggles were not experienced/did not apply, 23%-36.5% reported experiencing these struggles at least somewhat. The most frequent struggle was to find ultimate meaning. The mean observed for moral injury was 6.5 (range of 1-10); applying established criteria indicated it was troubling for at least 50%. The mean for post-traumatic growth was 4 (on a scale of 0-6); using established criteria, 41% experienced PTG. Quantitative findings were illustrated by the qualitative responses that occasionally expressed spiritual tragedy and transformation concurrently. CONCLUSION The professional work of nursing impacts nurses in invisible, spiritual ways that can be tragic and/or transformative. RELEVANCE TO CLINICAL PRACTICE Interventions to address nurses' mental health challenges must include attention to these invisible struggles. Nurses' mental health challenges must be met in part by addressing how they can surmount spiritual tragedy-and allow spiritual transformation.
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Affiliation(s)
| | - Hazel M Ada
- Education and Training, Adventist Health White Memorial, Los Angeles, California, USA
| | - Carrie Dupée
- Pediatric Department, Children's Services, Pomona Valley Hospital Medical Center, Pomona, California, USA
| | - Michael Jordan
- Advanced Bioethics Consulting, LLC, Los Angeles, California, USA
- Integrated Research and Bioethics, Adventist Health White Memorial, Los Angeles, California, USA
| | - Patti Radovich
- Nursing Research, Loma Linda University Health Hospitals, Loma Linda, California, USA
| | - Kendal C Boyd
- Department of Psychology, Loma Linda University, Loma Linda, California, USA
| | - Salem Dehom
- School of Nursing, Loma Linda University, Loma Linda, California, USA
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Gurney T, O'Sullivan B, McGrail M, Martin P. Understanding the non-professional needs of early career doctors: An interview-based study. Int J Health Plann Manage 2023; 38:330-346. [PMID: 36300857 DOI: 10.1002/hpm.3587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 08/22/2022] [Accepted: 10/13/2022] [Indexed: 11/09/2022] Open
Abstract
Speciality colleges and health services are often well attuned to professional factors, but non-professional needs are less acknowledged and are the focus of this study. This likely relates to limited research about the non-professional needs of early career doctors. This study aimed to describe the non-professional needs of doctors in their early postgraduate career, including how they intersect with career and training experiences. Semi-structured interviews were conducted with 32 male and female medical graduates working across all Australian states and territories, spanning a variety of speciality areas and early career stages. Participants were asked about their career journey to date including non-professional factors related to their experiences. This study identified important non-professional needs, that strongly interplayed with career and training experiences, including: children's education; partner's career needs; family stability; major life stages; proximity to the extended family; and spending time with immediate family. Results suggested clear gender differences, with female doctor's needs orientated to partner work and carer responsibilities, while male doctor's needs were oriented to spending time with family and meeting the family's needs. Non-professional needs should be considered as legitimate needs within health service employment and speciality training arrangements enabling early career doctors to realise their full potential.
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Affiliation(s)
- Tiana Gurney
- The University of Queensland Rural Clinical School, Toowoomba, Queensland, Australia
| | - Belinda O'Sullivan
- The University of Queensland Rural Clinical School, Toowoomba, Queensland, Australia
| | - Matthew McGrail
- The University of Queensland Rural Clinical School, Toowoomba, Queensland, Australia
| | - Priya Martin
- The University of Queensland Rural Clinical School, Toowoomba, Queensland, Australia
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Ageel M. Pandemic Critical Care Research during the COVID-19 (2020-2022): A Bibliometric Analysis Using VOSviewer. BIOMED RESEARCH INTERNATIONAL 2022; 2022:8564649. [PMID: 36452061 PMCID: PMC9705102 DOI: 10.1155/2022/8564649] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 10/15/2022] [Accepted: 11/02/2022] [Indexed: 12/01/2023]
Abstract
This paper has reviewed the global research on the pandemic critical care research during the COVID-19 from 2020 to 2022. To this end, a bibliometric and cluster analysis by full counting has been carried out using VOSviewer software and bibliographic data extracted from the Scopus database. The research found and studied 2778 documents. The types of research documents were limited to an article (81.46%), a letter (9.43%), an editorial (3.92%), a note (3.92%), a conference paper (0.90), and a short survey (0.04%). The results show an incessant increase in the number of research documents published and citations received during the COVID-19 pandemic. The U.S., U.K., Italy, and France have been shown to be the most productive countries, and there is a predominance of European institutions supporting and fostering research on pandemic critical care. Cecconi, M. (Italy) and Shankar-Hari, M. (U.K.) produced the highest number of research documents. Mapping of citation, co-citation, co-authorship, and keyword cooccurrence highlighted the hotspot, knowledge structure, and important themes. Citation dynamics for the top-cited research documents revealed static discourse. By reviewing the evolutionary trends of pandemic critical care research investigated factors, such as the influential works, main research topics, and the research frontiers, this paper reveals the scientific literature production's main research objectives and directions that could be addressed and explored in future studies. This paper reveals the scientific literature production's main research objectives and directions that could be addressed and explored in future studies after reviewing the evolutionary trends of pandemic critical care research during the COVID-19 and the investigated factors, such as influential works, main research topics, and research frontiers.
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Affiliation(s)
- Mohammed Ageel
- College of Medicine, Jazan University, Jazan 45142, Saudi Arabia
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Abstract
AbstractHealthcare institutions have been under pressure for years now, climaxing in the COVID-19 crisis. Even if they are not operating at a trouble spot of the current COVID-19 pandemic, healthcare leaders need to be highly resilient to remain effective as well as staying healthy themselves. The purpose of this study is to shed light on healthcare leaders’ challenges and, more important, their specific resilience factors. By doing so, we can expand the knowledge of this fragmented research field and deliver an integrated framework that has so far been lacking. We conducted 20 in-depth interviews with healthcare leaders. More precisely, 35% (7) of our interviewees were physicians, 55% (11) worked in nursing, and 10% (2) were nonclinical professionals, with 50% (10) of our participants working in upper, 40% (8) in middle, and 10% (2) in lower leadership positions. Based on a qualitative content analysis approach, we identified main healthcare leaders’ challenges as well as crucial resilience factors (i.e., individual, situational, and behavioral factors). By integrating insights from contemporary leadership and work-related resilience research, we were able to develop an integrated framework of healthcare leaders’ resilience. Considering resilience as a context-dependent construct, we are contributing to the resilience and healthcare literature by investigating the specialty of healthcare leaders’ resilience. This study is contributing to the future development of resilience interventions in healthcare organizations that might help not only healthcare leaders to better cope with critical situations but also promote resilience development among their followers and organizations.
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Hughes MT, Rushton CH. Ethics and Well-Being: The Health Professions and the COVID-19 Pandemic. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2022; 97:S98-S103. [PMID: 34789657 PMCID: PMC8855760 DOI: 10.1097/acm.0000000000004524] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
The COVID-19 pandemic has had a profound impact on health professionals, adding to the moral suffering and burnout that existed prepandemic. The physical, psychological, and moral toll of the pandemic has threatened the well-being and integrity of clinicians. The narrative of self-sacrifice and heroism bolstered people early on but was not sustainable over time. For health professions students, the learning environment changed dramatically, limiting opportunities in direct patient care and raising concerns for meeting training requirements. Learners lost social connections and felt isolated while learning remotely, and they witnessed ethical tensions between patient-centered care and parallel obligations to public health. Worries about transmission of the virus and uncertainty about its management contributed to their moral suffering. Educators adjusted curricula to address the changing ethical landscape. Preparing learners for the realities of their future professional identities requires creation of interprofessional moral communities that provide support and help develop the moral agency and integrity of its members using experiential and relational learning methods. Investing in the well-being and resilience of clinicians, implementing the recommendations of the National Academy of Medicine, and engaging learners and faculty as cocreators of ethical practice have the potential to transform the learning environment. Faculty need to be trained as effective mentors to create safe spaces for exploring challenges and address moral adversity. Ethics education will need to expand to issues related to health systems science, social determinants of health, and public health, and the cultivation of moral sensitivity, character development, professional identity formation, and moral resilience.
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Affiliation(s)
- Mark T. Hughes
- M.T. Hughes is assistant professor, Department of Medicine, Johns Hopkins University School of Medicine, and core faculty, Johns Hopkins Berman Institute of Bioethics, Baltimore, Maryland
| | - Cynda H. Rushton
- C.H. Rushton is Anne and George L. Bunting Professor of Clinical Ethics, Johns Hopkins University School of Nursing and Johns Hopkins Berman Institute of Bioethics, Baltimore, Maryland
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Pathman DE, Sonis J, Harrison JN, Sewell RG, Fannell J, Overbeck M, Konrad TR. Experiences of Safety-Net Practice Clinicians Participating in the National Health Service Corps During the COVID-19 Pandemic. Public Health Rep 2022; 137:149-162. [PMID: 34694922 PMCID: PMC8721684 DOI: 10.1177/00333549211054083] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVES The impact of the COVID-19 pandemic has been particularly harsh for low-income and racial and ethnic minority communities. It is not known how the pandemic has affected clinicians who provide care to these communities through safety-net practices, including clinicians participating in the National Health Service Corps (NHSC). METHODS In late 2020, we surveyed clinicians who were serving in the NHSC as of July 1, 2020, in 20 states. Clinicians reported on work and job changes and their current well-being, among other measures. Analyses adjusted for differences in subgroup response rates and clustering of clinicians within practices. RESULTS Of 4263 surveyed clinicians, 1890 (44.3%) responded. Work for most NHSC clinicians was affected by the pandemic, including 64.5% whose office visit numbers fell by half and 62.5% for whom most visits occurred virtually. Fewer experienced changes in their jobs; for example, only 14.9% had been furloughed. Three-quarters (76.6%) of these NHSC clinicians scored in at-risk levels for their well-being. Compared with primary care and behavioral health clinicians, dental clinicians much more often had been furloughed and had their practices close temporarily. CONCLUSIONS The pandemic has disrupted the work, jobs, and mental health of NHSC clinicians in ways similar to its reported effects on outpatient clinicians generally. Because clinicians' mental health worsens after a pandemic, which leads to patient disengagement and job turnover, national programs and policies should help safety-net practices build cultures that support and give greater priority to clinicians' work, job, and mental health needs now and before the next pandemic.
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Affiliation(s)
- Donald E. Pathman
- Department of Family Medicine, Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Jeffrey Sonis
- Department of Family Medicine, Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Department of Social Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | | | - Robert G. Sewell
- Office of Healthcare Access, Section on Rural and Community Health Systems, Division of Public Health, Alaska Department of Health and Social Services, Anchorage, AK, USA
| | - Jackie Fannell
- Provider Retention and Information System Management Collaborative, National Rural Recruitment and Retention Network (3RNET), Jefferson City, MO, USA
| | - Marc Overbeck
- Oregon Primary Care Office, Oregon Health Authority, Portland, OR, USA
| | - Thomas R. Konrad
- Department of Family Medicine, Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Health Workforce Analytics, Chapel Hill, NC, USA
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