An examination of the career decision-making self-efficacy of final-year nursing students

BACKGROUND

One in four newly graduated registered nurses leave their employment positions within the first year. To reduce this attrition, nursing stakeholders could focus on the final year of nursing education because students at this stage make professional career plans, including their practice destination for the graduate year and their commitment to the profession. Previous studies provide evidence of nursing students' career preferences and specialty choices. However, there is a dearth of data that focuses on the students' career decision-making process.

AIM

This study examined the self-efficacy or confidence of final-year nursing students in making career decisions and the factors that influence their career decision-making process.

SETTING AND PARTICIPANTS

Final year pre-registration nursing students (N = 222) at two public universities in Western Australia.

METHODS

An online survey was used to collect cross-sectional data. The Career Decision Self-Efficacy Scale - Short Form was used to investigate nursing students' confidence in making career decisions. Career decision-making self-efficacy refers to the confidence to successfully complete career decision-making tasks. Descriptive statistics were used to describe the participants' characteristics. The chi-square test was used to assess the significance of the difference between categorical data, and binary logistic regression was used to determine the odds of the factors that predict career decision self-efficacy.

RESULTS

Forty-seven percent of participants who answered all Career Decision Self-Efficacy Scale - Short Form questions had good confidence in making career decisions. Factors such as the setting of the final clinical placement, the intention to be employed in the specialisation or organisation of their final placement and the students' assessment of their clinical experience were associated with career decision-making confidence.

CONCLUSIONS

Most participants had low confidence in making career decisions. This study provides ideas for nursing stakeholders to implement measures to improve students' confidence to make informed career decisions.

The impact of final-year clinical placements on nursing students' career planning for the graduate year and beyond

AIMS

This study had three objectives: 1) to determine final-year nursing students' career preferences and long-term career plans; 2) to investigate factors influencing nursing students' specialty choices following their final-year clinical placement(s); and 3) to understand how final-year clinical placements can be used to develop the career interests of nursing students to different nursing specialties.

BACKGROUND

Clinical placement provides an insightful experience that may influence students to feel inclined to work in certain specialties. Therefore, each clinical placement should promote students' learning and enhance positive experiences that could develop their career interests and encourage them to seek employment in the specialty on graduation.

DESIGN

A cross-sectional online survey.

METHODS

The survey was structured using the Career Decision Self-Efficacy Scale - Short Form. The questionnaire was distributed to final-year nursing students (N = 222) at two public universities in Western Australia. This study specifically reports on the Goal selection and Planning domains of the Career Decision Self-Efficacy Scale - Short Form, which were explored through additional questions prompting participants to explain their career preferences and reasons for their nursing specialty choices.

RESULTS

Most participants, fifty-three percent, had low confidence in making career decisions. The Goal Selection and Planning questions measured the students' confidence in choosing a suitable practice destination and preparing for their professional careers. Overall, participants prefer employment in hospital settings both in the short- and long-term aspects of their nursing career. The factors influencing the students' career decisions were classified into three main categories: the clinical environment, educational factors and individual factors.

CONCLUSIONS

The nursing curriculum may encourage nursing students to work in some specialties over others. This study provides insight into factors that may promote or inhibit students' career choices and how students may be motivated to pursue the less preferred nursing specialties.

Opting In and Out: A Qualitative Study Exploring Career Break Experiences of Registered Dietitian Nutritionists

BACKGROUND

Since 2002, an average of 17.5% of registered dietitian nutritionists (RDNs) have reported being out of the paid dietetics workforce, and approximately half of those report intention to return. With the Academy of Nutrition and Dietetics' focus on expanding workforce demand and capacity, understanding why and how dietitians opt in and out of the dietetics workforce may provide insights into how to potentially reduce the number of career breaks or expedite and enhance the reentry process.

OBJECTIVE

To explore the lived experiences and perspectives of dietitians who were taking (with intention to return) or had taken a career break and returned to the paid dietetics' workforce.

DESIGN

A qualitative study with semistructured interviews was conducted.

PARTICIPANTS/SETTING

Participants (n = 22) were recruited through purposive sampling over social media. They were required to be credentialed as RDNs, reside in the United States, and have either previously or currently (with intent to return) taken a break from the dietetics workforce. Interviews were conducted using Zoom videoconferencing technology during September 2021.

DATA ANALYSIS

Data were analyzed using a Coding Reliability Thematic Analysis approach.

RESULTS

The data are summarized in four themes: (1) motivations to leave and return, (2) staying connected with dietetics, (3) preparing to return and returning to the dietetics workforce, and (4) desired resources for career breaks and reentry.

CONCLUSIONS

Understanding the experiences of dietitians who take career breaks may help inform career reentry and help the profession meet the current and future workforce demand.

Implementation and effectiveness of a nurse navigation programme based on noddings' care theory in first-year undergraduate nursing students for professional identity and career planning: A quasi-experimental study

AIMS

Development and evaluation of the effectiveness of a Nurse Navigation programme based on Noddings' Care theory on two dependent variables which were professional identity and career planning among first-year undergraduate nursing students.

BACKGROUND

First-year undergraduate nursing students generally have a low sense of professional identity and career planning, resulting in a loss of nursing power after graduation. Implemention of a Nurse Navigation program based on Noddings' Care theory may be potentially useful in cultivating their professional identity and career planning.

DESIGN

A quasi-experimental study.

METHODS

A convenience sample of 122 first-year undergraduate nursing students from two medical universities was recruited between September 2021 and June 2022. Students in the experimental group (n = 63) participated in the Nurse Navigation programme based on Noddings' Care theory, which contained four core components, spreading over 50 lessons. Those in the control group (n = 59) underwent a traditional training programme with five components across 44 lessons. The two groups were compared in terms of their level of professional identity by Professional identity questionnaire for nurse students (PIQNS) and career planning by Career planning questionnaire (CPQ) after the training using the t-test.

RESULTS

The mean score of professional identity in the experimental group increased significantly from 51.02 ± 8.46 at baseline to 58.02 ± 8.81 after the intervention (p < 0.001), with a large effect size (Cohen's d=0.810). Also, this post-intervention score was statistically significantly higher than that (52.86 ± 9.27) in the control group (p = 0.002), with a medium effect size (Cohen's d=0.571). The mean score of career planning in the experimental group increased significantly from 81.76 ± 9.86 at baseline to 94.52 ± 10.81 after the intervention (p < 0.001), with a large effect size (Cohen's d = 1.233). Also, this post-intervention score was statistically significantly higher than that (88.25 ± 9.30) in the control group (p < 0.001), with a medium effect size (Cohen's d=0.623).

CONCLUSIONS

The Nurse Navigation programme based on Noddings' Care theory showed effectiveness in enhancing professional identity and career planning among first-year undergraduate nursing students in China. Further rigorous studies are needed to examine its effectiveness and long-term impacts on these students.

Musings of Two Administrators for Those Considering a Career Change

There is a learning curve when stepping into an administrative position, whether you have been planning the change for years or find yourself asked to replace someone who has left unexpectedly. Two associate deans offer perspectives on things we wish we had known prior to taking on our current position. Some are practical skills that can also be helpful in any faculty position, while others relate to the different perspectives an administrator needs. We also point out some experiences we feel helped set us up for success, which should be available to anyone considering a similar change of career. Our experiences may offer some benefit for individuals considering administrative positions by helping them reflect on what questions to ask themselves while choosing their next career step.

Effect of the Management in Nursing course on students' time management and career planning attitudes: A single-group pre-test post-test study

AIM

This study aimed to determine the effect of the Management in Nursing course on the time management and career planning attitudes of nursing students.

BACKGROUND

University education is important for young people to develop their time management skills, plan their careers, and implement these plans.

DESIGN

This is a semi-experimental study used single-group pre-test post-test design.

METHODS

This study sample included 133 fourth-year nursing students who enrolled for the Management in Nursing course in the 2019-2020 academic year. Introductory Information Form, Career Futures Inventory (CFI), and Time Management Questionnaire (TMQ) were used for data collection.

RESULTS

A statistically significant difference was found between the pre- and post-test time planning and TMQ scores. Moreover, a significant difference was found between the pre- and post-test career adaptability, career optimism and CFI scores. No significant difference was found between the pre- and post-test scores for the TMQ's time attitudes and time wasters subdimensions; similarly, the CFI's perceived knowledge of the job market subdimension indicated no significant difference between the pre- and post-test scores.

CONCLUSIONS

The results of this study indicated that the Management in Nursing course improved the time management skills of fourth-year nursing students as well as increased adaptability and optimism in their career planning attitudes.

Professional Coaching in Medicine and Health Care

Professional coaching can support individuals and organizations in four ways: (1) improving provider experience of working in health care, (2) supporting provider role and career development, (3) helping build team effectiveness, and (4) building an organizational coaching culture. There is evidence about effectiveness of coaching in business, and an increasing body of literature, including small randomized, controlled trials, supporting use of coaching in health care. This article summarizes the framework for professional coaching, describes ways professional coaching can support the four processes above, and provides case scenarios that contextualize understanding of how professional coaching can be of benefit.

Evaluation of career planning group counseling and its effectiveness for intern male nursing students

OBJECTIVE

To investigate the influence of group counselling on the career planning and career maturity of male nursing students.

METHOD

Sixty male nursing students were randomly selected from a specific-level first-class hospital in Hunan Province from July to August 2020 by using the convenience sampling method and were subsequently divided into the control group and the experimental group using the random number table method. The control group received routine pre-job training, including aspects concerning the hospital profile, nurse etiquette, nursing core systems, professional ethics, nursing emergency treatment and career prospects and planning. In the experimental group, career planning group counselling was added after the regular pre-service training (once a week) with each session lasting 2 h for a total of six training sessions. At six weeks and three months after the intervention, the career status evaluation scale and the college students' career maturity scale were used to compare the career planning and career maturity status of the two groups of male nursing students.

RESULTS

After six weeks and three months of intervention, all the dimensions and total scores of both the career status evaluation scale and the career maturity scale in the experimental group were superior to those in the control group with statistically significant differences (all P < 0.05). The repeated measures of variance analysis indicated that the differences in the total score for career planning and the four dimensions in terms of intergroup effect, time effect and interaction effect between the two groups were statistically significant (P < 0.05). The intergroup effect, time effect and interaction effect of the total score for vocational maturity, career goal, career confidence, career value, career freedom and career reference of the two groups were statistically significant (P < 0.05), while the time effect of the relative dependency dimension was also statistically significant (P < 0.05).

CONCLUSION

Group counselling can significantly improve the career planning and career maturity status of male nursing students and has a certain long-term effect.

The Effectiveness of a Blended Learning-Based Life Design Course: Implications of Instruction and Application of Technology

Purpose

Due to the outbreak of the COVID-19 pandemic in 2021 in Taiwan, we have adapted the face-to-face Life Design course to a blended learning approach with educational technology to cope with the problem of cross-generational confusion and anxiety towards later life from learners.The objectives of this study are to.evaluate learners' reactions after attending the Life Design course including their level of satisfaction, engagement (Level 1), and the applicability of courses in their life.evaluate their learning outcomes after attending the Life Design course, such as their acquisition of knowledge, skills, attitudes, confidence, commitment (Level 2), and behavioral changes (Level 3).explore the factors that enable and prevent students from transferring their learning in this course to the action taking and making behavioral changes.explore how the application of educational technology can enhance the teaching and learning in the Life Design course.

Methods

This study used an action research method to solve two main problems we identified in practice: students' confusion about their future life and the shortcomings of traditional teaching methods, which cannot meet the learning needs of this type of course due to the requirement of intensive personal reflection and self-disclosure. Participants were 36 master's students who completed the Life Design course. Based on this course's design, implementation, and evaluation, we used the new Kirkpatrick Learning Assessment Model (Kirkpatrick J, Kirkpatrick WK. An introduction to the new world Kirkpatrick Model. Kirkpatrick Partners, 2021) to analyze the learning effectiveness on the Reaction, Learning, and Behavioral levels.

Results

To facilitate learners to overcome the cross-generational confusion of their life design and solve the shortage of face-to-face teaching methods, we took biographical learning as the core theme for this Life Design course and designed online and offline learning activities. The blended learning approach with educational technology allowed us to go beyond time and location constraints and provide a holistic and inseparable learning experience in both formats. The result of the evaluation shows that students who took the Life Design course were highly satisfied with the overall course design, topics, and the suitability of a blended learning approach, which motivated them to extend their learning outside the classroom and helped them benefit from a more trusted, personal and hybrid interaction with teachers and their peers both online and offline. On the learning level, students not only learned the correct knowledge of age perspectives, changed their views of career and personal development, and acquired skills for life design, but were also confident and committed to applying what they have learned in their future life. After the course, many students applied and integrated the learning into behavioral changes in their life. In terms of the difficulties and hindrances encountered in action taking, many students mentioned the lack of peers' support and constraints from their busy daily life. Many suggested providing extra support after the course with regular impulse, follow-ups, and individual feedback from teachers and peers in an online learning community. This indicates how educational technology can better support these elements in continuous learning and the transfer of learning.

Conclusion

Based on these results, we affirm that implementing this Life Design course with a blended learning approach is indeed better than a fully physical course. However, the focus of a blended learning approach should be on learners from a pedagogical perspective rather than technology.

The relationship between delay of gratification and work engagement: The mediating role of job satisfaction

Undoubtedly, teachers remain at the forefront of implementing rural education. This indicates the significant impact their job involvement has on the overall achievements of schools in rural areas. Studies have found that teachers in rural areas often face more difficulties and fewer opportunities in their work. In general, they need a stronger ability to tolerate delay of gratification if they want to have higher job involvement. However, there is currently insufficient research on the impact of career delay of gratification on teachers' job involvement. This study has been conducted to explore the relationship between the delay of gratification and the level of job involvement among physical education (PE) teachers in rural areas, as well as the mediating effect of job satisfaction. 530 PE teachers in the rural areas of Hunan Province, China, have been selected through random sampling as the participants of this study. They have been required to anonymously fill in a Delay of Gratification Scale, Job Involvement Scale and Job Satisfaction Scale to collect the data for investigation and analysis. The study found positive correlations among delay of gratification, job satisfaction, and job involvement among PE teachers in rural areas (P < 0.01), with job satisfaction playing a partial mediating role and intervening variable in the relationship between delay of gratification and job involvement (P < 0.01). Ultimately, delays in gratification directly and, through job satisfaction, indirectly promotes the job involvement of the teachers. The findings of this study reveal the impacts of delaying gratification on the job involvement of PE teachers in rural areas and provide a theoretical basis for increasing the job involvement of PE teachers in rural areas.

Career future perceptions and attitudes towards migration of nursing students: A cross-sectional multicenter study

BACKGROUND

It is important to understand the perceptions of career plans and attitudes towards migration of nursing students so that it can be possible to review the education programs in this direction and plan an effective health workforce.

AIM

To determine nursing students' career future perceptions and attitudes towards migration.

DESIGN

Descriptive and cross-sectional online survey.

METHODS

The study was completed with 3053 students from 52 universities located in seven different regions of Turkey who agreed to participate in the study. The data were collected using the "Student Information Form", "Attitude Scale for Brain Drain (ASBD)" and "Career Futures Inventory (CFI)" with an online questionnaire. Descriptive statistics, independent samples t-test, one-way analysis of variance and correlation were used to analyze the data.

RESULTS

Mean age of the students was 20.29 ± 2.28 and most were females. Students' mean total scores of ASBD, and CFI were 56.64 ± 12.22 and 91.32 ± 11.71 respectively. There was a statistically significant difference between the total mean scores of ASBD and the region of the university where the students studied, gender, being multilingual, desire to work abroad after graduation and experience of participating in student exchange programs and between the total mean scores of CFI and experience of participating in an exchange program. There was a positive and statistically significant relationship between ASBD and CFI total mean scores (p < 0.05).

CONCLUSION

Nursing students' attitudes towards migration and perceptions of career future were positive and there was a positive relationship between attitudes towards migration and perceptions of career future.

Modernising physician resource planning: a national interactive web platform for Canadian medical trainees

Background

Healthcare systems rely heavily upon human resources to ensure high-quality access to care for the general population. With significant health worker shortages predicted worldwide in the coming decades, maximizing the current workforce by means of a physician resource planning (PRP) strategy that ensures the right number, mix, and distribution of physicians to meet population needs is warranted. In Canada, there is an insufficient number of primary care providers, and disproportionately low numbers of specialist physicians in rural compared to urban regions. Currently, Canadian medical students are not effectively included in PRP strategy and lack the required information for career orientation to help rebalance the population’s workforce needs. This paper present the Health Human Resource (HHR) Platform, a comprehensive web tool that includes relevant workforce data to empower medical students in choosing a discipline based on both personal interests and social accountability.

Results

Physician workforce data, comments from Canadian residency program directors, and career planning resources were collected by the Canadian Federation of Medical Student’s (CFMS) HHR Task Force. This information was consolidated to create a national interactive platform that uses a map, comparison table, and trend graphs to illustrate over 500,000 unique data points from 37 datasets, including specific information and resources spanning 62 medical specialties from 2015 onwards. There was a 24.6% response rate for program director comments. During the first 4 months of the HHR Platform launch, there were 2434 different users, of which 985 were returning, with an average of 20.0 users per day spending on average 3 min on the platform.

Conclusions

The HHR Platform constitutes a national approach to PRP informing medical students on the mix and distribution of physicians needed to meet the future healthcare demands of the Canadian population.

Factors Associated with Having Ever Considered a Cancer Research Career

Increasing cancer workforce diversity is a priority for the National Cancer Institute. Cancer research encompasses a wide range of disciplines including basic, clinical, behavioral, and social sciences, but many research development programs are narrowly focused. Our aim was two-fold: to describe undergraduate students' knowledge of and interest in cancer research careers and to identify factors associated with having ever considered a cancer research career. Undergraduate students (n = 857) completed a paper questionnaire. Most students associated cancer careers with bench science and healthcare or public health, but less so for applied fields. Most respondents (69%) received career counseling in high school but only 4% had cancer-specific career counseling. Nearly half the respondents (49%) indicated they or an immediate family member had been diagnosed with cancer, and 17% had attended a cancer appointment. Only 10% of respondents indicated that they had ever considered a career in cancer research. Associated factors included cancer-specific career counseling (odds ratio [OR] 8.05; 95% confidence interval [CI] 3.60, 18.03), attended a cancer appointment (OR 2.37; 95% CI 1.34, 4.20), being slightly (vs. very) worried about developing cancer (OR 0.32; 95% CI 0.15, 0.68), and Other (vs. White) race (OR 2.83; 95% CI 1.34, 5.97). Personal experience with cancer and knowledge of cancer careers appear to be driving factors in career choice for cancer research. Increasing student exposure to cancer careers, possibly in junior high or high school, may be one mechanism for recruiting more underrepresented undergraduate students into cancer-related fields of study.

Influences of nursing students' career planning, internship experience, and other factors on professional identity

BACKGROUND AND OBJECTIVE

Nursing professional identity is an important factor in the development of nursing education and clinical practice. Career-planning curriculums enable students to learn relevant knowledge and skills in a targeted manner, in addition to achieve career targets. Assessment and analysis of the present situation of Chinese nursing students' career planning and professional identity may provide an important guidance for the improvement of teaching content and quality of the career-planning curriculum. This study aimed to describe nursing students' professional identity, and to find out influences of nursing students' career planning, internship experience, and other factors on professional identity.

METHODS

A descriptive cross-sectional research method was employed to conduct a questionnaire on 453 full-time junior and senior undergraduate nursing students in China in December 2019.

RESULTS

The average score for nursing students' professional identity was 101.42, which is at a moderately low-level. There was a significantly positive correlation between the level of nursing students' career planning and professional identity (r = 0.529, P < 0.01). Nursing students' professional identity was also influenced by grade, age, acceptance of career-planning curriculums, and other factors.

CONCLUSION

The results indicated that the level of professional identity in nursing students is closely associated with their career planning. One strategy to improve this situation is to motivate universities to pay further attention to the effectiveness of career-planning curriculums and, to improve the quality of teaching and guidance system.

Influencing factors and strategy to the career planning of operating room nurses

Aim

This study aims to investigate the status quo of self‐career planning of nurses working in operating rooms (OR) and analyse the influencing factors.

Methods

A total of 1,418 nurses working in OR were selected and surveyed using a general data questionnaire, a nurse career planning questionnaire and an organizational career management questionnaire.

Results

Multiple linear regression analysis showed that organizational career management perception, hospital‐grade and monthly income were the influencing factors of self‐career planning score of nurses working in OR, which could explain the 56.6% variation of career organization management.

Conclusion

The status quo of self‐career planning in OR nurse was at the middle level, and the scores of different dimensions were not balanced. Reasonable self‐career planning helps the OR nurses improve their professional skills and increase their commitment to work and satisfaction.

Factors influencing acceptance or decline of a hospital-sponsored scholarship by nursing students in Taiwan: a qualitative descriptive study

Background

Maintaining sufficient nursing personnel is critical for healthcare systems worldwide. Improving retention of nurses is one means of addressing this shortfall. To foster retention, some hospitals in Taiwan provide nursing scholarships contingent on recipients signing a 3-year employment contract. However, it is unclear what factors influence students’ decisions to accept or reject a scholarship.

Methods

The purpose of this exploratory qualitative descriptive study was to obtain an understanding of the subjective experiences of fourth-year nursing school students (N = 87) who accepted (n = 43) or declined (n = 44) a hospital-sponsored nursing school scholarship. Students were selected by purposive sampling from the department of nursing of a private university in northern Taiwan. Data were collected between 2013 and 2014 using face-to-face-in-depth interviews.

Results

The mean age of participants was 22.7 years; most (94%) were female (n = 82). Analysis of the interview data showed the choice to accept or decline the scholarship and making career decisions occurred in three stages for both groups: the considering their options, making the decision, and assessment of their decision.

Conclusions

Although the variables at each of these stages differed between groups, both sponsored and non-sponsored students felt a responsibility to continue as employees of the hospital after graduation. Financial status, the hospital environment, and future long-term career goals were important factors affecting the acceptance or rejection of the hospital scholarship. These results could provide insight into factors students consider important for making long-term commitments as a nursing professional, which could not only improve retention of nurses, but also serve as a guideline for career planning.

Career and professional development services for pharmacy students

INTRODUCTION

As the number of pharmacy programs and graduates continue to rise, pharmacy students are being faced with new challenges in seeking post-graduate positions. A Career Connections program was established as part of the student affairs office to develop, implement, and evaluate career and professional development at the University of Michigan College of Pharmacy. The objective of this paper was to evaluate student perceptions and value of career and professional development services in preparing students for competitive job and residency markets.

METHODS

An electronic survey was administered to second-, third-, and fourth-professional year students and 2017 graduates to evaluate all facets of career and professional development services offered by the college of pharmacy.

RESULTS

The majority of students (76.8%) were satisfied with their access to career development services. Of all the services and events evaluated, students were most satisfied with the internship panel, fourth-year residency seminars, and third-year professional development elective course. Additional services recommended by students included more networking opportunities with alumni, continued exposure to different careers in pharmacy, and more emphasis on the job searching process.

CONCLUSIONS

Career development services were generally perceived favorably. The college has implemented several changes based on feedback from students, including splitting students into career-based tracks in the professional development elective and adding additional job-searching seminars. Future initiatives will include increasing outreach to college alumni. Career and professional development services at pharmacy programs should be continuously evaluated in a rapidly changing post-graduate landscape.

Navigating the Postgraduate Research Fellowship: A Roadmap for Surgical Residents

BACKGROUND

To preserve the future of surgical innovation, opportunities for surgical residents to receive structured research training are paramount. The objective of this article is to help surgical residents navigate a research fellowship by overviewing key topics such as choosing an area of focus and supervisor, applying for external funding, transitioning away from clinical duties, managing intellectual property, integrating family planning, and incorporating research experience into independent career development.

MATERIALS AND METHODS

Using the framework of the University of Toronto's graduate degree-awarding Surgeon-Scientist Training Program, the authors outline key considerations, decisions, and pearls for surgical residents considering or currently enrolled in a full-time research fellowship training program.

RESULTS

Full-time research fellowships offer a unique opportunity for residents interested in an academic career. Such full-time research fellowships away from clinical duties allow surgical trainees to focus on developing key research competencies, including how to generate hypotheses, apply research methodology, gain experience presenting and publishing manuscripts, and ultimately apply these skills as independent investigators to improve patient and population health. Research fellowships may also be an opportunity to develop intellectual property or facilitate family planning. Practical tips are provided for the transition back into clinical training and how to effectively market one's research skills for career advancement.

CONCLUSIONS

The authors outline key considerations, decisions, and pearls for surgical residents considering or currently enrolled in a full-time research fellowship training program. By adhering to the principles highlighted in this article, residents will be able to successfully navigate a full-time research fellowship to optimize their intellectual development, maximize their academic productivity, and facilitate their transition into an independent investigator.

Encouraging residents' professional development and career planning: the role of a development-oriented performance assessment

BACKGROUND

Current postgraduate medical training programmes fall short regarding residents' development of generic competencies (communication, collaboration, leadership, professionalism) and reflective and deliberate practice. Paying attention to these non-technical skills in a structural manner during postgraduate training could result in a workforce better prepared for practice. A development-oriented performance assessment (PA), which assists residents with assessment of performance and deliberately planned learning activities, could potentially contribute to filling this gap. This study aims to explore residents experiences with the PA.

METHODS

We conducted a qualitative interview study with 16 residents from four different medical specialties who participated in the PA, scheduled halfway postgraduate training. The PA was conducted by an external facilitator, a psychologist, and focused specifically on professional development and career planning. Residents were interviewed 6 months after the PA. Data were analysed using the framework method for qualitative analysis.

RESULTS

Residents found the PA to be of additional value for their training. The overarching merit was the opportunity to evaluate competencies not usually addressed in workplace-based assessments and progress conversations. In addition, the PA proved a valuable tool for assisting residents with reflecting upon their work and formulating their learning objectives and activities. Residents reported increased awareness of capacity, self-confidence and enhanced feelings of career-ownership. An important factor contributing to these outcomes was the relationship of trust with the facilitator and programme director.

CONCLUSION

The PA is a promising tool in fostering the development of generic competencies and reflective and deliberate practice. The participating residents, facilitator and programme directors were able to contribute to a safe learning environment away from the busy workplace. The facilitator plays an important role by providing credible and informative feedback. Commitment of the programme director is important for the implementation of developmental plans and learning activities.

The effects of patients initiated aggression on Chinese medical students' career planning

BACKGROUND

Patient initiated aggression is common among Chinese health-care workers, reaching over 10,000 incidents annually (Jinyang web. http://6d.dxy.cn/article/55497 . 2013), and the tense doctor-patient relationship generates stress among medical students. Because of the paucity of data (few surveys pay attention to the effects of violence perpetrated by patients on medical students), this study aimed to characterize patient initiated aggression against medical students.

METHODS

In this cross-sectional survey conducted at a medical school in West China in 2015, 157 medical students completed a self-administered questionnaire and the Short Form-36, which assesses quality of life. The associations between patient initiated aggression exposure and medical students' career planning or quality of life were assessed using a chi-square test.

RESULTS

Of the 157 medical students, 48 (30.6%) reported having suffered patient initiated aggression at least once during the previous year in the form of mental abuse (20.4%), offensive threat (14.6%), physical violence (8.3%), sexual harassment (verbal: 8.3% or physical: 1.6%), and extreme violence (physical violence leading to surgical treatment or hospitalization) (0.6%). Insufficient communication was the primary reason cited (27.2%). Emotional attack (mental abuse and offensive threat) occurrence differed among age groups (χ2 = 9.786, P = 0.020) and was ubiquitous among those aged >30 years old. Women were more likely than men to suffer physical violence (χ2 = 6.796, P = 0.009). Patient initiated aggression was not significantly associated with medical students' career planning or quality of life.

CONCLUSIONS

In this study, patient initiated aggression, albeit common, as in the rest of China, did not appear to be associated with medical students' career planning or quality of life. However, the characteristics described can inform policymaking and the design of programs to minimize patient initiated aggression occurrence.

Evaluation of a technical and nontechnical skills curriculum for students entering surgery

BACKGROUND

Prior interventions to address declining interest in surgical careers have focused on creating early exposure and fostering mentorship at the preclinical medical student level. Navigating the surgical environment can be challenging, however, and preclinical students may be more likely to pursue a surgical career if they are given the tools to function optimally.

MATERIALS AND METHODS

We designed a 10-wk technical and nontechnical skills curriculum to provide preclinical students with knowledge and skills necessary to successfully navigate the surgical learning environment, followed by placement in high-fidelity surgical simulations and scrubbing in on operative cases with attending surgeons. We administered pre-post surveys to assess student confidence levels in operative skills, self-perceptions of having a mentor, overall course efficacy, and interest in a career in surgery.

RESULTS

The overall response rates presurvey and postsurvey were 100% (30 of 30) and 93.3% (28 of 30), respectively. Confidence levels across all operative skills increased significantly after completing the course. Faculty mentorship increased significantly from 30.0% before to 61.5% after the course. Overall effectiveness of the course was 4.00 of 5 (4 = "very effective"), and although insignificant, overall interest in a career in surgery increased at the completion of the course from 3.77 (standard deviation = 1.01) to 4.17 (standard deviation = 0.94).

CONCLUSIONS

Our curriculum was effective in teaching the skills necessary to enjoy positive experiences in planned early exposure and mentorship activities. Further study is warranted to determine if this intervention leads to an increase in students who formally commit to a career in surgery.

Acknowleding attributes that enable the career academic nurse to thrive in the tertiary education sector: A qualitative systematic review

OBJECTIVE

To optimise the career development in early career academic nurses by providing an overview of the attributes necessary for success.

BACKGROUND

Evidence of early prospective career planning is necessary to optimise success in the tertiary sector. This is particularly important for nurse academics given the profession's later entry into academia, the ageing nursing workforce and the continuing global shortage of nurses.

DESIGN

A qualitative systematic review.

METHODS

Academic Search Complete, CINAHL, Medline, ERIC, Professional Development Collection and Google Scholar databases were searched; resulting in the inclusion of nine qualitative nurse-only focussed studies published between 2004 and 2014. The studies were critically appraised and the data thematically analysed.

RESULTS

Three abilities were identified as important to the early career academic nurse: a willingness to adapt to change, an intention to pursue support and embodying resilience. These abilities give rise to attributes that are recommended as key to successful academic career development for those employed on a continuing academic basis.

CONCLUSIONS

The capacity to rely on one's own capabilities is becoming seen as increasingly important. It is proposed that recognition of these attributes, their skilful application and monitoring outlined in the review are recommended for a successful career in academia.

Treading the clinical pathway: a qualitative study of advanced practice nurses in a local health district in Australia

Background

Career planning in nursing is often haphazard, with many studies showing that nurses need personal motivation, education, and the support of workplaces, which are often dominated by political and fiscal agendas. Nurses often need institutional and personal support to plan their careers and make decisions regarding their career aspirations.

Method

A descriptive qualitative design was used. Data were gathered using semi-structured digitally recorded interviews and analysed for common categories. Twenty seven (n = 27) participants were interviewed.

Results

There were four categories revealed by the participants who described their career progression experiences: moving up the ladder, changing jobs for career progression, self-driven and the effects of institutional environments.

Conclusion

Many of the participants’ careers had been shaped serendipitously. Similar to other studies, these nurses felt political, institutional and financial factors impacted on their career opportunities. There are implications for nursing managers with more support required for nurses to plan their career trajectories. In addition to an organisation centred approach to career planning, nurse leaders and managers must take into account the personal and professional requirements of their nurses. Nurses themselves also need to take personal responsibility for career development. Greater support for nurses’ career planning and personal drive will help organisations to plan their future workforce needs.

Practical approaches to family-friendly medical studies

Based on the pilot study carried out by the Office of the Dean of the Medical University of Ulm on the family-friendliness of the organisation of medical education in Ulm, this paper describes concrete measures that were designed at the university or have been partly implemented already.

More flexibility and customization are essential characteristics and prerequisites of a family-friendly medical school as part of university education structures. Flexibility and customization can be achieved by designing lesson plans and study regulations so that both childcare is assured and that in emergencies, help can be quickly offered with a minimum of bureaucracy.

More flexibility includes, amongst other things, adequate means for the individual to compensate for missed compulsory attendances and examination dates. The necessary shift in thinking and the willingness to cooperate on behalf of the management and teaching staff can be supported through the audit for family-friendliness “berufundfamilie” (job and family) or “familiengerechte hochschule” (family-friendly university), as well as strategic management tools of family-friendly corporate policies.

Supporting mechanisms such as effectively networked advice services, course progression monitoring based on data, providing a parents’ passport with a cross-semester training contract, creating more interaction between student-parents or other students through a parent community or by study pairings and finally, reliable information on and compliance with the maternity leave rules for pregnant and breastfeeding medical students can help safeguard successful studying with children.

Family and career-conscious hospitals - problem areas and necessary steps

This paper aims to describe the wide range of compatibility issues between work in the medical profession and the family. Several topics are intertwined and overlap in some areas.

Family friendliness in curative medicine, healthcare, medical studies and the training, specialisation and CPD of doctors is a key theme in the current debate on the future of health and family policies. The rising proportion of women and changes in the medical community characterise the future of medicine. Topics such as working hours and organisation of work, as well as family support and maternity leave, must be discussed further and in particular regarding employees in the health services. This overview will describe where Germany has issues, what is already being done well in the hospitals but could still be improved.

Starting a family during medical studies? Results of a pilot study on family friendliness in the study of medicine at the University of Ulm

Objective: The Ulm pilot study aimed to explore factors for a successful combination of medical education and starting a family. The empirical data derived from this study constitutes the foundation for an evidence-based reform of the medical curriculum in Ulm.

Methods: In 2009, qualitative interviews with 37 of the 79 medical students with children at University of Ulm were conducted and analyzed using content analysis. The detected problem areas were used to develop a quantitative questionnaire for studying parents and academic teaching members in medical education in Ulm.

Results: The parents were older, more often married and more likely to already have obtained a first training. One third of the students thought there was no ideal time to start a family during the years of medical education or specialist training. However, the majority of the students (61%) were convinced that parenthood is more compatible with medical studies than with specialist training. The interview data suggests that the end of medical school (4^th to 6^th year of studies), preferably during semester break, is especially suitable for child birth since it allows students to continue their studies without ‘losing time’.

Conclusion: The biography and career of studying parents in medicine have specific characteristics. Universities and teaching hospitals are required to no longer leave the compatibility of family and study responsibilities to the students themselves. Rather, flexible structures need to be implemented that enable students to start a family while continuing their education. This means providing more childcare and greater support regarding academic counselling and career development.