Workforce

劳动力
  • 文章类型: Journal Article
    目的:本研究旨在探讨如何支持新手护士教育者在成为高等教育教育者时培养对教学和学习的理解,他们如何理解自己作为护理教育工作者的角色,并确定在一个跨国护理校园经历的发展教学内容知识的机遇和挑战是卡塔尔。
    背景:由于其专业的临床背景和经验,新手护士教育者经常被用来担任教育者的角色。然而,他们通常很少或根本没有关于教育教学法和当前教学实践的正规教育。这些专业学习需求可能难以驾驭,并为具有挑战性的新角色做出贡献。新手护士教育工作者经常描述需要对他们的教学实践有更多的信心,并理解他们的局限性和关于教学和学习的知识差距。尽管研究和政策强调需要训练有素的护士教育工作者,具有适当的教育和知识,以在中学后的学术环境中教学,护理教育仍然与不一致的招聘方法和对专业发展的支持不足作斗争,引发持续的担忧。
    方法:本研究采用定性案例研究。
    方法:使用四种方法收集数据:教学工件收集,个人引导反思性问题,一对一访谈和观察笔记。七名新手护士教育工作者参与了这项研究。使用循环编码进行数据分析以识别主题。
    结果:与新手护士教育者专业发展相关的三个主题包括1)初始和持续的准备,2)过渡到教育者角色期间所需的专业学习和支持,以及3)新手护士教育者专业学习的障碍。
    结论:新手护士教育者在开始新的角色时可能有显著的专业学习需求。至关重要的是要确保周到和精心设计的入职流程包括早期介绍专业发展,同时提供持续的专业学习机会。新手护士教育工作者将利用各种支持,因为他们开始他们的新角色。开发全面的教学实践和教学内容的知识是困难的,同时导航一个完整的教学负荷。因此,在新手护士教育者的职业生涯中,早期的工作量调整将为专业发展留出时间。
    OBJECTIVE: This study aimed to explore how novice nurse educators are supported in cultivating an understanding of teaching and learning as they become educators in higher education, how they understand their roles as nursing educators and to identify the opportunities and challenges in developing pedagogical content knowledge experienced at one transnational nursing campus is Qatar.
    BACKGROUND: Novice nurse educators are frequently employed to begin educator roles because of their specialised clinical backgrounds and experiences. Yet, they often have little or no formal education regarding educational pedagogy and current teaching practices. These professional learning needs can be difficult to navigate and contribute to a challenging new role. Novice nurse educators often describe a need for more confidence in their teaching practices and understanding of their limitations and knowledge gaps regarding teaching and learning. Although research and policy emphasise the need for well-trained nurse educators with the appropriate education and knowledge to teach in post-secondary academic settings, nursing education still struggles with inconsistent approaches to recruitment and inadequate support for professional development, raising ongoing concerns.
    METHODS: A qualitative case study was used for this study.
    METHODS: Four methods were used to collect data: teaching artifact collection, individual guided reflective questions, one-on-one interviews and observational notes. Seven novice nurse educators participated in this study. Data analysis was done using cycle coding to identify themes.
    RESULTS: Three themes related to novice nurse educators\' professional development include 1) initial and ongoing preparation, 2) professional learning and support needed during transitions into educator roles and 3) barriers to novice nurse educator professional learning.
    CONCLUSIONS: Novice nurse educators may have significant professional learning needs as they begin new roles. It is essential to ensure that thoughtful and well-designed onboarding processes includes an early introduction to professional development while offering ongoing professional learning opportunities. Novice nurse educators will draw on various supports as they start their new roles. Developing well-rounded teaching practices and pedagogical content knowledge is difficult while navigating a full teaching load. Therefore, workload adjustments early in novice nurse educators\' careers will allow time for professional development.
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  • 文章类型: Journal Article
    背景:COVID-19大流行强调了在公共卫生危机之前需要一支训练有素的公共卫生队伍。公共卫生培训中心定期评估劳动力需求,其疫情前数据在指导危机后的公共卫生劳动力发展方面发挥着至关重要的作用。
    方法:2019年,俄克拉荷马州第6区中南部公共卫生培训中心(R6SCPHTC)的合作伙伴共同对位于卫生资源与服务管理第6区的公共卫生人员进行了在线调查。
    方法:从3月到4月,R6SCPHTC收集了503份调查,包括来自俄克拉荷马州的201项调查。询问人口和劳动力特征的问题,工作环境,培训需求和兴趣,培训准入和后勤,和R6SCPHTC在线资源的知识。
    结果:主要发现包括,大流行前俄克拉荷马州公共卫生劳动力的三分之二由40岁或40岁以上的员工组成,几乎没有公共卫生或医学学位。大多数受访者在卫生部门和部落工作,几乎一半是一线工人。尽管至少有一半对公共卫生活动和主题培训感兴趣的参与者熟悉他们,对他们与这些活动和主题相关的能力的信心只有不到一半。定性数据提供了定量解决的培训需求的详细信息,并描述了新的培训领域。调查参与者对各种培训方法和技术设备表示了兴趣。大多数受访者不熟悉通过R6SCPHTC提供的免费培训。
    结论:与区域和国家公共卫生人员类似,俄克拉荷马州的劳动力在COVID-19之前已经需要培训和支持。需要将时间和资源投入到当前和未来的劳动力中。虽然解决重点公共卫生技能和主题仍然很重要,需要对当前和新兴主题进行培训。提供具有扩展内容的可访问培训将为俄克拉荷马州的公共卫生劳动力做好准备。
    BACKGROUND: The COVID-19 pandemic highlighted the need for a well-trained public health workforce prior to the public health crisis. Public health training centers regularly assess workforce needs and their pre-pandemic data play vital roles in guiding public health workforce development beyond the crisis.
    METHODS: In 2019, Oklahoma partners of the Region 6 South Central Public Health Training Center (R6SCPHTC) co-conducted an online survey of the public health workforce located in the Health Resources & Services Administration Region 6.
    METHODS: Between March and April, the R6SCPHTC collected 503 surveys, including 201 surveys from Oklahoma. Questions inquired about demographic and workforce characteristics, work contexts, training needs and interests, training access and logistics, and knowledge of R6SCPHTC online resources.
    RESULTS: Key findings included that two-thirds of the pre-pandemic Oklahoma public health workforce consisted of employees age 40 or older with few holding public health or medical degrees. The majority of respondents worked for health departments and Tribes, and almost half were frontline workers. Although at least half of the participants interested in training on public health activities and topics were familiar with them, confidence in their abilities related to these activities and topics was expressed by less than half. Qualitative data provided details on training needs addressed quantitatively and described new training areas. Survey participants expressed interest in diverse training delivery methods and technological devices. Most respondents were not familiar with the free trainings available through the R6SCPHTC.
    CONCLUSIONS: Similar to the regional and national public health workforce, Oklahoma\'s workforce needed training and support already before COVID-19. Time and resources need to be invested into the current and future workforce. While addressing priority public health skills and topics remains important, training on current and emerging topics is needed. Providing accessible trainings with expanded content will prepare Oklahoma\'s public health workforce for the future.
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  • 文章类型: Journal Article
    背景:在1990-2000年期间,哈萨克斯坦经历了在农村地区工作的医疗保健专业人员数量的下降。自2009年以来,国家政府一直在实施财政激励措施,以鼓励医疗保健专业人员搬迁到农村地区。本研究旨在调查农村医疗劳动力分布的时空格局,并评估该激励计划的影响。
    方法:使用ARIMA模型和差异分析进行了中断时间序列分析,以研究激励计划对哈萨克斯坦农村地区不同类别医疗保健劳动力密度的影响从2009年到2020年。
    结果:与1998年至2008年相比,2009年至2020年农村医疗保健专业人员的数量显着增加。然而,按人均计算,这一增长不太明显。此外,观察到内科医生和儿科医生的密度下降。哈萨克斯坦不同地区的农村护士和医生的密度存在很大差异。哈萨克斯坦政府于2009年推出的激励计划包括一次性津贴和住房激励。发现该计划对观察到的农村医疗保健专业人员数量的增加没有显着贡献。
    结论:应进行未来的研究,以检查激励计划对其他医学亚专业的影响,尤其是初级从业者。解决农村地区医护人员短缺的问题是一个复杂的问题,需要采取多方面的方法。除了经济激励,可以考虑其他政策来增加搬迁并改善农村地区医疗保健专业人员的保留。
    BACKGROUND: During the 1990-2000, Kazakhstan experienced a decline in the number of healthcare professionals working in rural areas. Since 2009, the national government has been implementing financial incentives to encourage healthcare professionals to relocate to rural areas. This study aims to investigate the temporal and spatial patterns in the distribution of the rural healthcare workforce and evaluate the impact of this incentive scheme.
    METHODS: Interrupted Time Series Analysis using ARIMA models and Difference in Differences analyzes were conducted to examine the impact of the incentive scheme on the density of different categories of the healthcare workforce in rural Kazakhstan in the period from 2009 to 2020.
    RESULTS: There was a significant increase in the number of rural healthcare professionals from 2009 to 2020 in comparison to the period from 1998 to 2008. However, this increase was less pronounced in per capita terms. Moreover, a decline in the density of internists and pediatricians was observed. There is substantial variation in the density of rural nurses and physicians across different regions of Kazakhstan. The incentive scheme introduced in 2009 by the government of Kazakhstan included a one-time allowance and housing incentive. This scheme was found to have contributed insignificantly to the observed increase in the number of rural healthcare professionals.
    CONCLUSIONS: Future research should be undertaken to examine the impact made by the incentive scheme on other medical subspecialties, particularly primary practitioners. Addressing the shortage of healthcare workers in rural areas is a complex issue that requires a multifaceted approach. Aside from financial incentives, other policies could be considered to increase relocation and improve the retention of healthcare professionals in rural areas.
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  • 文章类型: Journal Article
    COVID-19大流行暴露了医疗保健服务方面的巨大差距,质量,以及迫切需要提高数字卫生人力资源的能力,特别是在拉丁美洲。大流行期间,政府机构支持的在线课程和远程健康计划,泛美卫生组织,以及其他公共和私人资源,在满足培训需求方面发挥了至关重要的作用。本文讨论了拉丁美洲背景下的数字健康能力建设计划的作用,特别关注秘鲁的案子.我们强调数字卫生能力和相关政策的发展,同时还描述了与该领域能力建设有关的选定经验。此外,我们讨论了机构和国家之间合作伙伴关系的关键作用,强调数字健康文化相关培训计划的重要性。这些举措有可能加快拉丁美洲的培训和研究机会,利用政府机构的参与,非政府组织,工业,大学,专业社团,和社区。
    The COVID-19 pandemic has exposed significant gaps in healthcare access, quality, and the urgent need for enhancing the capacity of digital health human resources, particularly in Latin America. During the pandemic, online courses and telehealth initiatives supported by governmental agencies, the Pan American Health Organization, and other public and private resources, have played a crucial role in meeting training demands. This article discusses the role of capacity building programs in digital health within the context of Latin America, with a specific focus on the Peruvian case. We highlight the development of digital health competencies and related policies, while also describing selected experiences related to capacity building in this field. Additionally, we discuss the pivotal role of collaborative partnerships among institutions and countries, emphasizing the importance of culturally relevant training programs in digital health. These initiatives have the potential to accelerate training and research opportunities in Latin America, drawing on the involvement of government agencies, non-governmental organizations, industry, universities, professional societies, and communities.
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  • 文章类型: Journal Article
    本文旨在综合对COVID-19大流行期间家庭医护人员的学术研究,以了解他们的工作场所挑战是如何被放大的。危机传播研究人员指出,危机为增长提供了机会和威胁。本文认为,许多影响家庭医护人员的问题一直存在,但是大流行使政策制定者能够清楚地看到它们,因为大流行使家庭医疗工作者每天面临的问题成为焦点。因此,作者对大流行期间有关家庭保健工作者的文献进行了叙述性分析,以了解大流行如何加剧结构性问题,导致该人群的心理健康困难增加。通过了解大流行如何加剧心理健康问题,政策制定者可以制定解决方案,以抵御下一次公共卫生危机,这无疑将影响最被剥夺公民权的人。
    This Article seeks to synthesize academic research on home healthcare workers during the COVID-19 pandemic to understand how their workplace challenges were magnified. Crisis communication researchers note that a crisis provides both opportunities and threats for growth. This Article argues that many of the issues that have impacted home healthcare workers have always been present, but the pandemic allows policy makers the ability to see them clearly because the pandemic brought a spotlight to the issues that home healthcare workers face on a daily basis. Consequently, the author employed a narrative analysis of the literature concerning home healthcare workers during the pandemic to understand how the pandemic exacerbated structural issues that led to an increase in mental health difficulties for this population. By understanding how the pandemic exacerbated mental health issues, policy makers can craft solutions that can withstand the next public health crisis which will undoubtedly impact the most disenfranchised.
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  • 文章类型: Journal Article
    在全球范围内,农村地区仍然缺乏护士和助产士。已发现高级实践护理可以通过旨在保留的职业发展来解决劳动力短缺问题。区域卫生服务机构试图就开发高级实践护理框架与工作人员进行磋商。
    本研究旨在探讨护士和助产士在区域卫生服务中的观点:(i)他们的角色如何与修改后的高级实践角色划定(APRD)工具保持一致,以及(ii)在他们的服务中实施此类框架的潜力。
    在澳大利亚东南部的GoulburnValleyHealth(GVH)进行的案例研究使用了混合方法设计,对所有护理和助产人员以及具有高级人员的焦点小组进行了调查。
    要求所有护士和助产士填写经过验证的改良ARPD问卷,要求3-6年级的护士和助产士参加焦点小组。
    从183份问卷和38名焦点小组讨论参与者中,研究结果一致认为,GVH的护士和助产士报告说,花费大部分时间在直接病人护理上,花费在研究活动上的时间最少,出版和/或领导。虽然教育被强烈接受,先进的实践通常得到支持,高级工作人员提到缺乏资源,文化和人员短缺限制了教育机会,职业发展和实施先进的实践框架。
    虽然先进的实践框架可以解决这一医疗服务人员短缺的问题,这一框架的实施受到农村卫生服务中普遍存在的资源缺乏和劳动力短缺的制约。建议制定一项国家战略,在有需要的领域嵌入高级实践护理和助产框架的高级实践角色和资源实施。
    UNASSIGNED: Across the globe, shortages of nurses and midwives in rural regions persist. Advanced practice nursing has been found to address workforce shortages through career progression aimed at retention. A regional health service sought to consult with staff about developing an advanced practice nursing framework.
    UNASSIGNED: This study aimed to explore the perspectives of nurses and midwives at a regional health service on (i) how their roles aligned with the modified Advanced Practice Role Delineation (APRD) tool and (ii) the potential for implementation of such a framework at their service.
    UNASSIGNED: A case study conducted at Goulburn Valley Health (GVH) in southeast Australia used a mixed method design with a survey of all nursing and midwifery staff and focus groups with senior staff.
    UNASSIGNED: All nurses and midwives were asked to complete a validated modified ARPD questionnaire and those in Grades 3-6 were asked to participate in a focus group.
    UNASSIGNED: From 183 questionnaires and 38 participants in the focus group discussions, findings concurred that nurses and midwives at GVH reported spending most time on direct patient care and minimal time on research activities, publication and/or leadership. While education was strongly embraced and advanced practice usually supported, senior staff cited the lack of resources, the culture and staff shortages as restricting opportunities for education, career development and implementation of an advanced practice framework.
    UNASSIGNED: While an advanced practice framework could address staff shortages at this health service, implementation of such a framework is constrained by the lack of resources and workforce shortages common in rural health services. A national strategy that embeds advanced practice roles and resources implementation of advanced practice nursing and midwifery frameworks in areas of need is recommended.
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  • 文章类型: Review
    目的:本研究的目的是探索和了解工作场所的组织文化,为在工作中经历围绝经期和更年期症状的工作人员提供支持和福祉。
    方法:公认的是,大部分女性劳动力都会出现更年期和更年期症状。缺乏对护士如何通过更年期得到支持的研究(Cronin等人。心理健康护理中的问题,42,2021,541-548)。围绝经期和更年期过渡可能是一个具有挑战性的时期,许多人可能需要症状管理和支持(RCN,更年期和工作:对RCN代表的指导,2020)。本文提出了一个案例研究(CSR)方法来检查一个医疗保健组织。
    方法:使用CSR设计:向所有受雇员工分发调查,审查有关更年期的可用文档,并与来自组织不同级别的经理进行访谈。COREQ合并标准用于报告本研究报告的定性研究。
    结果:案例研究使用调查生成了定量和定性数据,采访和文件。该组织的数据(n=6905)显示,女性劳动力占81.9%,其中40.6%的年龄在41至55岁之间,意味着三分之一的组织在围绝经期和更年期工作。调查答复(n=167)收集了有关围绝经期和更年期症状患病率的传记和心理测量数据。采访了七名管理人员,重点介绍了两个主题:获得更年期支持和文化的机会,并分析了该组织关于更年期的13份文件的内容。研究设计允许采用迭代方法进行数据收集,并为经历围绝经期和更年期的人提供对需求和支持的深入了解。这些发现有助于医疗机构了解他们的劳动力,并考虑到更多的女性员工,特别是护士,需要为所有员工提供以人为本的支持机制和组织方法。
    OBJECTIVE: The aim of the study was to explore and understand the organizational culture of a workplace in terms of support and well-being for staff experiencing perimenopausal and menopausal symptoms at work.
    METHODS: It is widely acknowledged that perimenopause and menopause symptoms are experienced by a large percentage of the female workforce. There is a lack of research into how nurses are supported through menopause (Cronin et al. Issues in Mental Health Nursing, 42, 2021, 541-548). The perimenopause and menopause transition can be a challenging time where many may require symptom management and support (RCN, The Menopause and Work: Guidance for RCN Representatives, 2020). This paper presents a case study research (CSR) approach to examine one healthcare organization.
    METHODS: CSR design was used: A survey distributed to all staff employed, a review of the available documentation on menopause and interviews with managers from different levels of the organization. The COREQ consolidated criteria was used for reporting the qualitative research reported this study.
    RESULTS: The case study generated both quantitative and qualitative data using surveys, interviews and documentation. Data from the organization (n = 6905) showed a majority female workforce of 81.9% with 40.6% aged between 41 and 55 years old, meaning a third of the organization working through perimenopause and menopause. Survey responses (n = 167) collected biographical and psychometric data on the prevalence of perimenopausal and menopausal symptoms. Seven managers were interviewed highlighting two themes: Access to support and culture of menopause and 13 documents from the organization on menopause were analysed for content. The study design permitted an iterative approach to data collection and providing an in-depth understanding of the needs and support for those experiencing perimenopause and menopause. The findings help healthcare organizations to understand their workforce and take in to account the larger numbers of female employees particularly nurses with the need to provide person-centred support mechanisms and an organizational approach for all employees.
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  • 文章类型: Journal Article
    背景:COVID-19大流行强调了强大的公共卫生基础设施对保护和支持社区健康的重要性。这包括确保适应性劳动力能够在快速变化的环境中领先,有效沟通,并应用系统思维来利用跨部门的伙伴关系,帮助促进卫生公平。10个区域公共卫生培训中心(PHTCs)通过在这些和其他战略领域的技能发展和技术援助来提高当前和未来公共卫生劳动力的能力。
    方法:本研究调查了在大流行期间,地区PHTCs及其合作伙伴支持公共卫生人员的活动。10个地区PHTCs的代表于2022年春季完成了一项调查。调查包括(1)从2018-2021年年度绩效报告中拉动培训使用趋势,以及(2)评估类型的问题,内容,以及培训需求评估的范围,培训和技术援助,学生安置,和PHTCNetwork合作活动发生在2020年1月1日至2021年12月31日。受访者还反映了使用趋势,挑战,吸取的教训,影响的故事,和未来的PHTC实践。
    结果:在大流行期间,区域PHTCs参与了许多评估需求的努力,为实践社区提供培训和技术援助,促进建立学生能力的项目,以支持公共卫生机构的努力,并与PHTC网络合作开展国家级计划。在这些活动中,区域PHTCs调整了方法并相互学习,以满足区域需求。
    结论:区域PHTCs在其区域和国家范围内为学生和专业发展提供了基础公共卫生知识和技能,同时灵活应对大流行期间该领域不断变化的需求。我们的研究强调了在大流行后环境中公共卫生劳动力发展的合作和适应性方法的机会。
    The COVID-19 pandemic underscored the importance of a strong public health infrastructure for protecting and supporting the health of communities. This includes ensuring an adaptive workforce capable of leading through rapidly changing circumstances, communicating effectively, and applying systems thinking to leverage cross-sector partnerships that help promote health equity. The 10 Regional Public Health Training Centers (PHTCs) advance the capacity of the current and future public health workforce through skill development and technical assistance in these and other strategic areas.
    This study examines activities through which the Regional PHTCs and their partners supported the public health workforce during the pandemic. Representatives of the 10 Regional PHTCs completed a survey in the spring of 2022. The survey included (1) pulling trends in training usage from 2018-2021 annual performance reports and (2) questions assessing the type, content, and reach of training needs assessments, training and technical assistance, student placements, and PHTC Network collaborative activities that occurred from January 1, 2020, to December 31, 2021. Respondents also reflected on trends in use, challenges, lessons learned, stories of impact, and future PHTC practice.
    During the pandemic, the Regional PHTCs engaged in numerous efforts to assess needs, provide training and technical assistance to the practice community, facilitate projects that built student competency to support public health agency efforts, and collaborate as the PHTC Network on national-level initiatives. Across these activities, the Regional PHTCs adjusted their approaches and learned from each other in order to meet regional needs.
    The Regional PHTCs provided student and professional development in foundational public health knowledge and skills within their regions and nationally while being flexible and responsive to the changing needs of the field during the pandemic. Our study highlights opportunities for collaboration and adaptive approaches to public health workforce development in a postpandemic environment.
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  • 文章类型: Journal Article
    背景:在医疗培训连续体的所有组成部分中,农村医疗培训已被证明可以增强农村劳动力的成果。然而,由于澳大利亚医疗劳动力分布不均,增加农村的卫生服务在满足各级受训人员监督要求的能力方面受到限制,尤其是初级医生培训。尽管纵向程序设计和教学法通过纵向综合职员模型在医学院教育中蓬勃发展,这尚未广泛转化为职前培训。这项研究描述了如何在农村卫生服务中概念化和实施纵向方案设计,以创建新颖的实习计划。
    方法:采用描述性案例研究方法来描述和评估纵向综合实习计划。审查了相关的计划文件,例如名册和认证提交,以帮助描述计划。在该计划第一年(2021年)的中间(5月)和结束(11月)期间对参与该计划的参与者进行了访谈,以调查实习模式的观点和经验。
    结果:每周,实习生在医院急诊科排行1天,在普外科或普通内科排行3天,6个月后交换纪律。这样,实习生纵向完成核心旋转,满足认证和监督要求。此外,每周1天在一般实践中进行平行咨询。参与者将计划推动者描述为组织愿景和员工支持,以及学科的纵向附件。确定的障碍是医务人员的脆弱性质和该计划的长期可持续性。该计划的好处包括增值和为实践做好准备,特别是在农村地区。
    结论:符合认证的实习生计划,通过纵向医学教育模式,可以在农村卫生服务中成功实现监督和学习要求。由于实习年是农村通才培训途径的关键组成部分,类似创新模式的发展为农村社区提供了发展自己未来医疗劳动力的机会。
    Rural medical training along all components of the medical training continuum has been shown to enhance rural workforce outcomes. However, due to the maldistribution of the Australian medical workforce, health services of increased rurality are limited in their ability to fulfil the supervision requirements for all levels of trainees, especially junior doctor training. Although longitudinal program design and pedagogy has flourished in medical school education through the Longitudinal Integrated Clerkship model, this has not yet been widely translated to prevocational training. This study describes how a longitudinal program design was conceptualised and implemented within a rural health service to create a novel internship program.
    A descriptive case study methodology was employed to describe and evaluate the longitudinal integrated internship program. Relevant program documents such as rosters and accreditation submissions were reviewed to aid in describing the program. Interviews with participants involved in the program were conducted during the middle (May) and end (November) points of the program\'s first year (2021) to investigate perspectives and experiences of the internship model.
    Each week, interns were rostered for 1 day in the hospital\'s emergency department and 3 days in general surgery or general medicine, swapping disciplines after 6 months. In this way, interns completed core rotations longitudinally, meeting accreditation and supervision requirements. Additionally, 1 day per week was spent parallel consulting in general practice. Participants described program enablers as the organisational vision and staff buy-in, as well as the longitudinal attachments to disciplines. Barriers identified were the tenuous nature of the medical workforce and long-term sustainability of the program. Benefits of the program included value-adding and preparedness for practice, particularly in a rural context.
    Intern programs that meet the accreditation, supervision and learning requirements can be successfully delivered at rural health services through longitudinal models of medical education. As the intern year is a key component of the rural generalist training pathway, development of similar innovative models provides the opportunity for rural communities to grow their own future medical workforce.
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  • 文章类型: Journal Article
    背景:芬兰旨在投资于社区护理和促进改革的长期精神卫生(MH)政策已导致精神病医院病床数量的减少。然而,由于各种社会因素,大部分资源仍分配给医院和社区居民服务,经济和政治因素。尽管以前的研究集中在这些服务的数量和成本上,没有研究评估新兴的使用模式,他们的技术性能以及与劳动力结构的关系。
    目的:本研究的目的是观察赫尔辛基-乌西马地区(芬兰)MH服务的主要护理类型的使用模式及其技术性能(效率),并分析技术绩效与相应的劳动力结构之间的潜在关系。
    方法:样本包括急性住院护理,非住院护理和门诊护理服务。分析采用回归分析,蒙特卡罗模拟,模糊推理和数据包络分析。
    结果:分析表明,服务用户数量与住院时间之间存在统计上显着的线性关系,非医院住院护理的床位数量和门诊护理服务的接触者数量。这三种服务类型显示了类似的技术性能模式,平均相对技术效率高,效率低。最有效率的急症医院及门诊护理服务综合多学科小组,而精神科医生和护士的特点是非医院住宿护理。
    结论:结果表明,资源数量和利用率变量与用户数量呈线性关系,并且所有类型的服务的相对技术效率相似。这表明基于劳动力分配的MH管理具有较小的差异。因此,在制定芬兰南部MH系统的有效政策和干预措施时,应考虑劳动力能力的分布。
    BACKGROUND: Long-term mental health (MH) policies in Finland aimed at investing in community care and promoting reforms have led to a reduction in the number of psychiatric hospital beds. However, most resources are still allocated to hospital and community residential services due to various social, economic and political factors. Despite previous research focussing on the number and cost of these services, no study has evaluated the emerging patterns of use, their technical performance and the relationship with the workforce structure.
    OBJECTIVE: The purpose of this study was to observe the patterns of use and their technical performance (efficiency) of the main types of care of MH services in the Helsinki-Uusimaa region (Finland), and to analyse the potential relationship between technical performance and the corresponding workforce structure.
    METHODS: The sample included acute hospital residential care, non-hospital residential care and outpatient care services. The analysis was conducted using regression analysis, Monte Carlo simulation, fuzzy inference and data envelopment analysis.
    RESULTS: The analysis showed a statistically significant linear relationship between the number of service users and the length of stay, number of beds in non-hospital residential care and number of contacts in outpatient care services. The three service types displayed a similar pattern of technical performance, with high relative technical efficiency on average and a low probability of being efficient. The most efficient acute hospital and outpatient care services integrated multidisciplinary teams, while psychiatrists and nurses characterized non-hospital residential care.
    CONCLUSIONS: The results indicated that the number of resources and utilization variables were linearly related to the number of users and that the relative technical efficiency of the services was similar across all types. This suggests homogenous MH management with small variations based on workforce allocation. Therefore, the distribution of workforce capacity should be considered in the development of effective policies and interventions in the southern Finnish MH system.
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