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Providing specialist clinical skills in soft tissue and intra-articular injection through a postgraduate masters module.

Current philosophy and policy changes in the National Health Service are encouraging healthcare practitioners to extend their clinical skills to create a more patient-centred approach thus allowing patients to be seen in a timely and more appropriate manner. This often requires further development of the practitioners' skills and knowledge. One approach to achieve this is through collaboration between employers and educational providers to ensure that educational experience is not only evidence based but also responsive to the needs of the current and future workforce. A postgraduate module was developed to raise critical and evaluative skills, as well as the technical skills of practitioners using injections in the management of joint and soft tissue pathology, while developing a professional responsibility towards injection practice. The module emphasized learning though experience by contextualizing the theoretical aspects of the module and by its student centred assessments. Further strengths of this module are that it has utilized academic and clinical expertise and knowledge to enable clinicians to gain additional skills and the multidisciplinary approach engendered good working practice Overall the module was evaluated positively by both tutors and students and not only met its aims but also addressed the current professional and policy issues around continuing professional development.

Journal Article↗

The local public health workforce in rural communities.

This work describes the public health workforce and training needs of rural local public health agencies (LPHAs) in comparison with suburban and metropolitan LPHA jurisdictions. A survey was sent to 1,100 LPHAs nationwide. The rural urban commuting area codes (RUCAs) defined LPHAs as rural or urban, and the Standard Occupational Classification system enumerated the workforce. Most occupational classifications had significantly fewer staff in rural LPHAs. Public health nurses ranked as the most needed staff and serve in various important capacities in rural LPHAs. In terms of training, job-specific or programmatic continuing education was identified as the most important training need. Developing leadership and public health workforce capacity within rural public health is an essential agenda item for rural America. Decision makers may need to consider different organizational structures while balancing the need for local input and control. Regionalization and collaborative approaches to difficult workforce issues may present potential solutions to workforce challenges.

Employment↗

Training needs analysis: an evaluation framework.

Training needs analysis (TNA) is the first step in the training and educational strategy of an organisation and is crucial to meeting the continuing professional development needs of the healthcare workforce and service. TNA must be carefully planned, conducted and have clear outcomes to ensure that training interventions are implemented effectively and that they lead to meaningful changes in service delivery. However, there is a death of literature on approaches to critique TNA. This article describes a framework developed specifically to evaluate the effectiveness of TNA. The framework combines approaches that have been used to evaluate conventional research studies and audit.

Attitude of Health Personnel↗

Medical workforce issues in Australia: "tomorrow's doctors--too few, too far".

The Australian medical workforce, like those of most developed countries, is increasingly "feminised" and exposed to the global market for doctors. Demand for healthcare services is increasing in the Australian community. Concern in relation to doctor shortages is increasing, particularly in rural areas. There should be greater flexibility for entry of highly-trained overseas doctors. There is an urgent need to increase medical school student intake. Issues of workforce practice, including "task" substitution, should be explored.

Australia↗

Is competency based training/education useful for workplace training.

This paper discusses and explores whether competency based training is useful for workplace training and education. Competency based training and education has re-emerged over the past decade as the panacea to meet the education and training needs to develop a more flexible and skilled Australian workforce. Nurse education has been affected by these re-emerging trends. The historical developments associated with competency based training is presented. Specifically the relevance of competency based training to nursing and nurse education is examined.

Attitude of Health Personnel↗

Establishing a practice based primary care research network. The University Family Practice Network in South Australia.

BACKGROUND: Practice based research networks enable the study of primary care problems in a primary care setting. To be successful, our experience indicates that a network will need to incorporate a number of key components. In South Australia, a University Family Practice Network has been established to undertake primary health care research and teaching and to contribute to the general practice workforce. The University Family Practice Network is composed of five practices and is managed jointly by the Department of General Practice, Adelaide University and the South Australian Centre for Rural and Remote Health, Adelaide University and the University of South Australia. OBJECTIVE: This article details the successful establishment of the University Family Practice Network in the hope of providing a model for other universities who may be interested in setting up a practice based research network. DISCUSSION: The characteristics of this network include fractional academic positions for general practitioners, computerised medical records, location in rural and urban sites, regular meetings and the appointment of a research fellow. A number of benefits have arisen since the network's establishment that will assist its future development and sustainability. These include collocation with allied health services, development of local expertise and workforce support.

Australia↗

Construction of a model demonstrating neural pathways and reflex arcs.

Employment opportunities in the future will require higher skills and an understanding of mathematics and science. As a result of the growing number of careers that require solid science and mathematics training, the methods of science education are undergoing major reform. To adequately equip students for technologically advanced positions, new teaching methods must be developed that prepare tomorrow's workforce for the challenges of the 21st century. One such method is the use of models. By actively building and manipulating concrete models that represent scientific concepts, students are involved in the most basic level of Piaget's learning scheme: the sensorimotor stage. Models are useful in reaching all students at the foundational levels of learning, and further learning experiences are rapidly moved through higher learning levels. This success ensures greater comprehension and understanding compared with the traditional methods of rote memorization. We developed an exercise for the construction of an inexpensive, easy-to-build model demonstrating neural pathways and reflex arcs. Our exercise also includes many supplemental teaching tools. The exercise is designed to fulfill the need of sound physiological teaching materials for high school students.

Animals↗

Children's workforce strategy.

The Green Paper, Every child matters, recognised the crucial importance of the children's workforce to improving outcomes for children and young people. The Children's Workforce Strategy sets out the government's vision of a world-class children's workforce which is increasingly competent and confident, inspiring trust and respect from parents and carers as well as from children and young people themselves. The document sets out four major strategic challenges: to recruit more high quality staff into the children's workforce; to retain people in the workforce including by offering better development and career progression; to strengthen interagency and multi-disciplinary working; and to promote stronger leadership and management. The strategy builds on work already in hand and on existing good practice. It puts forward proposals to tackle each of the strategic challenges with action nationally and locally.

Child↗

Understanding the underlying drivers of inpatient cost growth: a literature review.

BACKGROUND: After the declining growth in inpatient hospital spending that occurred from 1994 through 1998, the recent trend in increased spending has been of concern to many. Understanding the underlying reasons for this new growth will aid decision makers in finding best means to manage inpatient costs. OBJECTIVE: To identify potential contributors to recent growth in inpatient spending. STUDY DESIGN: Literature review. METHODS: Healthcare and economic databases, prominent Web sites, and key journals were searched to identify potential drivers for the 1999-2001 rise in inpatient spending. Initial literature review and state-level regression analyses published in a companion paper were used to identify key explanatory factors, which were further explored. RESULTS: Although many of the contributors to the rise in inpatient costs overlap and are interrelated, the major cost drivers were identified as (1) workforce shortage; (2) new technology; (3) less tightly managed care; and (4) shifting hospital business directions. Underlying factors such as legislation, quality of care, limited access to noninpatient care, pressures on the safety net, population aging, and increasing chronic illness prevalence were found to influence the contributors and healthcare spending in general. CONCLUSIONS: Future trends in inpatient spending will depend on the response of the healthcare system to these cost drivers and underlying factors. Potential avenues to control inpatient spending include expanding access to primary care, encouraging cost-effective technology and more efficient hospital market structures, and developing incentives for the healthcare workforce.

Cost of Illness↗

Career development: a life span issue.

One of the challenges for individuals pursuing a career throughout their life span is how to maintain a high level of professional competence. As the composition of the workforce changes, and new technologies are developed, workers are faced with changing job demands and pressures. A major issue for the 1990s is how long a worker's skills will remain current. With rapid technological changes, workers may find it necessary to update continually their knowledge, skills, and abilities or risk becoming obsolete. Factors such as individuals' motivation and attitudes and organizational climate can contribute to choices regarding career development. Current research on the factors that contribute to career development activities is reviewed, along with the impact of multiple career transitions throughout the life span. Interventions such as retraining and outplacement, which allow individuals in later life to continue work, change jobs, and further develop their careers, are also discussed.

Age Factors↗

Modeling public health interventions for improved access to the gray literature.

OBJECTIVE: Much of the useful information in public health (PH) is considered gray literature, literature that is not available through traditional, commercial pathways. The diversity and nontraditional format of this information makes it difficult to locate. The aim of this Robert Wood Johnson Foundation-funded project is to improve access to PH gray literature reports through established natural language processing (NLP) techniques. This paper summarizes the development of a model for representing gray literature documents concerning PH interventions. METHODS: The authors established a model-based approach for automatically analyzing and representing the PH gray literature through the evaluation of a corpus of PH gray literature from seven PH Websites. Input from fifteen PH professionals assisted in the development of the model and prioritization of elements for NLP extraction. RESULTS: Of 365 documents collected, 320 documents were used for analysis to develop a model of key text elements of gray literature documents relating to PH interventions. Survey input from a group of potential users directed the selection of key elements to include in the document summaries. CONCLUSIONS: A model of key elements relating to PH interventions in the gray literature can be developed from the ground up through document analysis and input from members of the PH workforce. The model provides a framework for developing a method to identify and store key elements from documents (metadata) as document surrogates that can be used for indexing, abstracting, and determining the shape of the PH gray literature.

Access to Information↗

Cardiovascular disease and global health: threat and opportunity.

The transition in global health from infectious to chronic disease, especially cardiovascular disease, poses a threat to the economies of the less developed world. As a more sophisticated workforce becomes a highly valued and harder-to-replace economic investment, the increasing prevalence of cardiovascular risk factors becomes a threat to economic development. The next two decades offer a critical period for intervention to blunt the impact of these diseases. The response of the global assistance community has been inadequate and without impact. A new global health assistance paradigm is needed to support long-term prevention strategies to combat this epidemic.

Adult↗

Racial/ethnic diversity management and cultural competency: the case of Pennsylvania hospitals.

Major demographic trends are changing the face of America's labor pool, and healthcare managers increasingly face a scarcer and more diverse workforce. As a result, healthcare organizations (HCOs) must develop policies and practices aimed at recruiting, retaining, and managing a diverse workforce and must meet the demands of a more diverse patient population by providing culturally appropriate care and improving access to care for racial/ethnic minorities. Ultimately, the goal of managing diversity is to enhance workforce and customer satisfaction, to improve communication among members of the workforce, and to further improve organizational performance. Research on diversity management practices in HCOs is scarce, providing few guidelines for practitioners. This study attempted to close that gap. Results show that hospitals in Pennsylvania have been relatively inactive with employing diversity management practices, and equal employment requirements are the main driver of diversity management policy. The number and scope of diversity management practices used were not influenced by organizational or market characteristics. The results suggest that hospitals need to adopt diversity management practices for their workforces and need to pay particular attention to marketing and service planning activities that meet the needs of a diverse patient population.

Cultural Diversity↗

[The World Health Organization and the development of human resources of the health system].

Health workforce is among the main components of the health care system. The performance of the latter depends on the knowledge, competence and motivations of the various categories of health workers. The task of the World Health Organization is to analyze the main problems related to health workforce and to help member-states overcome these problems. An other task is to facilitate intercountry comparisons. To attain these objectives, WHO has developed a conceptual framework, taking into account elements such as the labour market, the health care system, the policies and macro-factors (economic, socio-demographic). Among the main issues related today to health workforce, one can quote: the numbers and distribution of health workers, their migration, their involvement into the field of public health, the contents of their training, and, finally, the increased risk factors they are challenging.

Career Mobility↗