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Background: In China, as the “gatekeepers”of rural residents’ health, the primary-level village doctors, play a very crucial role in ensuring and serving the health level of rural residents. However, the burnout of village doctors is gravely threatening the stability of rural primary medical system step by step. This study systematically evaluated the effects of personality, work engagement and alexithymia on burnout of village doctors, and further measured and assessed the mediating effect of alexithymia and work engagement in the association between personality and burnout. Methods: The subjects were 2684 village doctors in Jining, Shandong Province, China, from May to June 2019. Sociodemographic characteristics, alexithymia, personality, work engagement and job burnout were quantitated by self-completed questionnaire and measured by Likert 5–7 scale. One-way ANOVA, Person correlation analysis, and Structural Equation Modelling (SEM) were used for statistical analysis and mediating effect evaluation. Results: 2693 questionnaires were collected in total, of which 2684 were valid, with an effective rate of 96.2%. 65.2% of village doctors were diagnosed with burnout, and 54.3% showed moderate to severe emotional exhaustion, 61.6% showed moderate to severe low sense of personal achievement, and 33.9% showed moderate to severe depersonalization burnout. Personality had a direct positive effect on work engagement (β = 0.50, p < 0.001), a direct negative effect on alexithymia (β = − 0.52, p < 0.001) and burnout (β = − 0.50, p < 0.001) respectively. Work engagement had a direct negative effect on burnout (β = − 0.10, p < 0.001), while alexithymia had a direct positive effect on burnout (β = 0.16, p < 0.001). In the path between personality and burnout, both work engagement 95%CI:(− 0.17)–(− 0.08), and alexithymia 95%CI:(− 0.36)–(− 0.09), have significant mediating effects. These results strongly confirm that personality, alexithymia, and work engagement are early and powerful predicators of burnout. Conclusion: According to the results, medical administrators should pay attention to the personality characteristics of village doctors in vocational training, practice selection and job assignment, encourage village doctors to reflect on their own personality actively, and to reduce job burnout by obtaining necessary social support, constructing reasonable achievable career expectations, improving time management ability, and participating in psychological counselling programs. © 2021, The Author(s).

Background: Due to the complex nature of healthcare professionals’ roles and responsibilities, the education of this workforce is multifaceted and challenging. It relies on various sources of learning from teachers, peers, patients and may focus on Work Integrated Learning (WIL). The COVID-19 pandemic has impacted many of these learning opportunities especially those in large groups or involving in person interaction with peers and patients. Much of the curriculum has been adapted to an online format, the long-term consequence of which is yet to be recognized. The changed format is likely to impact learning pedagogy effecting both students and teachers. This requires a systematic approach to evaluation of online teaching and learning adaptation, in comparison to the previous format, where, in person education may have been the focus. Methods: The proposed study is a broad based evaluation of health professional education in a major Australian University. The protocol describes a mixed methods convergent design to evaluate the impact of online education on students and teachers in health professional courses including Medicine, Nursing, Allied Health and Biomedical Science. A framework, developed at the university, using Contribution Analysis (CA), will guide the evaluation. Quantitative data relating to student performance, student evaluation of units, quantity of teaching activities and resource utilization will be collected and subjected to relevant statistical analysis. Data will be collected through surveys (500 students and 100 teachers), focus groups (10 groups of students) and interviews of students and teachers (50 students beyond graduation and 25 teachers, for long term follow up to 12 months). Application of CA will be used to answer the key research questions on the short term and long-term impact of online education on teaching and learning approaches. Discussion: The protocol describes the study, which will be widely implemented over the various courses in Health Professional Education and Biomedical Science. It will evaluate how students and teachers engage with the online delivery of the curriculum, student performance, and resources used to implement these changes. It also aims to evaluate longitudinal outcome of student learning attributes and impact on graduate outcomes, which is poorly reported in educational literature. © 2021, The Author(s).

[No abstract available]

Background: Clinical supervision in general practice is critical for enabling registrars (GP trainees) to provide safe medical care, develop skills and enjoy primary care careers. However, this largely depends on the quality of supervision provided. There has been limited research describing what encompasses quality within GP clinical supervision, making it difficult to promote best practice. This study aimed to explore the attributes of high-quality clinical supervision for GP registrars. Methods: In 2019–20, 22 semi-structured interviews were conducted with GP supervisors who were peer-nominated as best practice supervisors, by Regional GP Training Organisations and GP Colleges in Australia. Purposeful sampling sought respondents with diverse characteristics including gender and career stage, practice size, state/territory and rurality. Interviews were conducted by video-consultation and recorded. De-identified transcripts were independently coded using iterative, inductive thematic analyses to derive themes that reflected quality in GP supervision. Results: Seven themes emerged. Participants understood the meaning of quality supervision based on their experience of being supervised when they were a registrar, and from reflecting and learning from other supervisors and their own supervision experiences. Quality was reflected by actively structuring GP placements to optimise all possible learning opportunities, building a secure and caring relationship with registrars as the basis for handling challenging situations such as registrar mistakes. Quality also encompassed sustaining and enhancing registrar learning by drawing on the input of the whole practice team who had different skills and supervision approaches. Strong learner-centred approaches were used, where supervisors adjusted support and intervention in real-time, as registrar competence emerged in different areas. Quality also involved building the registrar’s professional identity and capabilities for safe and independent decision-making and encouraging registrars to reflect on situations before giving quality feedback, to drive learning. Conclusions: This study, although exploratory, provides a foundation for understanding the quality of clinical supervision in general practice, from the perspective of peer-recognised GP supervisors. Understanding and adopting quality within GP supervision may be improved by GPs sharing exemplars of best practice and having opportunities for professional reflection. The findings could be used as a point of reference for devising GP supervisor curriculum, resources and professional development activities. © 2021, The Author(s).

Background: Attracting and retaining sufficient health workers to provide adequate services for residents of rural and remote areas has global significance. High income countries (HICs) face challenges in staffing rural areas, which are often perceived by health workers as less attractive workplaces. The objective of this review was to examine the quantifiable associations between interventions to retain health workers in rural and remote areas of HICs, and workforce retention. Methods: The review considers studies of rural or remote health workers in HICs where participants have experienced interventions, support measures or incentive programs intended to increase retention. Experimental, quasi-experimental and observational study designs including cohort, case–control, cross-sectional and case series studies published since 2010 were eligible for inclusion. The Joanna Briggs Institute methodology for reviews of risk and aetiology was used. Databases searched included MEDLINE (OVID), CINAHL (EBSCO), Embase, Web of Science and Informit. Results: Of 2649 identified articles, 34 were included, with a total of 58,188 participants. All study designs were observational, limiting certainty of findings. Evidence relating to the retention of non-medical health professionals was scant. There is growing evidence that preferential selection of students who grew up in a rural area is associated with increased rural retention. Undertaking substantial lengths of rural training during basic university training or during post-graduate training were each associated with higher rural retention, as was supporting existing rural health professionals to extend their skills or upgrade their qualifications. Regulatory interventions requiring return-of-service (ROS) in a rural area in exchange for visa waivers, access to professional licenses or provider numbers were associated with comparatively low rural retention, especially once the ROS period was complete. Rural retention was higher if ROS was in exchange for loan repayments. Conclusion: Educational interventions such as preferential selection of rural students and distributed training in rural areas are associated with increased rural retention of health professionals. Strongly coercive interventions are associated with comparatively lower rural retention than interventions that involve less coercion. Policy makers seeking rural retention in the medium and longer term would be prudent to strengthen rural training pathways and limit the use of strongly coercive interventions. © 2021, The Author(s).

Background: Residents need to be trained across the boundaries of their own specialty to prepare them for collaborative practice. Intraprofessional learning (i.e. between individuals of different disciplines within the same profession) has received little attention in the postgraduate medical education literature, in contrast to the extensive literature on interprofessional learning between individuals of different professions. To address this gap, we performed a scoping review to investigate what and how residents learn from workplace-related intraprofessional activities, and what factors influence learning. Methods: The PRISMA guidelines were used to conduct a scoping review of empirical studies on intraprofessional workplace learning in postgraduate medical education published between 1 January 2000 to 16 April 2020 in Pubmed, Embase, PsycINFO, ERIC and Web of Science. This study applied ‘best fit’ framework-based synthesis to map the existing evidence, using the presage-process-product (3P) model developed by Tynjälä (2013). Results: Four thousand three hundred thirty records were screened, and 37 articles were included. This review identified influencing (presage) factors that derived from the sociocultural environment, learner and learning context. Studies described that complexity of care can both facilitate and hinder learning. Furthermore, intraprofessional learning is threatened by professional stereotyping and negative perceptions, and awareness of learning opportunities and explicit reflection are critical in intraprofessional workplace learning. Studies described a range of informal and formal intraprofessional activities (process) under the headings of collaboration in clinical practice, rotations or placements, formal educational sessions and simulated workplace training. In general, learners responded well and their attitudes and perceptions improved, learners reported increased knowledge and skills and positive behavioural changes (product). Learning outcomes were reported in the domains of patient-centred care, collaborative attitudes and respect, mutual knowledge and understanding, collaborative decision making, communication, leadership, teamwork and reflexivity. Conclusions: This review gives insight into the high learning potential of intraprofessional activities. Many of the included studies relied on self-reported perceptions of change, therefore, future research should focus on generating more robust evidence including objectively examined outcome measures. This review offers a comprehensive overview of the factors that influence intraprofessional workplace learning in postgraduate medical education. Finally, we provide recommendations for enhancing intraprofessional learning in clinical practice. © 2021, The Author(s).

Background: High attrition rate and nursing workforce shortage have been a prevailing world challenge. Professional commitment is a known key factor for attracting and retaining the nursing workforce. Objective: To design, implement and evaluate the impact of a one-week structured education program, underpinned by the exemplar education strategy, on the professional commitment of undergraduate nursing students. Design: A quasi-experimental study was designed with pre- and post-intervention measurements. The intervention was a structured, four module education program underpinned by the exemplar education strategy. Setting: Department of Nursing, Qianjiang College, Hangzhou Normal University, Zhejiang, China. Participants: 152 third-year nursing students who attended the education program and consented to participate were enrolled in the research. Methods: The intervention, the education program, was delivered over 16 h in one week of an 18-week semester. It was sequenced in four modules: expert lectures (3 h each), visiting a hospital (3 h), alumni salon (3 h), and submitting a reflection report (4 h). Professional commitment was measured by the Nursing Professional Commitment Scale (NPCS) administered both pre- and post-intervention. Results: The total professional commitment measurement score was significantly improved after the intervention. There were statistically significant differences before and after intervention in the four dimensions of professional commitment, namely, belief in goals and values, willingness to make an effort, desire to stay in the profession, and intrinsic positive value of work. Conclusion: The one-week professional education program underpinned by the exemplar education strategy effectively improved the level of professional commitment of the undergraduate nursing students. The program can be transferred into the curriculum to improve nursing students' professional commitment. The methodology can be applied in other aspects of nursing professional development. © 2021 Elsevier Ltd

The rapid development of advanced technology worldwide has promoted an increase in the need for highly skilled engineers who are adept at applying job-related technologies and have engineering competency (ENcom) to gain knowledge and introduce creative solutions. However, little is known about the underlying mechanism of the associations between ICT competencies related to work (ICT-Work) and the ENcom of engineering students. This study sought to examine the role of ICT-Work on ENcom. Based on the literature, self-esteem and self-regulated learning (SRL) were identified as factors that indicate the effect of ICT-Work on ENcom, while gender was identified as a moderator that conditioned these mediated relationships. The sample consisted of 1,313 undergraduate engineering students from eleven universities in Thailand. The results of structural equation modeling (SEM) showed positive direct and indirect effects of ICT-Work on ENcom, self-esteem, and SRL and confirmed that self-esteem and SRL mediate the impact of ICT-Work on ENcom. Moreover, multigroup SEM revealed no gender differences in the factor loadings and structural path coefficients of ICT-Work on ENcom via self-esteem and SRL. To prepare students for their professional lives in the digital world, educational institutions should emphasize the importance of developing engineering students in ICT-Work and the use of advanced ICT involved in the job. ©: © 2021 Buratin Khampirat. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

The study purpose was to examine perceived health education competencies among those responsible for planning, implementing, and evaluating health education programs. A total of 172 obesity prevention and nutrition education professionals in the United States completed a survey measuring their perceived competency to plan, implement, and evaluate nutrition education/obesity prevention education programs based on the National Commission for Health Education Credentialing health education competencies and their endorsement of various health education approaches. Using a series of multiple hierarchical regression models, we found that those trained in health education had greater perceived competency in assessing needs (B = 1.19, t = 2.11, p =.03), planning health education programs (B = 1.63, t = 2.96, p =.004), implementing health education programs (B = 1.00, t = 2.22, p =.03), evaluating health education programs (B = 4.85, t = 3.54, p =.001), and managing health education programs (B = 1.70, t = 2.21, p =.03) than those trained in nutrition or dietetics. Additionally, those trained in health education were more likely to endorse the use of a skill-based approach to obesity prevention (B = 0.25, t = 2.53, p =.01) and less likely to endorse teaching facts and information (B = 0.24, t = 1.99, p =.05) than those trained in nutrition or dietetics. These results have implications for improving the effectiveness of health education and promotion programs and the professional preparation of health educators and dietitians alike. © 2018 Society for Public Health Education.

Objective: The objective of the current review is to examine the association between exposure to strategies or interventions to retain health workers in rural and remote areas of high-income countries and improved retention rates. Introduction: Attracting and retaining sufficient healthcare staff to provide adequate services for residents of rural and remote areas is an international problem. High-income countries have specific challenges in staffing remote and rural areas; despite the majority of the population clustering in large cities, a significant number of communities are in rural, remote or frontier areas which may be perceived as less attractive locations in which to live and work. Inclusion criteria: The review will consider studies that include health workers in high-income countries where participants have been exposed to interventions, support measures or incentive programs to increase retention or workforce length of employment or reduce turnover for health workers in rural and remote areas. Analytical observational studies, case-control studies, analytical cross-sectional studies, descriptive observational study designs, and descriptive cross-sectional studies published from 2010 will be eligible for inclusion. Methods: We will use the JBI methodology for reviews of risk and etiology. A range of databases will be searched. Two reviewers will screen, critically appraise eligible articles, and extract data from included studies. Data synthesis will be conducted, where feasible, with RevMan 5.3.5. A random effects model will be used to conduct meta-analyses. We will assess the certainty of the findings using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach. © 2020 THE JOANNA BRIGGS INSTITUTE.