Predicting the effect of extrinsic and intrinsic job satisfaction factors on recruitment and retention of rehabilitation professionals

The purpose of this study was to ascertain which extrinsic and intrinsic job satisfaction areas are most predictive of rehabilitation professionals' career satisfaction and desire to stay on the job. This article discusses the results of a survey conducted on practicing occupational therapists, physical therapists, and speech-language pathologists regarding factors that contribute to career satisfaction and desire to stay on the job. Five hundred surveys were mailed to each profession; 463 were returned, of which 328 were able to be analyzed. Results from regression analysis showed that intrinsic factors such as professional growth and having a work environment in line with personal values are more significant in predicting career satisfaction than are extrinsic factors such as pay and continuing education. These same intrinsic factors are also significant in predicting the rehabilitation professional's desire to stay on the job. These findings are significant to healthcare managers desiring to recruit and retain qualified occupational therapists, physical therapists, and speech-language pathologists. In addition to extrinsic benefits such as pay, healthcare managers need to focus on provision of intrinsic factors such as opportunities for professional growth, recognition of accomplishments, and opportunities for departmental input to motivate rehabilitation professionals.     

Retention of allied health professionals in rural new south Wales: a thematic analysis of focus group discussions

ABSTRACT: BACKGROUND: Uneven distribution of the medical workforce is globally recognised, with widespread rural health workforce shortages. There has been substantial research on factors affecting recruitment and retention of rural doctors, but little has been done to establish the motives and conditions that encourage allied health professionals to practice rurally. This study aims to identify aspects of recruitment and retention of rural allied health professionals using qualitative methodology. METHODS: Six focus groups were conducted across rural NSW and analysed thematically using a grounded theory approach. The thirty allied health professionals participating in the focus groups were purposively sampled to represent a range of geographic locations, allied health professions, gender, age, and public or private work sectors. RESULTS: Five major themes emerged: personal factors; workload and type of work; continuing professional development (CPD); the impact of management; and career progression. 'Pull factors' favouring rural practice included: attraction to rural lifestyle; married or having family in the area; low cost of living; rural origin; personal engagement in the community; advanced work roles; a broad variety of challenging clinical work; and making a difference. 'Push factors' discouraging rural practice included: lack of employment opportunities for spouses; perceived inadequate quality of secondary schools; age related issues (retirement, desire for younger peer social interaction, and intention to travel); limited opportunity for career advancement; unmanageable workloads; and inadequate access to CPD. Having competent clinical managers mitigated the general frustration with health service management related to inappropriate service models and insufficient or inequitably distributed resources. Failure to fill vacant positions was of particular concern and frustration with lack of CPD access was strongly represented by informants. CONCLUSIONS: While personal factors affecting recruitment and retention of allied health study participants were similar to doctors, differences also existed. Allied health professionals were attracted by advanced work roles in a context of generalist practice. Access to CPD and inequitable resource distribution were strong 'push' factors in this group. Health policy based on the assumption of transferability between professions may be misguided.     

A longitudinal integrated placement and medical students' intentions to practise rurally

Medical Education 2012: 46 : 179–191 Context Integrated longitudinal rural placements are designed to promote favourable student attitudes towards and facilitate return to rural practice upon graduation. We explored the impact of an integrated placement on medical students’ attitudes towards rural practice. Methods Data were available from interviews with 10 medical students, 15 clinical supervisors and teachers, three community health staff, and focus groups made up of medical students. Socio‐cognitive career theory gave insight into the personal, contextual and experiential factors, as well as the career barriers, that influence students’ rural practice intentions. Framework analysis was used to develop a thematic framework illustrating the key findings. Results The longitudinal placement enabled students to achieve personal goals, and enhanced self‐efficacy beliefs and orientation towards the complex personal and professional demands of rural practice. The informal curriculum, including multifaceted interactions with patients and their families, clinical teachers and other health care staff, was a vital experiential component. Students assimilated these rich experiences into their practice and evolving notions of professional identity as rural practitioners. Some students had little intention of practising rurally, partly as a result of contextual barriers such as geographic isolation, family and relationship needs, restricted postgraduate training opportunities and limited opportunities for specialist practice. Conclusions The richness of the informal curriculum in a longitudinal rural placement powerfully influenced students’ intentions to practise rurally. It provided an important context for learning and evolving notions of professionalism and rural professional identity. This richness could be reinforced by developing formal curricula using educational activities based around service‐led and interprofessional learning. To overcome the contextual barriers, the rural workforce development model needs to focus on socialising medical students into rural and remote medicine. More generic issues include student selection, further expansion of structured vocational training pathways that vertically integrate with longitudinal rural placements and the maintenance of rurally focused support throughout postgraduate training.     

Why do junior doctors not want to work in a rural location,and what would induce them to do so?

Objective: Identify the most important factors associated with choosing rural medical practice. Design: Cross‐sectional design using a web survey to collect quantitative and qualitative data. Participants: One hundred and ninety junior doctors – 91 interns, 99 PGY2. Main outcome measures: Choice of practice location (urban/rural), reason for choosing location, enticement to a rural location. Results: Twenty‐seven per cent of junior doctors preferred a rural practice location. Preference to practice in a rural area was associated with medical placement bonding schemes, rural background, rural placement experience and being older. High levels of professional expectations and prestige were associated with a preference for an urban location. The most important reasons for choosing a practice location included consideration of partner, family and friends (35.3%), preference for a location (20.5%), lifestyle goals (19.5%) and career opportunities, specialty requirements and infrastructure (17.9%). Those who preferred an urban compared with a rural location gave more importance to factors concerning partner, family and friends. The factors that would entice a doctor to a rural location included partner and family considerations (27.0%), professional support (20.3%), and career opportunities, specialty requirements and infrastructure (16.3%). Women gave more importance to partner and family factors than men. Conclusions: Our findings support the continuation of policies that are known to encourage choice of rural practice, but highlight the need for additional strategies that consider the personal and professional needs of this generation of doctors.     

Recruitment and retention issues for occupational therapists in mental health: Balancing the pull and the push

Background/aim: Recruitment and retention issues for mental health occupational therapists have been the subject of significant concern for many years. This paper describes recruitment and retention issues as reported by mental health occupational therapists employed by a large Area Health Service in metropolitan Sydney. Method: Thirty‐eight mental health occupational therapists (response rate 84%) completed a survey in the first half of 2008. Key themes investigated were: overall satisfaction; attractive elements of positions; positive aspects of positions; constraints of positions; factors associated with leaving positions; supervision; professional development; career pathways; and interest in and access to management positions. Results: Key elements that kept respondents in positions included the nature of the work, being in a supportive team and the opportunity to use occupational therapy skills. Elements that prompted people to consider leaving positions were the desire for new and different types of work, a desire to work closer to home, insufficient time or high workloads, feeling ‘bored’ or ‘stale’, organisational change or juggling multiple demands, working in unsupportive or dysfunctional teams and family or other personal factors. Conclusions: The results supported the development of a ‘push and pull’ conceptualisation of recruitment and retention issues, including job‐related (intrinsic) and non‐job‐related (extrinsic) issues. This conceptualisation allows organisations to closely examine factors that attract practitioners to positions and those that support or damage staff tenure.     

Choosing to practice in rural dietetics: What factors influence that decision?

OBJECTIVE: The present study aimed to identify those factors that influence the decision of a dietitian to consider working in a rural area. DESIGN: A qualitative design using focus groups was chosen for this study to allow for in-depth data to be obtained. SETTING: University of Newcastle, Callaghan Campus. SUBJECTS: Twenty-three students/new graduates from the Bachelor of Health Science (Nutrition and Dietetics) degree at the University of Newcastle. MAIN OUTCOME MEASURES: Not applicable, this project was an exploratory study. RESULTS: A number of factors that influence the decision of dietetic students and newly graduated dietitians to consider working in a rural area were identified. These fell into the following main thematic areas: job prospects; rural lifestyle; comfort zones; support networks; promotion opportunities/professional development; type of work/work role; rural needs; and time frame. CONCLUSIONS: The present study found that choosing a location to work (whether it be a rural one or not) is a complex process and involves a number of interacting factors. Also those factors that may influence one dietitian to choose a career in a rural area may also be the factors that influence another dietitian not to choose a career in a rural area.     

Faculty development: a ‘Field of Dreams’?

Objectives  Participants in faculty development workshops often comment that 'those who need faculty development the most attend the least'. The goals of this study were to explore the reasons why some clinical teachers do not participate in centralised faculty development activities and to learn how we can make faculty development programmes more relevant to teachers' needs.
Methods  In 2006, we conducted focus groups with 16 clinical teachers, who had not participated in faculty development activities, to ascertain their perceptions of faculty development, reasons for non-participation and perceived barriers to involvement. Content analysis and team consensus guided the data interpretation.
Results  Focus group participants were aware of faculty development offerings and valued the goals of these activities. Important reasons for non-participation emerged: clinical reality, which included volume of work and lack of (protected) time; logistical issues, such as timing and the central location of organised activities; a perceived lack of financial reward and recognition for teaching, and a perceived lack of direction from, and connection to, the university.
Conclusions  Clinical reality and logistical issues appeared to be greater deterrents to participation than faculty development goals, content or strategies. Moreover, when asked to discuss faculty development, teachers referred to their development as faculty members in the broadest sense, which included personal and career development. They also expressed the desire for clear guidance from the university, financial rewards and recognition for teaching, and a sense of 'belonging'. Faculty development programmes should try to address these organisational issues as well as teachers' personal and professional needs.     

Factors affecting the recruitment and retention of pharmacists to practice sites in rural and remote areas of New South Wales: a qualitative study

OBJECTIVE: To explore factors affecting recruitment and retention of pharmacists in rural/remote areas of New South Wales (NSW). DESIGN: Qualitative semistructured in-depth interviews. SETTING: Primary care--rural/remote community pharmacies. PARTICIPANTS: Purposive sample of 12 community pharmacists. MAIN OUTCOME MEASURES: Factors affecting recruitment and retention of pharmacists in rural/remote areas of NSW. RESULTS: Respondents reported a variety of personal and professional reasons for taking up rural practice, including previous rural experience and a preference for working in rural over metropolitan areas. The main factor affecting retention in rural areas was the high level of professional satisfaction and interprofessional rapport. Perceived reasons for the current under-supply of pharmacists to rural/remote areas of NSW included changing demographics of the pharmacy undergraduate degree programs and pharmacy workforce, and negative perceptions of rural pharmacy practice and rural lifestyle. CONCLUSIONS: This study identified factors believed to affect recruitment and retention of pharmacists in rural/remote areas. There appears to be considerable overlap between the factors, with different weightings of importance for different individuals. The lack of consensus for a proposed method of resolving this problem highlights its complexity and the need for further studies in this area.     

Personal-professional boundary issues in the satisfaction of rural clinicians recruited from within the community: findings from an exploratory study

Objective: The objective of this paper is to highlight, from within a broad study of recruitment/retention, findings that identify personal–professional boundaries as key challenges for rural child and youth mental health clinicians recruited from within the community. Design: Two mixed methods online questionnaires followed by semistructured telephone interviews with a small subset of respondents were administered to clinicians, team leaders, supervisors and managers whose practice responsibilities encompass rural settings in three regions of British Columbia, Canada. Participants: Forty‐four clinicians and 27 team leaders/managers participated in the survey while eight clinicians and one team leader/manager participated in the semistructured interviews. Half the clinician respondents were recruited from within the community. Of those recruited from outside the community, half had prior experience living or working in a rural community. Main outcome measures: Levels of satisfaction with lifestyle, practice and preparation for practice were compared across categories of respondents identified earlier. Open‐ended comments were coded by theme and also compared across categories of respondents. Results: While expressing their higher levels of satisfaction with rural lifestyle and professional practice, clinicians recruited from within rural communities report significant initial and ongoing stress related to personal–professional boundaries and dual relationships. They also report lower levels of satisfaction with orientation and preparation for practice relevant to dealing with these stressors. Conclusion: Prior attachment to rural communities, increasingly viewed as an effective recruitment and retention strategy, requires better preparation and ongoing supports to enable practitioners to deal with dual relationships and the personal–professional boundary issues that are a direct consequence of their attachments.     

Attraction and retention of qualified health workers to rural areas in Nigeria: a case study of four LGAs in Ogun State, Nigeria

INTRTODUCTION: A shortage of health workers is a major problem for Nigeria, especially in rural areas where more than 70% of the population live. At the primary care level, trained community health officers provide services normally reserved for doctors or medical specialists. The community health officers must therefore be supported and motivated to provide effective quality healthcare services. This study aimed to determine factors that will attract and retain rural and urban health workers to rural Nigerian communities, and to examine differences between the two groups. METHODS: A cross-sectional survey measured health workers' work experience, satisfaction with, and reasons for undertaking their current work; as well as reasons for leaving a work location. Data were also gathered on factors that attract health workers to rural settings and also retain them. RESULTS; Rural health workers were generally more likely to work in rural settings (62.5%) than their urban counterparts (16.5%). Major rural motivators for both groups included: assurances of better working conditions; effective and efficient support systems; opportunities for career development; financial incentives; better living conditions and family support systems. The main de-motivator was poor job satisfaction resulting from inadequate infrastructure. Rural health workers were particularly dissatisfied with career advancement opportunities. More urban than rural health workers expressed a wish to leave their current job due to poor job satisfaction resulting from poor working and living conditions and the lack of career advancement opportunities. CONCLUSIONS: Motivational factors for attraction to and retention in rural employment were similar for both groups although there were subtle differences. Addressing rural health manpower shortages will require the development of a comprehensive, evidence-based rural health manpower improvement strategy that incorporates a coordinated intersectoral approach, involving partnership with a range of stakeholders in rural health development.     

Professional and social support networks of rural general practitioners

ABSTRACT: This study explored the nature of rural general practitioners' (GPs) professional and personal support networks. A qualitative design was employed, using in-depth interviews with a diverse sample of GPs in rural Queensland. The support network of the rural GPs in this study incorporated the domains of clinical, workforce and social support, with clinical support as the most important domain. There was a preference for face-to-face contact wherever possible. Such contact was particularly important in the process of developing the network and for personal support. Despite this, many network contacts were by telephone out of necessity. There were few notable differences between male and female rural GPs on the issues explored in the present study. General Practitioners' satisfaction with their professional interactions was varied across the sample. The findings suggest that level of satisfaction may be associated with intentions to leave or stay for this group.     

What are the motivating and hindering factors for health professionals to undertake new roles in hospitals? A study among physicians,nurses and managers looking at breast cancer and acute myocardial infarction care in nine countries

BackgroundMany European countries experience health workforce skill-mix changes due to population ageing, multimorbidity and medical technology. Yet, there is limited cross-country research in hospitals.MethodsCross-sectional, observational study on staff role changes and contributing factors in nine European countries. Survey of physicians, nurses and managers (n = 1524) in 112 hospitals treating patients with breast cancer or acute myocardial infarction. Group differences were analysed across country clusters (skill-mix reform countries [England, Scotland and the Netherlands] versus no reform countries [Czech Republic, Germany, Italy, Norway, Poland and Turkey]) and stratified by physicians, nurses and managers, using Chi-squared, Mann-Whitney U and Kruskal Wallis tests.ResultsNurses in countries with major skill-mix reforms reported more frequently being motivated to undertake a new role (66.5%) and having the opportunity to do so (52.4%), compared to nurses in countries with no reforms (39.2%; 24.8%; p < .001 each). Physicians and nurses considered intrinsic motivating factors (personal satisfaction, use of qualifications) more motivating than extrinsic factors (salary, career opportunities). Reported barriers were workforce shortages, facilitators were professional and management support. Managers’ recruitment decisions on choice of staff were mainly influenced by skills, competences and experience of staff.ConclusionManagers need to know the motivational factors of their employees and enabling versus hindering factors within their organisations to govern change effectively.     

GETTING THE BALANCE RIGHT? GPS WHO CHOSE TO STAY IN RURAL PRACTICE

Background: Despite major challenges to the retention of rural GPs in Australia, little is known about why some rural GPs stay long‐term within their communities. Method: A group of rural GPs interviewed as part of another study about 10 years ago were re‐interviewed to explore their attitudes to their reasons for staying. Results: Eighteen of the original group of 23 could be contacted and 13 were interviewed. Factors that appeared to promote staying in rural practice were: strong attachment to the community; and practice arrangements that allow for adequate time off‐call and for holidays. However, several GPs were stressed and some had considered leaving. The stressors were similar to those identified in earlier research, including overwork and having to send children to boarding school. Conclusion: Personal and professional support arrangements within the community appear to be associated with decisions by rural GPs to remain in practice for substantial periods of time. Retention strategies should focus on facilitation of local integration. What is already known: Some doctors stay for prolonged periods of time in rural practice, although most leave after a few months or years. The reasons why rural doctors stay have until now not been explored. What this study adds: Rural doctors who stay for prolonged periods of time, defined in this study as 10 or more years, have established personal and professional support networks that have provided protection from the more negative aspects of rural professional life.     

农村订单定向医学生基层执业意愿及影响因素分析——以云南省为例

目的:以云南省为例,分析农村订单定向医学生的基层长期执业意愿及影响因素,为促进订单定向医学生基层长期执业提供依据。方法:采取分层整群抽样方法,对云南省3所高等院校的1 673名农村订单定向医学生进行问卷调查,内容包括个人基本情况、政策认知和态度、报考动因、执业意愿等,共收集有效问卷1 613份。采用多重响应、卡方检验、二元Logistic回归等方法进行数据分析。结果:83.51%的医学生了解免费培养政策, 87.85%的医学生支持免费培养政策,仅有35.46%的医学生愿意在基层长期执业;就读年级、政策认知、政策态度、为家乡人民服务、想当全科医生、个人职业发展有限、个人婚姻问题、工作待遇低等变量对订单定向医学生基层长期执业意愿有显著影响。结论:订单定向医学生扎根基层的长期执业意愿不强。应基于人才培养定位,强化专业认同培养,重视职业素质培育,创建良好职业发展环境。     

我国农村基层卫生人才队伍建设的现状、问题及建议

目前,农村基层医疗卫生工作取得了较大的进展,但是仍然缺乏一支稳定、专业的卫生人才队伍。与城镇相比,农村基层卫生人才数量不足、专业水平低、接受培训与实际需求脱节、流动性强等问题的存在,使得农村医疗服务质量难以提高,人才问题依然是制约农村卫生服务发展的瓶颈。本文分析了农村基层卫生人才的现状、存在的问题及其成因,并建议从人力资源管理的各个环节出发建设一支高素质的农村基层卫生人才队伍,既要从招聘、培训的角度来吸引人才、提升人才素质,又要从薪酬、考核的角度来激励人才、留住人才,最后还要为基层卫生人才提供一个良好的职业发展通道,让他们能在农村实现自我的价值。     

Staff satisfaction. Down the line

A survey of 34,400 staff in 59 London trusts found general dissatisfaction with pay but satisfaction with immediate managers, equal opportunities and communications. A good working relationship with an immediate manager emerged as key to feeling valued. The better the communications in a trust, the more staff felt valued. Forty-two per cent of respondents--14,000 people--did not have a personal development plan and had not had an appraisal, leaving them outside major career development systems. This left them dissatisfied.     

Faculty development: if you build it,they will come

Medical Education 2010: 44 : 900–907 Objectives The goals of this study were three‐fold: to explore the reasons why some clinical teachers regularly attend centralised faculty development activities; to compare their responses with those of colleagues who do not attend, and to learn how we can make faculty development programmes more pertinent to teachers’ needs. Methods In 2008–2009, we conducted focus groups with 23 clinical teachers who had participated in faculty development activities on a regular basis in order to ascertain their perceptions of faculty development, reasons for participation, and perceived barriers against involvement. Thematic analysis and research team consensus guided the data interpretation. Results Reasons for regular participation included the perceptions that: faculty development enables personal and professional growth; learning and self‐improvement are valued; workshop topics are viewed as relevant to teachers’ needs; the opportunity to network with colleagues is appreciated, and initial positive experiences promote ongoing involvement. Barriers against participation mirrored those cited by non‐attendees in an earlier study (e.g. volume of work, lack of time, logistical factors), but did not prevent participation. Suggestions for increasing participation included introducing a ‘buddy system’ for junior faculty members, an orientation workshop for new staff, and increased role‐modelling and mentorship. Conclusions The conceptualisation of faculty development as a means to achieve specific objectives and the desire for relevant programming that addresses current needs (i.e., expectancies), together with an appreciation of learning, self‐improvement and networking with colleagues (i.e., values), were highlighted as reasons for participation by regular attendees. Medical educators should consider these ‘lessons learned’ in the design and delivery of faculty development offerings. They should also continue to explore the notion of faculty development as a social practice and the application of motivational theories that include expectancy–value constructs to personal and professional development.     

九家医院老年科医务人员工作满意度影响因素分析

目的 分析北京市九家医院老年科医务人员的工作满意度情况及其影响因素,通过调查所显示的问题和结论为医院管理者提供改进管理意见,使老年科医务人员队伍可持续发展.方法 从老年科医务人员的背景因素、对老年工作的职业态度、工作状态、报酬和待遇、成长和职业发展五个维度设计老年科医务人员工作满意度调查问卷,对北京市九家市属医院的老年科医务人员进行随机调查,使用SPSS软件对收集的问卷进行统计分析,运用逐步回归分析法找到工作满意度的影响因素.结果 对总收入的感受、对老年科职业热爱程度、工作压力感觉、单位提供增加新经验和成长的机会、工作中的人文关怀、院领导对老年科工作的重视程度、是否有子女、家人对从事老年科工作所持态度等八个方面,是影响老年科医务人员工作满意度的因素.结论 医院相关管理人员需要针对这八个方面采取干预措施,以期老年科医务人员能够获得更多的工作满足感,从而提高工作效能,使老年科医务人员队伍能够健康有序地发展.