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PubMed1995

A quarter-century of experience with career change education: an option for turning specialists into generalists.

The Physician Refresher program, now 25 years old, at the Medical College of Pennsylvania offers training to clinically inactive physicians. The authors examined the characteristics of program participants to determine whether specialists who took the program to prepare for a change to a primary care career made the intended change. Application data from all registrants between 1982 and 1993 were compared with data on previously reported groups from 1968-1975 and 1976-1981. Specialist registrants' subsequent practice activities were documented from the AMA Medical Directory and the American Board of Medical Specialties Directory; a telephone survey elicited their reasons for making or not making the career change to primary care. During the last decade of the program women registrants constituted 36% of the total; international medical graduates (IMGs) 43%; and clinically inactive physicians 38%. Specialists outnumbered those in primary care by two to one. Although 65% of specialists planned to switch to primary care, ultimately only 27% of the total did so; many, especially the IMGs, were serving the disadvantaged. Those who did not switch cited a variety of disincentives, including individual educational needs not met by a general refresher course. If the medical profession accepts the need to devise programs that "retool" specialists to provide primary care, those programs should be specifically designed to address the individual needs of the specialists involved. Concomitantly, the incentives to make the switch need to be enhanced.

Adult↗
PubMed1996

The University of Maryland Medical System invests in its community's minorities.

As a private, non-state-owned teaching hospital adjacent to a predominately low income African American community in Baltimore, the University of Maryland Medical System (hereafter called the Medical System) in partnership with the state's medical school has historically provided excellent medical care to the community's residents regardless of their ability to pay. Nevertheless, executive leadership recognized that the Medical System needed to be even more socially and economically responsible to the minority community by investing more of the system's resources in that community. Doing so would improve the economic strength of the community, and this strength would help the Medical System to continue to thrive and expand its business in Baltimore City. Therefore, in the late 1980s, the Medical System created a program that focuses on greater inclusion of minorities particularly African Americans, in personnel, construction, purchasing, and community outreach. In the area of personnel, recruitment efforts have focused on increasing the representation of minorities, particularly African Americans, in management and residency positions. The result has been the creation of a more supportive environment for minority personnel throughout the organization as well as for minority patients and vendors who have dealings with the medical system. In the area of construction, minority development efforts have included the establishment of a flexible bid-award policy and a partnership with the minority business community. As a result, total construction dollars spent with minority-owned firms increased from $2 million to $18 million over seven years, and the portion of these dollars spent with African American-owned firms increased sixfold. In the area of purchased goods and services, more creative approaches to improving minority participation have been necessary. These have included partnering minority distributors with major suppliers and literally assisting in the creation of new minority firms capable of effectively responding to the competitive marketplace. As a result, purchasing dollars spent with minority-owned firms increased from $1.5 million to $3.2 million in four years, and the portion of these dollars spent with African American-owned firms nearly tripled. In community outreach, a comprehensive program has emerged that includes education, career development, disease prevention, and health promotion activities. The Medical System has encountered many barriers to success in these efforts but fortunately has overcome many of them. This article outlines the methods the system has used to achieve its minority development goals, with particular emphasis on the difficult area of purchasing.

Baltimore↗
PubMed2002

Helping medical school faculty realize their dreams: an innovative, collaborative mentoring program.

Junior faculty wishing to achieve successful careers in academic medicine face many challenges. To facilitate faculty in their career development, the authors implemented and evaluated an innovative collaborative, or peer-group, mentoring program at their medical school. Based on Rogerian and adult learning principles, the program incorporated development of skills in key areas for career development, a structured values-based approach to career planning, and instruction in scholarly writing. The 80-hour program has so far been conducted twice over two academic years (1999-2001) with 18 faculty (50% women). Quantitative and qualitative methods were used in the evaluation. Program attendance was 89%. All participants completed a written academic development plan, an exercise they rated as valuable. They also completed an average of one to three manuscripts for publication. Evaluation data highlighted the critical nature of a supportive learning environment and the reasons participants chose to attend the program consistently. Key meaningful outcomes for most participants were: (1) identification of their core values; (2) a structured process of short- and long-term career planning based on these core values; (3) the development of close, collaborative relationships; (4) development of skills in such areas as gender and power issues, negotiation and conflict management, scholarly writing, and oral presentation, and (5) improved satisfaction linked to participants' decisions to remain in academic medicine. Participants developed a sense of personal transformation and empowerment. The authors conclude that collaborative mentoring offers a new approach to faculty development that addresses limitations of traditional approaches in a satisfying and cost-effective way.

Faculty, Medical↗
PubMed1989

Downsizing: how one hospital responded to decreasing demand.

However difficult, organizational downsizing will be a reality for many hospitals throughout the next decade. The experience of one hospital system is described in this case study for the purpose of sharing the lessons learned during the process.

Communication↗
PubMed1990

Helping postacute traumatically brain injured clients return to work: three case studies.

This paper presents three case studies of individuals who had sustained a severe brain injury and who are clients of a return to work programme emphasizing a supported employment approach. The case studies illustrate the types of interventions which are utilized, including job placement; job site and off-site training, advocacy, and compensatory strategies; and ongoing assessment and maintenance of social and productive gains in order to assist with job retention. The results of the case studies may be generalized to the population of brain injury survivors who require intensive and long-term intervention and support in order to return to employment.

Adult↗
PubMed1997

Vocational perspectives and neuromuscular disorders.

The present study analyses the actual occupational situation, vocational handicaps and past labour career of a group of about 1000 Dutch patients suffering from a neuromuscular disorder (NMD). On the basis of the likelihood of a substantial employment history and sufficient numbers of patients, four types of NMD were selected: dystrophia myotonica (DM), hereditary motor and sensory neuropathy, (HMSN), spinal muscular atrophy (SMA) and myasthenia gravis (MG). Results show that a labour career is in reach of most NMD patients, even for those with severe limitations. It is concluded that physical limitations seem not to be decisive in that respect. The loss of the quality of communication, the loss of mental abilities and the effect of the diseases on the facial expression, as with some DM patients, are also important for chances on the labour market. Though the labour participation of NMD patients tends to decrease after the age of 34, the availability of work adaptations makes it possible to prolong the labour career. Analysis of the actual work situation of NMD patients shows that both disorder-related limitations and work characteristics play an important role in the amount of physical work problems encountered. It is argued that physical labour has to be regarded as generally unsuitable for NMD patients. This has implications for the sort and level of education to be attained by NMD patients. Career counselling as a focus point for the choice of an educational programme may improve labour market opportunities as well as quality of employment of NMD patients. Allowing for and accepting the possible effects of the disorder in the work situation are considered to be important in respect to labour participation and work satisfaction of workers with NMD. Reducing time pressure demands and increasing the freedom to organize one's work, are measures to be given especial consideration.

Adult↗
PubMed1998

Integration into work of unemployed new immigrant women from single parent families.

In recent years, Israel has absorbed hundreds of thousands of people from the former USSR. For most of them the migration constituted a situation of weighty pressure arising from the changes and shocks encountered in all areas of life: on the emotional, family, social and employment levels. One of the most prominent among the new immigrants is the single-parent segment, which constitutes 13.6% (17,750 single-parent family units) of the immigrant population, headed in the great majority of cases by mothers. The employment situation is particularly severe in the segment, owing to their special family circumstances, which make it difficult for them to find suitable employment. The economic implications of this state of affairs are grave and frequently lead to poverty. This article describes a project for the integration into work of unemployed female immigrants by means of two parallel programmes: (1) workshop for job-seeking skills; (2) establishment and operation of a self-help group. Both of these programmes are backed by a social support network that took shape during the course of the project. The components of the programmes are described and the findings consequent to their operation are presented.

Acculturation↗
PubMed2003

Development of job-seeking ability in people with arthritis: evaluation of a pilot program.

Working Horizons is an intervention designed to prevent work disability by addressing the internal and external barriers faced by people with arthritis in their attempts to enter or maintain their positions in the employment arena. The aim of the pilot study was to determine whether Working Horizons influenced participants' self-efficacy and psychological well-being and to describe the experience of Working Horizons from the perspectives of participants and employment advisors (EAs). The study was a pre-test post-test design with an Intervention Group (n = 22) and Comparison Control Group (n = 22). Quantitative data were collected by self-completed questionnaires at baseline and at six-months follow-up. Qualitative data were collected via open questions on the questionnaires, interviews with a sub-sample of 10 participants, and a focus group with EAs at the end of the programme. Pilot data suggested that Working Horizons was effective in terms of increasing participants' job-seeking self-efficacy. In addition, the Intervention Group showed significant improvements on self-esteem and satisfaction with life. Qualitative findings confirmed that participants felt more 'confident' in relation to seeking employment, were more accepting of their condition, felt more positive and had greater awareness of the social model of disability. Participants valued the emotional and instrumental support provided by the EAs, who acted as successful 'work' role models. Interventions, such as Working Horizons, may be an effective means of addressing work disability, acting as a gateway to statutory services. The value of suitable role models in mentoring capacities was highlighted.

Adult↗
PubMed1995

Graduate education in health policy and management: the University of Massachusetts experience, 1978-1990.

For students in undergraduate and graduate programs in health policy and management, particularly those who wish to be trained as public-health-oriented generalist health administrators, as well as those charged with the responsibility of being their teachers, it is important to consider the trajectory, tensions, and rewards of a career in health policy and management. This article begins by examining what we have learned from earlier research and writing on health policy and management careers and then moves on to analyzing the career history and professional development of 40 graduates of the generalist health policy and management program at the University of Massachusetts School of Public Health. Finally, the article reaches some conclusions about career paths for generalist health administrators trained in at least one school of public health.

Adult↗
PubMed1997

The nurse manager as career coach.

The conventional wisdom has been that career coaching is an important part of the nurse manager's role. In the current stressful healthcare environment, nurse managers seem more than ever in need of direction in this area. This paper examines the nurse manager's traditional role as a career coach, identifies the problems the current environment poses for implementation of that role and, considers options for achieving the goal of supporting staff with career development.

Career Mobility↗