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BACKGROUND: High burnout and low retention rates among trainee doctors threaten the future viability of the UK medical workforce. This study empirically examined factors that can sustain trainee doctors. METHOD: A total of 323 trainee doctors from 25 National Health Service (NHS) Trusts in England and Wales completed an online survey on their training and employment experiences. A mixed method approach was employed. RESULTS: Structural equation modelling revealed that perceived compassionate leadership of hospital senior leaders (CLSL) (i.e., doctors in senior clinical and management positions, and senior managers) is directly and negatively associated with trainee doctors' burnout and intention to quit. We propose the associations may be indirectly strengthened through two mediating pathways: increased psychological contract fulfilment (PCF) of training/organisational support and reduced worry about the state of the NHS; however, only the former is supported. The model can explain a substantial 37% of the variance in reported burnout and 28% of intention to quit among trainee doctors. Being a Foundation Year (FY) trainee was significantly associated with poor PCF and burnout. Rich qualitative data further elaborated on their experiences in terms of senior leaders' awareness of their training/working experiences, listening to and acting on. CONCLUSIONS: Active and demonstrable CLSL plays a vital role in trainee doctors' retention. It has both direct (through support) and indirect effects through improving trainee doctors' PCF to reduce burnout and intention to quit. This seems particularly valuable among FY doctors. Implications for the development and management of the medical workforce are discussed.
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This cross-sectional study uses a national data set of medical prescription claims to examine contraception service and workforce changes from January 2019 through December 2022 in the US.
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Anticoncepción , HumanosRESUMEN
As a part of the growing strand of employee-centered HRM research, employee well-being is suggested to be a key mechanism that may help to explain the relationship between HRM and performance. To investigate how an employee's well-being mediates the HRM-performance relationship, we distinguish between two types of well-being identified in prior work, happiness well-being and health well-being, and present arguments for differences in their effects on individual performance. Building on Job Demands-Resources (JDR) theory, we propose that happiness well-being positively mediates the relationship between perceived High-Performance Work Systems (HPWS) and individual task performance, while health well-being negatively mediates this focal relationship. Thus, happiness well-being fits the "mutual gains" perspective. In contrast, health well-being fits the "conflicting outcomes" perspective, and thus may be harmed by the HPWS to enhance the performance. We find partial support for our arguments in an analysis of longitudinal survey data of 420 participants spanning a total of four waves of data collection.