Foreign Healthcare Professionals in Germany: A Questionnaire Survey Evaluating Discrimination Experiences and Equal Treatment at Two Large University Hospitals.

OBJECTIVE: To identify facilitators and barriers and derive concrete measures towards better workplace integration of migrants working in the German healthcare sector. DESIGN: Two-centre cross-sectional quantitative online survey of experiences of discrimination among healthcare professionals with a migration history in two large German university hospitals. PARTICIPANTS: 251 participants fully completed the questionnaires. MAIN OUTCOME MEASURES: Experiences of discrimination and perception of inequality. RESULTS: Fifty-five percent of migrant health workers had had at least some command of German before arriving in Germany. Members of all professional groups surveyed expressed experiences of discrimination related to language, nationality, race/ethnicity, and sex/gender. The proportions of staff with experiences of discrimination by peers differed significantly among occupational roles, with nurses and technologists having the most experiences of discrimination. The perception of inequality was reported more frequently than experiences of discrimination and had a negative impact on workplace satisfaction. Specifically, the compulsion to compete was a frequent feeling stated by participants. CONCLUSION: The mechanisms of discrimination and structural inequality revealed by our survey could inform specific measures, for example at the management level, to increase workplace satisfaction and attract migrant health workers in the long term.

Process- and outcome evaluation of an orientation programme for refugee health professionals.

BACKGROUND: Refugee health professionals experience several barriers on their path to re-entering their original occupations in host countries. Several training programmes exist in order to address these barriers and enable a successful labour market integration.Objective: This study aims to evaluate a specific orientation programme for the labour market integration of refugee health professionals in Germany. The programme lasts three months and comprises three elements (German technical terminology language course, cross-cultural coaching and a job shadowing).Design: A mixed-methods design was implemented to evaluate the programme. To assess participants' skills improvement and satisfaction, self-developed questionnaires were used. For in-depth-evaluation of individual experiences, qualitative interviews were conducted at four time points (pre, half-time, post, follow-up) with both programme participants and programme providers about their experiences.Results: Participants described impacts on their personal situation and improvement of their language, professional and formal skills. Some participants also described negative effects mostly due to unsupervised shadowing. Additional barriers, such as cost of travel were identified as challenges for participation.Conclusion: Training programmes may affect language skills, professional skills and formal resources. However, programme providers need to anticipate negative effects and introduce actions for preventing negative outcomes. Moreover, programmes should be designed to reduce work-related fear and anxiety amongst participants.

Qualification programmes for immigrant health professionals: A systematic review.

BACKGROUND: Immigrant health professionals are a particularly vulnerable group in a host country's labour market, as they face several barriers when re-entering their occupations. International studies indicate that early interventions can increase the employability of immigrants. Qualification programmes are one of these early interventions that can support the re-integration of these health professionals into the labour market. The purpose of this review is to identify international qualification programmes for immigrant health professionals, analyse their content and evaluate their effectiveness. METHODS: Six international databases (PubMed, Web of Science, CINAHL, PsychInfo, EBSCO and ProQuest Social Sciences) were systematically searched. The search terms were identified using the PICOS-framework. The review was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Articles were screened independently by two authors and discussed. Studies included in the final synthesis were assessed with the Mixed Methods Appraisal Tool (MMAT) and Kirkpatrick's Training Evaluation Model. RESULTS: Out of 10,371 findings, 31 articles were included in the final synthesis. The majority of them were addressed to international health care professionals and doctors. Two of them were addressed to refugee doctors. Three types of programme elements were identified: teaching, clinical practise and social support. The programmes' length ranged from 2 days to up to 2.5 years. Despite recommendations in its favour, pre- and post-programme support was scarce. Results also indicate a lack of transparency and quality in terms of evaluation. Effectiveness was mostly observed in the area of language improvement and an increase in self-confidence. CONCLUSION: This review points out the lack of systematically evaluated qualification programmes for immigrant health professionals. Programme providers should focus on implementing programmes for all health professionals as well as for underrepresented groups, such as refugees. In order to generate best practises it is necessary to evaluate these programmes. This requires the development of appropriate instruments when working with immigrant population in the context of educational programmes.