PA and NP onboarding in primary care: The participant perspective.

OBJECTIVE: To describe new graduate physician associate/assistant (PA) and NP perspectives of onboarding programs in their first primary care position. METHODS: Thirteen semistructured interviews were conducted with new graduate PAs and NPs who participated in onboarding programs. Interviews were transcribed and then analyzed using an inductive coding methodology. RESULTS: Analyses revealed nine thematic concepts that are described in two frameworks. Structural components are improving competence, training on the electronic health record (EHR), promoting mentorship, orienting to organizational dynamics, tailoring ramp-up of patient scheduling, clarifying expectations, and providing clear organizational support. Psychosocial factors are creating comfort and building self-confidence. DISCUSSION: The results describe and delineate important components for onboarding that administrators can incorporate into existing and future programs. CONCLUSION: Understanding participants' experiences with onboarding programs is essential for ensuring successful transition to practice for new graduate PAs and NPs.

WOMENtorship: The #WomenInMedicine perspective.

Mentorship is essential for career development, personal development, and job satisfaction for physicians in academic medicine. Women in academic medicine face unique challenges including significant gender disparities in positions of leadership as well as difficulty finding mentors. As leaders in academic medicine, we have collated several structured recommendations for physicians of both genders seeking to be better mentors to female trainees and early career physicians. We discuss each of these recommendations in detail including the following: acknowledging your own strengths and limitations as a mentor, addressing issues of work-life integration, helping your mentee set long-term career goals, and acting as a sponsor as well as a mentor. We hope these suggestions are helpful for current and aspiring mentors and provide a platform to improve career development for female physicians and reduce gender inequities in academic medicine.

"They do not see us as one of them": a qualitative exploration of mentor mothers' working relationships with healthcare workers in rural North-Central Nigeria.

BACKGROUND: In HIV programs, mentor mothers (MMs) are women living with HIV who provide peer support for other women to navigate HIV care, especially in the prevention of mother-to-child transmission of HIV (PMTCT). Nigeria has significant PMTCT program gaps, and in this resource-constrained setting, lay health workers such as MMs serve as task shifting resources for formal healthcare workers and facility-community liaisons for their clients. However, challenging work conditions including tenuous working relationships with healthcare workers can reduce MMs' impact on PMTCT outcomes. This study explores the experiences and opinions of MMs with respect to their work conditions and relationships with healthcare workers. METHODS: This study was nested in the prospective two-arm Mother Mentor (MoMent) study, which evaluated structured peer support in PMTCT. Thirty-six out of the 38 MMs who were ever engaged in the MoMent study were interviewed in seven focus group discussions, which focused on MM workload and stipends, scope of work, and relationships with healthcare workers. English and English-translated Hausa-language transcripts were manually analyzed by theme and content in a grounded theory approach. RESULTS: Both intervention and control-arm MMs reported positive and negative relationships with healthcare workers, modulated by individual healthcare worker and structural factors. Issues with facility-level scope of work, workplace hierarchy, exclusivism and stigma/discrimination from healthcare workers were discussed. MMs identified clarification, formalization, and health system integration of their roles and services as potential mitigations to tenuous relationships with healthcare workers and challenging working conditions. CONCLUSIONS: MMs function in multiple roles, as task shifting resources, lay community health workers, and peer counselors. MMs need a more formalized, well-defined niche that is fully integrated into the health system and is responsive to their needs. Additionally, the definition and formalization of MM roles have to take healthcare worker orientation, sensitization, and acceptability into consideration. TRIAL REGISTRATION: Clinicaltrials.gov number NCT01936753 , registered September 3, 2013.

Promoting Health Through Policy and Systems Change: Public Health Students and Mentors on the Value of Policy Advocacy Experience in Academic Internships.

Emerging professionals and new Certified Health Education Specialists often lack academic training in and actual experience in National Commission for Health Education Credentialing Area of Responsibility VII: Communicate, Promote, and Advocate for Health, Health Education/Promotion, and the Profession. For undergraduate and graduate students who have an opportunity to complete an internship or practicum experience, gaining experience in Competencies 7.2: Engage in advocacy for health and health education/promotion and 7.3: Influence policy and/or systems change to promote health and health education can have a profound impact on their career development and their ability to advocate for policies that promote health and health equity. Compelling evidence suggests that interventions that address social determinants of health such as poverty and education and those that change the context through improved policy or healthier environments have the greatest impact on public health, making it vital for emerging public health professionals to gain experience in policy advocacy and systems change. In this commentary, students and faculty from two large universities in the U.S.-Mexico border region reflect on the value of policy advocacy in academic internship/fieldwork experiences. Based on their experiences, they highly recommend that students seek out internship opportunities where they can participate in policy advocacy, and they encourage university faculty and practicum preceptors to provide more opportunities for policy advocacy in both classroom and fieldwork settings.

Rural Mentorships in Health Care: Factors Influencing Their Development and Sustainability.

BACKGROUND: The need to recruit and retain health care providers remains a concern in rural communities. This project aimed to better understand what health care providers and senior leaders value in mentorship and determine the best way to implement a mentorship program in rural western Canada. METHOD: Health care providers and senior leaders from a rural health region were recruited through convenience and snowball sampling. Participants were interviewed using a semistructured interview guide, and data were analyzed using thematic analysis. RESULTS: Two main themes were revealed: rural mentorship challenges and facilitators. Challenges included administrative, scope of practice, and interpersonal, whereas facilitators included mentorship as a recruitment and retention strategy, openness and commitment, structured mentorship programs, and community influence. CONCLUSION: This information will enable administrators and educators to more successfully implement mentorship programs for a variety of health care professionals working within rural environments and facilitate staff development, recruitment, and retention. J Contin Educ Nurs. 2018;49(7):322-328.

Creating a Path: How Mentoring Can Help.

Mentoring exists in formal and informal processes in many areas of nursing practice. This article explores the mentoring relationship between the two editors of this column. J Contin Educ Nurs. 2017;48(5):201-202.

From Transition Shock to Competent Practice: Developing Preceptors to Support New Nurse Transition.

BACKGROUND: It is well known that new graduate nurses (NGRNs) are likely to have a difficult transition from nursing school into professional practice and often experience a phenomenon known as transition shock. Evidence suggests using preceptors as an effective method supporting the NGRNs through this difficult transition. METHOD: This project evaluated the effectiveness of a structured preceptor development program by measuring perceptions of transition to practice and first-year retention of two groups of former graduate nurses-the first comprising preceptors trained through a preceptor development program, and the second comprising preceptors who did not participate in structured training. RESULTS: Graduate nurses who had well-trained preceptors had higher, more positive perceptions about their ability to render safe and optimal care, as well as higher first-year retention. CONCLUSION: A structured preceptor-training program may contribute to an improved transition to practice and improved first-year retention rates of NGRNs.

Mentoring relationships of New Zealand nurses: results of an empirical study (Part 2).

The first national study of mentoring relationships of New Zealand nurses used three issues from the descriptive literature as its conceptual framework. The results and discussion of the study are reported in part two. Results demonstrated that moderate levels of mentoring according to Kram's (1985) typology occurred amongst nurses and that they had many supportive relationships, mainly with women who were peers. The characteristics of nurses' mentoring relationships did not differ significantly from mainstream empirical data when factors such as gender, organisational status, age differences and duration of relationships were considered. Concerns about the future direction of mentoring research and in particular about recent international literature calling for the development of a separate mentoring theory for women conclude the article.