Quantifying hierarchy and dynamics in US faculty hiring and retention.

Faculty hiring and retention determine the composition of the US academic workforce and directly shape educational outcomes1, careers2, the development and spread of ideas3 and research priorities4,5. However, hiring and retention are dynamic, reflecting societal and academic priorities, generational turnover and efforts to diversify the professoriate along gender6-8, racial9 and socioeconomic10 lines. A comprehensive study of the structure and dynamics of the US professoriate would elucidate the effects of these efforts and the processes that shape scholarship more broadly. Here we analyse the academic employment and doctoral education of tenure-track faculty at all PhD-granting US universities over the decade 2011-2020, quantifying stark inequalities in faculty production, prestige, retention and gender. Our analyses show universal inequalities in which a small minority of universities supply a large majority of faculty across fields, exacerbated by patterns of attrition and reflecting steep hierarchies of prestige. We identify markedly higher attrition rates among faculty trained outside the United States or employed by their doctoral university. Our results indicate that gains in women's representation over this decade result from demographic turnover and earlier changes made to hiring, and are unlikely to lead to long-term gender parity in most fields. These analyses quantify the dynamics of US faculty hiring and retention, and will support efforts to improve the organization, composition and scholarship of the US academic workforce.

Recruiting women faculty through inclusive, family-friendly practices.

Recruitment of STEM faculty is biased against parents and caregivers. Specifically, women experience discrimination associated with childrearing and marriage. Underestimating the value of these candidates leads to a tremendous loss of talent. Here, we present a toolkit to facilitate the recruitment of talented women caregivers by providing guidelines for hiring.

A Healthcare-Academic Practice Partnership Program to Promote Student Nurse Readiness for Work.

Highly skilled new graduate nurses must be better prepared to face the clinical and professional challenges in today's healthcare environment. Compounding these challenges are the growing resignations of clinical faculty and experienced clinical nurses. Innovative programs are needed to bridge the knowledge-practice gap with opportunities to create pipelines to aid the future nursing workforce. A multihospital health system partnered with a local college of nursing to develop a Nursing Student Pipeline Program, which allows nursing students to perform select nursing tasks as employees of the health system. Fifty-six students have been hired to participate in the pilot program. Of the students eligible for hire and who completed the program, 24 are current employees with the healthcare system. Students, preceptors, and managers report the benefits of this program, including that participating in the program supports increasing readiness for practice upon graduation.

The impact of international health worker migration and recruitment on health systems in source countries: Stakeholder perspectives from Colombia, Indonesia, and Jordan.

INTRODUCTION: To address domestic shortages, high-income countries are increasingly recruiting health workers from low- and middle-income countries. This practice is much debated. Proponents underline benefits of return migration and remittances. Critics point in particular to the risk of brain drain. Empirical evidence supporting either position is yet rare. This study contributes to filling this gap in knowledge by reporting high-level stakeholders' perspectives on health system impacts of international migration in general, and active recruitment of health workers in specific, in Colombia, Indonesia, and Jordan. METHOD: We used a multiple case study methodology, based on qualitative methods integrated with information available in the published literature. RESULTS: All respondents decried a lack of robust and detailed data as a serious challenge in ascertaining their perspectives on impacts of health worker migration. Stakeholders described current emigration levels as not substantially aggravating existing health workforce availability challenges. This is due to the fact that all three countries are faced with health worker unemployment grounded in unwillingness to work in rural areas and/or overproduction of certain cadres. Respondents, however, pleaded against targeting very experienced and specialised individuals. While observing little harm of health worker migration at present, stakeholders also noted few benefits such as brain gain, describing how various barriers to skill enhancement, return, and reintegration into the health system hamper in practice what may be possible in theory. CONCLUSION: Improved availability of data on health worker migration, including their potential return and reintegration into their country of origin's health system, is urgently necessary to understand and continuously monitor costs and benefits in dynamic national and international health labour markets. Our results imply that potential benefits of migration do not come into being automatically, but need in-country supportive policy and programming, such as favourable reintegration policies or programs targeting engagement of the diaspora.

Increasing the number of nursing faculty: Evaluation of a university system workforce grant.

BACKGROUND: The University of Wisconsin System Incentive Grant, Nurses for Wisconsin: Learn, Teach, Lead (N4WI) was a workforce initiative to address the nursing faculty shortage at four universities and included funding nurses to their terminal degree, postdoctoral fellowships, and loan forgiveness for faculty hires. It also included professional development opportunities for awardees. PURPOSE: The purpose of the article is to disseminate the evaluation of N4WI and discuss the impact of the project. METHODS: Methods of evaluation included assessment of data points as well as qualitative information. FINDINGS: N4WI was successful in achieving its goal of increasing nursing faculty applicants and hires at the respective schools with total awardees numbering 54. DISCUSSION: As a result of N4WI and using it as a template, nursing organizations within the state collaborated to successfully pursue state funding to grow nursing faculty called Wisconsin Nurse Educator Program to benefit the 44 nursing programs in Wisconsin.

Recruitment and selection of community health workers in Iran; a thematic analysis.

BACKGROUND: In Iran, community health workers (CHWs) are selected and employed according to the instructions of the Ministry of Health (MOH). The present study aimed to investigate the views of different stakeholders regarding the selection criteria, as well as the competency of CHWs. METHODS: This study was conducted using a qualitative thematic analysis in Golestan Province, Iran. Data were collected using semi-structured interviews with managers, supervisors, CHWs, and common people in 2021. The interviews were recorded and then transcribed. To extract key themes, the six-step Brown model was used, which involved becoming acquainted with the data, meaningful organization of transcripts, extracting primary open codes, searching for themes in an iterative approach, theme extraction, defining themes, and preparing a report. The relationships between codes and sub-themes and themes were represented using ATLAS.ti version 8. RESULTS: Data saturation was achieved after interviewing 22 people. The extracted data included 340 open codes, two main sub-themes of "CHW effectiveness" and "CHW sustainability", and three main themes of "criteria for employing competent people", "barriers to employing competent people", and "identifying the barriers to employing competent people", according to the MOH instructions. CONCLUSION: In the present study, local hiring was one of the major challenges in the competency-based selection of CHWs. One of the most repeated codes was expanding the local hiring concept and its requirements. Since different regions of Iran have different climatic, economic, cultural, and social conditions, the selection and hiring criteria for CHWs should be tailored to the needs of the community.

Reimagining the Preceptor Role.

Preceptors are responsible for departmental specific orientation and shaping the development of the new graduate in the early weeks and months of their nursing career. Turnover of direct care nurses has increased at an alarming rate since the start of the pandemic and new graduate nurses continue to be in high demand, but the diminishing number of qualified preceptors presents a challenge. Innovative approaches are needed to make way for increasing the pace of hiring and onboarding new graduates. A group orientation approach was identified as an opportunity to redesign orientation for newly licensed registered nurses in an employer-based transition to practice nurse residency programs. Findings from the first cohort suggest that leaders, preceptors, direct care nurses, and new graduate orientees were satisfied with a group orientation model. Preparing novice nurses to enter practice requires organizational commitment and resources. Group orientation may be a useful approach to foster new graduate nurses' transition to practice and advance the preceptor role.

Closing the Workforce Staffing Chasm by Breaking Boundaries: Innovative Partnerships and Strategies Between Recruitment and Nursing.

As hospitals are experiencing a nursing shortage, nursing leaders must build innovative partnerships and strategies between nursing and recruitment to close the workforce gap. One large health care system was experiencing a high vacancy rate. To improve recruitment and retention efforts, nursing leaders partnered with the recruitment department and other key stakeholders to develop strategies. Together, they designed a candidate-centric recruiting and hiring process, designed innovative recruitment campaigns including recruiting former employed nurses, recruitment of traveling nurses into employees, increased graduate nurse recruitment efforts, and implementation of a registered nurse (RN) Ambassador program. The team improved work process efficiency for recruiters and candidates. Retention efforts focused on engaging nurses in the work environment, decreasing nurse leader workload to allow a focus on staff relationships, and improving exit processes in an effort to retain the nurse. The actual vacancy rate was as high as 20.9% in July 2021 to 8% in September 2022, indicating the system is closing the vacancy rate and nearing the goal of 5%.

Transition to Perioperative Specialty Practice: A Solution to RN Outward Migration.

Frontline nurses are exiting the workforce, fueling a crisis in health care. Years of chronic staffing shortages, trauma experienced during the COVID-19 pandemic, and faculty shortages resulting in lessened ability to produce new nurses are complicating the ability of hospitals and health systems to provide high-quality care at a time when hundreds of thousands of nurses are predicted to leave the profession. A solution to this problem, which may produce internal "churn," can also create the opportunity for an internal pipeline of transition to specialty practice-recovering nurses who otherwise might be lost. An influx of experienced nurses to the perioperative setting from medical/surgical, telemetry, emergency departments, and intensive care units provides a unique opportunity to fill critical vacancies for a department that traditionally hires less experienced nurses and has expected vacancies due to nurses of retirement age leaving. Key components of a transition to practice arising from the desire to leave stressful, traumatic bedside roles and seek "safer" and perceived less stressful clinical positions involve assessing and promoting resilience and demonstrating self-efficacy. Creating the right environment and offering an evidence-based training opportunity for experienced nurses in a specialty transition to practice can leverage years of experience and skill, support new skill acquisition, stem outward migration of nurses, and potentially salvage the careers of nurses who have contributed to the profession.

Introduction to the special issue on criterion measurement.

Criterion identification and measurement is often an afterthought in criterion-related validation research. Yet it is essential in determining what predictor measures to use in operational settings. Accordingly, this special issue discusses recent advances in addressing the "criterion problem" in U.S. military enlisted personnel selection and classification research. In this introductory paper, broad issues regarding criterion identification and measurement in the military and previous research on this topic are reviewed and subsequent papers, which address specific criterion issues and describe an unprecedented joint-service criterion project, are introduced.

Health professionals' licensing: the practice and its predictors among health professional hiring bodies in Ethiopia.

BACKGROUND: Evidence suggests that not all human resource departments have hired their facility staff based on federal licensing standards, with some hiring without an active license. This is common in some, if not all, parts of the country. The paucity of healthcare experts, high turnover rates, employee burnout, and challenges in training and development issues were all key recruiting challenges globally. OBJECTIVE: To assess the practice of health professionals' licensing and its predictors among hiring bodies in Ethiopia, March 24/2021-May 23/2021. METHODS: A cross-sectional study was conducted in privately and publicly funded health facilities throughout Ethiopia. For each region, a stratified sampling strategy was utilized, followed by a simple random sampling method. Documents from the recruiting bodies for health professionals were reviewed. A pretested structured questionnaire and document review tool were used to extract data confidentially. A descriptive analysis of the basic hiring body characteristics was conducted. Hiring body characteristics were analyzed in bivariate and multivariate logistic regression to identify factors associated with best health professionals licensing practice. Data management and analysis were conducted with Epi-Data version 4.4.3.1 and SPSS version 23, respectively. RESULTS: The analysis included 365 hiring bodies and 4991 files of health professionals (1581 from private and 3410 from public health organizations). Out of 365 hiring bodies studied, 66.3% practiced health professional licensing. A total of 1645 (33%) of the 4991 professionals whose files were reviewed were found to be working without any professional license at all. Furthermore, about 2733 (55%) have an active professional license, and about 603 (12%) were found to work with an expired license. Being a private facility (adjustedOR = 21.6; 95% CI = 8.85-52.55), obtaining supervision from a higher organ (adjustedOR = 19.7; 95%CI: 2.3-169.1), and conducting an internal audit (adjustedOR = 2.7; 95% CI: 1.15-6.34) were predictors of good licensing practice. CONCLUSIONS: The licensing of health practitioners was poorly practiced in Ethiopia as compared to the expected proclamation of the country. A system for detecting fake licenses and controlling revoked licenses does not exist in all regions of the country.

Growing Neonatal Advanced Practice Providers via Mentorship Can Fill the Need: Program Description and Tool Kit.

BACKGROUND: The need for neonatal advanced practice providers (APPs) has been described. Hospital training programs for neonatal physician assistants (PAs) have been developed by physicians. No publications exist about programs administered by neonatal APPs for both new graduate neonatal nurse practitioners (NNPs) and neonatal PAs. PURPOSE: The purpose of this work was to mentor, train, and hire neonatal APPs in a program administered by neonatal APPs. METHODS: We developed a 2-pronged approach to attract PAs and new graduate NNPs. Marketing strategies included receptions, information, and mentorship. A 12-month neonatal PA fellowship program included clinical mentorship and weekly didactics. Case-based presentations were provided by neonatal APPs, neonatologists, and allied professionals. The new graduate NNP program included clinical mentorship and monthly meetings with peer support, lectures, and case presentations. Neonatal APPs were clinical mentors. Team-building activities supported mentorship and collaboration among all care providers. FINDINGS: In less than 5 years, 10 PAs and 11 new graduate NNPs have been trained and hired, as well as experienced neonatal APPs hired for this regional neonatology program. For the first time in years, locum tenens neonatal APPs are not required. We have developed a "tool kit" of content, activities, exercises, and evaluations to support successful attainment of expected competencies. IMPLICATION FOR RESEARCH: Future studies can measure retention, satisfaction, and clinical outcomes. IMPLICATION FOR PRACTICE: A successful training program has been implemented to meet the growing demand. We support the values of integrity, collaboration, and equity to facilitate this successful paradigm shift among all neonatal professional team members.

Diversity Practices for Hiring the New Graduate Nurse.

A multistep selection process was established to assist in securing top talent while achieving diversity objectives for a nurse residency program. The selection process incorporated objective scoring tools, diverse panel interviews, unconscious bias training, and standardized interview questions to decrease unconscious and implicit bias. As a result, the entry-level nursing workforce has become more diversified by race, gender, age, and academic training.

Gender-based differences in letters of recommendation in applications for general surgery residency programs in Canada.

BACKGROUND: In Canada, residency programs do not have many objective measures for ranking candidates. Instead, ranking relies on subjective measures such as letters of reference, which can be affected by the genders of the writer and the applicant. Our study assesses letters of recommendation for a general surgery program in Canada to categorize differences in reference letters based on the genders of applicant and letter writer. METHODS: We assessed 215 reference letters from 51 general surgery candidates for systematic differences in the descriptors used for male and female applicants and differences based on male and female authorship. RESULTS: Female applicants were more often described as mature, pleasant and flexible. Male applicants were more often described as having initiative, completing research, earning awards and performing extracurricular activities. Female writers were more likely to highlight an applicant's interest, initiative, response to feedback, knowledge of their limits, flexibility, communication, achievement in research and awards, confidence and ability to be a good assistant. Significantly more female applicants had female letter writers, compared with male applicants. CONCLUSION: These differences may affect the acceptance of applicants based on their gender and the genders of people who recommend them. Future research is required to explore how these differences in how applicants are described may affect residency selection committees' perceptions and rankings of applicants.