Nursing labor supply in Iran: a survey in Shiraz public hospitals in 2022.

BACKGROUND: The labor supply of nurses, as one of the main healthcare workers, is an important issue in health human resources planning in all health systems. Finding the factors affecting it, could help policymakers to solve the shortage of nursing work supply. The present study aimed to investigating the quantity and factors affecting the nurses' labor supply in Iran. METHOD: In this cross-sectional study, a sample of 598 nurses working in public hospitals of Shiraz (Iran) were selected via proportionate stratified random sampling method. The required data was collected using a structured questionnaire which asked working hours and other related factors. To analyze the data, descriptive statistics, univariate analysis and multivariate linear regression were performed using STATA 15. The multivariate labor supply model was estimated separately for married and single nurses.  RESULTS: The average weekly working hours of nurses was 54.65 h in all medical centers and 50.28 h in the main hospital. The regression results showed that the labor supply of nurses with work experience (ß = - 0.368, P = 0.014), satisfaction with work shift arrangement (ß = - 2.473, P = 0.001), income between 60-89 million rial (ß = - 14.046, P = 0.002), income between  90-119 million rial(ß = - 12.073, P = 0.012), and working in the emergency department (ß = - 5.043, P = 0.017) had negative and significant relationship; But there was a positive and significant relationship with satisfaction of the work environment (ß = 1.86, P = 0.011), workload at work (ß = 1.951, P = 0.023) and employment status (contractual employees) (ß = 4.704, P = 0.004). CONCLUSION: The labor supply function of nurses is affected by demographic, economic and non-economic factors. The most contributing factors were related to non-economic variables. It seems that the non-financial cost and benefits related to the job as well as internal factors have more important role on the nurses' labor supply.

Workforce survey of Australian health information management graduates, 2017-2021: A 5-year follow-on study.

Background: Employment outcomes of La Trobe University's 2012-2016 health information manager (HIM) graduate cohort were reported previously. Objectives: To identify the 2017-2021 Australia-based, graduate HIMs' early career employment experiences; identify employment roles and destinations; investigate knowledge and skill sets utilised in professional performance; and compare outcomes with the previous study. Method: A cross-sectional design was utilised. An online survey elicited: demographic data, position-related details and knowledge-skills applied in the workplace. Inter- and intra-cohort comparisons were calculated. Results: Of contactable graduates, 75% (n = 150) completed the survey; 90% (n = 132) had held at least one profession-related position postgraduation; 51% gained employment before final examinations and 92% within 6 months. In their first role, 87% joined the public healthcare sector, 47% had worked in two or more positions and 12.3% in three or more positions. Categorisation of position titles showed that 40% had undertaken "health information management" roles, 14.9% "health classification," 16.6% "data management and analytics," 17.4% "health ICT" and 11.1% "other," roles. Almost two-thirds (64.1%) had utilised three or four of the four professional knowledge-skill domains. There was an increase, from the 2012 to 2016 cohort, in those undertaking "data management and analytics" and "health ICT" roles, and a decrease in "health classification" role uptake. Conclusion: Early-career HIMs have very high employability. They engage throughout health care, predominately in the public health sector. Their mobility reflects national workforce trends. The majority utilise all or most of the professional knowledge-skill domains studied at university.

Approaches and Components of Health Workforce Planning Models: A Systematic Review.

Background: To date, there is still no uniformity in forecasting models for health workforce planning (HWFP). Different countries use various HWFP models, some of which are context-specific. The objective of this systematic review is to determine approaches and components of HWFP models. Methods: A systematic review of studies published in English and Persian between 2004 and 2021 was performed by searching PubMed Central, MEDLINE, Web of Science, Scopus, Eric, and Elmnet databases. Articles that assessed HWFP models, focused on health service delivery, used input-output models, and a clear formulation process were included. Articles that scored ≥20 points on the "strengthening the reporting of observational studies in epidemiology" checklist were considered of acceptable quality for inclusion. Results: Twenty articles were included for qualitative synthesis based on the inclusion and exclusion criteria. Most studies used the mixed method approach "supply and demand", whereas target- and needs-based approaches were used less frequently. The number of components used to estimate supply, demand, needs, and targets were 42, 32, 11, and 6, respectively. In addition, several unique factors used in the various HWFP models were identified. Conclusion: Different approaches are used in HWFP models, which is indicative of the lack of consensus on this topic. High diversity in the identified factors is related to the approach used and the context in which the model is applied.

Algorithmic prediction of anaesthesia manpower quantity needs: A multicentre study.

BACKGROUND: A shortage of anaesthetists affects health system globally. This is a study on task-force to develop a predictive model for the appropriate number of anaesthetic providers (Y). METHODS: A cross-sectional study was performed with randomisation from every health service region across Thailand. The decision-making criteria for manpower needed were written and provided guidance. The number of personnel was calculated from the sum of total time spent by all anaesthetic providers divided by duration of the service. Linear regression analysis was applied. RESULTS: In total 3774 patients were included from 18 hospitals. The factors that affect the anaesthetic providers' allocation needs were included in the predictive model, calculated as Y = 3.53 + [0.56 (standard centre) + 0.36 (advanced centre) + 1.03 (specialty centre)] + 0.07 (American Society of Anesthesiologists physical status IV and V) + 0.61 (advanced anaesthetic medication) + [0.61 (monitored anaesthesia care) + 0.17 (general anaesthesia)] - [0.27 (pre-anaesthetic duration within 31-60 minutes) + (0.61 (over 60 minutes)] - [0.85 (anaesthetic duration within 31-60 minutes) + 1.04 (within 61-120 minutes) + 1.32 (over 120 minutes)] - [0.16 (post-anaesthetic duration within 31-60 minutes) + 0.45 (within 61-90 minutes) + 0.74 (over 90 minutes)]. CONCLUSION: The anaesthesia manpower algorithm developed during this study can be used to calculate the number of anaesthetists per population to maintain health services.

[Analysis of variation trend in health workforce equity allocation in China].

OBJECTIVE: To analyze the long-term trends of the changes in the equity of China's health workforce allocation to provide a reference for the more balanced and orderly development of China's health system. METHODS: The Gini coefficient was used to evaluate the degree of equity in the allocation of health workforce between regions, and the Gini coefficients for the allocation of doctors and nurses based on population and regional gross domestic product (GDP) distribution were calculated respectively. RESULTS: In 2019, the number of licensed (assistant) physicians per 1 000 population in China was 2.77, and the number of registered nurses per 1 000 population was 3.18. The Gini coefficient for the distribution of licensed (assistant) physicians by population was 0.141 in 2002, decreasing to 0.081 by 2014 and then remained stable. The Gini coefficient for the distribution of registered nurses by population was 0.164 in 2002 and decreased to 0.066 in 2018. The Gini coefficient for the distribution of licensed (assistant) physicians by GDP was 0.236 in 2002, decreased to 0.169 in 2013, then increased to 0.183 and remained stable. The Gini coefficient for the distribution of registered nurses by GDP was 0.206 in 2002, decreased to 0.150 in 2013, and then increased each year to 0.180 in 2019. The equity of the allocation of registered nurses by population was worse than the equity of the allocation of licensed (assistant) physicians in 2002, and in 2016, for the first time, exceeded that of licensed (assistant) physicians. CONCLUSION: Equity in the allocation of health workforce across China has improved, but the improvement in equity between regions has hit a bottleneck, with health workforce allocation in the western regions still relatively scarce. Although nursing workforce allocation equity caught up with licensed (assistant) physicians, the number of licensed (assistant) physicians is close to that of developed western countries, while there is a large gap in registered nurses. It is recommended that the relevant authorities make good long-term planning for health workforce, further increase the policy for the introduction of health workforce in the western region, and increase the supply of healthcare services in the western region with the help of digital transformation of healthcare and internet healthcare. At the same time, they should further increase investment in resources for higher nursing education and actively plan to cope with the ageing population.

Practice and exploration of capacity building for infection control practitioners / 中华医院管理杂志

Infection prevention and control(hereinafter referred to as " infection control" )practitioners are the backbone of infection control teams of individual departments. Their capacity-building is key to improving the management efficiency at both hospital and department levels, which can effectively ensure medical safety. Since 2017, a tertiary traditional Chinese medicine hospital had scored desirable results based on the analysis of the problems existing in their capacity-building. In its explorations, the hospital attempted to improve the professional competency and management ability by the following measures. These measures included improving and standardizing the organization and management, establishing an on-the-job training system, formulating an annual management manual of department′s infection control teams, implementing a cross inspection system and patrol system of the practitioners during an epidemic, establishing an assessment and evaluation system and incentive mechanism, establishing infection control elite teams, and building a mode dominated by infection control doctors. These experiences can provide reference for optimizing the capacity building of the infection control practitioners.

Emergency deployment of human resources in public emergencies from the perspective of rescue in public emergencies / 中华医院管理杂志

In the case of public emergency, cross regional and institutional deployment of health technicians as a contingency measure is imperative in alleviating the shortage of medical resources and improving the medical capacity in the location of emergency. The authors rounded up common modes of such deployment, namely independent deployment of a complete organization, deployment by job division for individual responsibility, deployment of individuals joining in a cooperative action, and that of expert guidance. In practice, the emergency deployment of health technicians was faced with serial challenges, such as their mobility, interoperability, professionalism, economy and persistence. To improve the performance of emergency deployment, it is necessary to strengthen the routine emergency skill reserve and simulation drill, to formulate " wartime" joint diagnosis and treatment decision-making rules, to build high-level health emergency teams, to establish and improve a complete, flexible and orderly deployment mechanism of such human resources, and to improve the honor award and reward system for health emergency personnel.

Analysis of variation trend in health workforce equity allocation in China / 北京大学学报(医学版)

OBJECTIVE@#To analyze the long-term trends of the changes in the equity of China's health workforce allocation to provide a reference for the more balanced and orderly development of China's health system.@*METHODS@#The Gini coefficient was used to evaluate the degree of equity in the allocation of health workforce between regions, and the Gini coefficients for the allocation of doctors and nurses based on population and regional gross domestic product (GDP) distribution were calculated respectively.@*RESULTS@#In 2019, the number of licensed (assistant) physicians per 1 000 population in China was 2.77, and the number of registered nurses per 1 000 population was 3.18. The Gini coefficient for the distribution of licensed (assistant) physicians by population was 0.141 in 2002, decreasing to 0.081 by 2014 and then remained stable. The Gini coefficient for the distribution of registered nurses by population was 0.164 in 2002 and decreased to 0.066 in 2018. The Gini coefficient for the distribution of licensed (assistant) physicians by GDP was 0.236 in 2002, decreased to 0.169 in 2013, then increased to 0.183 and remained stable. The Gini coefficient for the distribution of registered nurses by GDP was 0.206 in 2002, decreased to 0.150 in 2013, and then increased each year to 0.180 in 2019. The equity of the allocation of registered nurses by population was worse than the equity of the allocation of licensed (assistant) physicians in 2002, and in 2016, for the first time, exceeded that of licensed (assistant) physicians.@*CONCLUSION@#Equity in the allocation of health workforce across China has improved, but the improvement in equity between regions has hit a bottleneck, with health workforce allocation in the western regions still relatively scarce. Although nursing workforce allocation equity caught up with licensed (assistant) physicians, the number of licensed (assistant) physicians is close to that of developed western countries, while there is a large gap in registered nurses. It is recommended that the relevant authorities make good long-term planning for health workforce, further increase the policy for the introduction of health workforce in the western region, and increase the supply of healthcare services in the western region with the help of digital transformation of healthcare and internet healthcare. At the same time, they should further increase investment in resources for higher nursing education and actively plan to cope with the ageing population.

Analysis on the staff salary status in traditional Chinese medicine hospitals of Sichuan province in 2020 / 中华医院管理杂志

Objective:To analyze the staff salary status and the influencing factors in traditional Chinese medicine(TCM) hospitals implementing the salary system reform in Sichuan province in 2020, for reference in optimizing the salary system reform of such hospitals.Methods:Cluster sampling and institutional survey were used to collect the salary information of 26 TCM hospitals in 21 cities(prefectures)of Sichuan province implementing the salary system reform in 2020. Such information was then subject to descriptive analysis, while the influencing factors of salary were subject to one-way analysis of variance and generalized linear model multifactor analysis.Results:15 428 staff from 26 TCM hospitals were included as the research objects. In 2020, personnel expenditure accounted for 40.23% of the total expenditure, and 24.34% of which came from financial subsidy in 26 TCM hospitals. The average annual payable income per person was(149 312±74 288)yuan, 67.82% of which being performance pay. Analysis of variance showed that there were significant differences among the salary levels of staff in different economic regions, hospital grades, hospital levels, gender, educational background, position, seniority, performance pay ratio, employment in the government system and other natures, senior and other professional titles, doctors and other positions( P<0.05), and the differences were still statistically significant after adjustment by generalized linear model( P<0.05). Conclusions:The reform of the salary system of Sichuan TCM Hospitals has basically achieved equal pay for equal work, and the income of low-level personnel has been improved. However, the salary level was not very motivated and the salary structure was not guaranteed. It is necessary to strengthen financial precision subsidies, increase the proportion of personnel expenditure, so as to support the increase of the absolute value of salary in non-core economic areas, improve the salary structure, reasonably widen the salary gap among different educational backgrounds and positions, further optimize internal distribution, and ensure the sustainable development of Chinese medicine talents.

Analysis of salary characteristics and influencing factors of personnel expenditure in medical institutions in Sichuan province / 中华医院管理杂志

Objective:To analyze the salary characteristics of medical institutions and the influencing factors of personnel expenditure as found in the salary system reform of public hospitals in Sichuan province, for reference in furthering such reform in public hospitals.Methods:The data of personnel expenditure, business operation and medical services came from 96 medical institutions in 21 cities(prefectures)of Sichuan province from 2017 to 2020 by means of institutional survey. The average salary level and salary structure of medical staff were used to describe the salary characteristics, and the total salary was presented by the level of personnel expenditure. The measurement data was represented by M(IQR), the counting data was described by frequency and constituent ratio, and the influencing factors of personnel expenditure were analyzed by generalized linear mixed model. Results:From 2017 to 2020, the personnel expenditure of medical institutions increased by 13.04% annually. In 2020, the per capita salary level of medical staff was 151 900 yuan, while the basic salary and performance salary accounted for 16.20% and 54.60% of personnel expenditure respectively. The analysis results of the generalized linear mixed model showed that the average cost of patients per visit( β=0.596), the level of drugs and sanitary materials consumed per 100 yuan medical income( β=0.286), the number of medical visits( β=0.328), and the years [(2018, 2019, 2020) β=0.025, 0.052, 0.066] were positively correlated to personnel expenditure, while the average length of stay( β=-0.693), the proportion of medical service income( β=-0.392), and the balance rate of income and expenditure( β=-0.062)were negatively correlated to personnel expenditure( P<0.05). The proportion of fiscal subsidy revenue, regional GDP and asset-liability ratio were not the influencing factors of personnel expenditure( P> 0.05). Conclusions:In the reform of the salary system of the province, its salary level of medical institutions has surpassed the current wage ceiling of these institutions. As the salary distribution was mainly made based on the workload, the " baton" role of the salary system reform has begun to pay off. However, the basic guarantee role of compensation has not yet been fully leveraged.Further reform is needed in upgrading refined management, and timely dynamic adjustment of personnel expenditure in combination with the hospital's financial performance and cost analysis, and reasonably optimizing the level of medical staff compensation.

Exploration of clinicians′ practice competency evaluation based on medical record homepage data / 中华医院管理杂志

The professional title evaluation of health professionals needs to highlight the clinical performance and actual contribution, and make full use of the information system of medical and health institutions to collect relevant data as an important basis for such evaluation.Based on this, the project team innovatively developed a " clinical work data extraction system" , to extract and calculate the performance indexes of clinicians using data from homepages of medical records. Meanwhile, the team established a reference scale based on the data in the hospital quality monitoring system; developed a " health workers evaluation data platform" , visually presenting the comparison results between the clinical work performance evaluation data of a clinician, and the reference scale and the data of other applicants. In the 2021 annual evaluation of senior professional titles among some medical institutions directly under the National Health Commission and such provinces as Sichuan, Shandong and Chongqing, this method was used to extract homepage data of medical records of 7 833 applicants from 39 medical specialties in 1 416 medical institutions, and finally 6 093 people (77.79%) completed the calculation of clinical work evaluation index data. The initial application results showed that the evaluation of senior clinicians′ professional competence based on homepage data of the medical record was feasible in the senior professional title evaluation of various medical institutions at all levels equipped with the electronic medical record database system, and could effectively present the performance level and actual contribution of the applicant.

Study of salary incentives mechanism for general practitioners from the perspective of integrated incentives: insights of the United Kingdom / 中华医院管理杂志

Optimizing the salary system of general practitioners and establishing a compensation incentives mechanism fitting its needs, would contribute effectively to the development of the general practitioner system in China. Fully leveraging the salary incentive system, the United Kingdom(UK) effectively improved the working enthusiasm of general practitioners and its quality of primary medical services, and limited its medical expenses as well. The authors expounded the incentive mechanism of general practitioners′ salary in the UK from such dimensions as salary model and salary structure, and introduced the implementation effect. Based on Robbins′ comprehensive incentive theory, the authors introduced the internal logic of the UK′s general practitioners′ salary incentive mechanism. Based on the UK experiences, along with existing problems in China, the authors recommended on setting up value-based salary levels, optimizing the salary structure, and establishing a dynamic adjustment mechanism. These ideas are expected to help optimize the salary incentive mechanism for general practitioners in China.

Establishment and management of hospital emergency personnel pool under regular epidemic prevention and control / 中华医院管理杂志

Under the situation of regular epidemic prevention and control of COVID-19, the hospitals need to establish an emergency personnel pool and update it regularly. The author introduced the experience of establishing and managing the emergency personnel pool in a hospital, including the use of information technology to achieve scientific grouping and dynamic management, strengthening the emergency response ability, epidemic prevention and control training and assessment of all staff, ensuring their mental health and logistics support, and improving the performance assessment, salary and welfare system of emergency personnel.From December 2021 to May 2022, the members of the emergency personnel pool completed a total of 62 emergency support tasks. The response time and team gathering time of all emergency tasks were reduced to less than 1 hour. A total of 4 421 medical personnel were sent. The nucleic acid test results of COVID-19 during the tasks were negative, the infection rate was zero, and no adverse events occurred.

Key issues and trends of health manpower management in the world / 中华医院管理杂志

Health manpower is key to the functioning of the health system. There exists a general need to strengthen health human resources in countries at large as they achieve universal health coverage. Through the systematic collection and sorting out of the declarations, initiatives, guidelines in the world and topics at the World Health Assemblies on health manpower-related issues since 2000, this paper summarized and analyzed the key issues and trends on health manpower planning, education and training, international migration, and compensation management, in order to provide reference for China′s health manpower management and practice.

Progress and challenge of health human resources development in China / 中华医院管理杂志

The authors systematically reviewed the progress of health human resources development, personnel management system and conceptual changes from 2011 to 2020 in China, and analyzed the status quo in this regard. The past 10 years have witnessed rapid progress of health human resources, namely better personnel management system and constant innovation in human development concepts. As required by the strategy of empowering the country with talents in the new era, as well as the overall promotion for the Healthy China initiative and the high-quality development of the health industry, higher requirements have been put forward for the quantity and quality, structural distribution and management innovation of health human resources. Therefore it is necessary to further expand the coverage of talents work and innovate talents policy, thus keeping the upgrade of the capability and competence of health talents.

Practice and exploration on the talents working mechanism of " provincial hospital recruit staff and county hospital get experts" / 中华医院管理杂志

In the context of the construction of " double sinking and double upgrading" in Zhejiang province, a provincial hospital explored a pilot talent working mechanism of " provincial hospital recruit staff and county hospital get experts" in the process of cooperating with county hospitals. In view of the problem that high-quality medical human resources were difficult to sink, with the flexibility of the reform of post filing and staffing, we put forward the idea of " provincial hospital recruit staff and county hospital get experts" , established key support disciplines, recruited staff by provincial hospitals, and arranged experts to precisely " sink as needed" to help disciplines of county hospitals. It helped to explore the establishment of a long-term mechanism to promote the flow of excellent medical talents to remote mountain areas, built a " specialized community" of provincial and county hospitals, and improved the medical service capacity, medical quality and discipline construction of county hospitals.

Study on the influencing factors of turnover intention of pre-hospital emergency nurses in Beijing / 中华医院管理杂志

Objective:To explore the influencing factors of turnover intention of pre-hospital emergency nurses in Beijing, and provide references for reducing the turnover rate of pre-hospital emergency nurses and stabilizing the pre-hospital emergency nursing team.Methods:Pre-hospital emergency nurses from 2 emergency centers in Beijing were selected as the survey objects, and a self-designed questionnaire was used to conduct an online survey in September 2019. The questionnaire covered such aspects as the main demographic characteristics, workload, doctor-patient relationship, professional identity, job burnout and turnover intention. Descriptive analysis was conducted for the data, while rank-sum test and Kappa consistency test were used for univariate analysis, and ordered logistic regression analysis was used for multivariate analysis.Results:A total of 340 valid questionnaires were received, among which 41.5% (141) of the nurses said that they occasionally considered quitting, 11.7% (40) said they often considered quitting, while the scoring of professional identity was (33.29±6.00), and that of job burnout was (63.70±14.90). Univariate analysis showed that age, work units, self-rated health status, professional identity, job burnout, seniority, workload, doctor-patient relationship, and pressure of title promotion were significant ( P<0.05). The results of multivariate analysis showed that job burnout, average number of car trips per shift, and self-rated health status were positively correlated with turnover intention, while professional identity was negatively correlated with turnover intention ( P<0.05). Conclusions:The turnover intention of pre-hospital emergency nurses in Beijing was found at a high level. The authorities are recommended to rationalize the scheduling system and increase the staffing of pre-hospital emergency nurses; establish the diversion policy, title promotion system and post risk special allowance for such nurses; and train medical aid workers to undertake the transfer and lifting of patients, so as to reduce the turnover intention of these nurses.

Study on the driving mechanism of the formation of doctors′ turnover intention in public hospitals based on the grounded theory / 中华医院管理杂志

Objective:To explore the driving mechanism contributing to doctors′ turnover intention in public hospitals based on the grounded theory.Methods:" Willingness or intention for doctors to quit public hospitals" was used as the theme word, and the literature was retrieved from CNKI published from January 1, 2017 to January 1, 2022. Based on the grounded theory, NVivo 11.0 software was used for a qualitative analysis of the literature. The three-level coding method of open coding, axial coding and selective coding was used to identify the main categories affecting the willingness of doctors to quit public hospitals. On this basis, the driving mechanism model was integrated. In-depth interviews with hospital managers were used to test the theoretical saturation.Results:When 31 papers were coded, four level-1 influencing factors of the formation of doctors′ turnover intention in public hospitals were summarized: career selection deviation, practice reality, perceived experience and external opportunity. Among them, perceived experience was the direct driving factor; career selection deviation was the initial driving factor, and the practice reality was the key driving factor, both of them affected the perceived experience; external opportunity was the possible driving factor.Conclusions:In order to prevent doctors from willing to leave, the following measures are expected: the hospital management should improve both its recruitment evaluation indexes and recruitment effectiveness; pay attention to doctors′ psychological capital management and cultivate positive perception; promote the reform of performance pay, emphasize fairness and value; pay attention to employee relationship management and build a supportive hospital culture.

Educação permanente para qualificação do processamento de esterilização de materiais na Atenção Primária: contribuições da integração ensino-serviço / Permanent education to qualify the materials processing and sterilization in Primary Health care: contributions of the service-learning integration

Este manuscrito objetiva relatar uma prática de Educação Permanente em Saúde para qualificação do processamento e esterilização de materiais de uma Central de Materiais Esterilizados em um cenário de Estratégia Saúde da Família, a partir da integração ensino-serviço. A experiência foi realizada em uma Unidade Básica de Saúde situada no Oeste de Santa Catarina, durante o segundo semestre de 2016, envolveu estudantes e docentes de uma universidade pública e 11 trabalhadores da Estratégia de Saúde da Família. Realizou-se reunião com a coordenação, roda de conversa com os profissionais e elaboração de instrumentos (checklist e procedimento operacional padrão). As atividades de Educação Permanente em Saúde favoreceram a transformação da práxis dos atores do serviço e da academia, possibilitando o diálogo corresponsável pela qualificação da assistência, segurança do paciente e gestão do trabalho.

This manuscript aims to report a Permanent Education in the Healthcare field to qualify the materials processing and sterilization in a Material Sterilization Center in a practice scenario of Family Health Strategy, based on the service-learning integration. This experience was conducted in a Health Center located in the West of Santa Catarina, during the second semester of 2016, involving students and professors of a public university and 11 workers of one Family Heath Strategy. A meeting was held with the coordinator, a round-table discussion and the elaboration of tools (checklist and standard operating procedure). The activities of Permanente Education in the Healthcare field have favored the praxis transformation of those working in the service and academia, enabling a responsible dialogue for qualification of care, patient safety, and work management.

Assessment of community-based education in community health officers' training at a Rural Medical College in Northern Ahmednagar District of Maharashtra, India: A longitudinal study.

We evaluated the Community Health Officer (CHO) training program in northern Ahmednagar district of Maharashtra, India. A longitudinal study was conducted among 110 CHO trainees from August 2019 to January 2020. The trainees undertook field visits and survey with lectures and clinical postings. Evaluation was based on pre- and post-Multiple Choice Question tests, the WHO Education of Health Personnel Checklist, Journals, and Logbooks. MannWhitney U-test, Wilcoxon-rank test were used to compare nonnormal variables while t-test was used for comparison of age. Initially, nursing graduates performed better than Ayurveda graduates, especially in punctuality, grasp on problems, and problem-solving ability. Nursing graduates kept better journals and logbooks. Female trainees performed better than male trainees. Ayurveda and nursing graduates were comparable at the end of the training. Need-based training and upskilling of mid-level healthcare providers can be done at scale by roping in medical colleges.