Career flexibility for PAs: What makes switching specialties successful?

ABSTRACT: Switching specialties is common among physician associates/assistants (PAs) and important in combating burnout. Despite this, little is known about the PA experience with switching specialties. This study sought to identify factors associated with successfully switching specialties using semistructured interviews with PAs and hiring managers. Participants reported that switching specialties was initially challenging for managers and PAs because of insufficient onboarding and unrealistic expectations, but they also reported that they were generally satisfied with long-term outcomes. Our findings suggest that PAs hoping to switch specialties may want to focus on building a professional network, identifying areas where they can highlight relevant experience, and demonstrating their intent to remain in that role. Hiring managers could benefit from considering their hiring practices and tailoring onboarding expectations for new hires.

Diversity of returnee executives' foreign experience and corporate social responsibility performance.

Top managers' past experiences (e.g., foreign experience) significantly impact their decision-making behavior, which may influence firms' sustainable development. The available literature, focusing on the role of the increase in the number of top executives with foreign experience in corporate social responsibility (CSR), yields mixed results. In order to clarify the ambiguous relationship between executive foreign experience and CSR, we empirically examine the effect of the geographic diversity of top executives' foreign experience on CSR. Based on a hand-collected dataset of the top management team's (TMT's) foreign experience, we demonstrate the positive impact of the geographic diversity of returnee executives' foreign experience on firms' CSR using Chinese A-share listed firms from 2009 to 2018. Moreover, this impact is stronger in firms with political connections with the central government and in regions with good market development. Furthermore, the mechanism analysis shows that returnee executives drive firms' CSR by promoting corporate donations and green innovation. This paper offers clear policy implications by suggesting that hiring returnees with a broad geographic scope of foreign experience as corporate executives is an efficient way to enhance firms' CSR.

Preference Signaling and the Integrated Plastic Surgery Match: A National Survey Study.

OBJECTIVE: Rooted in economics market strategies, preference signaling was introduced to the Plastic Surgery Common Application (PSCA) in 2022 for integrated plastic surgery residency applicants. This study surveyed program and applicant experience with preference signaling and assessed how preference signals influenced likelihood of interview invitations. DESIGN: Two online surveys were designed and distributed to all program directors and 2022-2023 applicants to integrated plastic surgery. Opinions regarding the utility of preference signaling were solicited, and the influence of preference signals on likelihood of interview offers was assessed. SETTING: All integrated plastic surgery programs. PARTICIPANTS: All 88 program directors and 2022-2023 applicants to integrated plastic surgery. RESULTS: A total of 45 programs and 99 applicants completed the survey (response rates, 54.2% and 34.2%, respectively). Overall, 79.6% of applicants and 68.9% of programs reported that preference signals were a useful addition to the application cycle. Programs reported that 41.4% of students who sent preference signals received interview offers, compared to 84.6% of home students, 64.8% of away rotators, and 7.1% of other applicants; overall, students who signaled were 5.8 times more likely to receive an interview offer compared to students who were not home students and did not rotate or signal. After multivariable adjustment, programs with higher Doximity rankings, numbers of away rotators, and numbers of integrated residents per year received more preference signals (all p < 0.05). CONCLUSIONS: Applicants and programs report that preference signaling was a useful addition to the integrated plastic surgery application cycle. Sending preference signals resulted in a higher likelihood of interview offers among nonrotators. Preference signaling may be a useful tool to reduce congestion in the integrated plastic surgery application cycle.

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.

Pearls and pitfalls in letters of recommendation for neurology residency applications.

Letters of recommendation are a cornerstone of residency applications. Variability and bias in letters exists across specialties, neurology being no exception. Studies done in other specialty fields assessing nuanced language uncovered key attention points for improvement and mitigation of bias, lessons from which should be applied in the field of neurology. We review common pearls and pitfalls in the letter solicitation, writing and reading process, with suggested best-practices for residency applicants, letter writers, and program faculty reviewers. We advocate for the thoughtful selection of writers, emphasis on highlighting professional skills, and attention to implicit bias. This discussion focuses on recommendations for US advanced or categorical neurology programs, but elements of this guidance may apply more broadly to fellowship and faculty promotion letters as well.

Help Me Help You: How to Request a Letter of Recommendation.

Letters of recommendation (LORs) are an essential component of a career in medicine. The process for obtaining certain letters, particularly those associated with scheduled periods of professional transition, often is governed by established institutional or specialty norms. The process of requesting LORs in more common scenarios-local or national awards, committee assignments, and leadership positions-many times is less clearly defined, however. Despite the important role that LORs play in professional development, the published literature on how to solicit a recommendation is limited, creating challenges for both those requesting LORs ("applicants") and the letter writers. This perspective piece offers insight on how to best identify and communicate with a potential writer. These suggestions are derived from the limited relevant literature and from the authors' experience both with requesting letters themselves and writing letters as leaders in undergraduate and graduate medical education. The goal is to reduce ambiguity for applicants and ensure that writers receive the information necessary to provide an informed and effective recommendation.

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.

Incorporación del dietista-nutricionista en un hospital universitario: declaración de postura de la Comisión de Nutrición del Hospital Universitario La Paz / Dietitian-nutritionist incorporation in a university hospital: position statement of the Commission on Nutrition, Hospital Universitario La Paz

El presente documento tiene como objetivo plantear y justificar la incorporación del dietista-nutricionista en los equipos multidisciplinares deatención integrada en la educación, el tratamiento y el seguimiento de aquellos pacientes con patologías que cursen con alteraciones del estadonutricional, tanto en su defecto como en su exceso, en el área sanitaria de la Comunidad Autónoma de Madrid.El estado nutricional de los pacientes hospitalizados se beneficiará de la incorporación del dietista-nutricionista al equipo multidisciplinar que,actualmente, se ocupa de la atención de estos. El manejo de la terapia nutricional por dietistas-nutricionistas ha demostrado ser costo-efectiva,habida cuenta de la repercusión sanitaria que tiene el estado nutricional en la evolución clínica y prevención de enfermedades como la diabetes,los trastornos de la conducta alimentaria, la obesidad, el cáncer, la insuficiencia cardiaca, la osteoporosis, la enfermedad celiaca y la enfermedadrenal crónica, entre otras.(AU)

The present document has the objective of justifying the incorporation of a dietician/nutritionist to the multidisciplinary teams of specialized carethat provide education, food anamnesis, nutritional recommendations, treatment and follow up of those patients in risk of malnutrition in Madrid.The appropriate nutritional status of hospitalized patients bears a close relationship with the existence of dieticians at hospitals. Dieticians usenutrition therapy as a cost-effective means to achieve significant health benefits by preventing or altering the course of diabetes, obesity, hyper-tension, lipid metabolism disorders, heart failure, osteoporosis, celiac disease, and chronic kidney disease, among other diseases.(AU)

Recherche participative : perspectives croisées autour des savoirs académiques et expérientiels dans le domaine des addictions.

Participatory research can help improve addiction services. However, the superficial involvement of people with experiential knowledge runs the risk of reproducing social inequity rather than strengthening their empowerment. This article aims to present a critical analysis, co-constructed through a dialogue between people with academic and experiential knowledge, of different types of participation and collaboration undertaken over a number of years, while also examining issues raised by the professionalization or formalization of the role of people with experiential expertise in participatory research in the field of addiction. The results of this analysis have led to a co-constructed critical assessment that deals with the following themes: 1) a description of the collaborative process over time and the diverse ways in which people with experiential knowledge have been involved; 2) conceptual considerations with respect to the terms used and the identities linked to them; 3) aspects that have facilitated collaboration; 4) obstacles and challenges that were encountered. This dialogue between academic and experiential knowledge highlights the need to review institutional rules so as to better recognize the status of people with experiential knowledge involved in research. Recognition of skills related to eligibility for research positions should not be limited to academic qualifications. Experiential knowledge should be integrated into hiring processes as a recognized type of expertise.

Breast Imaging Fellowship Virtual Interviews: The Program Director's Perspective.

OBJECTIVE: To evaluate breast imaging fellowship program directors' perspectives on the virtual interview process. METHODS: A 20-question survey constructed by members of the Fellowship Match Committee of the Society of Breast Imaging was distributed to all 99 breast imaging program directors registered with the Society. An initial e-mail with a link to the survey was distributed on September 9, 2022, and the survey was closed on October 1, 2022. Results were compiled and a descriptive statistical analysis was performed utilizing Microsoft Excel. RESULTS: There were 63 total responses (63/99, 64% response rate). There was a wide distribution in both the number of applications received and the number of interviews each program offered. Just under a fifth (12/63, 19%) of programs received 1 to 5 applications, whereas a quarter (16/63, 25%) received over 40 applications. In contrast, over a quarter (17/63, 27%) of programs interviewed 1 to 5 applicants, and only a small number (3/63, 5%) interviewed over 40 applicants. When reporting what worked best with the virtual interview process, the responses fell into the following 4 categories: efficiency, flexibility, virtual format, or other. When reporting what did not work well, the most common response (14/37, 38%) was conveying the atmosphere of the program in the virtual setting. CONCLUSION: This study provides an assessment of the virtual interview experience from the perspective of breast imaging fellowship programs, which may be useful in optimizing future interview experiences for programs and applicants.

Identifying Gender and Racial Bias in Pediatric Fellowship Letters of Recommendation: Do Word Choices Influence Interview Decisions?

OBJECTIVES: To describe linguistic differences in letters of recommendation (LORs) for pediatric fellowship candidates based on applicant and letter writer demographics and to examine if these differences influenced the decision to interview a candidate for a fellowship position. STUDY DESIGN: LORs for applicants to 8 pediatric subspecialty fellowships at a single academic center from the 2020 Match were analyzed in this cross-sectional study. Frequency of validated agentic and communal terms in each letter were determined by a language processing web application. Bias was determined as having a >5% surplus of agentic or communal terms. RESULTS: We analyzed 1521 LORs from 409 applicants: 69% were women, 28% were under-represented minorities in medicine (URM), and 50% were invited to interview. Overall, 66% of LORs were agentic biased, 16% communal biased, and 19% neutral. There was no difference in bias in LORs by an applicant's gender (woman 67% agentic vs man 62% agentic; P = .058), race, or ethnicity (non-URM 65% agentic vs URM 67% agentic; P = .660). Despite a lower frequency of agentic terms in LORs for applicants invited for interviews, when accounting for other components of an application and applicant demographics, no significant association was made between language bias in LORs and fellowship interview status. CONCLUSIONS: The frequency of agentic and communal terms in LORs for pediatric subspecialty fellowship candidates were not found to influence the decision to invite a candidate to interview. However, raising awareness of potential areas of bias within the pediatric fellowship selection process might lead to a more equitable and holistic approach to application review.

Language Patterns in Letters of Recommendation for Residency Applicants in Otolaryngology.

OBJECTIVE: Assess for gender and race patterns in agentic and communal language used in letters of recommendation for Otolaryngology-Head and Neck Surgery (OHNS) residency applicants. STUDY DESIGN: Retrospective content analysis. SETTING: Applications from OHNS applications at a single training institution for the 2019 and 2020 match cycles. METHODS: A total of 2283 letters of recommendation for 611 OHNS applicants were analyzed. Applicant and letter writer gender, applicant race and ethnicity, and applicant characteristics including United States Medical Licensing Examination® Step 1 score, research productivity, and medical school rank were extracted. Agentic and communal word use from the letters of recommendation was compared across applicant and writer characteristics using multilevel negative binomial regression modeling. RESULTS: Letter writers use a greater rate of agentic terms when describing applicants who self-identify as Asian (incidence rate ratio [IRR] = 1.16, p < .01) or "Other/not reported" (IRR = 1.23, p < .01) as compared to white applicants. Further, standardized letters of evaluation had significantly more communal language and less agentic language. Although there was an increase in communal language in letters for female applicants compared to male applicants, these gender differences disappeared in the multivariate model. CONCLUSION: Multivariate analysis demonstrated no significant gender-based patterns in the communal or agentic language in letters of recommendation for OHNS residency applicants. However, letters for applicants identifying as Asian or "other/not reported" had more frequent use of agentic terms. Future studies should investigate other components of residency applications to assess how gender and race bias might unfairly influence an applicant's chances at a given program.

Addressing the Elephant in the Room: Perceptions and Treatment of Underrepresented in Medicine Physician Assistants/Associate Educators.

ABSTRACT: On Thursday, June 27, 2023, the US Supreme Court struck down race-conscious admission practices in higher education. While other demographic factors, such as the traditional Health Resources and Services Administration-disadvantaged background indicators, can be considered during the holistic admission process, explicit consideration based on race and/or ethnicity is prohibited. As a result, physician assistant/associate (PA) programs are tasked with developing novel ways to address equity, diversity, and inclusion during the admission and hiring processes. As Drumgold et al note, closing the PA workforce diversity gap is necessary to achieve health equity. Despite this, PA programs consistently struggle to attract and retain underrepresented in medicine (URiM) faculty, staff, and students. The latest PA Education Association Student Report indicates that more than 75% of applicants consider faculty and student body diversity when applying to programs. As such, addressing disparities in the recruitment, promotion, evaluation, and retention of URiM faculty is paramount. Here, the authors outline ongoing recruitment and retention challenges for URiM faculty along with institutional recommendations to ensure URiM PA faculty success and engagement.

Using natural language processing to increase prediction and reduce subgroup differences in personnel selection decisions.

The purpose of this research is to demonstrate how using natural language processing (NLP) on narrative application data can improve prediction and reduce racial subgroup differences in scores used for selection decisions compared to mental ability test scores and numeric application data. We posit there is uncaptured and job-related constructs that can be gleaned from applicant text data using NLP. We test our hypotheses in an operational context across four samples (total N = 1,828) to predict selection into Officer Training School in the U.S. Air Force. Boards of three senior officers make selection decisions using a highly structured rating process based on mental ability tests, numeric application information (e.g., number of past jobs, college grades), and narrative application information (e.g., past job duties, achievements, interests, statements of objectives). Results showed that NLP scores of the narrative application generally (a) predict Board scores when combined with test scores and numeric application information at a level of correlation equivalent to the correlation between human raters (.60), (b) add incremental prediction of Board scores beyond mental ability tests and numeric application information, and (c) reduce subgroup differences between racial minorities and nonracial minorities in Board scores compared to mental ability tests and numeric application information. Moreover, NLP scores predict (a) job (training) performance, (b) job (training) performance beyond mental ability tests and numeric application information, and (c) even job (training) performance beyond Board scores. Scoring of narrative application data using NLP shows promise in addressing the validity-adverse impact dilemma in selection. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Promoting inclusive recruiting and selection into military training schools: Admission waivers versus retesting.

There is high-level interest in diversifying workforces, which has led organizations-including the U.S. Armed Forces-to reevaluate recruiting and selection practices. The U.S. Coast Guard (USCG) has encountered particular difficulties in diversifying its workforce, and it relies mainly on the Armed Services Vocational Aptitude Battery (ASVAB) for assigning active-duty recruits to one of 19 specialized training schools. When recruits' scores fall below ASVAB entrance standards, the USCG sometimes offers admission waivers. Alternatively, recruits can retest until their ASVAB scores meet the entrance standard. Retesting has shown mixed results in the personnel selection literature, so our main interest is to determine whether retesting or waivers best support USCG recruits' training school outcomes, especially for recruits identifying as an underrepresented minority (URM). We use data from 16,624 USCG recruits entering between 2013 and 2021 and fit augmented inverse propensity weighted models to assess differences in training outcomes by pathway to admission while accounting for self-selection into pathways. Our analyses found (a) no difference in training outcomes between recruits who qualified from their initial scores and recruits who retested, (b) recruits who received waivers were less likely to complete training school on time and spent more time in remedial training when they failed training school compared to those who retested, and (c) improvement in training outcomes for retesting over waivers was larger for recruits identifying as an URM. Results suggest that retesting may be an effective strategy for workforce diversification and for improving outcomes among recruits identifying as an URM. (PsycInfo Database Record (c) 2024 APA, all rights reserved).