“There hasn’t been a career structure to step into”: a qualitative study on perceptions of allied health clinician researcher careers

Background There are many demonstrated benefits for health service organizations engaging in research. As a result, growing numbers of clinicians are being encouraged to pursue research as part of their clinical roles, including in allied health (AH). However, while the benefits of having clinician researchers embedded in AH services have been well established, the career needs of those engaged in these dual roles are poorly understood. The aim of this study was to examine perspectives of the career pathway for AH clinicians engaged in “clinician researcher” roles within Australian health services. Methods A qualitative descriptive study was conducted, utilizing semi-structured interviews. Purposive sampling was used to ensure selection of varied locations, professions and role types. Results were analysed using thematic analysis. Trustworthiness was established using regular peer debriefing during theme development, and respondent validation of final themes. Results Fifty-seven AH clinician researchers, including those who did and did not have research as a formal component of their current role, participated in semi-structured interviews. Key themes were as follows: (1) clinician researchers prefer roles which are embedded in health services; (2) current opportunities for clinician researcher roles in health are insufficient; (3) there are deficiencies in the pathway for clinician researcher careers; (4) clinician researchers are not always valued or incentivized by health services; (5) the current career challenges impair the viability of clinician researcher careers; and (6) the clinician researcher career path has been improving, and there is hope it will continue to improve. Conclusion This study outlines a number of weaknesses in the current career structure and opportunities for AH clinician researchers in Australian health services. In particular, while there are strong intrinsic drivers to pursue this dual career, extrinsic drivers are poorly developed, including a lack of job opportunities, an unstable career pathway and a lack of valuing or incentivizing this career choice within health services. This often means that clinician researchers feel compelled to choose between a research or clinical career, leading to loss of this valuable combined skill set. The findings of this research may assist health services in developing and supporting improved clinician researcher career pathways.

Promising Pathways: Investigating Personal Factors Promoting Nonprofit Executives

The nonprofit sector has been critiqued for failing to systematically develop leadership to meet the sector’s professionalizing needs. The personal profile of who sits in the nonprofit executive position can be insightful about what experience and training have been deemed appropriate for nonprofit leadership and may reveal career pathways to the executive position. In this paper, the career backgrounds of 185 nonprofit association executives are reported upon, investigating if the credentials and experience held by these executives helped expedite their career pathway to the top position. The findings indicate that nonprofit sector experience was a significant predictor of time to the executive position, but that other career variables, such as education, credentials, and other previous experiences did not significantly impact the time to the position. This study adds to what we know about the professionalization of the nonprofit sector and raises questions about what signals readiness for the sector’s executive position.

The perceived impact of the COVID-19 pandemic on medical students’ future careers

Background: The COVID-19 pandemic disrupted medical education on multiple levels, and medical students have been forced to adjust to distance learning, altered clinical opportunities, and standardized testing inconsistencies. We sought to identify the effects of these dramatic deviations on medical students’ career plans. Methods: We conducted a cross-sectional online survey of medical students between July 13, 2020, and September 9, 2020 in order to assess the implications of the COVID-19 pandemic on students’ career decisions. Descriptive statistics were calculated for all variables. Results: Of the 585 eligible medical students, we had a final sample of 76 responses (n=76) (13% response rate). Students felt neutral regarding having more time to explore research projects (Mean ± SD; 3.06 ± 1.18) and hobbies (3.43 ± 1.28). Most survey respondents somewhat disagreed that they considered quitting medical school during the pandemic (1.55 ± 1.10). Students somewhat agreed that they view the field of medicine more positively since the onset of the COVID-19 pandemic (3.60 ± 1.09). Respondents somewhat agreed that they would be unable to explore other specialties and find their best fit (3.55 ± 1.32). We found that the minority (4/66, 6%) of students had considered changing their specialty. Students felt neutral in terms of their Step 1 (3.25 ± 1.05) or Step 2 (2.81 ± 1.02) score deterring them from future career opportunities. Conclusions: Most medical students have experienced barriers in their career pathway as a direct cause of COVID-19 restrictions on medical education, including the ability to explore different specialties to discover their best fit or find a chance to network with mentors. However, despite these obstacles, most students remain committed to medicine.

Clinical academic careers for general practice nurses: a qualitative exploration of associated barriers and enablers

Background The delivery of research in healthcare in the UK is dependent on a subgroup of clinicians – clinical academics – who concurrently engage in clinical practice and academic activities. The need to increase access to such roles for general practice nurses has been identified, although the need for a robust career framework remains. Aims This study, with a qualitative interview and focus group design, aimed to explore the concept of clinical academic careers for general practice nurses by identifying barriers and enablers associated with pursuing and performing such roles. Methods General practice nurses ( n = 18) and general practitioners ( n = 5) engaged in either an audio -recorded interview or focus group. Verbatim transcripts were subjected to thematic analysis. Results Four themes were identified: awareness and understanding; career pathway; personal and professional attributes; and organisational factors. Awareness and understanding were generally poor. Participants suggested that the career pathway was unclear, although it was generally assumed that such roles were ‘out of reach’ and require a minimum of Master’s level education. An interest in research and the confidence to perform such duties were reported as the required personal and professional attributes. Organisational factors included the need for employers to understand the value and benefit of general practice nurse clinical academic roles, along with ensuring that the inevitable competing demands of such a role were appropriately managed. Conclusions This study highlights the difficulties faced by general practice nurses wishing to pursue a clinical academic career. Academia is seemingly placed on a pedestal, emphasising the need to embed research training early in nursing education to alter general practice nurse perceptions that clinical academic roles are unobtainable. The development of a robust career pathway for general practice nurse clinical academic roles may have a positive impact on the retention of experienced general practice nurses and attract newly qualified nurses. This research provides evidence as to the need for one.

Developmental Evaluation for Extension Programs

Logic models have garnered acclaim for their usefulness and disdain for the time required to create good ones. We argue that the orderly, analytical nature of logic models is opposed to many Extension programs, and we explain developmental evaluation, an approach that highlights ongoing development, adaptations, and rapid response. We use our recently completed evaluation of the 4-H Science: Building a 4-H Career Pathway Initiative to demonstrate developmental evaluation’s key principles. Recommendations for Extension include the need to embrace developmental evaluation for program planning and evaluation and for Extension evaluators to conduct case studies using developmental evaluation and other approaches.

School and Employment-Related Barriers for Youth and Young Adults with and without a Disability during the COVID-19 Pandemic in the Greater Toronto Area

Purpose: Youth and young adults are particularly vulnerable to the socio-economic impacts of Coronavirus Disease (COVID-19). The purpose of this study was to explore barriers to school and employment for youth with and without a disability during the pandemic. Methods: This qualitative comparison study involved in-depth interviews with 35 youth and young adults (18 with a disability; 17 without), aged 16–29 (mean age 23). An interpretive, thematic analysis of the transcripts was conducted. Results: Our findings revealed several similarities and some differences between youth and young adults with and without disabilities regarding barriers to school and employment during the COVID-19 pandemic. Key themes related to these barriers involved: (1) difficult transition to online school and working from home (i.e., the expense of setting up a home office, technical challenges, impact on mental health), (2) uncertainty about employment (i.e., under-employment, difficult working conditions, difficulty finding work, disability-related challenges) and (3) missed career development opportunities (i.e., canceled or reduced internships or placements, lack of volunteer opportunities, uncertainties about career pathway, the longer-term impact of the pandemic). Conclusion: Our findings highlight that youth and young adults with disabilities may need further support in engaging in meaningful and accessible vocational activities that align with their career pathway.

Nurses’ impact on care, role, training, and career pathway

This chapter outlines the key roles of nurses in primary care and the community in the context of women’s health. This includes practice nurses, sexual and reproductive health nurses, and school nurses, alongside healthcare assistants and associates. Hospital nurses (both clinic and ward) and specialist nurses have their roles defined, and aspects of relevant training and accreditation are covered. The chapter also discusses the evolution of specialist role in the context of prescribing. Finally, mentorship, supervision, and career development is covered.

1004 Student Perspectives on Surgical Careers

Aim To investigate medical students’ understanding of skills needed as surgeons and how prepared they feel to pursue surgical careers, and to identify methods to support and prepare medical students who want to pursue surgical careers. Method A student-led National Surgical Conference (Cardiff, 2018) ran a consensus and debate session entitled ‘Are students adequately prepared for a career in surgery at medical school?’, including a questionnaire addressing elements of medical school curriculums relevant to surgery and the importance of developing technical skills and non-technical skills (NTS). Results 60 delegates completed the questionnaire: Year1-3 (n = 38), Year4-6 (n = 15), intercalating (n = 4), foundation doctors (n = 3). Delegates most frequently stated specific surgical skills (20.1%), broader surgical skills (20.1%) and interpersonal skills (17.2%) as the most important skills to be a surgeon. 75% rated technical skills and NTS as equally important, 25% rated technical skills as more important. 12.5% felt unconfident in their NTS to be an efficient surgical team-member, 37.5% felt between confident and unconfident, and 50% were confident. 26.3% felt unprepared to pursue surgical careers following medical school, 70.2% felt between prepared and unprepared, and 3.5% felt prepared. More practical surgical skills sessions (35%), career pathway sessions (15%), surgically relevant teaching (16%) and theatre or surgical placements (19%) were the most frequently wanted improvements. Conclusions Prospective surgeons highly valued developing surgical skills and overall do not feel prepared to pursue surgery. Medical students would benefit from education on the surgical career pathway and the importance of the non-practical components of surgery, including patient safety and NTS.

329 Cardiothoracic Surgery: National Survey of Medical Students' Perspectives

Aim Cardiothoracic surgery (CTS) is a rapidly evolving specialty requiring the recruitment of talented graduates. This study aims to explore perceptions and exposure of medical students nationally, to CTS. Method Medical students currently in the clinical years of their study were invited to complete an online questionnaire exploring their perceptions of CTS. The questionnaire evaluated students’ personal speciality interest, interest in pursuing CTS as a career, exposure to CTS throughout medical school and using a 5-point likert-scale. Results A total of 917 students were surveyed across 30 different medical schools, of these 378 (41.2%) had exposure to CTS either through their medical school or via extra-curricular activities. 526 (57.3%) were considering CTS as a career choice, 76 (8.3%) were considering it as their top choice of which 9 (11.8%) were final years. Overall, 16.9% (76) of medical students in their penultimate and final years are considering a career in CTS, 39.5% of whom were undecided as to which subspeciality with cardiac surgery being the most popular choice after this. The length of training and the high competition for places were the most deterring factors for medical students while the skilful nature of the surgery and its impact on patients’ lives were attracting factors to CTS. Conclusions Despite many students recognizing CTS as a highly impactful and stimulating field this is not reflected by the number of students wanting to undertake a career pathway within CTS. Very few students have dedicated CTS placements which may be a factor in lack of interest.