Bridging the Gap 2021- Summary Report

Differential Attainment Healthcare professionals are among the most respected, valued members in any society- and also the most regulated. It attracts some of the most talented, innovative and resilient individuals who are keen to do good. Respect, job satisfaction and autonomy are fundamental to the experience of any professional, and often valued above financial or material reward. Doctors are no different. Education and training of the healthcare workforce is a lengthy and resource intense process. No nation-state can be truly self-sufficient. Hence workforce migration is a reality where various pull and push factors lead to professionals moving across countries and continents, in the service of populations. Society is divided along many lines and steeped with structural inequalities. Many of these are the result of thousands of years of history, legacy and societal wrongs. Healthcare services and professionals reflect similar patterns of the 'big society'. The phenomenon of differential attainment (DA), which is the subject of this report is simply a manifestation of such structural inequalities. DA or differential outcomes for doctors due to their age, race, gender, sexual orientation, ethnicity, disability, socio-economic deprivation or influenced by migrant status - rather than motivation, ability, effort or enterprise. DA is fundamentally unfair. Those affected by DA are either unaware or unable to counteract the influence on their careers. DA leads to demoralisation, disengagement and poor outcomes for professionals and their patients. It takes its toll not only on careers but on lives and livelihoods. DA leads to a huge under-utlisation of human resources- a true waste of talent and enterprise. This report- BTG21 focuses on DA in the medical profession exploring the career cycle through the themes of recruitment, assessments, career progression, research & academia, leadership roles, awards and professionalism. BTG21 is people-centred and in tackling inequalities offers solutions on career fulfillment and wellbeing- by an ideological shift of hearts and minds. Thematic Synthesis BTG21 summary report is the culmination of a thematic synthesis of evidence covering the full spectrum of medical careers. It presents lived experiences (collected through mixed method approaches) capturing patterns in peoples experiences through an online survey, and in-depth qualitative interviews with a purposive sample of professionals from across the career cycle, range of ethnic heritage, medical specialism and country of origin. Followed by consensus developed through workshops by a triumvirate of experts, stakeholders and grassroots professionals. There are 5 primary causes of DA- bias, social class & deprivation, immigration status, geographical and individual factors and impacts every stage of medical professional careers. The thematic synthesis reviews are published in the Sushruta Journal of Health Policy. Recommendations The Workshop discussions, recommendations (the 10-point plan) include policy enablers, immediate actions and research questions in the following areas; Tackling bias Embracing diversity & inclusion Celebrating the contribution of migrants Leveling the playing field Inclusive leadership & accountability Removing structural barriers Review-Reform-Rethink assessments Redefining professionalism Disaggregation-intersectionality-benchmarking of data Support-flexibility & Wellbeing

Approaching Teaching as a Complex Emotional Experience: The Teacher Professional Development Stages Revisited

Along the evolving teaching journey, teachers experience a series of events that allow them to transition from novice to expert. Throughout the years, such transition has been the object of theories and debates about how this process is carried out, and when it is that teachers move from one stage to the other. This article presents a study of a Mexican teacher of English and examines the professional-developmental stages based on Huberman’s (1993) career cycle model. Its aim is to understand the challenges and decisions a teacher may encounter in her or his career. The article shows the realities a teacher faces by exploring the concepts of emotions, identity, socialization, and agency. Moreover, it questions the belief that teachers achieve expertise through accumulating years of practice.

Investigation of self-Efficacy sources of classroom teachers based on various variablesSınıf öğretmenleri öz-yeterlik kaynaklarinin çeşitli değişkenlere göre incelenmesi

The aim of the study is to clarify classroom teachers’ self-efficacy sources perception. Four factors of self-efficacy and general total values based on various variables. Independent variables are gender, teaching experiences, and cities where participant work in. Mastery experiences, Vicarious Experiences, Verbal persuasion and Emotional and psychological states are defined as four factors that constitute sources of self-efficacy. In this quantitative survey study, convenient sampling was used. Self-efficacy is affected by instructional methods used by teachers, materials and infrastructure of learning environments. That is why author determine easily accessible two cities to compare different locations and opportunities. In total of 128 volunteer classroom teachers, 69 female participants (53.9%) and 59 male participants (46.1%) participated in the study. Findings show female teachers have statistically significant higher scores on vicarious experiences and verbal persuasion than male participants according to Mann Whityney U test results [U1(3512)=-2,183; U2(3221)=-2,283; p<.05]. Teaching experiences showed statistically significant results about emotional and physiological factor. Teaching experiences did not have statistically significant effect on total scores of self-efficacy sources and also vicarious experiences factor. Kruskal Wallis H scores did not show statistically meaningful scores for teaching experiences effect on mastery experiences and verbal persuasion. On the other hand, Emotional and psychological states have statistically significant effect on sources of self-efficay [H(1218)=7,198; p<.05]. The items emphasize “negative feelings like anxiety, sadness. Location did not show any statistically significant differences on total scores of self-efficacy sources and also four factors of it. Female classroom teachers are affected by verbal constructive/positive feedbacks on their profession than male classroom teachers schools administrators can use the finding to motivate them. Verbal persuasion can be used to create high expectations from themselves and recognize their educational products. The higher teaching experiences teachers have the lowest worries they have. Teachers in induction stage of teacher career cycle could be supported to decrease about their emotional-physiological concerns on teaching to support self-efficacy sources.Extended English summary is in the end of Full Text PDF (TURKISH) file.ÖzetBu çalışmanın amacı sınıf öğretmenlerinin öz-yeterlik kaynaklarını kendi aldı ve deneyimlerini ifade etmelerine bağlı kalarak ortaya koymaktır. Öz-yeterlik kaynaklarının 4 boyutu ve toplam puanlarının çeşitli değişkenlere göre incelenmiştir. Bağımsız değişkenler cinsiyet, öğretmenlik deneyimi, görev yapılan il olarak belirlenmiştir. Performans başarıları olarak da ifade edilebilen doğrudan deneyimler, dolaylı deneyimler, sözel ikna ve duygusal ve psikolojik durum köz-yeterlik kaynaklarının boyutlarıdır. Nicel tarama araştırması olan bu çalışmada Uygun Örneklem kullanılmıştır. Öz-yeterlik öğretim yöntemleri, meğitim materyalleri, okul altyapısı gibi birçok faktörden etkilendiğini alanyazın desteklemektedir. Bu nedenle farklı iki ilde bu çalışmayı gerçekleştirmek amaçlanmıştır. Toplam 128 gönüllü sınıf öğretmeni çalışmaya katılmıştır. Katılımcıların 69’u kadın (%53,9), 59’u erkektir. (%46,1).Mann Whitney U testi sonuçlarına göre [U1(3512)=-2,183; U2(3221)=-2,283; p<.05] Kadın sınıf öğretmenleri erkek sınıf öğretmenlerinden istatistiksel olarak anlamlı dolaylı yaşantılar ve sözel ikna boyutlarında daha yüksek puanlar almıştır. Öğretmenlik deneyiminde fizyolojik ve duygusal durum boyutta toplam öz-yeterlik boyutlarının genel toplamında istatistiksel olarak anlamlı bir ilişkisi bulunmamıştır. Kruskal Wallis H puanları performans başarıları ve sözel ikna boyutlarında anlamlı bir ilişki bulunmamıştır. fizyolojik ve duygusal durum öğretmenlik deneyimiyle ilişkili bulunmuştur [H(1218)=7,198; p<.05]. Bu boyutun maddeleri incelendiğinde endişe, korku, gibi olumsuz Kabul edilebilecek durumların öğrenme ortamında yaşanmasının deneyimle azaldığı sonucuna varılabilir. Kadın sınıf öğretmenleri sözel ikna boyutundan istatistiksel olarak anlamlı bir şekilde etkilenmekte olduğundan okul yöneticileri/müdürlerin sözel iknayı öğretmenlerin motivasyonunu artırmada kullanabileceği düşünülebilir. Bu durumun öz-yeterlik kaynaklarını destekleyerek etkili bir öz-yeterlik hissiyle eğitim çıktıları desteklenebilir. Öğretmenlik deneyimi ve arttıkça öğretmenlerin öğrenme ortamında kaygılarının azaldığı belirlenmiştir. Mesleğine yeni başlayan öğretmenlerin duygusal-fizyolojik boyutta kaygıları olduğu çalışmanın bulguları arasındadır ve bu dönemdeki öğretmenlere motivasyon arttırıcı destekler verilebilir.

Factors that affect general practice as a choice of medical speciality: implications for policy development

Objective This article critically appraises the range of personal, professional and social factors that affect the choice of speciality across medical students, prevocational doctors, general practice registrars and general practitioners. Methods This qualitative study applied constructs from the fields of decision theory and career theory to better understand the complex nature of choosing a speciality. In all, 47 in-depth interviews were conducted with participants at different stages of their career cycle. The data was codified and analysed using NVivo to identify key factors that influenced speciality choice. Results The research identified 77 individual findings influencing general practice as a choice of medical speciality. These were distilled into a matrix to show that factors such as money, prestige and peer interaction did not have a compelling effect, whereas clinical and academic role models, flexibility, work–life balance, scope of practice, connection with patients, training environment and practical opportunities did. Conclusion The findings indicate that the decision in relation to the choice of medical speciality is a complex cognitive process that is undertaken within a personal, social and professional context particular to each individual. What is known about the topic? Current literature aims to quantify changes in attitudes towards choice of speciality or the effect of particular variables in isolation while ignoring the complexity of this decision process and how the numerous variables compare with each other. What does this paper add? The present study is the first intergenerational research on this topic in the Australian context and the paper dismisses the role of prestige and remuneration as key drivers of choice in picking general practice as a speciality, noting that money is merely a ‘hygiene factor’. What are the implications for policy makers? A policy framework outlining 10 key principles is presented to assist policy makers seeking to affect workforce outcomes by applying policy levers to influence doctors’ choice of speciality.

Multi-stage expectation-confirmation framework for salespeople expectation management

Purpose Despite its significance in salespeople management, salespeople expectation management has received little attention in the literature, especially in the industrial marketing literature. In response, the purpose of this study is to leverage the expectation confirmation theory to present a conceptual framework that provides an effective tool for salespeople expectation management. Design/methodology/approach This study first explores the application and strategic implications of expectation-confirmation theory in salespeople expectation management and theorizes that salespeople establish pre-expectations (expectations that are developed before joining the firm), experience multiple stages of the expectation-confirmation process throughout their sales career with a firm and – in each stage – establish either a longer-term commitment to or permanent disengagement from the firm. Findings A winning strategy for sales organizations is to recognize salespeople expectations and to meet or beat these expectations. Salespeople expectation management is particularly important in sales organizations that frequently find aligning sales force management strategies with organizational imperatives to be challenging. Research limitations/implications This study extends expectation-confirmation theory by presenting a conceptual framework that: identifies the existence of pre-expectations of salespeople and their outcomes; recognizes that the expectation-confirmation process occurs across multiple stages in the salespeople’s career cycle; recognizes that the level of expectations in previous stages of one’s career cycle influences the level of expectations in subsequent stages; and conceptualizes the non-linear relationship between expectations, tenure and turnover intentions. Originality/value The multiple expectation-confirmation framework can be used for effective salespeople expectation and turnover management and may also serve as a general model of organizational interventions.

Becoming part of the city: Influences on the career choice of an urban music educator

The purpose of this case study was to examine and describe the life experiences that influenced one music teacher’s career choice to teach music in an urban school. The primary research question is: What experiences influenced the participant to pursue urban music education as a career? Calling upon research into urban music education and career choice, the article used a “secondary analysis” of survey, journal, and interview data collected in a larger investigation of the teacher career cycle, as viewed through the lens of narrative research. Findings are presented in four categories, and indicate that the teacher’s career choice was influenced by three primary elements: (a) feeling a need to be of service to others; (b) experiencing cultural differences; and (c) curiosity about the city; all of which led to (d) being a part of the city. These elements combined to form not just a career choice, but a strong sense of commitment to teaching music in a specific city. Implications for both urban music education and music teacher education are discussed, as are suggestions for further research.

Teacher education and career cycle: Educational level and pathways effects in Serbia and Greece

Given the importance of teachers? work and effectiveness, the authors have chosen to study how the teachers? education determines their vocational behavior in terms of enthusiasm and growing and career frustration in Serbia and Greece. They examined the significance of education level and education pathway in mutual interaction and in interaction with intrinsic motivation of career choice. The study used survey methodology. The questionnaire was administered to a convenience sample of 213 secondary school teachers. The results indicate that career characteristics do not differ with respect to the level of formal education and the authors conclude that transit to the world of work can be made after the bachelor level, when the bachelor program includes adequate pedagogical preparation. The effect of education pathway interaction with intrinsic motivation was significant in the sample of Greek teachers. Teachers, who had undergone more thorough preparation for teaching, have developed their job attitudes independently from their career choice motivations. The lesser significance of initial motivation for teaching is interpreted as a possibility to compensate for lower levels of motivation by developing teaching competences, i.e. facilitating self-efficacy through teacher training. No evidence of teacher preparation effects was found in the Serbian sample, indicating that teachers educated according to the old system pathways cannot be expected to achieve different job attitude.

Descriptions of the second stage of music teachers’ careers

The purpose of this study was to describe experiences of 12 second-stage music teachers as several themes emerged from a secondary analysis of previously collected written survey and interview data. Participants were previously involved in studies in which they were asked to reflect on their beginning teaching experiences and discuss their music teaching careers in the last 10 years (Conway, 2012a, 2012b). Data from the previous studies were then used in a secondary analysis in which we examined the data through the lens of “career cycle” and “second stage” theory. Experiences in the second stage included: (a) feeling settled; (b) assuming leadership; (c) uncertainty; and (d) seeking new challenges. These are discussed in relation to past research and suggestions for future research are provided.