Taylor Francesca, Drennan Vari M, Halter Mary, Calestani Melania
Centre for Health & Social Care Research, Joint Faculty of Kingston University and St George's University of London, St George's University of London, Cranmer Terrace, London SW17 ORE, UK.
School of Allied Health, Midwifery and Social Care, Joint Faculty of Kingston University and St George's University of London, St George's University of London, Cranmer Terrace, London SW17 ORE, UK.
Health Policy. 2020 May;124(5):525-530. doi: 10.1016/j.healthpol.2020.03.001. Epub 2020 Mar 16.
Health workforce planners in many high-income countries are considering policy strategies to retain home and overseas-trained health professionals. There is a lack of evidence on how hospitals can successfully integrate and retain skilled overseas professionals in relevant work roles. This study aimed to explore the integration and retention experiences of skilled American physician assistants/associates working in English hospitals.
A qualitative study using semi-structured telephone interviews was undertaken in spring 2017 and spring 2018. Data were coded and analysed using thematic analysis. The study was framed within a theoretical model of role development.
Nineteen physician assistants/associates participated in interviews at timepoint one, and seventeen at timepoint two, across seven English hospitals. Four themes were identified in the integration and retention processes experienced by participants: motivations and expectations, seeking role identity, acceptance and integration, and establishing a niche role. Supervising doctors appeared instrumental in creating opportunities through training and system adjustment that enabled development of niche roles; offering an effective match between participant skills and interests, and medical/surgical team or organisational needs. Whether or not they had a niche role influenced the decision of participants to remain or leave.
Integration approaches that maximise the value of the skilled health professional to the medical/surgical team and support retention, including development of optimum roles, require time and resources.
许多高收入国家的卫生人力规划者正在考虑制定政策战略，以留住本国培养和海外培养的卫生专业人员。目前缺乏关于医院如何成功整合并留住熟练的海外专业人员从事相关工作岗位的证据。本研究旨在探讨在美国接受培训的熟练医师助理在英国医院工作时的整合与留用经历。
于2017年春季和2018年春季进行了一项采用半结构化电话访谈的定性研究。使用主题分析法对数据进行编码和分析。该研究以角色发展的理论模型为框架。
在七家英国医院中，19名医师助理在第一个时间点参与了访谈，17名在第二个时间点参与了访谈。在参与者经历的整合和留用过程中确定了四个主题：动机和期望、寻求角色认同、接受和整合以及确立特殊角色。监督医生似乎通过培训和系统调整创造机会发挥了重要作用，这些机会促成了特殊角色的发展；使参与者的技能和兴趣与医疗/外科团队或组织需求实现有效匹配。他们是否有特殊角色影响了参与者留下或离开的决定。
要实现最大化熟练卫生专业人员对医疗/外科团队的价值并支持其留用的整合方法，包括发展最佳角色，需要时间和资源。
