Andah Efioanwan, Essang Blessing, Friend Charlotte, Greenley Sarah, Harvey Kathryn, Spears Maria, Reeve Joanne
Academy of Primary Care, Hull York Medical School, University of Hull, Hull, UK
Academy of Primary Care, Hull York Medical School, University of Hull, Hull, UK.
BJGP Open. 2021 Apr 26;5(2). doi: 10.3399/BJGPO.2021.0005. Print 2021 Apr.
The NHS is facing a workforce crisis. Responses to date have focused on improving recruitment of staff, but less attention has been paid to retention.
To conduct a rapid review using Rosabeth Moss Kanter's three Ms model of workforce motivation as a sensitising framework to examine the current medical workforce crisis. The work considers how insights from research in other professions offers new thinking for understanding what motivates doctors to continue working.
DESIGN & SETTING: Rapid literature review with secondary analysis of existing research examining reasons for leaving medicine.
A systematic search strategy was developed with the aid of an information specialist. The search terms used were: medical professionals, retention, and NHS. The exclusions were: commentaries, non-medical professionals, non-English language, and it was limited to post-1990. The search was applied to three electronic databases, MEDLINE, Embase, and Healthcare Management Information Consortium (HMIC). This produced a dataset describing study design, and factors related to motivation for leaving the medical profession. Comparative thematic analysis distilled core themes explaining the reasons for leaving and their relation to the three Ms model.
Of 3389 abstracts identified, screening and assessment produced 82 articles included in the final analysis. Thematic analysis identified four key themes: low morale, disconnect, unmanageable change, and lack of personal and professional support. The themes of mastery, membership, and meaning were substantially present within the dataset.
Kanter's three Ms model of motivation can be applied to the medical workforce to understand retention issues. This work supports the development of targeted solutions to tackle the worsening workforce crisis.
英国国民医疗服务体系（NHS）正面临劳动力危机。迄今为止的应对措施主要集中在改善员工招聘方面，但对留用问题的关注较少。
运用罗莎贝斯·莫斯·坎特（Rosabeth Moss Kanter）的劳动力激励三要素模型作为敏感框架进行快速综述，以审视当前的医疗劳动力危机。这项工作探讨了其他职业研究中的见解如何为理解激励医生继续工作的因素提供新的思路。
对现有研究进行二次分析的快速文献综述，以研究离开医疗行业的原因。
在信息专家的协助下制定了系统的搜索策略。使用的搜索词为：医疗专业人员、留用和NHS。排除的内容包括：评论、非医疗专业人员、非英语语言的文献，且仅限于1990年以后的文献。搜索应用于三个电子数据库，即医学文献数据库（MEDLINE）、荷兰医学文摘数据库（Embase）和医疗保健管理信息联盟（HMIC）。这产生了一个描述研究设计以及与离开医疗行业动机相关因素的数据集。比较主题分析提炼出了解释离职原因及其与三要素模型关系的核心主题。
在识别出的3389篇摘要中，经过筛选和评估，最终分析纳入了82篇文章。主题分析确定了四个关键主题：士气低落、脱节、难以应对的变革以及缺乏个人和专业支持。在数据集中，掌握、归属和意义这几个主题大量存在。
坎特的激励三要素模型可应用于医疗劳动力，以理解留用问题。这项工作有助于开发针对性的解决方案，以应对日益恶化的劳动力危机。
