Formerly Birmingham Medical School, University of Birmingham, Birmingham, UK.
Formerly National School of Healthcare Science, Health Education England, Birmingham, UK.
BMC Health Serv Res. 2021 Oct 6;21(1):1059. doi: 10.1186/s12913-021-07064-1.
Understanding the influences on healthcare professionals' career choices and progression can inform interventions to improve workforce retention. Retention of health professionals is a high priority worldwide, in order to maintain expertise and meet the needs of national populations. In the UK, investment in clinical scientists' pre-registration education is high and the need to retain motivated scientists recognised.
We conducted a mixed methods study to investigate the career choices and progression of early career clinical scientists. First job sector and salary of trainees who completed the UK pre-registration Scientist Training Programme (STP) between 2014 and 2019 were analysed using descriptive statistics and Chi-Squared tests. Semi-structured interviews conducted with volunteer practising clinical scientists who completed the programme in 2015 or 2016 were analysed thematically and reviewed for alignment with theories for understanding career choice and workforce retention.
Most scientists who completed the STP between 2014 and 2019 obtained a post in the UK National Health Service (NHS) and achieved the expected starting salary. Life scientists were more likely to work in non-NHS healthcare settings than other scientific divisions; and physiological scientists less likely to achieve the expected starting salary. Experiences during training influenced career choice and progression 0-3 years post qualification, as did level of integration of training places with workforce planning. Specialty norms, staff turnover, organisational uncertainty and geographical preferences influenced choices in both the short (0-3 years) and longer term (5 + years). Interviewees reported a strong commitment to public service; and some could foresee that these priorities would influence future decisions about applying for management positions. These factors aligned with the components of job embeddedness theory, particularly that of 'fit'.
Training experiences, personal values, specialty norms and organisational factors all influence UK clinical scientists' early career choices and progression. Job embeddedness theory provides a useful lens through which to explore career choice and progression; and suggests types of intervention that can enhance the careers of this essential group. Interventions need to take account of variations between different scientific specialties.
了解医疗保健专业人员职业选择和职业发展的影响因素，可以为改善劳动力保留率的干预措施提供信息。在全球范围内，为了保持专业知识并满足国家人口的需求，专业人员的保留率是重中之重。在英国，对临床科学家预备注册教育的投资很高，并且认识到需要留住有积极性的科学家。
我们进行了一项混合方法研究，以调查早期职业临床科学家的职业选择和职业发展。使用描述性统计和卡方检验分析了 2014 年至 2019 年期间完成英国预注册科学家培训计划（STP）的学员的第一份工作部门和薪资。对 2015 年或 2016 年完成该计划的志愿执业临床科学家进行了半结构化访谈，采用主题分析，并对其进行了审查，以与理解职业选择和劳动力保留的理论保持一致。
在 2014 年至 2019 年期间完成 STP 的大多数科学家都在英国国家医疗服务体系（NHS）获得了职位，并获得了预期的起薪。生命科学家比其他科学部门更有可能在非 NHS 医疗保健环境中工作；而生理科学家则不太可能获得预期的起薪。培训期间的经历会影响 0-3 年的职业选择和发展，培训地点与劳动力规划的融合程度也会影响职业选择和发展。专业规范、人员流动、组织不确定性和地理偏好会影响短期（0-3 年）和长期（5 年以上）的选择。受访者报告说，他们对公共服务有强烈的承诺；并且有些人可以预见，这些优先事项将影响他们未来申请管理职位的决定。这些因素与工作嵌入理论的组成部分，特别是“契合”，相一致。
培训经验、个人价值观、专业规范和组织因素都会影响英国临床科学家的早期职业选择和职业发展。工作嵌入理论为探索职业选择和职业发展提供了一个有用的视角；并提出了可以增强这一重要群体职业发展的干预类型。干预措施需要考虑到不同科学专业之间的差异。
