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Ironside A, Thoma B, Trinder K, Bueckert S, Lee T, Domes T. The value of admissions characteristics for predicting the practice location of University of Saskatchewan College of Medicine graduates. CANADIAN MEDICAL EDUCATION JOURNAL 2022; 13:64-72. [PMID: 36440083 PMCID: PMC9684043 DOI: 10.36834/cmej.74288] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
BACKGROUND The physician workforce in Saskatchewan depends upon the retention of locally trained physicians. Characteristics collected at the time of medical school application may predict future practice location, but these associations have not been explored. METHODS We identified the current practice location of University of Saskatchewan College of Medicine graduates who matriculated between 2000 and 2013 and extracted data from their admission applications including gender, age, high school, previous university, and current location at the time of application. We then conducted univariate and multivariate analyses to evaluate associations between these characteristics and rural- and Saskatchewan-based practice. RESULTS We identified the current practice location of 1,001 (98.9%) of the graduates of the included cohorts. Attending a Saskatchewan high school (p < 0.001), a high school in a smaller population center (p < 0.01), and a Saskatchewan university (p < 0.001) were predictive of Saskatchewan-based practice. Attending a high school outside of Saskatchewan (p < 0.05), a high school in a smaller population center (p < 0.001), and living in a small population centre at the time of application (p < 0.05) were predictive of rural-based practice within or outside of Saskatchewan. CONCLUSION Demographic characteristics collected at time of medical school application are associated with future Saskatchewan- and rural-based practice. These findings will guide admissions policies in Saskatchewan and may inform admission practices of other medical schools.
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Affiliation(s)
- Avery Ironside
- College of Medicine, University of Saskatchewan, Saskatchewan, Canada
| | - Brent Thoma
- College of Medicine, University of Saskatchewan, Saskatchewan, Canada
- Department of Emergency Medicine, University of Saskatchewan, Saskatchewan, Canada
- Clinical Educator, Royal College of Physicians and Surgeons of Canada, Ontario, Canada
| | - Krista Trinder
- College of Medicine, University of Saskatchewan, Saskatchewan, Canada
| | - Sherrill Bueckert
- College of Medicine, University of Saskatchewan, Saskatchewan, Canada
| | - Tara Lee
- College of Medicine, University of Saskatchewan, Saskatchewan, Canada
- Department of Family Medicine, University of Saskatchewan, Saskatchewan, Canada
| | - Trustin Domes
- College of Medicine, University of Saskatchewan, Saskatchewan, Canada
- Department of Surgery, University of Saskatchewan, Saskatchewan, Canada
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Noya F, Carr S, Freeman K, Thompson S, Clifford R, Playford D. Strategies to Facilitate Improved Recruitment, Development, and Retention of the Rural and Remote Medical Workforce: A Scoping Review. Int J Health Policy Manag 2022; 11:2022-2037. [PMID: 34973053 PMCID: PMC9808272 DOI: 10.34172/ijhpm.2021.160] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 11/14/2021] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Medical workforce shortages in rural and remote areas are a global issue. High-income countries (HICs) and low- and middle-income countries (LMICs) seek to implement strategies to address this problem, regardless of local challenges and contexts. This study distilled strategies with positive outcomes and success from international peer-reviewed literature regarding recruitment, retention, and rural and remote medical workforce development in HICs and LMICs. METHODS The Arksey and O'Malley scoping review framework was utilised. Articles were retrieved from electronic databases Medline, Embase, Global Health, CINAHL Plus, and PubMed from 2010-2020. The Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) guideline was used to ensure rigour in reporting the methodology in the interim, and PRISMA extension for scoping review (PRISMA-ScR) was used as a guide to report the findings. The success of strategies was examined against the following outcomes: for recruitment - rural and remote practice location; for development - personal and professional development; and for retention - continuity in rural and remote practice and low turnover rates. RESULTS Sixty-one studies were included according to the restriction criteria. Most studies (n=53; 87%) were undertaken in HICs, with only eight studies from LMICs. This scoping review found implementation strategies classified as Educational, Financial, and Multidimensional were successful for recruitment, retention, and development of the rural and remote medical workforce. CONCLUSION This scoping review shows that effective strategies to recruit and retain rural and remote medical workforce are feasible worldwide despite differences in socio-economic factors. While adjustment and adaptation to match the strategies to the local context are required, the country's commitment to act to improve the rural medical workforce shortage is most critical.
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Affiliation(s)
- Farah Noya
- Division of Health Professions Education, School of Allied Health, University of Western Australia, Perth, WA, Australia
| | - Sandra Carr
- Division of Health Professions Education, School of Allied Health, University of Western Australia, Perth, WA, Australia
| | - Kirsty Freeman
- Division of Health Professions Education, School of Allied Health, University of Western Australia, Perth, WA, Australia
- Duke National University Singapore Medical School, Singapore, Singapore
| | - Sandra Thompson
- Western Australian Centre for Rural Health, The University of Western Australia, Perth, WA, Australia
| | - Rhonda Clifford
- School of Allied Health, University of Western Australia, Perth, WA, Australia
| | - Denese Playford
- The Rural Clinical School of WA, School of Medicine, The University of Western Australia, Perth, WA, Australia
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Noya F, Carr S, Thompson S, Clifford R, Playford D. Factors associated with the rural and remote practice of medical workforce in Maluku Islands of Indonesia: a cross-sectional study. HUMAN RESOURCES FOR HEALTH 2021; 19:126. [PMID: 34627282 PMCID: PMC8502290 DOI: 10.1186/s12960-021-00667-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Accepted: 09/28/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Many factors contribute to engagement in rural and remote (RR) medical practice, but little is known about the factors associated with rural and remote medical practice in such remote locations as the Maluku Province of Indonesia. This study describes factors associated with actual RR practice, preferred RR practice, and intention to remain practice in Maluku Province. METHODS An online survey of work-related experience and intentions for future rural work was administered to 410 doctors working in the Maluku province of Indonesia. Participant characteristics were described using descriptive statistics, associations between the independent variables with the location of the workforce, intention to remain practice in Maluku, preference for future RR practice in Maluku were analysed using Chi-square tests and logistic regression. RESULTS A total of 324 responses (79% response rate) were recorded, comprising 70% females and 30% Pattimura University graduates of doctors employed in Maluku. Doctors working in RR areas were more likely to be a GP (OR 3.49, CI 1.03-11.8), have a monthly salary of more than IDR 6 million (OR 11.5, CI 4.24-31.1), and have no additional practice (OR 2.78, CI 1.34-5.78). Doctors intended to stay practice in Maluku were more likely to be born in Maluku (OR 7.77, CI 3.42-17.7) and have graduated from Pattimura University (OR 3.06, CI 1.09-8.54), and less likely to be a temporary employee (OR 0.24, CI 0.10-0.57). Doctors who prefer future RR practice in Maluku were more likely to experience rural living (OR 2.05 CI 1.05-3.99), have a positive indication of the impact of community exposure during medical schools on their current practice (OR 2.08, CI 1.06-4.09), currently practising in RR Maluku (OR 8.23, CI 3.27-20.8); and less likely to have bigger take-home pay (OR 0.30, CI 0.13-0.70). CONCLUSION This study indicates that special attention should be given to recruiting doctors with a rural background and ongoing support through attractive opportunities to build a sustainable RR workforce. Since a regional medical school helps supply doctors to the RR areas in its region, a sustained collaboration between medical schools and local government implementing relevant strategies are needed to widen participation and improve the recruitment and retention of RR doctors.
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Affiliation(s)
- Farah Noya
- Division of Health Professions Education, School of Allied Health, University of Western Australia, Perth, Australia
- Medical Education Unit, Faculty of Medicine, Pattimura University, Ambon, Indonesia
- Health Professions Education Building, The University of Western Australia, Crawley Avenue (off Mounts Bay Road-next to CAR PARK 25), Nedlands, WA 6009 Australia
| | - Sandra Carr
- Division of Health Professions Education, School of Allied Health, University of Western Australia, Perth, Australia
| | - Sandra Thompson
- Western Australian Centre for Rural Health, The University of Western Australia, Perth, Australia
| | - Rhonda Clifford
- School of Allied Health, University of Western Australia, Perth, Australia
| | - Denese Playford
- The Rural Clinical School of WA, School of Medicine, The University of Western Australia, Perth, Australia
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Why Interested Surgeons Are Not Choosing Rural Surgery: What Can We Do Now? J Surg Res 2021; 263:258-264. [PMID: 33735686 DOI: 10.1016/j.jss.2021.01.032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 01/28/2021] [Accepted: 01/31/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND There is a growing deficit of rural surgeons, and preparation to meet this need is inadequate. More research into stratifying factors that specifically influence choice in rural versus urban practice is needed. METHODS An institutional review board-approved survey related to factors influencing rural practice selection and increasing rural recruitment was distributed through the American College of Surgeons. The results were analyzed descriptively and thematically. RESULTS Of 416 respondents (74% male), 287 (69%) had previous rural experience. Of those, 71 (25%) did not choose rural practice; lack of professional or hospital support (30%) and lifestyle (26%) were the primary reasons. A broad scope of practice was most important among surgeons (52%), who chose rural practice without any previous rural experience. Over 60% of urban practitioners agreed that improved lifestyle and financial advantages would attract them to rural practice. The thematic analysis suggested institutional support, affiliation with academic institutions, and less focus on subspecialty fellowship could help increase the number of rural surgeons. CONCLUSIONS Many factors influence surgeons' decisions on practice location. Providing appropriate hospital support in rural areas and promoting specific aspects of rural practice, including broad scope of practice to those in training could help grow interest in rural surgery. Strong collaboration with academic institutions for teaching, learning, and mentoring opportunities for rural surgeons could also lead to higher satisfaction, security, and potentially higher retention rate. These results provide a foundation to help focus specific efforts and resources in the recruitment and retention of rural surgeons.
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Mohammadiaghdam N, Doshmangir L, Babaie J, Khabiri R, Ponnet K. Determining factors in the retention of physicians in rural and underdeveloped areas: a systematic review. BMC FAMILY PRACTICE 2020; 21:216. [PMID: 33097002 PMCID: PMC7585284 DOI: 10.1186/s12875-020-01279-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Accepted: 10/05/2020] [Indexed: 01/14/2023]
Abstract
Background Imbalance in distribution of Health Care Workers (HCWs) in a country is a global challenge. Almost all of the rural and underdeveloped areas are struggling with the shortage of HCWs, especially physicians. Therefore, this study aimed to identify factors governing the retention of physicians in rural and underdeveloped areas. Methods International databases including Scopus, PubMed, Web of Science, Proquest, and Embase were searched using Mesh terms in order to find peer-reviewed journal articles addressing physicians’ retention factors in rural and underdeveloped areas. The records were screened, and any duplicate results were removed. The quality of the studies was assessed according to the Critical Appraisal Skills Program developed for different types of studies. Then, through content analysis, the related factors were identified from finally selected papers, coded, and categorized. Results The initial search resulted in 2312 relevant articles. On the basis of specific selection criteria, 35 full-text articles were finally reviewed.. The major affecting factors in physicians’ retention in rural and underdeveloped regions were classified into the following six categories: 1) financial; 2) career and professional; 3) working conditions; 4) personal; 5) cultural; and 6) living conditions factors. Conclusion There is a complex interplay of factors governing physicians’ retention in rural and underdeveloped areas. If health organizations are concerned with physicians’ retention in deprived areas, they should take into account these main factors. Moreover, they should develop policies and strategies to attract and retain physicians in rural and underdeveloped areas.
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Affiliation(s)
- Nasrin Mohammadiaghdam
- Department of Health Policy& Management, Tabriz Health Services Management Research Center, Iranian Center of Excellence in Health Management, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Leila Doshmangir
- Department of Health Policy& Management, Tabriz Health Services Management Research Center, Iranian Center of Excellence in Health Management, Tabriz University of Medical Sciences, Tabriz, Iran. .,Social Determinants of Health Services Research, Health Management and safety Promotion Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Javad Babaie
- Department of Health Policy& Management, Tabriz Health Services Management Research Center, Iranian Center of Excellence in Health Management, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Roghayeh Khabiri
- Department of Health Policy& Management, Tabriz Health Services Management Research Center, Iranian Center of Excellence in Health Management, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Koen Ponnet
- Faculty of Social Sciences, imec-mict-Ghent University, Ghent, Belgium
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Sirili N, Frumence G, Kiwara A, Mwangu M, Anaeli A, Nyamhanga T, Goicolea I, Hurtig AK. Retention of medical doctors at the district level: a qualitative study of experiences from Tanzania. BMC Health Serv Res 2018; 18:260. [PMID: 29631589 PMCID: PMC5891935 DOI: 10.1186/s12913-018-3059-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2016] [Accepted: 03/23/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Retention of Human Resources for Health (HRH), particularly doctors at district level is a big challenge facing the decentralized health systems in poorly resourced countries. Tanzania, with 75% of its population in rural areas, has only 26% of doctors serving in rural areas. We aimed to analyze the experiences regarding the retention of doctors at district level in Tanzania from doctors' and district health managers' perspectives. METHODS A qualitative study was carried out in three districts from June to September 2013. We reviewed selected HRH documents and then conducted 15 key informant interviews with members of the District Health Management teams and medical doctors working at the district hospitals. In addition, we conducted three focus group discussions with Council Health Management Team members in the three districts. Incentive package plans, HRH establishment, and health sector development plans from the three districts were reviewed. Data analysis was performed using qualitative content analysis. RESULTS None of the districts in this study has the number of doctors recommended. Retention of doctors in the districts faced the following challenges: unfavourable working conditions including poor working environment, lack of assurance of career progression, and a non-uniform financial incentive system across districts; unsupportive environment in the community, characterized by: difficulty in securing houses for rent, lack of opportunities to earn extra income, lack of appreciation from the community and poor social services. Health managers across districts endeavour to retain their doctors through different retention strategies, including: career development plans, minimum financial incentive packages and avenues for private practices in the district hospitals. However, managers face constrained financial resources, with many competing priorities at district level. CONCLUSIONS Retention of doctors at district level faces numerous challenges. Assurance of career growth, provision of uniform minimum financial incentives and ensuring availability of good social services and economic opportunities within the community are among important retention strategies.
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Affiliation(s)
- Nathanael Sirili
- Unit of Epidemiology and Global Health, Department of Public Health and Clinical Medicine, Umeå University, Sweden, SE90185 Umeå, Sweden
- Department of Development Studies, School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, P.O.BOX 65454 Dar es Salaam, Tanzania
| | - Gasto Frumence
- Unit of Epidemiology and Global Health, Department of Public Health and Clinical Medicine, Umeå University, Sweden, SE90185 Umeå, Sweden
| | - Angwara Kiwara
- Unit of Epidemiology and Global Health, Department of Public Health and Clinical Medicine, Umeå University, Sweden, SE90185 Umeå, Sweden
| | - Mughwira Mwangu
- Unit of Epidemiology and Global Health, Department of Public Health and Clinical Medicine, Umeå University, Sweden, SE90185 Umeå, Sweden
| | - Amani Anaeli
- Unit of Epidemiology and Global Health, Department of Public Health and Clinical Medicine, Umeå University, Sweden, SE90185 Umeå, Sweden
| | - Tumaini Nyamhanga
- Unit of Epidemiology and Global Health, Department of Public Health and Clinical Medicine, Umeå University, Sweden, SE90185 Umeå, Sweden
| | - Isabel Goicolea
- Department of Development Studies, School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, P.O.BOX 65454 Dar es Salaam, Tanzania
| | - Anna-Karin Hurtig
- Department of Development Studies, School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, P.O.BOX 65454 Dar es Salaam, Tanzania
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Lemky K, Gagne P, Konkin J, Stobbe K, Fearon G, Blom S, Lapointe GM. A review of methods to assess the economic impact of distributed medical education (DME) in Canada. CANADIAN MEDICAL EDUCATION JOURNAL 2018; 9:e87-e99. [PMID: 30140340 PMCID: PMC6104329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
BACKGROUND Canadian distributed medical education (DME) increased substantially in the last decade, resulting in positive economic impacts to local communities. A reliable and simple method to estimate economic contributions is essential to provide managers with information on the extent of these impacts. This review paper fills a gap in the literature by answering the question: What are the most applicable quantitative methods to assess the economic impact of Canadian DME programs? METHODS The literature is reviewed to identify economic assessment methods. These are evaluated and compared based on the benefits, challenges, data needs, outputs and potential for use in the DME context. RESULTS We identified five economic impact methods used in similar contexts. Two of these methods have the potential for Canadian DME programs: the Canadian Input-Output (I-O) model and the Simplified American Council on Education (ACE) method. CONCLUSION Choice of a method is contingent on the ability to measure the salient economic impacts, and provide an output that facilitates sustainable decision making. This paper thus fills a gap by identifying methods applicable to DME. These methods will assist stakeholders to calculate economic impacts, resulting in both the advancement and sustainability of these programs over short-and long-term time frames.
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Affiliation(s)
- Kim Lemky
- Brandon University, Manitoba, Canada
| | - Pierre Gagne
- Campus de l’Université de Montréal en Mauricie, Faculté de médecine, Université de Montréal, Québec, Canada
| | - Jill Konkin
- Divison of Community Engagement, Edmonton Clinic Health Academy, University of Alberta, Alberta, Canada
| | - Karl Stobbe
- Niagara Regional Campus, Michael G. DeGroote School of Medicine, McMaster University, Ontario, Canada
| | | | - Sylvia Blom
- Charles H. Dyson School of Applied Economics and Management, Cornell University, New York, United States
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MacQueen IT, Maggard-Gibbons M, Capra G, Raaen L, Ulloa JG, Shekelle PG, Miake-Lye I, Beroes JM, Hempel S. Recruiting Rural Healthcare Providers Today: a Systematic Review of Training Program Success and Determinants of Geographic Choices. J Gen Intern Med 2018; 33:191-199. [PMID: 29181791 PMCID: PMC5789104 DOI: 10.1007/s11606-017-4210-z] [Citation(s) in RCA: 65] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Revised: 09/22/2017] [Accepted: 09/28/2017] [Indexed: 11/29/2022]
Abstract
BACKGROUND Rural areas have historically struggled with shortages of healthcare providers; however, advanced communication technologies have transformed rural healthcare, and practice in underserved areas has been recognized as a policy priority. This systematic review aims to assess reasons for current providers' geographic choices and the success of training programs aimed at increasing rural provider recruitment. METHODS This systematic review (PROSPERO: CRD42015025403) searched seven databases for published and gray literature on the current cohort of US rural healthcare practitioners (2005 to March 2017). Two reviewers independently screened citations for inclusion; one reviewer extracted data and assessed risk of bias, with a senior systematic reviewer checking the data; quality of evidence was assessed using the GRADE approach. RESULTS Of 7276 screened citations, we identified 31 studies exploring reasons for geographic choices and 24 studies documenting the impact of training programs. Growing up in a rural community is a key determinant and is consistently associated with choosing rural practice. Most existing studies assess physicians, and only a few are based on multivariate analyses that take competing and potentially correlated predictors into account. The success rate of placing providers-in-training in rural practice after graduation, on average, is 44% (range 20-84%; N = 31 programs). We did not identify program characteristics that are consistently associated with program success. Data are primarily based on rural tracks for medical residents. DISCUSSION The review provides insight into the relative importance of demographic characteristics and motivational factors in determining which providers should be targeted to maximize return on recruitment efforts. Existing programs exposing students to rural practice during their training are promising but require further refining. Public policy must include a specific focus on the trajectory of the healthcare workforce and must consider alternative models of healthcare delivery that promote a more diverse, interdisciplinary combination of providers.
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Affiliation(s)
- Ian T MacQueen
- Department of Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
- Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA, USA
| | - Melinda Maggard-Gibbons
- Department of Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
- Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA, USA
- Veterans Affairs/Robert Wood Johnson Clinical Scholars Program, UCLA, Los Angeles, CA, USA
| | - Gina Capra
- National Association of Community Health Centers, Bethesda, MD, USA
| | - Laura Raaen
- Evidence-Based Practice Center, RAND Corporation, Santa Monica, CA, 90407, USA
| | - Jesus G Ulloa
- Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA, USA
- Veterans Affairs/Robert Wood Johnson Clinical Scholars Program, UCLA, Los Angeles, CA, USA
- Department of Surgery, UCSF Medical School, San Francisco, CA, USA
| | - Paul G Shekelle
- Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA, USA
- Evidence-Based Practice Center, RAND Corporation, Santa Monica, CA, 90407, USA
| | - Isomi Miake-Lye
- Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA, USA
| | - Jessica M Beroes
- Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA, USA
| | - Susanne Hempel
- Evidence-Based Practice Center, RAND Corporation, Santa Monica, CA, 90407, USA.
- Department of Health Policy and Management, UCLA Fielding School of Public Health, Los Angeles, CA, USA.
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Underdahl L, Jones-Meineke T, Duthely LM. Reframing physician engagement: An analysis of physician resilience, grit, and retention. INTERNATIONAL JOURNAL OF HEALTHCARE MANAGEMENT 2017. [DOI: 10.1080/20479700.2017.1389478] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Louise Underdahl
- School of Advanced Studies, University of Phoenix, Los Angeles, CA, USA
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Invited commentary and correspondence. INTERNATIONAL JOURNAL OF THERAPY AND REHABILITATION 2010. [DOI: 10.12968/ijtr.2010.17.11.79542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
I would like to thank both the commentators for taking the time to review my recent article ‘Facilitating independence in personal activities of daily living after a severe traumatic brain injury’ Vol 17(9): 474–482, and take this opportunity to address some of the questions and points raised by Helen Harrington.
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