Implementation of a technician success and onboarding coordinator to reduce technician turnover

PURPOSE

This article provides an overview of changes implemented at an academic medical center to reduce pharmacy technician turnover.

SUMMARY

Pharmacy technician turnover has been a problem for years. Technicians come and go; they move on to other positions, and continuous turnover is an avoidable expense. With greater focus on creating a successful onboarding experience for newly hired technicians, turnover should decrease and satisfaction and engagement should increase. When a newly hired technician leaves a department within the first year, it can have a negative impact on the engagement of the remaining technicians who spent time training new hires in how to complete tasks, mentoring them, and incorporating them into the team. Creating a positive onboarding experience will decrease expenses accrued and minimize wasted resources and staff time dedicated to a technician who will not be around in 6 months to 1 year. At M Health Fairview, a Minneapolis, MN-based health system, technician retention has been improved through a standardized approach to onboarding and orientation, including creation of the new staff role of technician success and onboarding coordinator (TSOC).

CONCLUSION

A standard approach to onboarding pharmacy technicians and integrating them into the pharmacy department has proven to be essential to technician retention at M Health Fairview. To get started, it is important to find the right person for the TSOC role to coordinate successful onboarding of newly hired pharmacy technicians. That person should be an individual with passion to engage and inspire newly hired technicians, with several years of experience, and with the ability to cascade knowledge.

Venetoclax Initiation in Chronic Lymphocytic Leukemia: International Insights and Innovative Approaches for Optimal Patient Care

Venetoclax, a highly selective, oral B-cell lymphoma 2 inhibitor, provides a robust targeted-therapy option for the treatment of chronic lymphocytic leukemia (CLL), including patients with high-risk del(17p)/mutated-TP53 and immunoglobulin heavy variable region unmutated CLL and those refractory to chemoimmunotherapy across all age groups. Due to the potent pro-apoptotic effect of venetoclax, treatment initiation carries a risk of tumor lysis syndrome (TLS). Prompt and appropriate management is needed to limit clinical TLS, which may entail serious adverse events and death. Venetoclax ramp-up involves gradual, stepwise increases in daily venetoclax dosing from 20 mg to 400 mg (target dose) over 5 weeks; adherence to on-label scheduling provides a tumor debulking phase, reducing the risk of TLS. The key components of safe venetoclax therapy involve assessment (radiographic evaluation and baseline blood chemistry), preparation (adequate hydration), and initiation (blood chemistry monitoring). In addition to summarizing the evidence for venetoclax's efficacy and safety, this review uses hypothetical patient scenarios based on risk level for TLS (high, medium, low) to share the authors' clinical experience with venetoclax initiation and present global approaches utilized in various treatment settings. These hypothetical scenarios highlight the importance of a multidisciplinary approach and shared decision-making, outlining best practices for venetoclax initiation and overall optimal treatment strategies in patients with CLL.

Gaining acceptance, insight and ability to act: A process evaluation of a preventive stress intervention as part of a transition-to-practice programme for newly graduated nurses

AIM

To investigate how NGNs perceived and applied an intervention for preventing stress-related ill health embedded in a transition-to-practice programme when entering their professional life.

DESIGN

A qualitative exploratory descriptive design was selected for this study to gain insights and perspectives on the adoption and utilization of the intervention.

METHODS

In this qualitative methodology process evaluation, semi-structured and audio-recorded interviews were conducted with a sample of 49 nurses. Data were collected between December 2016 and July 2017, and were sorted in NVivo 12 Plus, followed by thematic analysis.

RESULTS

The analysis resulted in three change processes stimulated by the intervention: (a) Building acceptance of being new; (b) Gaining insight into professional development and health and (c) Practical steps for skills development, healthy habits and better-organized work. In addition to the three themes, barriers that hindered the progression of the processes were also described. Each process influenced the development of the others by stimulating a deeper understanding, motivation to change and courage to act. Several barriers were identified, including the use of cognitively demanding intervention tools, fatigue, high work demands, inconvenient work hours and a hostile social climate on the ward.

CONCLUSION

This process evaluation showed that newly graduated nurses used knowledge from the intervention and adopted new behaviours largely in accordance with how the intervention was intended to work.

IMPACT

When entering a new profession, it is crucial to receive a well-thought-out, structured and targeted introduction to the new professional role, tasks and work group. Nurses stated that the intervention increased their understanding of the role as new nurses and their insight into how to develop skills that promoted better functioning and recovery. The intervention also stimulated the development of new health behaviour and some new learning strategies.

Dissemination Strategies for mHealth Apps: Systematic Review

BACKGROUND

Among the millions of mobile apps in existence, thousands fall under the category of mobile health (mHealth). Although the utility of mHealth apps has been demonstrated for disease diagnosis, treatment data management, and health promotion strategies, to be effective they must reach and be used by their target audience. An appropriate marketing strategy can ensure that apps reach potential users and potentially convert them to actual users. Such a strategy requires definitions of target end users, communication channels, and advertising content, as well as a timeline for effectively reaching and motivating end users to adopt and maintain engagement with the mHealth app.

OBJECTIVE

The aim of this study was to identify strategies and elements that ensure that end users adopt and remain engaged with mHealth apps.

METHODS

A systematic search of the PubMed, PsycINFO, Scopus, and CINAHL databases was conducted for suitable studies published between January 1, 2018, and September 30, 2022. Two researchers independently screened studies for inclusion, extracted data, and assessed the risk of bias. The main outcome was dissemination strategies for mHealth apps.

RESULTS

Of the 648 papers retrieved from the selected databases, only 10 (1.5%) met the inclusion criteria. The marketing strategies used in these studies to inform potential users of the existence of mHealth apps and motivate download included both paid and unpaid strategies and used various channels, including social media, emails, printed posters, and face-to-face communication. Most of the studies reported a combination of marketing concepts used to advertise their mHealth apps. Advertising messages included instructions on where and how to download and install the apps. In most of the studies (6/10, 60%), instructions were oriented toward how to use the apps and maintain engagement with a health intervention. The most frequently used paid marketing platform was Facebook Ads Manager (2/10, 20%). Advertising performance was influenced by many factors, including but not limited to advertising content. In 1 (10%) of the 10 studies, animated graphics generated the greatest number of clicks compared with other image types. The metrics used to assess marketing strategy effectiveness were number of downloads; nonuse rate; dropout rate; adherence rate; duration of app use; and app usability over days, weeks, or months. Additional indicators such as cost per click, cost per install, and clickthrough rate were mainly used to assess the cost-effectiveness of paid marketing campaigns.

CONCLUSIONS

mHealth apps can be disseminated via paid and unpaid marketing strategies using various communication channels. The effects of these strategies are reflected in download numbers and user engagement with mHealth apps. Further research could provide guidance on a framework for disseminating mHealth apps and encouraging their routine use.

Investigating Attraction and Retention of Staff Within Public Mental Health Services in Victoria, Australia: Protocol for a Mixed Methods Study

BACKGROUND

A large proportion of Australians are affected by mental illness each year, and treatment gaps are well known. To meet current and future demands and enable access to treatment that is safe, effective, and acceptable, a robust and sustainable mental health workforce is required. Factors reported to attract people to work within the mental health sector include aspiring to help others, having an interest in mental health and human behavior, the desire to make a difference and do something worthwhile, personal lived experience, recognition, and value of discipline-specific roles. However, despite the various reasons people enter the public mental health workforce, recruitment and retention continue to be ongoing challenges. To date, there has been limited investigation into understanding which factors are most relevant to the current Victorian workforce. Furthermore, a comparison to health care workers outside of mental health is also needed to better understand the specific needs of staff within the mental health sector.

OBJECTIVE

This study aims to explore factors related to attraction, recruitment, and retention of the public mental health workforce in Victoria, Australia.

METHODS

The study is a multisite, mixed methods cross-sectional study to be conducted at 4 public hospital services within Victoria, Australia: 2 in metropolitan and 2 in regional or rural locations. Current, previous, and nonmental health workers will be asked to complete a 20-25-minute web-based survey, which is developed based on previous research and offered participation in an optional 30-60-minute semistructured interview to examine personal experiences and perceptions. Both aspects of the project will examine factors related to attraction, recruitment, and retention in the public mental health workforce. Differences between groups (ie, current, past, and nonmental health workers), as well as location, discipline, and health setting will be examined. Regression analyses will be performed to determine the factors most strongly associated with retention (ie, job satisfaction) and turnover intention. Qualitative data will be transcribed verbatim and thematically analyzed to identify common themes.

RESULTS

As of May 2023, we enrolled 539 participants in the web-based survey and 27 participants in the qualitative interview.

CONCLUSIONS

This project seeks to build on current knowledge from within Australia and internationally to understand role and service/system-related issues of attraction, recruitment, and retention specifically within Victoria, Australia. Seeking up-to-date information from across the health workforce may provide factors specific to mental health by illuminating any differences between mental health workers and health care workers outside of mental health. Furthermore, exploring motivators across health care disciplines and locations to enter, stay in, or leave a role in public mental health settings will provide valuable information to support how the sector plans and develops strategies that are fit for purpose.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

DERR1-10.2196/48855.

Financial incentives to promote employment of persons with disabilities: a scoping review of when and how they work best

PURPOSE

To assess the state of evidence on the use of financial incentives to employ, retain, and promote persons with disabilities.

MATERIALS AND METHODS

We completed a scoping review of the peer-reviewed literature published from 1990 to 31 March 2022. Inclusion criteria were - populations with a disability; employment, retention, or promotion; and use of financial incentives targeted at employers. Articles were excluded if incentive was targeted solely at persons with disabilities.

RESULTS

Seventeen articles met the inclusion criterion and were collated based on their study designs, type of incentive investigated, employment sector, and jurisdiction. We identified seven common themes that are relevant contextual and situational factors associated with the use of financial incentives to employ, retain, and promote persons with disabilities.

CONCLUSIONS

While the literature identified the fact that financial incentives are widely used, the current state of the literature is modest and insufficient to make strong statements about the evidence on how and when financial incentives work well or do not work well. The themes identified allude to a subset of contextual factors requiring consideration for incentive use; however, evaluative research is still required to substantiate best practices for their use.Implications for rehabilitationFinancial incentives for the recruitment, retention, and promotion of workers with disabilities take many different forms and can incent different behaviours based on their form and context.Workers with disabilities are as diverse as workers without disabilities, consequently the supports required will differ from situation to situation.In some cases, a worker with a disability may require several types of supports, at a point in time, or over their employment journey.Employer knowledge and experience are important considerations in the use of financial incentives, as are employer skills in recruitment, retention, and promotion of workers with disabilities.

Factors influencing the transition of foreign-educated nurses to the US healthcare setting: A systematic review

AIM

This literature review examined the impact of the orientation or onboarding programs on the transition of foreign-educated nurses to a US healthcare setting and factors influencing their transition.

BACKGROUND

Recruitment of foreign-educated nurses has been a solution to the ongoing nursing workforce shortage in the United States. However, they face various challenges in their transition to employment in the United States. Adequate orientation and continued support are needed for the successful transition of foreign-educated nurses.

METHODS

A systematic literature search was conducted in 2022 across PubMed, CINAHL, Academic Search Complete, Google Scholar, and MEDLINE databases. This review selected only articles published between 2015 and 2022 in English that addressed foreign-educated nurses' transition issues in US healthcare settings. The review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The quality of the articles was appraised using the John Hopkins Evidence-based Practice tool.

RESULTS

This review of 14 articles revealed that the quality of orientation and organizational support were positively associated with foreign-educated nurses' job satisfaction and turnover. Factors influencing foreign-educated nurses' transition included peer support, job assignment and workload, credentialing, communication and cultural adjustment, psychological factors, safety perceptions, work environment, and coping strategies.

DISCUSSION

There was a lack of literature that evaluated orientation or onboarding programs for foreign-educated nurses. Further research is needed to explore the effectiveness of supportive programs in promoting their smooth transition.

IMPLICATIONS FOR NURSING PRACTICE AND POLICY

Efficient onboarding or orientation programs and policies for foreign-educated nurses are crucial, considering the factors influencing their transition. Good programs and policies that prioritize the support, integration, and professional development of FENs will help maximize their contributions to health care.

Why every lab needs a handbook

A lab handbook is a flexible document that outlines the ethos of a research lab or group. A good handbook will outline the different roles within the lab, explain what is expected of all lab members, provide an overview of the culture the lab aims to create, and describe how the lab supports its members so that they can develop as researchers. Here we describe how we wrote a lab handbook for a large research group, and provide resources to help other labs write their own handbooks.

Comparing Glucose Outcomes Following Face-to-Face and Remote Initiation of Flash Glucose Monitoring in People Living With Diabetes

BACKGROUND

When launched, FreeStyle Libre (FSL; a flash glucose monitor) onboarding was mainly conducted face-to-face. The COVID-19 pandemic accelerated a change to online starts with patients directed to online videos such as Diabetes Technology Network UK for education. We conducted an audit to evaluate glycemic outcomes in people who were onboarded face-to-face versus those who were onboarded remotely and to determine the impact of ethnicity and deprivation on those outcomes.

METHODS

People living with diabetes who started using FSL between January 2019 and April 2022, had their mode of onboarding recorded and had at least 90 days of data in LibreView with >70% data completion were included in the audit. Glucose metrics (percent time in ranges) and engagement statistics (previous 90-day averages) were obtained from LibreView. Differences between glucose variables and onboarding methods were compared using linear models, adjusting for ethnicity, deprivation, sex, age, percent active (where appropriate), and duration of FSL use.

RESULTS

In total, 935 participants (face-to-face 44% [n = 413]; online 56% [n = 522]) were included. There were no significant differences in glycemic or engagement indices between onboarding methods and ethnicities, but the most deprived quintile had significantly lower percent active time (b = -9.20, P = .002) than the least deprived quintile.

CONCLUSIONS

Online videos as an onboarding method can be used without significant differences in glucose and engagement metrics. The most deprived group within the audit population had lower engagement metrics, but this did not translate into differences in glucose metrics.

Primary Prevention of Weight Gain Among New Bus Operators: Results of the "Success & Health Impacts For Transit operators during Onboarding" (SHIFT Onboard) Pilot Study

OBJECTIVE

This study aimed to test the feasibility and efficacy of an enhanced onboarding intervention to prevent weight gain and support the early job success of new bus operators.

METHODS

Control participants ( n = 9) completed usual practice new employee training and onboarding. Intervention participants ( n = 14) completed five supplemental trainings and four online challenges during their first year. Primary outcomes were body weight, dietary behaviors, physical activity, and sleep duration/quality. Early job success was evaluated with measures of newcomer adjustment.

RESULTS

The difference between intervention and control participants in body weight change at 12-month was -6.71 lb (Cohen's d = -1.35). Differences in health behavior changes were mixed, but newcomer adjustment changes favored the intervention group.

CONCLUSIONS

Results support the feasibility of enhanced onboarding for bus operators to prevent worsening health while simultaneously advancing their success as new employees.

Onboarding in Polish Enterprises in the Perspective of HR Specialists

The article discusses onboarding in Polish enterprises analyzed from the perspective of HR specialists. The subject of consideration in the article falls within the area of broadly understood concern for the sustainable development and well-being of employees adjusting to a new work environment during their adaptation period. Actions taken by HR specialists have a significant impact on the behavior of employees and their well-being and satisfaction in the new workplace, including commitment and care for all stakeholders involved in building a positive psychological climate at the time of starting work. The aim of the article was to identify onboarding practices implemented in selected types of Polish enterprises and selected factors determining the choice of specific practices, such as analyzing the dependencies between the type of an enterprise and the implementation of onboarding practices in it, identifying the perception of these practices by HR male and female specialists at a given age and with given seniority, and determining whether the practice of assigning a buddy to new employees depends on the type of enterprise. The study described in the article was conducted in 178 medium-sized Polish enterprises, of which, 25 were manufacturing companies, 34 were trading companies, and 119 were service companies. In each enterprise, an HR specialist completed a questionnaire on onboarding. The analysis of the dependencies between the type of company and the type of onboarding implemented in it (general, position, or team onboarding) revealed no statistically significant differences between the types of companies participating in the study and the type of onboarding implemented in them. The discrepancies between preferences for particular onboarding practices and the gender, age, and seniority of HR specialists participating in the study turned out to be statistically significant and indicate that manufacturing companies more often assign a buddy to new employees in their onboarding process than trading and service companies. The conclusions obtained from the research, apart from the cognitive value, have an application value, e.g., regarding the recruitment of HR specialists.

The affective commitment of newcomers in hybrid work contexts: A study on enhancing and inhibiting factors and the mediating role of newcomer adjustment

This study focuses on one of the most impacted human aspects of digital transformation in contemporary organizations: the development of the affective commitment of newcomers in hybrid work contexts. Specifically, this study addresses a research gap related to the factors that influence the affective commitment of newcomers in hybrid work contexts. First, it investigates the role of two drawbacks of the remote component of hybrid work contexts inhibiting affective commitment: workplace social isolation and technostress. Second, it explores the role of two factors that were previously investigated in in-presence contexts and proved to enhance affective commitment: perceived organizational support and perceived supervisor support. Moreover, this study considers the possible mediating role of newcomer adjustment, intended as a proximal outcome of successful onboarding and an antecedent of newcomer affective commitment. In order to examine enhancing and inhibiting factors and the mediating role of newcomer adjustment, a quantitative study was carried out involving newcomers who began to work in their current organization after January 2021 and who still do remote work at least 1 day a week. Results confirm the inhibiting role of workplace social isolation and the enhancing role of perceived organizational support and perceived supervisor support on affective commitment in hybrid work contexts. Furthermore, they support the mediating role of newcomer adjustment in the relationship between workplace social isolation and affective commitment. While contributing to theory advancement in understanding newcomer affective commitment in current hybrid work contexts, these results also suggest important managerial implications in the field of human resources management, specifically the need to pay greater attention to strategies devoted to increasing newcomers' perception of organizational and supervisor support.

The Importance of Effective Organizational Socialization for Preventing Stress, Strain, and Early Career Burnout: An Intensive Longitudinal Study of New Professionals

Burnout was originally conceptualized based on experiences of new professionals. Role clarity, task mastery, and social acceptance are recognized as key resources enabling new professionals' management of the challenges of the new profession. However, relations between these resources and stress, strain, and burnout have not yet been thoroughly investigated at professional entry. Increased understanding of these relations could have implications for strategies to prevent burnout. The aim of the study was to investigate within- and between-individual effects over the first months and relations to burnout at one-year post-entry. Data (n = 322) was collected weekly over the first 13 weeks and again 9 months later. Relationships were modelled using a multilevel regression model and correlation analysis. Results showed that on weeks when participants experienced higher role clarity, task mastery, and social acceptance, they reported significantly less stress, and that participants who experienced higher levels of the resources in general, reported significantly less strain. Levels of the resources at three months were related to symptoms of burnout at 12 months. The study findings provide support of the role of task mastery, role clarity, and social acceptance as resources buffering the impact of demands at professional entry on experiences of stress, strain, and burnout.

Academic medical center clinical research professional workforce: Part 2 - Issues in staff onboarding and professional development

Background

Defining key barriers to the development of a well-trained clinical research professional (CRP) workforce is an essential first step in identifying solutions for successful CRP onboarding, training, and competency development, which will enhance quality across the clinical and translational research enterprise. This study aimed to summarize barriers and best practices at academic medical centers related to effective CRP onboarding, training, professional development, identify challenges with the assessment of and mentoring for CRP competency growth, and describe opportunities to improve training and professionalization for the CRP career pathway.

Materials/Methods

Qualitative data from a series of Un-Meeting breakout sessions and open-text survey questions were analyzed to explore the complex issues involved when developing high-quality onboarding and continuing education opportunities for CRPs at academic medical centers.

Results

Results suggest there are several barriers to training the CRP workforce, including balancing foundational onboarding with role-based training, managing logistical challenges and institutional contexts, identifying/enlisting institutional champions, assessing competency, and providing high-quality mentorship. Several of these themes are interrelated. Two universal threads present throughout all themes are the need for effective communication and the need to improve professionalization of the CRP career pathway.

Conclusion

Few institutions have solved all the issues related to training a competent and adaptable CRP workforce, although some have addressed one or more. We applied a socio-technical lens to illustrate our findings and the need for NCATS-funded academic medical centers to work collaboratively within and across institutions to overcome training barriers and support a vital, well-qualified workforce and present several exemplars from the field to help attain this goal.

Welcome to the lab

Having a formal onboarding procedure for new lab members can lead to a happier and more productive working environment.

An Innovative Approach to Remote Electronic Health Onboarding Record Education Amid a Global Pandemic

The COVID-19 pandemic required social and physical distancing to reduce the spread of disease. The reduction in meeting sizes made it difficult to offer traditional in-person EHR training to new and transferring employees. This paper aims to share how one nurse educator team used an innovative approach to transition traditional EHR onboarding education to synchronous remote learning during the global pandemic. Participants in the remote learning course (n = 94) were compared with those who had previously completed the traditional course (n = 110). Postcourse evaluations for each group were comparable. Remote learning participants found the technology conducive to training and reported higher scores for locating and reviewing patient information than those in the traditional course. Providing remote EHR education is comparable with traditional classroom education. Remote learning provided a safe, effective way to onboard new staff during the pandemic.

Inclusive Communication Model Supporting the Employment Cycle of Individuals with Autism Spectrum Disorders

Difficulties with interpersonal communication experienced by individuals with autism spectrum disorders (ASD) significantly contribute to their underrepresentation in the workforce as well as problems experienced while in employment. Consistently, it is vital to understand how communication within the employment cycle of this group can be improved. This study aims to identify and analyze the possibilities of modifying the communication processes around recruitment, selection, onboarding, and job retention to address the specific characteristics and needs of the representatives of this group. This qualitative study is based on 15 in-depth interviews conducted with 21 field experts, i.e.,: therapists, job trainers, and entrepreneurs employing people with ASD. The findings of this research informed the creation of an inclusive communication model supporting the employment cycle of individuals with ASD. The most important recommendations within the model that was created include the modification of job advertisements, use of less structured job interviews, providing opportunities for mentorship, and supportive and non-direct, electronically mediated communication. To apply the above-mentioned solutions and take full advantage of the talents of people with ASD, it is also necessary to provide tailored sensitivity and awareness training programs for their direct addressees as well as their neurotypical colleagues, including managerial staff.

Mind like Water: Flexibly Adapting to Serve Patrons in the Era of COVID-19

The ability to be flexible and adapt quickly to changing circumstances is a crucial skill for librarians to develop in a world increasingly characterized by rapid change. It can take a crisis to learn how effective librarians have become in developing the needed adaptive behaviors, including a willingness to change workstyles, experiment with new technologies and readily move on from failed experiments. In this paper, librarians from the Preston Medical Library at the University of Tennessee Graduate School of Medicine, prompted by the crisis of COVID-19, present their response. Beginning with a description of how services were provided prior to the pandemic, librarians detail their response in several key areas and show how they implemented new approaches to teaching, collaboration, and mutual support, working together to handle patron issues and pursue scholarly activities.

An Exploratory Analysis of Increasing Self-Efficacy of Adults with Autism Spectrum Disorder Through the Use of Multimedia Training Stimuli

While some evidence-based vocational studies exist for adults with Autism Spectrum Disorder (ASD), most focus on social interaction. This mixed methods exploratory study investigated a multimedia approach to training ASD adults as a strategy for increasing self-efficacy and producing positive training outcomes during the anticipatory socialization and encounter phases of organizational assimilation. Ten ASD adults, seven men and three women, 19 to 42 years of age, participated in the study, which utilized video and virtual reality to instruct participants on how to wire an electrical socket. Significant increases in the participant's self-efficacy were found using a modified version of the New General Self-Efficacy (NGSE) scale. In addition, a thematic analysis of post-training comments showed that participants, overall, were engaged and had fun during the training. These findings suggest that a multimedia approach may be an effective strategy for achieving positive outcomes by increasing self-efficacy and engagement when training newly hired employees diagnosed with ASD to perform vocational tasks.

Making a Good Hire

Hiring the right employee is paramount to the success of any business. In 2019, with unemployment rates low and job openings high, hiring anyone might sound good. However, taking the time to find the right employee far outweighs the cost of replacing a bad or desperate hire. This article discusses the interviewing and onboarding process to shift the odds positively in the direction of making a lasting, good hire.

Evaluation of a Structured Onboarding Process and Tool for Faculty Members in a School of Pharmacy

Objective. To develop and assess the usefulness of a structured onboarding process and tool at a school of pharmacy to improve the overall onboarding experience for new faculty members. Methods. An assessment of a previously existing, informal onboarding process was conducted from January 1 to February 28, 2017. A structured onboarding tool was developed based on interviews with nine recently hired faculty members regarding their experiences with this legacy, unstructured onboarding process. Nine faculty members who onboarded while the legacy onboarding process was in place and six faculty members who onboarded after the new, onboarding tool was in place were included in the study. The experience of the pre-tool cohort was compared to that of the post-tool cohort. Results. More positive responses in the post-tool cohort were obtained compared to the pre-tool cohort in regard to timeline, expectations, and mentorship. More negative responses for the post-tool group were observed for communication. Overall utility of the onboarding tool changed from 56% (pre-tool group) to 80% (post-tool group). Free text feedback included recommendations to rearrange tasks throughout the onboarding process; clarifying mentor responsibilities and expectations; and providing an overview of the checklist to new faculty members on day 1. Conclusion. Overall, a structured onboarding process tool improved the onboarding experience for new faculty members. Given the lack of literature regarding a structured onboarding process in the academic setting, further refinement and analysis of the onboarding tool is needed.

Training the Next Generation of Pathologists: A Novel Residency Program Curriculum at Montefiore Medical Center/Albert Einstein College of Medicine

Pathology residency training is currently a time-intensive process, frequently extending up to 6 years in duration as residents complete 1 or 2 fellowships following graduation. Innovative training curricula may help address the impending changes in the health-care landscape, particularly future shortfalls in pathology staffing and changing health-care models that incorporate more work within interdisciplinary teams. Montefiore has created a novel residency training program aimed at accelerating the acquisition of competency in pathology, preparing residents for independent practice at the completion of residency training, and providing residents with the requisite adaptability and consultative skills to excel wherever they choose to practice. We describe the implementation of this novel pathology residency training curriculum at Montefiore Medical Center/Albert Einstein College of Medicine and the perception of residents in both the old curriculum and the new curriculum.

What They May Not Tell You and You May Not Know to Ask: What is Expected of Surgeons in Their First Year of Independent Practice

OBJECTIVE

The objective of this study was to explore the views and expectations that practicing general surgeons have of their junior colleagues who have recently finished training.

DESIGN

This is a qualitative study performed using focus group data consisting of open-ended questions concentrating on essential qualities and attributes of surgeons, behaviors observed in newly-graduated surgeons, and appropriate oversight of junior partners. Qualitative analysis was performed using grounded theory methodology with transcripts coded by 3 independent reviewers.

SETTING

Focus groups were conducted with surgeons practicing in rural and urban community settings.

PARTICIPANTS

Focus groups consisted of practicing general surgeons throughout the state of Oregon.

RESULTS

Focus groups were comprised of 31 practicing surgeons (10 female, 21 male) with varying ages and levels of experience practicing in both rural and urban environments. Qualitative analysis revealed the need for surgeons with strong interpersonal skills, teamwork, judgment, and broad technical skills who possess the appropriate amount of confidence and know when to ask for help. Frequently noted themes identified, included not knowing when to ask for help, overconfidence or underconfidence, as well as lack of judgment and lack of either quality or breadth of technical skill. Current oversight included direct observation, subjective evaluations from staff and colleagues, analysis of outcomes/quality, and either formal or informal mentorship arrangements.

CONCLUSIONS

This study highlights the need for graduating surgeons to be competent in multiple domains. The importance of knowing when to ask for help was stressed by practicing surgeons in both the rural and urban community setting, but is underemphasized in residency training, possibly due to less indirect resident supervision. Surgeons also emphasized the importance of mentorship, as professional growth continues long after completion of training.

Orientation Process for Newly Credentialed Athletic Trainers in the Transition to Practice

CONTEXT

  Orientation is an important part of socialization and transition to practice, yet the orientation process for newly credentialed athletic trainers (ATs) is unknown.

OBJECTIVE

  To determine how newly credentialed ATs are oriented to their roles.

DESIGN

  Cross-sectional study.

SETTING

  Online survey.

PATIENTS OR OTHER PARTICIPANTS

  Three hundred thirty-two of 1835 newly credentialed ATs (18%) certified and employed between January and September of 2013 completed the survey (129 men, 203 women; age = 23.58 ± 2.54 years).

DATA COLLECTION AND ANALYSIS

  The survey consisted of demographic information (eg, employment setting, job title) and 2 sections: (1) orientation tactics and (2) usefulness of orientation tactics. For the first section, participants identified if various orientation tactics were included in their orientations (eg, policies and procedures review). For the second section, participants identified how useful each orientation tactic was on a Likert scale (1 = not useful, 4 = very useful). Descriptive statistics were calculated for each survey item. Mann-Whitney U and Kruskal-Wallis tests were used to determine differences between demographic characteristics and orientation tactics. A Bonferroni correction accounted for multiple comparisons. A panel of experts established the content validity of the survey. The Cronbach α was used to establish internal consistency (α = 0.802) Results:  The most common orientation tactics were meeting with supervisors (n = 276, 82.9%) and staff members (eg, coaches; n = 266, 79.9%) and learning responsibilities (n = 254, 76.2%). The least common orientation tactics were simulation of the emergency action plan (n = 66, 19.8%) and preceptor development (n = 71, 21.3%); however, preceptor development was not applicable to many participants. The most useful orientation tactics were simulating the emergency action plan (3.45/4.0) and meeting with staff members (3.44/4.0). Participants who felt their orientation prepared them for their roles were exposed to more tactics during orientation (Mann-Whitney U = 17 212, P < .001).

CONCLUSIONS

  Many tactics were used to orient newly credentialed ATs to their roles, but orientations varied based on the practice setting.

Challenges and Solutions to New Manager Onboarding

This article outlines challenges and solutions to new managers onboarding within a department of pharmacy.

Facilitating a Major Staffing Transition in a State Psychiatric Hospital With Changes to Nursing Orientation

BACKGROUND

A large state psychiatric hospital experienced a state-mandated Reduction in Force that resulted in the abrupt loss and rapid turnover of more than 40% of its nursing and paraprofessional staff. The change exemplified current national trends toward downsizing and facility closure.

OBJECTIVE

This article describes revisions to the nursing orientation program that supported cost containment and fidelity to mission and clinical practices during the transition.

DESIGN

An existing nursing orientation program was reconfigured in alignment with principles of rational instructional design and a core-competencies model of curriculum development, evidence-based practices that provided tactical clarity and commonality of purpose during a complex and emotionally charged transition period.

RESULTS

Program redesign enabled efficiencies that facilitated the transition, with no evidence of associated negative effects.

CONCLUSION

The process described here offers an example for hospitals facing similar workforce reorganization in an era of public sector downsizing.

Graduate-Assistant Athletic Trainers' Perceptions of Professional Socialization in the Collegiate Setting: Part I

CONTEXT

Many newly credentialed athletic trainers (ATs) pursue graduate assistantships, which allow them to gain experience while being supervised by an experienced AT. The graduate-assistant (GA) ATs' perception of their socialization process into the collegiate setting is unknown.

OBJECTIVE

To explore the professional socialization of GAs in the collegiate setting.

DESIGN

Qualitative study.

SETTING

Phone interviews.

PATIENTS OR OTHER PARTICIPANTS

A total of 19 collegiate GAs (15 women, 4 men; average age = 23 ± 0.15 years; National Collegiate Athletic Association Division I = 13, II = 3, III = 2; National Association of Intercollegiate Athletics = 2; postprofessional athletic training program = 6) participated.

DATA COLLECTION AND ANALYSIS

Data were collected via phone interviews and transcribed verbatim. Interviews were conducted until data saturation occurred. Data were analyzed through phenomenologic reduction. Trustworthiness was established via member checks and peer review.

RESULTS

Four themes emerged: (1) role identity, (2) initial entry into role, (3) maturation, and (4) success. Before beginning their role, participants envisioned the assistantship as a way to gain independent experience while being mentored. They perceived themselves as the primary care providers for their athletic teams. Those who were immediately immersed into clinical practice adapted to their role quickly despite experiencing stress initially. Participants felt that a formal orientation process and a policies and procedures manual would have alleviated some of the initial stress. The GAs matured as they practiced clinically and developed confidence as they gained experience. Personal attributes, experience, and peer and supervisor support contributed to perceived success as GAs. Factors that hindered perceived success were lack of confidence, an unsupportive environment, and long hours.

CONCLUSIONS

When looking for graduate assistantships, ATs should seek a position that allows them to practice independently and provides didactic educational opportunities while aligning with their athletic training philosophies.

Channeling Community Contributions to Scientific Software: A Sprint Experience

In 2014, the khmer software project participated in a two-day global sprint coordinated by the Mozilla Science Lab. We offered a mentored experience in contributing to a scientific software project for anyone who was interested. We provided entry-level tasks and worked with contributors as they worked through our development process. The experience was successful on both a social and a technical level, bringing in 13 contributions from 9 new contributors and validating our development process. In this experience paper we describe the sprint preparation and process, relate anecdotal experiences, and draw conclusions about what other projects could do to enable a similar outcome. The khmer software is developed openly at http://github.com/dib-lab/khmer/.

Onboarding for Pathology Residency Programs-The Montefiore Experience

Onboarding is a system frequently used in the corporate world as a means of orienting incoming employees to their duties and inculcating the workplace values. The program aims to facilitate transition into new work roles and improve employee retention rates. At Montefiore, we have instituted an onboarding curriculum that is given to new anatomic and clinical pathology residents about a month prior to the start of residency. The program includes an introductory video series of basic histology and a series of anatomic and clinical case studies illustrating basic laboratory principles. This didactic content is tagged to learning objectives and short self-assessment modules. In addition, content related to the work ethos at Montefiore and the role of the core competencies and milestones in residency education are included. Finally, a broader component of the onboarding gives the incoming residents a social welcome to our area, including key information about living in the area surrounding Montefiore. The program has been well received by our residents for whom the content has helped to boost confidence when starting. We feel that the program is helpful in ensuring that all incoming residents start having received the same baseline didactic content. Transmitting this didactic content via onboarding allows our residents to begin the work of learning pathology immediately, rather than spending the first weeks of residency covering remedial content such as basic histology. Such a program may be useful to other pathology residencies, most of whom have residents from a range of backgrounds and whose prior exposure to pathology may be limited.

The professional socialization of the graduate assistant athletic trainer

CONTEXT

The graduate assistant athletic trainer (AT) position often serves as one's first experience working independently as an AT and is also an important aspect of the professional socialization process. The socialization experiences of graduate assistant ATs have yet to be fully explored.

OBJECTIVE

To understand the socialization process for graduate assistant ATs during their graduate experience.

DESIGN

Qualitative study.

SETTING

We conducted phone interviews with all participants.

PATIENTS OR OTHER PARTICIPANTS

A total of 25 graduate assistant ATs (20 women, 5 men) studying in 1 of 3 academic tracks: (1) accredited postprofessional athletic training program (n = 8), (2) postprofessional athletic training program (n = 11), or (3) a nonathletic training degree program (n = 6). The average age was 25 ± 5 years, and the median age was 24 years. Participants were certified by the Board of Certification for an average of 2 ± 0.4 years.

DATA COLLECTION AND ANALYSIS

We analyzed the data using a general inductive approach. Peer review, field notes, and intercoder reliability established trustworthiness. Data saturation guided participant recruitment.

RESULTS

The ability to gain clinical independence as a practitioner was an important socialization process. Having the chance to develop a relationship with a mentor, who provided support, guidance, and more of a hierarchical relationship, was an important socializing agent for the graduate assistant AT. Participants used the orientation session as a means to understand the expectations and role of the graduate-assistant position. Academic coursework was a way to achieve better inductance into the role via the opportunity to apply classroom skills during their clinical practice.

CONCLUSIONS

Socializing the graduate assistant blends formal and informal processes. Transition to practice is a critical aspect of the profession; thus, supporting autonomous practice with directed mentoring can promote professional maturity.

Training New-Hire Medical Information Specialists in the Pharmaceutical Industry: A Benchmarking Survey

Most pharmaceutical and biotechnology companies have a medical information (MI) department staffed by medical information specialists (MISs); to ensure that MISs perform their role in an accurate and compliant manner, companies must have robust training processes in place. The primary objective of this study was to benchmark the training processes for new-hire MISs in the pharmaceutical industry as well as their training preferences. Nineteen respondents from 19 companies completed a web-based survey, which resulted in a 41.3% response rate. These companies represented a variety of MI department sizes and number of products supported. Eighty-four percent (16/19) of companies had structured new-hire training processes in place. Approximately two-thirds of all respondents preferred live training on new-hire training topics. After completion of new-hire training, several companies (10/18) offered ongoing refresher training to their MISs. The results indicate that companies may benefit from having structured new-hire training procedures and tailoring training to MIS learning preferences.