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Background Professional satisfaction of health professional students can impact on their medical professional achievement. Understanding the professional satisfaction of health professional students and identifying its relative factors is beneficial to strengthen the professionalism education of health professional students, and provide solid foundation for future medical achievements. Methods A self-made questionnaire was used to survey undergraduate students of six medical universities in Hebei province. The survey included three aspects: students’ basic situation, professional selection and cognition, and basic situation of colleges. The Kruskal–Wallis H test was used to compare the professional satisfaction of students with different characteristics. All covariates were used in the ordinal logistics regression analysis to identify the independent factors associated with professional satisfaction. Results A total of 1238 (97.7%) students responded to the questionnaire in the survey, and 66.0% were women. Students with public health majors had decreased satisfaction compared with those with clinical-related majors. Professional satisfaction decreased among women compared with men. The non-first-choice students had lower professional satisfaction compared with the first-choice students. Students who chose their volunteer with the help of others had lower professional satisfaction compared with students who independently chose their volunteer. Students who did not understand the employment status had lower professional satisfaction compared with students who understood the employment status. Students with fewer employment prospects had lower professional satisfaction compared with students with bright employment prospects. Students generally dissatisfied with the canteen had lower professional satisfaction compared with students satisfied with the canteen. Students who were very satisfied or satisfied with teaching levels were more likely to have professional satisfaction. Conclusions The professional satisfaction of health professional undergraduates in Hebei province is high. Employment-related aspects and university environment influence professional satisfaction including canteens, understanding of employment status, teachers’ teaching level, etc., which are the main factors affecting professional satisfaction, but the factors such as student employment prospects and majors cannot be changed in the current environment.

In the present study phone interviews on working hours, salary, professional satisfaction and other topics were carried out with 30 equine veterinarians. None of the participants had more than five years of work experience. The gross annual wages ranged from CHF 36'400 to CHF 91'500. The study participants worked 42 to 93 hours per week. Only 13% were moderately satisfied with the job, the remaining participants were satisfied to highly satisfied. Sixty percent of the study participants were dissatisfied with their wages and wished to be paid according to the Swiss Veterinary Association (GST) salary recommendations. Five out of 27 wages were within the recommended ranges. The lowest wages were paid at the universities. Sixteen people worked more than the legal maximum of 50 hours a week. A big difference in total working hours per week existed. Especially since part-time workers had more working hours than participants in a full-time job. The study reflects the situation before 2018 and especially at the universities, before the introduction of a new employment contracts with a 50h week, wage adjustments and defined times for further training.In dieser Studie wurden 2018 30 Tierärztinnen und ­Tierärzte aus Pferdepraxen und Pferdekliniken zu Arbeitsstunden, Einkommen, Zufriedenheit und anderen Themen telefonisch befragt. Sie hatten nicht mehr als fünf Jahre Berufserfahrung. Die Bruttojahreslöhne hatten eine Spannbreite von 36’400.– CHF bis 91’500.– CHF. Die Studienteilnehmenden arbeiteten 42 bis 93 Arbeitsstunden pro Woche. Nur 13% waren mit der Arbeitsstelle mässig zufrieden, der Rest ist gut bis voll und ganz zufrieden. Sechzig Prozent der Studienteilnehmenden waren unzufrieden mit ihrem Lohn und wünschten sich eine Bezahlung gemäss den Lohnempfehlungen der Gesellschaft Schweizer Tierärztinnen und Tierärzte (GST). Fünf von 27 Löhnen befanden sich innerhalb dieser vorgeschlagenen Bandbreiten. Die niedrigsten Löhne wurden an der Universität bezahlt. Sechzehn Personen arbeiteten mehr als die gesetzlich vorgeschriebene Höchstzahl von 50 Arbeitsstunden pro Woche. Zusätzlich bestand eine grosse Differenz in der Anzahl der Wochenarbeitsstunden. Vor allem, da Teilzeit-Arbeitende zum Teil mehr Arbeitsstunden hatten als solche mit einer Vollzeitstelle. Die Studie widerspiegelt damit insbesondere an den Universitäten die Situation vor der Einführung eines neuen Arbeitsvertrages mit der 50h Woche, den Lohn­anpassungen und definierten Zeiten für Weiterbildung ab Januar 2018.Dans cette étude, 30 vétérinaires travaillant dans des pratiques et des cliniques équines ont été interrogés par téléphone quant à leurs heures de travail, leur revenu, leur satisfaction et d’autres sujets. Ils n’avaient pas plus de cinq ans d’expérience professionnelle. Le salaire annuel brut allait de 36 400 CHF à 91 500 CHF. Les participants à l’étude ont travaillé de 42 à 93 heures par semaine. Seuls 13% étaient modérément satisfaits de leur place de travail, les autres étaient satisfaits voire entièrement satisfaits. Soixante pour cent des participants à l’étude étaient insatisfaits de leur salaire et souhaitaient être payés conformément à la recommandation salariale de la SVS. Cinq des 27 salaires se situaient dans ces fourchettes suggérées. Les salaires les plus bas étaient payés par l’université. Seize personnes travaillaient plus que le maximum légal de 50 heures par semaine. Il y avait également une grande différence dans le nombre d’heures travaillées par semaine. En particulier les travailleurs à temps partiel avaient parfois travaillé plus d’heures que ceux disposant d’un emploi à temps plein. L’étude reflète la situation, notamment dans les universités, avant l’introduction d’un nouveau contrat de travail avec la semaine de 50h, les ajustements salariaux et les horaires définis pour la formation continue à partir de janvier 2018.In questo studio sono stati intervistati via telefono 30 veterinari di studi e cliniche che si occupano di equini sui loro orari di lavoro, reddito, soddisfazione e altri argomenti. Gli intervistati non avevano più di cinque anni di esperienza professionale. Gli stipendi lordi annui variano da CHF 36 400 a CHF 91 500. I partecipanti allo studio lavoravano dalle 42 alle 93 ore settimanali. Solo il 13% era moderatamente soddisfatto del lavoro, gli altri erano da buono a pienamente soddisfatti. Il sessanta per cento dei partecipanti allo studio non era soddisfatto del proprio stipendio e vorrebbero essere pagati secondo le raccomandazioni salariali della GST/SVS. Solo cinque dei 27 stipendi rientravano negli intervalli della GST/SVS. I salari più bassi venivano pagati dalle università. Sedici persone lavoravano più delle 50 ore settimanali massime prescritte dalla legge. Inoltre vi è una grande differenza nel numero di ore lavorate alla settimana. Ciò era vero soprattutto per i lavoratori a tempo parziale che a volte avevano più ore di lavoro di quelli a tempo pieno. Lo studio riflette la situazione, in particolare nelle università, prima dell’introduzione di un nuovo contratto di lavoro con la settimana di 50 ore, adeguamenti salariali e gli orari previsti per l’ulteriore formazione da gennaio 2018.

The ECHO (Extension for Community Health Outcomes) model has been introduced and implemented in several hospitals and health programs in Vietnam since 2015. In 2018, Vietnam National Children’s Hospital (VNCH) officially implemented the ECHO model to provide continuing medical education (CME) credits on pediatrics topics for medical staff in its satellite hospitals and health centers in the Northern region of Vietnam. This paper presents preliminary results of the ECHO program at VNCH. Methods included pre- and post-program assessments of pediatricians’ clinical knowledge, self-efficacy, and professional satisfaction. The analysis compared the differences between pre/post scores descriptively. Knowledge of participants increased by 22.5% points on average. More than 90% of Project ECHO-Pediatrics participants experienced increased confidence. Overall, there was an improvement in participants’ self-efficacy in the post-training compared to the pre-training (range 14.7%-22.6% difference from pre-training). All participants improved on their results in the clinical test immediately after the training and maintained it after 3 months. The study demonstrated the ability Project ECHO to improve healthcare worker knowledge and satisfaction.

Context: During the last decade, there has been a high increase in the number of dentists and dental practices in India. However, the literature on professional satisfaction among dental practitioners is lacking. Aims: This study aims to assess the level of professional satisfaction and to understand the effect of various factors associated with professional satisfaction among Telangana state dental practitioners. Settings and Design: A cross-sectional study was conducted for 2 months. Materials and Methods: Four hundred dental practitioners were approached. They were surveyed through a self-administered questionnaire. A modified version of the Dentist Satisfaction Survey was used to measure professional satisfaction. Data analysis was carried out using the Statistical Package for Social Sciences (SPSS version 18). Step-wise multiple regression was done to predict the effect of explanatory variables on outcome variable. The level of significance was set at P < 0.05. Results: A response rate of 56% was achieved. The mean score of overall professional satisfaction was 2.1 ± 1.4 out of 5. A high percentage of the dental practitioners showed satisfaction with respect, patient relations and delivery of care. The least satisfying factors were income and personal time. Stepwise multiple regression analysis showed that income, patient relations (

Introduction: Burnout is a syndrome conceptualized as result of the chronic stress at the work place which was not successfully managed. The possible negative effects on the medical staff, the patients and the health institutions have generated interest and motivated the research to understand the possible causes, these effects also influence the burnout predictors. The medical services suppliers within the emergency department have had one of the greatest exhaution occurences even before the pandemic. Being in the first line in contact with the suspected patients or confirmed with COVID-19 infection intensifies this fact. Both the working factors (working hours, years of practice, number of treated patients, professional development activities) and the socio- demographic factors (age, sex, civil status, income, education) are associated with the exhaustion at the work place. Material and methods: I have studied a total of 120 participants, receiving 115 valid questionnaires, the answering ratio being 95,83%. This was a descriptive, multicentre, transversal study of the medical and the auxiliary staff within the department UPU-SMURD of the County Clinic Emergency Hospital “Sf. Ap. Andrei” Galați. The staff gave their consent and attended a combined interview which consisted of a pilot questionnaire and a demographic questionnaire. Results and discussions: The average score of exhaustion at the staff level was 3.25, a great percentage of the doctors within the ED (45.8%), (n=24) indicates an increased level of exhaustion, only 26.8% (n=80) of nurses show an increased level of exhaustion. The average score of the stress level shown by the staff is 3.1, 66.6% (n=24) among which the doctors with an increased stress level 9.1% (n=9) auxiliary staff, 23.8% (n=80) of nurses. Conclusions: The results show us a high exhaustion, stress and depression ratio at the emergency doctors in comparison with the other professional categories within the ED. A high level of professional satisfaction is accompanied by an increased level of stress and of self-esteem.

CHAPTER 1: CHARACTERISING AUSTRALIA'S RURAL SPECIALIST PHYSICIAN WORKFORCE: THE PROFESSIONAL PROFILE AND PROFESSIONAL SATISFACTION OF JUNIOR DOCTORS AND CONSULTANTS: Objective: To assess differences in the demographic characteristics, professional profile and professional satisfaction of rural and metropolitan junior physicians and physician consultants in Australia.Cross-sectional, population level national survey of the Medicine in Australia: Balancing Employment and Life longitudinal cohort study (collected 2008-2016). Participants were specialist physicians from four career stage groups: pre-registrars (physician intent); registrars; new consultants ( 5 years since Fellowship); and consultants.Level of professional satisfaction across various job aspects, such as hours worked, working conditions, support networks and educational opportunities, comparing rural and metropolitan based physicians.Participants included 1587 pre-registrars (15% rural), 1745 physician registrars (9% rural), 421 new consultants (20% rural) and 1143 consultants (13% rural). Rural physicians of all career stages demonstrated equivalent professional satisfaction across most job aspects, compared with metropolitan physician counterparts. Some examples of differences in satisfaction included rural pre-registrars being less likely to agree they had good access to support and supervision from qualified consultants (odds ratio [OR], 0.6; 95% CI, 0.3-0.9) and rural consultants being more likely to agree they had a poorer professional support network (OR, 1.9; 95% CI, 1.2-2.9). In terms of demographics, relatively more rural physicians had a rural background or were trained overseas. Although most junior physicians were women, female consultants were less likely to be working in a rural location (OR, 0.6; 95% CI, 0.4-0.8).Junior physicians in metropolitan or rural settings have a similar professional experience, which is important in attracting future trainees. Increased opportunities for rural training should be prioritised, along with addressing concerns about the professional isolation and poorer support network of those in rural areas, not only among junior doctors but also consultants. Finally, making rural practice more attractive to female junior physicians could greatly improve the consultant physician distribution. CHAPTER 2: GENERAL PHYSICIANS AND PAEDIATRICIANS IN RURAL AUSTRALIA: THE SOCIAL CONSTRUCTION OF PROFESSIONAL IDENTITY: Objective: To explore the construction of professional identity among general physicians and paediatricians working in non-metropolitan areas.In-depth qualitative interviews were conducted with general physicians and paediatricians, plus informants from specialist colleges, government agencies and academia who were involved in policy and programs for the training and recruitment of specialists in rural locations across three states and two territories. This research is part of the Training Pathways and Professional Support for Building a Rural Physician Workforce Study, 2018-19.Individual and collective descriptors of professional identity.We interviewed 36 key informants. Professional identity for general physicians and paediatricians working in regional, rural and remote Australia is grounded in the breadth of their training, but qualified by location - geographic location, population served or specific location, where social and cultural context specifically shapes practice. General physicians and paediatricians were deeply engaged with their local community and its economic vulnerability, and they described the population size and dynamics of local economies as determinants of viable practice. They often complemented their practice with formal or informal training in areas of special interest, but balanced their practice against subspecialist availability, also dependent on demographics. While valuing their professional roles, they showed limited inclination for industrial organisation.Despite limited consensus on identity descriptors, rural general physicians and paediatricians highly value generalism and their rural engagement. The structural and geographic bias that preferences urban areas will need to be addressed to further develop coordinated strategies for advanced training in rural contexts, for which collective identity is integral. CHAPTER 3: SUSTAINABLE RURAL PHYSICIAN TRAINING: LEADERSHIP IN A FRAGILE ENVIRONMENT: Objectives: To understand Royal Australasian College of Physicians (RACP) training contexts, including supervisor and trainee perspectives, and to identify contributors to the sustainability of training sites, including training quality.A cross-sectional mixed-methods design was used. A national sample of RACP trainees and Fellows completed online surveys. Survey respondents who indicated willingness to participate in interviews were purposively recruited to cover perspectives from a range of geographic, demographic and training context parameters.Fellows' and trainees' work and life satisfaction, and their experiences of supervision and training, respectively, by geographic location.Fellows and trainees reported high levels of satisfaction, with one exception - inner regional Fellows reported lower satisfaction regarding opportunities to use their abilities. Not having a good support network was associated with lower satisfaction. Our qualitative findings indicate that a culture of undermining rural practice is prevalent and that good leadership at all levels is important to reduce negative impacts on supervisor and trainee availability, site accreditation and viability. Trainees described challenges in navigating training pathways, ensuring career development, and having the flexibility to meet family needs. The small number of Fellows in some sites poses challenges for supervisors and trainees and results in a blurring of roles; accreditation is an obstacle to provision of training at rural sites; and the overlap between service and training roles can be difficult for supervisors.Our qualitative findings emphasise the distinctive nature of regional specialist training, which can make it a fragile environment. Leadership at all levels is critical to sustaining accreditation and support for supervisors and trainees. CHAPTER 4: PRINCIPLES TO GUIDE TRAINING AND PROFESSIONAL SUPPORT FOR A SUSTAINABLE RURAL SPECIALIST PHYSICIAN WORKFORCE: Objective: To draw on research conducted in the Building a Rural Physician Workforce project, the first national study on rural specialist physicians, to define a set of principles applicable to guiding training and professional support action.We used elements of the Delphi approach for systematic data collection and codesign, and applied a hybrid participatory action planning approach to achieve consensus on a set of principles.Eight interconnected foundational principles built around rural regions and rural people were identified: FP1, grow your own "connected to" place; FP2, select trainees invested in rural practice; FP3, ground training in community need; FP4, rural immersion - not exposure; FP5, optimise and invest in general medicine; FP6, include service and academic learning components; FP7, join up the steps in rural training; and FP8, plan sustainable specialist roles.These eight principles can guide training and professional support to build a sustainable rural physician workforce. Application of the principles, and coordinated action by stakeholders and the responsible organisations, are needed at national, state and local levels to achieve a sustainable rural physician workforce.

Amaç: Tıp fakültesi öğrencilerinin mezuniyet sonrası uzmanlık tercihlerini belirleyen faktörler ile sağlıkta insan gücü (SİG) ihtiyacının örtüşmesi verimlilik için oldukça önemlidir. Araştırmanın amacı tıp fakültesi öğrencilerinin uzmanlık tercihlerini etkileyen nedenleri tespit etmektir. Gereç ve Yöntem: Kesitsel türdeki araştırmanın evrenini İstanbul’da bulunan tıp fakültelerindeki (n=19) öğrenciler (n=13.740) oluşturmaktadır. Hazırlık sınıfları çalışmaya dahil edilmemiştir. Olasılıksız örnekleme yöntemiyle 14 fakültedeki 826 öğrenciye ulaşılmıştır. Literatürde bulunan 19 faktörün uzmanlık tercihlerini ne düzeyde etkilediği Likert tipi anketle sorulmuştur. Bulgular: Uzmanlık yapmayı düşünen öğrencilerin (n=799); %58,6’sı kadındır. %65,2’si devlet üniversitelerinde, %58’1’i ise klinik sınıflarda okumaktadır. Öğrencilerin en çok tercih etmek istedikleri branşlar iç hastalıkları (n=235), göz hastalıkları (n=214), çocuk sağlığı ve hastalıkları (n=208) olmuştur. Temel ve klinik sınıflar arası bölüm tercihleri sıralandığında klinik sınıflarda beyin ve sinir cerrahisi 20 sıra aşağı inmiş, fizik tedavi ve rehabilitasyon ise 13 sıra yukarı çıkmıştır. Tercihte en etkili faktörler sırasıyla “bölümü sevmek”, “kişisel yetenek ve ilgi” ve “mesleki tatmin imkânı” olarak bulunmuştur. Ancak “bölümü sevmek” ve “mesleki tatmin imkânı” biyokimyada uzmanlık yapmak isteyen öğrenciler için öncelikli değildir (sırasıyla p=0,032, p=0,005). Sınıflar arasında anlamlı farklılık gösteren 11 faktörden sadece “kişisel ilgi ve yetenek” branş seçiminde temel sınıflarda, klinik sınıflara göre daha çok etkilidir (p, Background: Coherence between the manpower needs in healthcare and factors which determine the specialization preferences of medical faculty students (MFS) is very important for efficiency. This study examines the determinants of specialization preferences of MFSs in Istanbul. Material and Method: This cross-sectional study included all students in all classes except preparatory class (n=13,740) in medical faculties (n=19) in Istanbul. Eight hundred twenty-six students from 14 faculties were reached using a non-probability sampling method. A Likert-type questionnaire was used to determine the effects of 19 factors mentioned in academic literature. Results: Fifty eight percent of students who wanted to be a specialist were women, 58.1% were in clinical classes (CC), and 65.2% were from state universities. The branches most preferred by students were: internal medicine (n=235), ophthalmology (n=214) and pediatrics (n=208), respectively. When the branch preferences were ranked in BC and CC, neurosurgery went down 20 steps in CC and physical therapy and rehabilitation went up 13 steps. The most influential factors were “loving the branch (LB)”, “personal talent/interest (PTI)”, and “possibility of professional satisfaction (PPS)”. However “LB” and “PPS” weren’t priorities for students who wanted to specialize in biochemistry (p=0.032, p=0.005, respectively). 11 factors differed significantly between classes. Among them only “PTI” were more effective in selection of branches in BC than CC (p

Background Worldwide, policies exist on family presence during resuscitation (FPDR), however, this is still lacking in the Gulf Corporation Countries (GCC) in general and in the Kingdom of Bahrain in particular. The aim of this study is to assess the perspectives of healthcare providers (HP) on FPDR among those working in the emergency departments (EDs) in the Kingdom. Methods A self-administered anonymous electronic survey was collected from 146 HPs (emergency physicians and nurses) working in the three major EDs in the Kingdom of Bahrain. Besides demographic data, 18 items measuring HPs’ perceptions of FPDR were generated using the 5-point Likert scale. Results Surveys (n = 146) from physicians and nurses were analysed (45.9% vs. 54.1%, respectively). There were significant differences between physicians and nurses in terms of personal beliefs, FPDR enhancing professional satisfaction and behaviour, and the importance of a support person and saying goodbye (p Conclusion The study reflects that many HPs in EDs participated in and are familiar with FPDR, with the majority of ED physicians supporting it. Further studies should investigate the reasons for the lack of support from nurses. Results may contribute to the development of hospital ED policies that allow FPDR in the region.

Introduction: Plastic cannulas (PC) have shown efficacy in haemodialysis (HD) and are presented as a positive innovation for patients and vascular access survival. Objective: To analyse Spanish HD nurses' experience of using PC. Design: Cross-sectional observational study. Methods: An ad hoc questionnaire was administered on nurses' experience of PC use. Results: A total of 163 Spanish HD nurses were surveyed, of whom 42.3% had PC in their workplace and 50.9% had used them. In all, 55.8% had received training and 77.9% wished to receive more training. These needles were significantly more available in public institutions than in private centres (p < 0.001). There was no significant difference between years of experience and having received training (p = 0.915). There was a moderate-strong correlation (ρ = 0.659) between greater professional satisfaction with the product and greater patient satisfaction (p < 0.001). The nurses would make a median of two [P25 , 1; P75 , 3] modifications in the product design. The characteristics of the PC were rated positively by 55.8% and negatively by 10.3%. Conclusions: A substantial proportion of the nurses surveyed did not use PC and had not received training in their use. Respondents reported that PC could be improved and a small percentage perceived them negatively.Implications for practice: Based on the evidence presented and available, if we manage to integrate this knowledge and work on the continuum of achieving excellence, we will continue to grow as a profession and provide higher quality care.

In diesem Beitrag wird untersucht, ob und inwieweit sich das Ausmass der negativen Beanspruchung bei Lehrpersonen in der Schweiz der 5. – 9. Schulstufe (7. – 11. HarmoS) in den letzten zehn Jahren verändert hat. Auf der Grundlage einer nationalen sequentiellen Querschnittsanalyse können erstmals Aussagen zu Trends zwischen 2006 und 2014 gemacht werden: Das Ausmass der negativen Beanspruchung bleibt bei regionalen Unterschieden insgesamt relativ stabil und die Lehrkräfte sind trotz anhaltend hohen Anforderungen mit ihrem Beruf zufrieden. Die Befunde werden vor dem Hintergrund der national bedeutsamen Bildungsreformen in diesem Zeitraum diskutiert. (DIPF/Orig.), Cet article examine si et dans quelle mesure l’ampleur des sollicitations à l’égard des enseignant-es suisses de 5e à 9e année scolaire (7e à 11e HarmoS) a évolué au cours des dix dernières années en Suisse. Sur la base des données d’études transversales répétées au plan national, l’évolution entre 2006 et 2014 a pu être décrite pour la première fois: globalement, l’ampleur des sollicitations est restée relativement stable entre les années, mais on observe des évolutions différentes selon les régions. L’enquête montre également que les enseignant-es restent satisfait-es de leur profession malgré des exigences de plus en plus élevées. Les résultats sont discutés en relation avec les réformes scolaires significatives qui ont eu lieu en Suisse durant cette période. (DIPF/Orig.)

Introduction: Graduates’ perception about their situation and professional satisfaction, which are fundamental to identify the relation between a profes - sional formation and some demands of job market. Objective: To describe the characteristics of physical therapy graduates’ profiles and to analyze factors associated with satisfaction and professional training. Methods: It was invited graduates from 2001 to 2013. An online questionnaire about the characterization of graduates, professional improvement, job market and professional satisfac - tion was used. Results: There were 149 graduates, singles (50.5%) and women (75.8%). About 82.6% were verified professional qualification. In less than one year 69.8% entered the labour market and 85.9% worked with physiotherapy. The main areas of practice were traumatology and orthopedics (58.4%). Professional satisfaction was reported by 71.8% people and economic satisfaction only by 17.4%. Conclusion: The majority of the graduates worked in physiotherapy and sought professional qualification. Most of them were professionally satisfied but economically insatisfied.

Background: This study aimed to evaluate the level of professional satisfaction, to identify the presence of psychic suffering and their correlations in Emergency Medical Services professionals. Methods: The study is of the exploratory, census, descriptive, transversal type, with quantitative approach. It used three instruments: A sociodemographic questionnaire; the Professional Satisfaction Index—PSI; and the Self Report Questionnaire—SRQ-20. 200 professionals took part in the research (doctors, nurses, nursing technicians and conductors). Results: The data show that the majority of professionals are aged between 40 and 49 years old and that the largest quantity of women belong to the group of nurses. As to the PSI, the majority of professionals pointed out remuneration as the most important for satisfaction. In the overall satisfaction result, the physicians were those who had the highest level of satisfaction. Regarding the SRQ-20 scores, the group of nursing technicians and nurses had the highest prevalence for psychic suffering, with 44.56% and 43.48%. In the statistical analyses between each of the components of the professional satisfaction with the SRQ-20 scores, we verified statistically significant correlations when adopting (p < 0.05). The percentage of dissatisfied professionals was higher among those who had psyche suffering (88.1% × 68.1%), finding a significant correlation with satisfaction and psychological distress with p = 0.003. Conclusions: It was concluded that the discontent of workers with remuneration and managerial issues are predominant for total dissatisfaction with work and dissatisfaction exerts a strong influence on the presence of suffering in these professionals.

Objective: The objective of this study was to determine the prevalence of depression, anxiety, and stress among medical students. Materials and Methods: Students underwent face-to-face interview using predesigned, pretested, anonymous interview schedule using standardized survey instrument and Depression Anxiety Stress Scale 21 item. Information was also collected on sociodemographic, academic profile, and personal characteristics of students. All the students enrolled in the medical college from first to final year were invited to participate, and the study was conducted during mid-semester to ensure that there was no university examination or college festival/event. Results: A total of 187 students participated in the study giving a response rate of 94%. The participants were predominantly male (66%) and majority (65.8%) residing in hostel. It was noted that 7.5% reported parental conflict; 15.0% were “always” fearful about future life; 21.9% had poor relationship with family members; 22.5% were not satisfied with their body image; and 18.7% were globally dissatisfied. It was observed that 60 (32.0%), 75 (40.1%), and 82 (43.8%) students were affected by symptoms suggestive of depression, anxiety, and stress, respectively. On bivariate analysis, higher proportion of students with anxiety had a history of some medical condition (P < 0.05). Similarly, family history of chronic noncommunicable disorder was significantly (P < 0.05) associated with stress only while students with family history of mental illness had a higher proportion of depression (P < 0.05) only. It was also found that dissatisfaction with body image and global dissatisfaction with life was statistically (P < 0.05) associated with depression and anxiety while fair (poor) relationship with family members was statistically (P < 0.05) associated with depression only. Subjective (self) assessment of ability to cope with medical syllabus was inversely associated (P < 0.01) with ability, i.e., as the student's ability to cope with syllabus increases by one unit, the probability of occurrence of depression and anxiety decreases by 1.29 units and 0.71 units, respectively. Conclusion: It is noted that emotional distress is common among medical students, and there is an urgent need for attention, support, and personalized counseling.

OBJECTIVE To report satisfaction with services for children with hearing loss in urban and rural Australia. DESIGN Mixed-method approach using surveys and semi-structured interviews. SETTING Australian organisations that serve children with hearing loss. PARTICIPANTS One hundred parents of children with hearing loss and 91 professionals that serve children with hearing loss completed surveys. Seven parents and eight professionals were interviewed. MAIN OUTCOME MEASURES Comparison of satisfaction with services in rural and urban areas. RESULTS Timing of initial hearing services was similar in rural and urban areas. Children with hearing loss in rural areas had less satisfaction with services than children in urban areas. Parents of children with hearing loss in rural areas had higher costs, mainly linked to travel, than parents in urban areas. Parents and professionals were concerned that advantaged parents received more services for their child than disadvantaged parents. Parents and professionals in urban and rural areas were satisfied with mainstream education, but less satisfied with education for children with hearing loss and additional disability. Professional satisfaction was lower in rural areas than urban areas. CONCLUSIONS This small-scale study adds to research citing reduced services in rural areas. An exception is the newborn hearing screening program, with the limited data presented indicating the program is effectively overcoming the barrier of distance. However, children with hearing loss in rural areas have reduced access to ongoing services.

Buprenorphine is a critically important treatment for addressing the opioid epidemic, but there are virtually no studies of physicians' job satisfaction with providing buprenorphine. Physicians' job satisfaction has been linked to burnout and turnover as well as patients' adherence to treatment recommendations, so it is important to understand how physicians' satisfaction with providing buprenorphine treatment compares to their overall job satisfaction.As part of a cluster randomized clinical trial (RCT) focused on expanding access to medication for opioid use disorder, 55 physicians working in 38 organizations in Florida, Ohio, and Wisconsin completed a baseline web-based survey. Study measures included global job satisfaction, career satisfaction, and specialty satisfaction. Physicians who were waivered to prescribe buprenorphine were asked to rate their satisfaction with their current buprenorphine practice.Overall, physicians were generally satisfied with their jobs, their careers, and their specialties. When waivered physicians (n = 40) were compared to non-waivered physicians (n = 15) on 13 satisfaction items, there were no statistically significant differences. Among waivered physicians, ratings for buprenorphine work were significantly lower than ratings for general medical practice for finding such work personally rewarding, being pleased with such work, and overall satisfaction.Although waivered and non-waivered physicians both reported high global job satisfaction, these data suggest that some waivered physicians may view their buprenorphine work as somewhat less satisfying than their global medical practice. Given that job dissatisfaction is a risk factor for turnover and burnout, managers of treatment organizations should consider whether strategies may be able to mitigate some sources of lower satisfaction in the context of buprenorphine treatment. Trial registration ClinicalTrials.gov. NCT02926482. Date of registration: September 9, 2016. https://clinicaltrials.gov/ct2/show/NCT02926482.

Aim The aim of this study was to conduct a nationwide evaluation of career satisfaction and training experience among residents in pediatrics in both Ireland and Turkey. Patients and methods Questionnaires were designed by the authors and distributed electronically in Turkey to paediatric residents. The same questionnaire was translated to English and distributed to pediatric residents in Ireland in paper format. Data was collected on demographics (age, gender), characteristics of training institution, exposure to physical or psychological violence, average number of night shifts per month and usage of antidepressants and was analysed using SPSS. Five hundred residents (332 (66.4%) female, 168 (33.6%) male) in Turkey and sixty-one residents (46 (75.4%) female, 15 (24.6%) male) in Ireland completed the questionnaire. Results Resident satisfaction was approximated using a composite score of academic and professional satisfaction. Resident satisfaction was rated higher in Ireland than in Turkey (p 0.05) Conclusion This international comparative study describes a wide variation in the level of career satisfaction among residents in pediatrics. Irish residents were reportedly more satisfied with training, less likely to have considered resigning from residency, worked fewer night shifts, reported lower rates of antidepressant use and less exposure to violence at work than their Turkish peers. Regional, cultural and social factors as well as variation in working conditions may impact resident satisfaction. Measures such as reducing frequency of night shifts and support from occupational health may improve resident experience. Collaboration between national training organisations may inspire ideas for positive change.

The aims of this study were to determine whether male vs. female oral and maxillofacial surgery (OMS) residents, academic surgeons (i.e., faculty members), and private practitioners in the U.S. differed in their general career satisfaction and job/professional satisfaction. Survey data were collected in 2011-12 from 267 OMS residents (response rate 55%), 271 OMS academic surgeons (response rate 31%), and 417 OMS private practitioners (response rates 13% web-based survey and 29% postal mail survey). The results showed that while the male vs. female OMS private practitioners and academic surgeons did not differ in their career satisfaction, the female residents had a lower career satisfaction than the male residents (on four-point scale with 4=most satisfied: 3.03 vs. 3.65; p

Objective To analyze whether the application of Lean techniques to improve the flow of critically ill patients in a health region with its epicenter in the intensive care unit (ICU) of a reference hospital. Design Observational study with pre and post intervention analysis. Setting ICU of a reference hospital. Patients We design projects and a value stream map of flow and compared pre and post intervention. Interventions We recorded demographic data, patient transfers by EMS for lack of beds and delay times in the discharge from ICU to ward. Multidisciplinary meetings and perform daily visual panel, with high priority ICU discharge. We promote temporary relocation of critically ill patients in other special areas of the hospital. We performed a professional satisfaction questionnaire with pre and post implementation of process. We make a statistical analysis of pre and post-intervention comparisons. Results We planned for 2013 and progressively implemented in 2014. Analysis of patients entering the critical process flow (1) evaluate patients who must transfer for lack of beds, focusing on a diagnosis: pre 10/22 vs. 3/21 post ( p = .045); (2) analysis of time delay in the discharge from the ICU to ward: 360.8 ± 163.9 min in the first period vs. 276.7 ± 149.5 in the second ( p = .036); and (3) personal professional satisfaction questionnaire, with 6.6 ± 1.5 points pre vs. 7.5 ± 1.1 in post ( p = .001). Analysis of indicators such as the ICU acquired infections, length of ICU stay, the rate of re-admissions and mortality, with no significant differences between the two periods. Conclusions The application of Lean techniques in the critically ill process had a positive impact on improving patient flow within the health region, noting a decrease of transfers outside the region due to lack of beds, reduced delayed discharge from ICU to conventional ward and increased satisfaction of ICU professionals.

Dermatology is known as specialty that traditionally exhibits high levels of professional satisfaction, largely attributed to regular clinic hours and a lack of in-house call. Yet, the 2018 Medscape Dermatologist Lifestyle Survey showed that nearly one-third of dermatologists either currently experience or have experienced burnout during their careers. Although male and female dermatologists report similar burnout rates, 36% of female dermatologists reportedly work part-time compared with 14% of male dermatologists. The fact that female and male dermatologists experience similar rates of burnout even though women are more likely to work part-time suggests that female dermatologists might have additional or unique reasons for experiencing burnout compared with their male counterparts. Women in dermatology likely experience burnout, at least in part, as a result of stress from the demands of life outside of work. However, despite increasing interest in the development of burnout prevention strategies, efforts to reduce burnout have so far failed to acknowledge or address the unique reasons why female dermatologists may experience burnout. This article aims to better characterize causes of burnout that may disproportionately contribute to female burnout and to provide actionable steps to address burnout in female dermatologists. Keywords: Burnout, Female, Dermatologist, Maternity leave, Second shift, Household

Objective Vascular surgeons may experience physical discomfort during open and endovascular procedures. We aimed to understand and quantify the timing, severity, and location of the pain, as well as to identify how pain correlates with other factors. Methods An electronic survey was distributed to 1164 members of the Society for Clinical Vascular Surgery during the summer of 2016. There were 1089 (93.6%) surveys that were successfully delivered and 263 responses received (response rate of 24.2%). The survey was designed to quantify pain before, during, and after surgical procedures using the modified Borg scale. Questions aimed at determining surgeon workload, type of practice, burnout, and professional satisfaction were also included. Results Of the 263 total responses, 184 responders were male (82.1%). Workload data revealed that more than 87% of surgeons operate 3 or more days per week and 4 or more hours per day. Lead garments were worn by 48.4% these surgeons every day, with 91.4% wearing lead at least once per week. Pain was present in 74.7% of surgeons before beginning an operation, in 92.3% during an operation, and in 96.8% at completion. Before, during, and after surgery, 12.2% of vascular surgeons (n = 32) experience at least moderate pain. Years in practice had no effect on these results, and although not reaching statistical significance, there was a trend correlating surgeons who wear lead experiencing more pain immediately after performing an operation (P = .090). Of these surgeons, 31.4% acknowledged seeking medical help, although only 4.4% reported pain to their institutions. Professional satisfaction among vascular surgeons was inversely correlated with pain. Those expressing satisfaction with their profession had less pain before and two days after performing surgery (P ≤ .005). Self-reported burnout among surgeons positively correlated with increased pain. Burned out surgeons reported more pain while performing surgery (P ≤ .001), immediately after performing surgery (P ≤ .001), and persistent pain (P ≤ .001). Conclusions Physical discomfort during the performance of daily duties by vascular surgeons is ubiquitous. Our survey shows a correlation between self-reported workplace burnout and an increased severity of work-related pain. Additional studies are needed to determine the causality of these correlations and what potential interventions can be undertaken to decrease all work-related pain.

Die medizinische Habilitation stellt einen wesentlichen Erfolgsfaktor fur die Karriere eines Arztes dar. Ob sie jedoch noch eine akademische Befahigung oder doch eher ein Karriereinstrument beschreibt wird kontrovers diskutiert. In diesem Zusammenhang haben wir eine Umfrage bei Habilitierten in der Medizin durchgefuhrt, deren Ziel die Evaluation des Stellenwerts der Habilitation ist. Die Untersuchung wurde als Online-Umfrage mithilfe eines Fragebogens zu biographischen Merkmalen sowie zu subjektiven Einschatzungen habilitationsrelevanter Themen durchgefuhrt. Insgesamt konnten 628 Fragebogen ausgewertet werden. Der Stellenwert einer Habilitation wird von 68,6 % als hoch eingeschatzt und war bei 71,0 % fur ein berufliches Vorankommen notwendig. Die Chancen nach erfolgreicher Habilitation einen Lehrstuhl zu erhalten, werden nur mittelmasig bis niedrig eingestuft (68,1 %). Dennoch wurden 92,3 % erneut habilitieren und 86,5 % die Habilitation Fachkollegen empfehlen. Daher sprechen sich 78,8 % gegen die Abschaffung aus. Reformwunsche, wie eine bundeseinheitliche Habilitationsordnung, weniger Abhangigkeit von Ordinarien und mehr Transparenz wurden genannt. Die Habilitation hat einen hohen Stellenwert in der Medizin und deren Abschaffung wird mehrheitlich nicht gewunscht. Obwohl die Chancen auf einen Lehrstuhl nur gering eingeschatzt werden, scheint die Habilitation fur die Karriere forderlich. Jedoch besteht die Notwendigkeit zu wesentlichen inhaltlichen, strukturellen und internationalen Veranderungen.

Electronic Health Records (EHRs) have been shown to markedly alter clinical workflows and are associated with lower professional satisfaction scores among providers post-implementation. In light of these issues, questions exist regarding what barriers currently exist in EHRs to adequately meet the workflow needs of providers. The objective of this study was to describe what physicians perceive to be the current barriers to information gathering and overall workflow when using electronic health records (EHRs) to evaluate new patients. A web-based national survey was distributed to practicing physicians in primary care, general internal medicine, medicine subspecialties, general surgery, surgery subspecialties, general pediatrics, and pediatrics subspecialties from June to September 2014. Prominent themes pertaining to information gathering and overall workflow in the EHR were identified from narrative survey responses using constant comparison and axial coding to arrive at a grounded theory. Narrative responses from 327 physicians were obtained and analyzed from a total of 1385 respondents (24%). Major identified themes included: 1) Physicians struggle with unintuitive workflows and negative time impact; 2) EHR documentation was excessive and often of poor clinical value; 3) Provider-provider communication is negatively impacted by EHR challenges; and 4) Frustration with EHRs led to mistrust of vendors and clinical administration responsible for building and selecting the EHR software. Barriers such as inefficient workflows, increased time demands, and inconsistent documentation practices exist in EHRs that prevent ideal information gathering when evaluating a new patient. Results from this study could provide insights into new EHR interface redesign and development, and into new physician EHR training opportunities.

Background The professional gender gap is increasingly recognised in oncology. We explored gender issues perception and gender influence on professional satisfaction/gratification among young Italian oncologists. Methods Italian oncologists aged ≤40 years and members of the Italian Association of Medical Oncology were invited to participate in an online survey addressing workload/burnout, satisfaction in professional abilities and relations, relevant factors for professional gratification, and gender barriers. χ2 test for general association or χ2 test for trend was used to analyse the data. Results 201 young oncologists participated in the survey: 67% female, 71% aged 30–40 years, 41% still in training and 82% without children. Women and men were equally poorly satisfied by the relations with people occupying superior hierarchical positions. There was heterogeneity between women and men in current (p=0.011) and expected future (p=0.007) satisfaction in professional abilities: women were more satisfied by current empathy and relations with colleagues and were more confident in their future managerial and team leader skills. The most important elements for professional gratification indicated by all participants were, in general, work–life balance (36%) and intellectual stimulation/research (32%); specifically for women, work–life balance (48%) and intellectual stimulation/research (20%); and specifically for men, career (29%) and social prestige/recognition (26%). Heterogeneity within the same gender emerged. For example, the elements indicated by men as the most important were intellectual stimulation/research (39%) and work–life balance (21%) in general, versus social prestige/recognition (24%) and career (24%), respectively, specifically for men (p

Background The professional gender gap is increasingly recognised in oncology. We explored gender issues perception and gender influence on professional satisfaction/gratification among young Italian oncologists. Methods Italian oncologists aged ≤40 years and members of the Italian Association of Medical Oncology were invited to participate in an online survey addressing workload/burnout, satisfaction in professional abilities and relations, relevant factors for professional gratification, and gender barriers. ‡ 2 test for general association or ‡ 2 test for trend was used to analyse the data. Results 201 young oncologists participated in the survey: 67% female, 71% aged 30-40 years, 41% still in training and 82% without children. Women and men were equally poorly satisfied by the relations with people occupying superior hierarchical positions. There was heterogeneity between women and men in current (p=0.011) and expected future (p=0.007) satisfaction in professional abilities: women were more satisfied by current empathy and relations with colleagues and were more confident in their future managerial and team leader skills. The most important elements for professional gratification indicated by all participants were, in general, work-life balance (36%) and intellectual stimulation/research (32%); specifically for women, work-life balance (48%) and intellectual stimulation/research (20%); and specifically for men, career (29%) and social prestige/recognition (26%). Heterogeneity within the same gender emerged. For example, the elements indicated by men as the most important were intellectual stimulation/research (39%) and work-life balance (21%) in general, versus social prestige/recognition (24%) and career (24%), respectively, specifically for men (p

Background and aims Increased nurse-physician collaboration is a factor in improved patient outcomes. Limited autonomy of nurses has been proposed as a barrier to collaboration. This study aims to explore nurse-physician collaboration and potential associations with nurses' autonomy and pertinent nurses' characteristics in adult intensive care units (ICUs) in Cyprus. Design and Methods Descriptive correlational study with sampling of the entire adult ICU nurses' population in Cyprus (five ICUs in four public hospitals, n = 163, response rate 88·58%). Nurse-physician collaboration was assessed by the Collaboration and Satisfaction About Care Decisions Scale (CSACD), and autonomy by the Varjus et al. scale. Results The average CSACD score was 36·36 ± 13·30 (range: 7–70), implying low levels of collaboration and satisfaction with care decisions. Male participants reported significantly lower CSACD scores (t = 2·056, p = 0·04). CSACD correlated positively with years of ICU nursing experience (r = 0·332, p

The aim of this study was to examine the impact of utilizing medical scribes on clinic workflow, physician professional satisfaction, and patient satisfaction in rheumatology and endocrinology clinics.We conducted a within-practice pilot study of medical scribes that included a 6-week intervention phase (documentation assistance by medical scribes) followed by a control phase (usual documentation with no assistance) in outpatient rheumatology and endocrinology clinics at an academic medical center. We evaluated the following outcomes: physician professional satisfaction (range, 5-25, with higher values denoting higher satisfaction), autonomy (range, 4-16, with higher values denoting higher autonomy), perception of clinic workflow (range, 1 = calm, 5 = chaotic), and patient satisfaction (5-point Likert item, anchors: strongly agree, strongly disagree).Six physicians, including 3 rheumatologists and 3 endocrinologists, and 496 patients nested within their practices participated. The use of a medical scribe was not associated with physician professional satisfaction (18.17 [SD, 2.9] vs. 17.83 [SD, 1.94], not statistically significant), perception of clinic workflow (2.50 [SD, 0.84] vs. 3.17 [SD, 0.75], not statistically significant), or autonomy (8.67 [SD, 3.44] vs. 8.83 [SD, 3.06], not statistically significant). Physicians had an overall favorable view of the medical scribes program and perceived that documentation support provided by scribes was useful and easy to use and had a positive impact on their clinic workflow. Patient satisfaction was high during the intervention phase (99.4% strongly agree/agree) but not significantly different than in the control phase.Rheumatologists, endocrinologists, and their patients had consistently positive views regarding the use of a medical scribe without an observed negative effect on clinic workflow in outpatient clinics.

Rekabet sartlari ve yonetim paradigmalarinin cok hizli degistigi gunumuzde isletmelerin performansini sadece yoneticilerinin degil calisanlarinin da bireysel performansi belirlemektedir. Yapilan calismalar da calisanlarin bireysel is performanslarinin orgutsel basariyi etkileyen onemli faktorlerden birisi oldugunu gostermektedir. Bagimli olarak calisan 977 muhasebe meslek mensubu (mesleki stajyer, SM ve SMMM) uzerinde gerceklestirilen bu arastirma ile muhasebe meslek mensuplarinin meslek memnuniyeti, mesleki baglilik ve bireysel is performanslari arasindaki neden-sonuc iliskilerini ortaya koymak amaclanmaktadir. Ayrica mesleki bagliligin, meslek memnuniyeti ve bireysel is performansi iliskisinde bir ara degisken olup olmadigi da arastirilacaktir. Gelistirilen modelin degiskenlerine dayali olarak olusturulmus anket ile elde edilen verilerin analizi sonucunda meslek memnuniyetinin, muhasebe meslek mensuplarinin meslege duygusal, devam ve normatif bagliliklarini ve bireysel is performanslarini olumlu; meslege duygusal, devam ve normatif bagliligin da bireysel is performansini olumlu etkiledigi sonucuna ulasilmistir. Ayrica arastirmanin ara degisken analizine yonelik bulgulari, meslek memnuniyeti ile bireysel is performansi iliskisinde mesleki bagliligin kismi ara degisken oldugunu gostermektedir

Better working conditions for clinicians and staff could help primary care practices implement delivery system innovations and help sustain the US primary care workforce. Using longitudinal surveys, we assessed the experience of clinicians and staff in 296 clinical sites that participated in the Centers for Medicare and Medicaid Services (CMS) Federally Qualified Health Center (FQHC) Advanced Primary Care Practice Demonstration. Participating FQHCs were expected to achieve, within three years, patient-centered medical home recognition at level 3-the highest level possible. During 2013-14, clinicians and staff in these FQHCs reported statistically significant declines in multiple measures of professional satisfaction, work environment, and practice culture. There were no significant improvements on any surveyed measure. These findings suggest that working conditions in FQHCs have deteriorated recently. Whether findings would be similar in other primary care practices is unknown. Although we did not identify the causes of these declines, possible stressors include the adoption of health information technology, practice transformation, and increased demand for services.

To evaluate the relationship between burnout, satisfaction with electronic health records and work-life integration, and the career plans of US physicians.Physicians across all specialties in the United States were surveyed between August 28, 2014, and October 6, 2014. Physicians provided information regarding the likelihood of reducing clinical hours in the next 12 months and the likelihood of leaving current practice within the next 24 months.Of 35,922 physicians contacted, 6880 (19.2%) returned surveys. Of the 6695 physicians in clinical practice at the time of the survey (97.3%), 1275 of the 6452 who responded (19.8%) reported it was likely or definite that they would reduce clinical work hours in the next 12 months, and 1726 of the 6496 who responded (26.6%) indicated it was likely or definite that they would leave their current practice in the next 2 years. Of the latter group, 126 (1.9% of the 6695 physicians in clinical practice at the time of the survey) indicated that they planned to leave practice altogether and pursue a different career. Burnout (odds ratio [OR], 1.81; 95% CI, 1.49-2.19; P.001), dissatisfaction with work-life integration (OR, 1.65; 95% CI, 1.27-2.14; P.001), and dissatisfaction with the electronic health record (OR, 1.44; 95% CI, 1.16-1.80; P=.001) were independent predictors of intent to reduce clinical work hours and leave current practice.Nearly 1 in 5 US physicians intend to reduce clinical work hours in the next year, and roughly 1 in 50 intend to leave medicine altogether in the next 2 years to pursue a different career. If physicians follow through on these intentions, it could profoundly worsen the projected shortage of US physicians.

Objective To assess the factors that may influence physicians' desire to retire through an analysis of data collected through the American Academy of Pediatrics (AAP) State Pediatrician Workforce Survey. Study design An electronic survey was sent to retired and nonretired US pediatricians who held AAP membership. The respondents were asked about the importance of 12 factors that would influence or had influenced their decision to retire. The physicians who were not yet retired also were asked: “If you could afford to today, would you retire from medicine?” Results The survey was completed by 8867 pediatricians. Among the nonretired respondents, 27% reported that they would retire today if it were affordable. Increasing regulation of medicine, decreasing clinical autonomy, and insufficient reimbursement were rated as very important factors by >50% of these pediatricians. Among retired pediatricians, 26.9% identified the effort to keep up with clinical advances and changes in practice as a very important factor in their decision to retire. Younger physicians were significantly more likely to rate maintenance of certification requirements, insufficient reimbursement, lack of professional satisfaction, and family responsibilities as very important factors. Rural pediatricians were more interested in retiring than those working in academic settings. There were no sex differences. Conclusions Twenty-seven percent of pediatricians in practice today would retire today if it were affordable. Identifying and addressing the important factors that influence a pediatrician's desire to retire can potentially reduce the retirement rate of pediatricians and thus increase access to care for children.

In recent years, several studies focused on the training of dentists in Chile and other Ibero-American countries and its implications have been published. However, there is no analysis of all the evidence at a regional level. The aim of this article is to review the changes in training for dentists in Ibero-America, the educational and/or sanitary policies associated to these changes and the impact that they have for dentists in the future in Chile and the region. In general terms, a strong increase in the amount of available places for studying dentistry, without a clear sanitary or educational planning to justify it, has been observed in several countries of the region this rise does not show a positive impact in the access to dental treatment, especially for the poorest populations. Although the levels of satisfaction are high among dentists, an unemployment rise and a salary decrease have been observed over the last few years, which could impact professional satisfaction. In Ibero-America, an exponential increase of dental schools, without a positive impact on the oral health of the population, but negatively affecting workforce, is observed. Keywords: “Dentists”[MeSH], “Work”[MeSH], “Job Satisfaction”[MeSH], “Education, Dental”[MeSH], “Public Health”[MeSH]. Formacion de dentistas en Chile y otros paises iberoamericanos. Consideraciones en educacion, salud y trabajo. En los ultimos anos se han publicado varias investigaciones centradas en el aumento de la formacion de dentistas en Chile y otros paises de Iberoamerica. Sin embargo, no existen analisis de toda la evidencia a nivel regional. El objetivo de este articulo es revisar los cambios en la formacion de dentistas en Iberoamerica, las politicas educativas y/o sanitarias asociadas a dichos cambios y el impacto que han tenido en el futuro para los odontologos de Chile y la region. En terminos generales se observa un fuerte incremento en la cantidad de plazas disponibles para estudiar odontologia en varios paises del area, sin una clara planificacion sanitaria o educativa que lo justifique. Este crecimiento no ha mostrado un impacto positivo en el acceso a atencion odontologica, especialmente de aquellas poblaciones de escasos recursos. Si bien los niveles de satisfaccion de los dentistas son elevados, en los ultimos anos se ha observado un aumento de la cesantia y una disminucion de los sueldos, lo que podria impactar la satisfaccion profesional. En Iberoamerica se observa un crecimiento exponencial en la formacion de dentistas, que no ha impactado positivamente la salud oral de la poblacion, pero si negativamente a la fuerza laboral. Palabras clave: Dentistas, Trabajo, Satisfaccion Laboral, Educacion Dental, Salud publica.Palabras clave: Dentistas, Trabajo, Satisfaccion Laboral, Educacion Dental, Salud publica. Dentists’ training in Chile and some iberoamerican countries. Considerations for education, health and job. In the recent years many research focused on the training of dentists in Chile and other countries of Iberoamerica and its implications have been published. However, there is no analysis of all the evidence at a regional level. The aim of this article is to review the changes in the training of Dentists in Iberoamerica, the educational and/or sanitary policies associated to these changes and the impact that these have had in the future for the dentists in Chile and the region. In general terms it´s been observe a strong increase of the amount of available places for studying Dentistry in several countries of the area, without a clear sanitary or educational planning that justify it. This increment does not show and positive impact in the access to the dental treatment, especially in the poorest populations. Although the levels of dentist´s satisfaction are high, in the recent years have been observed a rise in the unemployment and a salary decrease, which could impact in the professional satisfaction. In Iberoamerica uncontrolled growth is observed in the training of dentists, which has no positive impact on the population´s oral health, but negatively to the workforce. Keywords: “Dentists”[MeSH], “Work”[MeSH], “Job Satisfaction”[MeSH], “Education, Dental”[MeSH], “Public Health”[MeSH].

The increasing cost of attending medical school has contributed to increasing physician indebtedness. The burden of medical school debt has implications for physician career choice, professional satisfaction, and burnout. This opinion discusses the impact of physician indebtedness, the importance of improving debt awareness among neurology trainees, and program- and policy-level solutions to the debt crisis.

Objective: The primary purpose of this article is to review the unique wellness factors that affect physicians practicing in rural communities. Research has indicated that rural communities often struggle to attract and retain primary care physicians and numerous wellness factors impact these attraction/retention rates. Method: Articles selected for inclusion in this review were determined based upon their relevance to rural physicians, overall wellness factors of physicians, and recruitment and retention of physicians in rural communities. Articles were included from peer-reviewed journals focusing upon both medical and psychological perspectives of rural physician wellness factors. Results: Results indicated that rural physicians often have fewer resources, an increased workload, and longer hours when compared to their urban counterparts. These factors contribute to lower job satisfaction, poor retention rates, and decreased physician wellness. Research also demonstrates that physicians who are unwell are more likely to experience substance abuse, depression, relationship difficulties, and general psychological distress. These issues are particularly prominent in rural practice settings and may have significant impact upon rural patients. Conclusion: To date, there are few assessment measures available to assess physician wellness and no evidence-based treatments to address wellness deficits in rural physicians' medical or psychological health. Such resources would have the potential to benefit individual rural physicians and the quality of healthcare they deliver to rural communities. Future research should focus upon the assessment and promotion of rural physician well being, which may improve recruitment and retention of quality physicians to provide optimal care in rural communities.

Nursingprofessional dignity isa complextopic.This articledescribesintrinsic and professionalnurs- ing dignity and gives some historical background on nursing in Italy as the setting for a qualitative study of dig- nity conducted in the same country. The study results show the importance of recognition of nursing professionaldignityasitrelatestoprofessionalsatisfactionandpatientcare.(JRadiolNurs2013;32:120-123.)

Purpose The authors surveyed currently practicing audiologists to evaluate their professional satisfaction and compared the results to a similar survey conducted in 1997. Method The authors repeated an audiologist professional satisfaction survey conducted in 1997; 382 randomly chosen, currently practicing audiologists participated. Responses to 38 statements were on a 5-point Likert scale (5 = strong agreement with a statement, 1 = strong disagreement with a statement ). The respondent sample was broken down into demographic subgroups, and statements were divided into subgroups reflecting 6 core reward areas that contribute to overall professional satisfaction. Results Mean group satisfaction was 3.9 ( n = 382; SD = 1.01), which has remained unchanged since 1997 ( p < .05). Private practice audiologists' mean group satisfaction of 4.31 ( n = 80, SD = 0.78) was higher than for other practice settings ( p < .05). AuD private practice owners' mean group satisfaction of 4.52 ( n = 46, SD = 0.66) was higher than for other degrees and practice settings ( p < .05). Core reward area ratings differed for AuD, MA/MS, and PhD degree holders ( p < .05). Correlations between the average core reward area ratings and mean group satisfaction met statistical significance ( p < .05). Conclusions These results have implications for goal setting and planning within the profession and for audiologists' career choices.

Aim: To determine the way in which Malmo University dental graduates perceive their problem-based dental education and evaluate their professional satisfaction. Method: The first five cohorts (graduating in years 1995–1999) of the problem-based curriculum were invited to participate. Of 166 graduates, 77% responded to a questionnaire comprising 20 questions on aspects of their dental education, professional situations and interest in postgraduate education. They were asked to rank their perception of their dental education and satisfaction with their professional situation on a visual analogue scale (VAS) with endpoints ranging from ‘Not at all’ (1) to ‘Very well’ (10). For other statements, the markings were made on a Likert scale from 1 (not important/not satisfied) to 5 (very important/very satisfied). There were also open-ended questions. Results: Most respondents perceived their education to prepare them well for a career in dentistry (median score VAS 8), and 90% rated above six on a VAS for their professional satisfaction as dentists. Importance and satisfaction were highly correlated with principles of the curriculum: holistic view, oral health, lifelong learning, integration between theory and clinic, and clinical competence. Forty-five per cent of the graduates noted the problem-based learning approach as the most valuable asset of their education, and 19% cited training in oral surgery as a deficit. Of the respondents, 77% expressed interest in specialist training and 55% in research education. Conclusion: Problem-based education was perceived to prepare graduates well for their profession, and their professional satisfaction was high.

OBJECTIVE To assess the level of burnout and professional satisfaction among the doctor and nurses working in an emergency department of a tertiary care hospital in Islamabad, Pakistan. METHODOLOGY A self-administered questionnaire-based cross-sectional study was conducted in the emergency department of Shifa international hospital, Islamabad. The questionnaire was based on a Maslach burnout inventory tool and pre-validated study. Data was collected from all the doctors and nurses who were working in this particular department for at least 3 months in any capacity. The tool consisted of 12 questions and covered 4 domains which included emotional exhaustion, depersonalization, personal accomplishment and personal satisfaction. RESULT There were 80 participants with 40% doctors and 60% nurses and the male to female ratio was 50-50%. The results found 78.8% of the study population showing low or no burnout and 21.3% having moderate to high burn out. 17% of the study population was emotionally exhausted and depersonalization was prevalent among 18% of study population. CONCLUSION Emotional exhaustion and depersonalization is a significant concern for the people working in the emergency department. A sense of personal accomplishment and satisfaction with the profession can be a prominent feature that prevents burnout.

Measuring the intraocular pressure using Goldmann applanation tonometry is becoming an essential skill for ophthalmic nurses and technicians. Learning to competently perform this procedure will enhance your professional practice and the patient experience.

CONTEXT Few studies have systematically examined the experience of rural practice from the physician's perspective or included physicians from an array of specialties, particularly non-primary care. PURPOSE To better understand differences between rural and urban physicians in perceptions of their practice environment. METHODS In 2001-2002, self-administered questionnaires were sent to a probability sample of primary care and specialist physicians identified from the American Medical Association's Physician masterfile in California. Logistic regression was performed to model the effect practice location had on key variables, controlling for physician demographics, specialty, and the insurance profile of the physician's patients. FINDINGS Completed questionnaires were obtained from 1,365 of 2,240 eligible urban physicians (61%), and 398 of 632 rural physicians (63%). Among primary care physicians, those in rural areas defined as nonadjacent or small non-metropolitan counties were the least likely to report pressures to see more patients, limit referrals, and limit treatment options. In contrast, among specialists, those in rural areas within metropolitan areas (or in large adjacent non-metropolitan counties) were more likely than urban specialists to report practice pressures. Although rural physicians in both primary care and specialist fields were more likely than urban physicians to report difficulty attracting new physicians to their communities, they perceived their overall practice climate to be better. Physicians in the nonadjacent-or-small non-metropolitan category were the most satisfied, but specialists in the nonadjacent-or-small non-metropolitan category were the least satisfied. CONCLUSION Physicians in rural California appear to have maintained a greater sense of clinical autonomy and higher professional satisfaction compared with their urban counterparts.

OBJETIVO: Identificar diferenças no perfil psicossocial do especializando e médico residente em radiologia e diagnóstico por imagem, avaliar a aspiração profissional e as motivações internas que os influenciaram a escolher a especialidade radiologia e diagnóstico por imagem e se o nível de satisfação profissional melhora a relação médico-paciente. MATERIAIS E MÉTODOS: Foi aplicado um questionário com 26 perguntas que constava também do teste de auto-estima de Rosenberg. RESULTADOS: A auto-estima está acima da média para 39,6% dos médicos. Para 38,7% dos alunos, a escolha da medicina se deu por aptidão ou realizações pessoais. Para 50,9% dos médicos entrevistados, os clientes compreendem e assimilam as informações transmitidas. Apresentam condições para esclarecer as dúvidas dos pacientes 77,4% dos médicos. CONCLUSÃO: Não há diferença no perfil psicossocial do especializando e do médico residente em radiologia e diagnóstico por imagem. A aspiração profissional e as motivações internas dos médicos residentes e especializandos têm as mesmas influências na escolha da especialidade. Os médicos residentes estão mais preparados para o envolvimento na relação médico-paciente do que os especializandos.

BACKGROUND In academia, women remain underrepresented. The authors' sought to examine differences in faculty position and professional satisfaction among academic physicians by gender. METHODS From 2008 to 2012, academic faculty members at a single institution were surveyed (2008, n = 737; 2010, n = 1151; and 2012, n = 971) regarding current position, choice of position, professional satisfaction, and desire for leaving. Logistic regression was performed to compare aspects of professional satisfaction by gender. RESULTS Men more often held tenure track positions compared with women (2008, 45 percent versus 20 percent; 2010, 47 percent versus 20 percent; and 2012, 49 percent versus 20 percent; p < 0.001). Women were more likely to engage in only clinical activities compared with men (2008, 31 percent versus 18 percent; 2010, 28 percent versus 14 percent; and 2012, 33 percent versus 13 percent; p < 0.001) and less likely to participate in research. Women chose tracks to accommodate work-life balance [2008, OR, 1.9 (95 percent CI, 1.29 to 2.76); 2010, OR, 2.0 (95 percent CI, 1.38 to 2.76); and 2012, OR, 2.1 (95 percent CI, 1.40 to 3.00)], rather than the opportunity of tenure [2008, OR, 0.4 (95 percent CI, 0.23 to 0.75); 2010, OR, 0.5 (95 percent CI, 0.35 to 0.85); and 2012, OR, 0.5 (95 percent CI, 0.29 to 0.76) compared with men. Men reported higher professional satisfaction compared with women (2008, 5.7 versus 5.4, p < 0.009; 2012, 5.3 versus 5.0, p < 0.03). Men were more likely to leave because of leadership opportunities (14.4 percent versus 9.2 percent, p < 0.03) and compensation (14.2 percent versus 9.2 percent, p < 0.03) compared with women. CONCLUSIONS Women report lower levels of professional satisfaction in academic practice compared with men. Given the increasing pressures of academic practice, efforts to align work-life balance and professional goals could potentially improve faculty satisfaction and retention.

Summary In this paper, we argue that practitioner–patient relationships in the manual therapies would be strengthened by a deeper understanding of the psychodynamics and emotions of those relationships. We suggest that in many cases, a purely bio-mechanical approach may neglect underlying psychological and emotional reasons of the patient's presenting condition, and consequently, lead to a less than adequate outcome for the patient. We offer easily adopted suggestions that could enhance the practice of practitioners of manual therapies as well as other professions that rely on the application of physical methods of diagnosis and treatment. These suggestions could lead to improved prognosis and increased professional satisfaction for practitioners. This paper describes five key dynamics that characterize practitioner–patient relationships: (i) pain as a form of communication; (ii) the ‘heart-sink' patient; (iii) dependency; (iv) the erotic transference; (v) endings and loss.

Purpose The Index of Work Satisfaction (IWS) is a comprehensive scale assessing nurses' professional satisfaction. The aim of the present study was to explore: a) the applicability, reliability and validity of the Greek version of the IWS and b) contrasts among the factors addressed by IWS against the main themes emerging from a qualitative phenomenological investigation of nurses' professional experiences. Methods A descriptive correlational design was applied using a sample of 246 emergency and critical care nurses. Internal consistency and test–retest reliability were tested. Construct and content validity were assessed by factor analysis, and through qualitative phenomenological analysis with a purposive sample of 12 nurses. Scale factors were contrasted to qualitative themes to assure that IWS embraces all aspects of Greek nurses' professional satisfaction. Results The internal consistency (α = 0.81) and test–retest (tau = 1, p < 0.0001) reliability were adequate. Following appropriate modifications, factor analysis confirmed the construct validity of the scale and subscales. The qualitative data partially clarified the low reliability of one subscale. Conclusions The Greek version of the IWS scale is supported for use in acute care. The mixed methods approach constitutes a powerful tool for transferring scales to different cultures and healthcare systems.

Objective To evaluate the effects of organizational change and sharing of specialist skills and information technology for diabetes in two primary care groups (PCGs) over 4 years. Methods In PCG-A, an intervention comprised dedicated specialist sessions in primary care, clinical guidelines, educational meetings for professionals and a shared diabetes electronic patient record (EPR). Comparison was made with the neighbouring PCG-B as control. In intervention and control PCGs, practice development work was undertaken for a new contract for family doctors. Data were collected for clinical measures, practice organizational characteristics and professional and patient views. Results Data were analysed for 26 general practices including 17 in PCG-A and nine in PCG-B. The median practice-specific proportions of patients with HbA1c recorded annually increased in both areas: PCG-A from median 65% to 77%, while PCG-B from 53% to 84%. For cholesterol recording, PCG-A increased from 50% to 76%, and PCG-B from 56% to 80%. Organizational changes in both PCGs included the establishment of recall systems, dedicated clinics and educational sessions for patients. In both PCGs, practices performing poorly at baseline showed the greatest improvements in organization and clinical practice. Primary care professionals’ satisfaction with access and communication with diabetes specialist doctors and nurses increased, more so in the intervention PCG. Only 16% of primary care professional respondents used the diabetes EPR at least monthly. Patient satisfaction and knowledge did not change. Conclusions Improvements in practices’ organizational arrangements were associated with improvements in clinical care in both PCGs. Sharing specialist skills in one PCG was associated with increased professional satisfaction but no net improvement in clinical measures. A shared diabetes EPR is unlikely to be used, unless integrated with practice information systems.

Bei der Bevolkerung geniest der Arztberuf nach wie vor ein sehr hohes Ansehen. Er hat jedoch auch erhebliche Schattenseiten. Diese sind eine hohe zeitliche und psychische Belastung, eine geringe Lebenszufriedenheit, wenig Freizeit und Privatleben, starke gesundheitliche Belastungen in Verbindung mit einem erhohten gesundheitlichen Risikoverhalten. Zwischen Januar 2004 und Marz 2006 wurden in den Bundeslandern Hessen, Niedersachsen, Sachsen und Thuringen niedergelassene Urologinnen und Urologen uber Ihre Lebenszufriedenheit, ihr gesundheitliches Befinden und ihre Berufszufriedenheit befragt. Von 599 der angeschriebenen Arzte sandten 194 den 14-seitigen Fragebogen ausgefullt zuruck. Die Rucklaufquote betrug 30,8%. Der Fragebogen beinhaltete Fragen zur beruflichen Situation, zu Wunschen und Planen, zur Gesundheit, zur Person, zur Lebenssituation und zur Einstellung zu verschiedenen Lebensbereichen. Folgende Fragebogen wurden eingesetzt: Fragen zur beruflichen Selbstwirksamkeit von Abele et al. (2000), zur beruflichen Belastung und zur Lebenszufriedenheit (FLZ) von Fahrenberg et al. (2000) und zur beruflichen Gratifikation (ERI) von de Jonge et al. (2000). Die korperlichen Beschwerden wurden mit der Kurzform des Giesener Beschwerdebogens (GBB24) erfasst. Wenn moglich wurden die Daten mit denen einer reprasentativen Bevolkerungsstichprobe verglichen. Die Auswertung ergab, dass sich die urologischen Vertragsarzte am meisten durch den burokratischen Verwaltungsaufwand belastet fuhlen, gefolgt von der unsicheren Zukunft und dem Mangel an Privatleben. Obwohl >74,8% glauben, dass ihre gesundheitliche Verfassung gut bzw. sehr gut sei, leiden die Urologinnen und Urologen viel mehr an Herz- und Magenbeschwerden als der Durchschnitt der Bevolkerung und sind in weit hoherem Mase erschopft. Bei einer uberdurchschnittlich hohen Verausgabungsbereitschaft liegt das Verausgabungs-Belohnungs-Ungleichgewicht weit uber dem der Bevolkerungsstichprobe. Letzteres konnte eine Ursache fur die psychosomatischen Beschwerden der Arztinnen und Arzte sein.

The AAP has underscored the role and responsibility of pediatricians in screening their patients for developmental and learning problems and working with parents, schools, and other professionals to ensure that students with these problems receive appropriate educational and therapeutic interventions. We have proposed a model that is time-efficient and can be tailored to the level of interest and experience of the pediatrician. At a minimum, the primary care physician should elicit any parental concerns about school performance, affirm these, and direct the student and parents to appropriate resources in the community for further evaluation and intervention as necessary. Pediatricians who wish to understand more fully the nature and underpinnings of their patients' learning difficulties can formulate a preliminary diagnosis and develop a plan for treatment using a structured system of information gathering that can be combined with information about the child's medical status and supplemented by brief direct testing in the office setting. By following these approaches, primary care pediatricians can provide comprehensive care for their patients and their families in their medical home and also can derive considerable professional satisfaction.