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This book is for health professionals who are becoming involved in the education of people entering their professions. It introduces many of the challenges that educators must engage with in the twenty-first century; challenges that will preoccupy our attention for many years to come. The world of professional practice in healthcare is changing and the education we provide to prepare people for that practice is also changing. How do we prepare professional practitioners for this changing world? How do we prepare them for the changes that are yet to come? What challenges and changes do they need to be aware of? How do we prepare educators both academics and workplace educators for these challenges? This volume opens up and articulates the issues we face in preparing people to enter the contemporary world of healthcare. Experienced educators should also find much of interest in these pages. Practice-based education provides an overarching framework for consideration of the issues involved. There are five sections in the book: - Section 1: Introduction - Section 2: Health Professional Education in Context - Section 3: Teaching and Research - Section 4: Case Studies - Section 5: Future Directions.

The importance of a sustainable health workforce is increasingly recognised. However, the building of a future health workforce that is responsive to diverse population needs and demographic and economic change remains insufficiently understood. There is a compelling argument to be made for a comprehensive research agenda to address the questions. With a focus on Europe and taking a health systems approach, we introduce an agenda linked to the ‘Health Workforce Research’ section of the European Public Health Association. Six major objectives for health workforce policy were identified: (1) to develop frameworks that align health systems/governance and health workforce policy/planning, (2) to explore the effects of changing skill mixes and competencies across sectors and occupational groups, (3) to map how education and health workforce governance can be better integrated, (4) to analyse the impact of health workforce mobility on health systems, (5) to optimise the use of international/EU, national and regional health workforce data and monitoring and (6) to build capacity for policy implementation. This article highlights critical knowledge gaps that currently hamper the opportunities of effectively responding to these challenges and advising policy-makers in different health systems. Closing these knowledge gaps is therefore an important step towards future health workforce governance and policy implementation. There is an urgent need for building health workforce research as an independent, interdisciplinary and multi-professional field. This requires dedicated research funding, new academic education programmes, comparative methodology and knowledge transfer and leadership that can help countries to build a people-centred health workforce.

Approximately 13% of the total UK workforce is employed in the health and care sector. Despite substantial workforce planning efforts, the effectiveness of this planning has been criticised. Education, training, and workforce plans have typically considered each health-care profession in isolation and have not adequately responded to changing health and care needs. The results are persistent vacancies, poor morale, and low retention. Areas of particular concern highlighted in this Health Policy paper include primary care, mental health, nursing, clinical and non-clinical support, and social care. Responses to workforce shortfalls have included a high reliance on foreign and temporary staff, small-scale changes in skill mix, and enhanced recruitment drives. Impending challenges for the UK health and care workforce include growing multimorbidity, an increasing shortfall in the supply of unpaid carers, and the relative decline of the attractiveness of the National Health Service (NHS) as an employer internationally. We argue that to secure a sustainable and fit-for-purpose health and care workforce, integrated workforce approaches need to be developed alongside reforms to education and training that reflect changes in roles and skill mix, as well as the trend towards multidisciplinary working. Enhancing career development opportunities, promoting staff wellbeing, and tackling discrimination in the NHS are all needed to improve recruitment, retention, and morale of staff. An urgent priority is to offer sufficient aftercare and support to staff who have been exposed to high-risk situations and traumatic experiences during the COVID-19 pandemic. In response to growing calls to recognise and reward health and care staff, growth in pay must at least keep pace with projected rises in average earnings, which in turn will require linking future NHS funding allocations to rises in pay. Through illustrative projections, we show that, to sustain annual growth in the workforce at approximately 2·4%, increases in NHS expenditure of 4% annually in real terms will be required. Above all, a radical long-term strategic vision is needed to ensure that the future NHS workforce is fit for purpose.

Background There has been a growing imbalance between supply of dermatologists and demand for dermatologic care. To best address physician shortages, it is important to delineate supply and demand patterns in the dermatologic workforce. The goal of this study was to explore dermatology supply and demand over time. Methods We conducted a cross-sectional analysis of workforce supply and demand projections for dermatologists from 2021 to 2036 using data from the Health Workforce Simulation Model from the National Center for Health Workforce Analysis. Estimates for total workforce supply and demand were summarized in aggregate and stratified by rurality. Scenarios with status quo demand and improved access were considered. Results Projected total supply showed a 12.45% increase by 2036. Total demand increased 12.70% by 2036 in the status quo scenario. In the improved access scenario, total supply was inadequate for total demand in any year, lagging by 28% in 2036. Metropolitan areas demonstrated a relative supply surplus up to 2036; nonmetropolitan areas had at least a 157% excess in demand throughout the study period. In 2021 adequacy was 108% and 39% adequacy for metropolitan and nonmetropolitan areas, respectively; these differences were projected to continue through 2036. Conclusions The findings suggest that the dermatology physician workforce is inadequate to meet the demand for dermatologic services in nonmetropolitan areas. Furthermore, improved access to dermatologic care would bolster demand and especially exacerbate workforce inadequacy in nonmetropolitan areas. Continued efforts are needed to address health inequities and ensure access to quality dermatologic care for all.

Introduction . Shifting care from hospitals into community‐based settings is a major policy goal internationally. Community health services in England currently face the greatest workforce shortages of all sectors, threatening the feasibility of this policy. Moreover, little is known about the extent of variation in community workforce provision regionally and how this relates to determinants of need. Aim . To analyse regional variation in the community services workforce in England between 2010 and 2021. Methods . We obtained NHS workforce statistics data on the number of nurses and nursing support staff providing community services at each NHS organisation in England, from March 2010 to November 2021. We aggregated the organisation‐level data to both regional and national levels, which enabled us to maintain consistent units of analysis across the decade. To examine longitudinal trends and regional variation in workforce provision, we calculated the number of staff per 100,000 population aged 65+ in each region and each period. We then graphed and summarised the variation and examined the correlations with levels of deprivation and rurality. Results . There was a twofold variation in community services workforce provision between English regions. In November 2021, the number of staff per 100,000 people aged over 64 ranged from 300 in the South West to 697 in the North West. Most regions experienced a reduction in provision between 2010 and 2021, with a 21.2% reduction nationally. East of England experienced the largest reduction of 39.3%, whilst London experienced a 2.1% increase. In November 2021, regions with more deprived populations had higher workforce provision and regions with a larger proportion of residents living in rural areas had lower workforce provision. Conclusions . The size of the community services workforce has fallen relative to population needs, contradictory to the policy priority to enhance care in the community. There was substantial regional variation in the size of the workforce, which has persisted throughout the decade. Workforce provision was higher in more deprived areas but lower in rural areas, potentially impacting equitable access in rural areas.

BackgroundPrimary PCI (PPCI) for ST-elevation myocardial infarction (STEMI) remains a cornerstone of acute cardiovascular care. However, the sustainability of the national PPCI rota, particularly the impact on workforce wellbeing and future service delivery, remains unclear.ObjectiveTo characterise the demographics, workload distribution, and perspectives of PPCI operators in Ireland with respect to service sustainability and personal impact.MethodsA national survey was distributed to all on-call PPCI operators in Ireland assessing demographics, call frequency, post-call recovery and perceived workforce sufficiency. Responses were collected anonymously and then descriptively analysed.ResultsOf 57 eligible PPCI operators, 48 responded (figure 1) (84% response rate), comprising 96.5% males (n = 46) and 3.5% females (n = 2). Median age was 46 years (range 35–64). The distribution of respondents per centre was: SJH (12/12), MMUH (14/16), UHL (7/8), CUH (5/7), WUH (3/6), UHG (5/7), and LUH (1/1) (figure 2). PPCI call frequency varied widely both across and within centres, ranging from 1:4 to 1:14. Overall, 46% of operators were on a 1:4 to 1:7 rota, 10% on 1:8 to 1:10, and 44% on 1:11 to 1:15. Notably, 96% of respondents reported no protected time post-call while 53% reported that PPCI call impacted their physical or mental health and/or personal life. 37.5% felt the call frequency was excessive; 46% believed there were insufficient PPCI operators at their centre. Additionally, 48% indicated that PPCI duties limited their ability to take leave, and over 58% stated fatigue significantly impaired their post-call clinical functioning. Although most found it feasible to arrange call cover, this typically required a swap. With respect to service planning, 11 operators anticipate opting out by 2030, with this number rising to 23 by 2035. However since 2020, 21 new operators have joined the rota. When asked about an appropriate opt-out age, 38% suggested 55, 46% preferred 60, and 2 respondents favoured 50. Respondents were asked what changes they wanted implemented to the PPCI rota. Key recommendations included protected post-call rest, fairer distribution of general duties, increased staffing, non-punitive leave cover, rota participation by all public interventionalists with step-down options, split holiday cover, alignment with EU work-time standards, and improved coordination with local hospitals.ConclusionThe current Irish PPCI service relies on a small, male dominated workforce with considerable variability in call frequency. The high burden of fatigue and reported impact on wellbeing highlight the need for structured rota reform, succession planning, and post-call recovery strategies to sustain national PPCI delivery.Abstract 79 Figure 1[Image Omitted. See PDF.]Abstract 79 Figure 2[Image Omitted. See PDF.]

Purpose This paper aims to provide a critical reflection on the Great Resignation in the hospitality and tourism industry in the wake of the COVID-19 pandemic. Specifically, this paper reviews the causes and effects of the Great Resignation, addresses the labor shortage in this industry and proposes strategies that can help manage the challenges. Design/methodology/approach This paper is based on a critical analysis of emerging phenomena, related literature and researchers’ experiences and insights. Findings The Great Resignation has presented unprecedented challenges for the hospitality and tourism industry. A closer examination reveals that the pandemic has served as a catalyst rather than a leading cause of this trend. Workforce issues are becoming increasingly complex under contemporary influences, including internal elements such as new explications at work and external factors like the gig economy and technology implementation. Practical implications This study provides practical implications on how Hospitality and Tourism practitioners can respond to the Great Resignation on micro, meso and macro levels. The practical implications revolve around employees’ changing needs and preferences in the wave of Great Resignation, as well as the necessity for employers’ reflection and improvement. Originality/value This study marks an initial attempt to provide a critical assessment of a contemporary issue involving the Great Resignation. This paper extends its discussion through an advanced analysis of the issue, offers suggestions to manage current obstacles related to labor issues in hospitality and tourism, and illuminates future research directions.

Anne Marie Rafferty and Aisha Holloway discuss five ways to improve working conditions for the nursing profession, which will also have benefits for healthcare professionals more generally

The current state of the US pathologist workforce is uncertain, with deficits forecast over the next 2 decades. To examine the trends in the US pathology workforce from 2007 to 2017. A cross-sectional study was conducted comparing the number of US and Canadian physicians from 2007 to 2017 with a focus on pathologists, radiologists, and anesthesiologists. For the United States, the number of physicians was examined at the state population level with a focus on pathologists. New cancer diagnoses per pathologist were compared between the United States and Canada. These data from the American Association of Medical Colleges Center for Workforce Studies' Physician Specialty Data Books and the Canadian Medical Association Masterfile were analyzed from January 4, 2019, through March 26, 2019. Numbers of pathologists were compared with overall physician numbers as well as numbers of radiologists and anesthesiologists in the United States and Canada. Between 2007 and 2017, the number of active pathologists in the United States decreased from 15 568 to 12 839 (-17.53%). In contrast, Canadian data showed an increase from 1467 to 1767 pathologists during the same period (+20.45%). When adjusted for each country's population, the number of pathologists per 100 000 population showed a decline from 5.16 to 3.94 in the United States and an increase from 4.46 to 4.81 in Canada. As a percentage of total US physicians, pathologists have decreased from 2.03% in 2007 to 1.43% in 2017. The distribution of US pathologists varied widely by state; per 100 000 population, Idaho had the fewest (1.37) and the District of Columbia had the most (15.71). When adjusted by new cancer cases per year, the diagnostic workload per US pathologist has risen by 41.73%; during the same period, the Canadian diagnostic workload increased by 7.06%. The US pathologist workforce decreased in both absolute and population-adjusted numbers from 2007 to 2017. The current trends suggest a shortage of US pathologists.