MCREW

RECENT PUBLICATIONS

Author(s):
Abel Chikanda
Handbook of African Economic Development
Migration has emerged as one of the most important tools for development on the African continent in the twenty-first century. This chapter reviews the linkages between diasporas and development with a major focus on the new African diasporas. It starts by mapping the international destinations of African migrants globally before examining the developmental implications of these movements. The introduction of mobile-based remittance platforms has enhanced accessibility of remittances to rural dwellers who frequently lack access to banking services. Diasporic contributions such as short-term returns and diaspora networks, which depend on the goodwill of the diaspora, should be pursued as a supplemental, rather than as an integral strategy to meet the skills need in Africa. The chapter concludes with a call to centre migrants in the migration-development debate by paying attention to the challenges they face during the migration process as well as their integration experiences in the destination regions.
Author(s):
Geraldina Polanco
Work in the Global Economy
Mobility (and control over it) is partially mediated by migrant capital and how it is evaluated across time and space. This study draws on the concept of multiple migration – wherein migration is viewed as potentially multidirectional and open-ended over the life course – to examine the plight of male, Mexican hospitality staff globally on the move. These participants are unique in that they had experience working as hospitality staff in different countries under different legal classifications. In the US they were undocumented, in Mexico they were deported nationals, and in Canada they were received as temporary migrant workers. Their accounts bring different mobilities – illegal, forced, contract, and returned – under one analytical frame to illuminate how mobilities are spatially and geographically regulated. As the article details, their mobility depended on the resources they accrued during migration and whether these resources could be converted into relevant capital, with class, gender and race significant mediating factors. When contextualised, their accounts offer unique insights into immigration controls, transnational labour regimes, political economy and how access to capital shapes gendered identities and hierarchies. Their evaluations vis-à-vis other (global) workers also mediated their legal incorporation, governed by normative ideals that shape prospects and life outcomes in the current economy.
Author(s):
Breanna K. Wodnik, Meena Andiappan, Erica Di Ruggiero, James V. Lavery
BMJ Open
Introduction An organisation’s ability to learn and adapt is key to its long-term performance and success. Although calls to improve learning within and across health organisations and systems have increased in recent years, global health is lagging behind other sectors in attention to learning, and applications of conceptual models for organisational learning to this field are needed.

Leveraging the 4I Framework This article proposes modifications to the 4I framework for organisational learning (which outlines the processes of intuition, interpretation, integration and institutionalisation) to guide the creation, retention and exchange of knowledge within and across global health organisations.

Proposed Expansions Two expansions are added to the framework to account for interorganisational learning in the highly interconnected field: (1) learning pathways across organisations via formal or informal partnerships and communities of practice and (2) learning pathways to and from macro-level ‘coordinating bodies’ (eg, WHO). Two additional processes are proposed by which interorganisational learning occurs: interaction across partnerships and communities of practice, and incorporation linking global health organisations to coordinating bodies. Organisational politics across partnerships, communities of practice and coordinating bodies play an important role in determining why some insights are institutionalised while others are not; as such, the roles of the episodic influence and systemic domination forms of power are considered in the proposed additional organisational learning processes.

Discussion When lessons are not shared across partnerships, communities of practice or the research community more broadly, funding may continue to support global health studies and programmes that have already been proven ineffective, squandering research and healthcare resources that could have been invested elsewhere. The ‘6I’ framework provides a basis for assessing and implementing organisational learning approaches in global health programming, and in health systems more broadly.
Journal of Management Studies
Author(s):
Erin M. Reid, Farnaz Ghaedipour, Otilia Obodaru
Journal of Management Studies
Family arrangements are crucial to people’s abilities to meet the high demands of professional careers; but most scholarship has examined stable, highly remunerated professions. To understand the relationship between career and family within the increasing number of precarious professions, we analyse interviews with 102 journalists. We discover two broad types of career-work practices these professionals employ to engage family in their careers: career-family positioning (i.e., crafting a narrative of how career and family relate) and career-family resourcing (i.e., generating resources from family for career or vice-versa). Together, these practices touch more family members – spouses, children, parents, siblings, and extended family members – and involve a wider range of resources than documented in stable fields. By piecing together variations of these practices, professionals construct career strategies that address their difficult context in different ways. Two strategies largely accept the demands and precarity, by prioritizing career and drawing on family, or prioritizing career and forgoing family. A third, prioritizing family over career, involves defying the demands. Gender does not clearly influence which career strategy people pursue. These findings advance scholarship on career and family in the professions, social-symbolic work, and contribute to careers research more broadly.
Author(s):
Ruo Mo, Meena Andiappan
Journal of Organizational Behavior
The consensus of the literature has suggested that competition prompts individuals to act unethically. However, prior research that explored the ethical implication of competition has largely ignored the role of contexts within its examination—studying competition generally independent of other social relationships/actors. Drawing on the relational perspective of competition (i.e., rivalry), we propose that broader social relationships in which rivalry relationships are embedded will give rise to alternative psychological processes that can account for a curbing effect of rivalry on workplace cheating behavior. Results from one pre-registered experiment and three surveys on working professionals suggest that exposure to rivalry leads to a heightened perception of peer monitoring, which in turn is associated with lower cheating behavior at work. We further find that the effect of rivalry on the perception of peer monitoring is stronger (weaker) when employees’ leader–member exchange (LMX) relationship with their supervisor is lower (higher), highlighting the significance of other social actors in the rivalry process. This research complements the literature with a balanced perspective regarding the ethical implication of competition and contributes to the theory building of rivalry by providing an interpersonal lens to the psychology of rivalry.
Author(s):
Payal Sharma, Madeline Toubiana, Kisha Lashley, Felipe Massa, Kristie Rogers, Trish Ruebottom
Journal of Management Inquiry
Over the past several years, there has been ongoing dialog within our academic journals and the profession regarding the value of examining extreme, unconventional, or unsettling contexts in management research. These conversations have highlighted that perhaps more than ever, we as a society are facing unprecedented grand and perplexing challenges, and conducting research in unconventional or extreme settings can reveal complex dynamics or relationships that we may not understand otherwise. Less discussed, however, are methodological considerations for conducting research in unique contexts. As such, we aim to extend the explicit discussion of effective strategies for scholars who consider the perspectives and workplace realities of unusual or unconventional populations. We bring together a collection of reflective essays rooted in the authors’ experiences of collecting data from extreme contexts or unusual samples. We highlight how these rich experiences in the field required the authors to modify or extend methodological conventions with the goal of guiding scholars pursuing research in similarly unconventional contexts.
Author(s):
Melissa Kimber, Elizabeth Baker-Sullivan, Donna E Stewart, Meredith Vanstone
JMIR Research Protocols
Background:
The optimal educational approach for preparing health professionals with the knowledge and skills to effectively recognize and respond to family violence, including child maltreatment and intimate partner violence, remains unclear. The Violence, Evidence, Guidance, and Action (VEGA) Family Violence Education Resources is a novel intervention that can be completed via self-directed learning or in a workshop format; both approaches focus on improving health professional preparedness to address family violence.

Objective:
Our studies aim to determine the acceptability and feasibility of conducting a randomized controlled trial to evaluate the effectiveness of the self-directed (experimental intervention) and workshop (active control) modalities of VEGA, as an adjunct to standard education, to improve learner (Researching the Impact of Service provider Education [RISE] with Residents) and independent practice (RISE with Veterans) health professional preparedness, knowledge, and skills related to recognizing family violence in their health care encounters.

Methods:
The RISE with Residents and RISE with Veterans research studies use embedded experimental mixed methods research designs. The quantitative strand for each study follows the principles of a pilot randomized controlled trial. For RISE with Residents, we aimed to recruit 80 postgraduate medical trainees; for RISE with Veterans, we intended to recruit 80 health professionals who work or have worked with Veterans (or their family members) of the Canadian military or the Royal Canadian Mounted Police in a direct service capacity. Participants complete quantitative assessments at baseline, after intervention, and at 3-month follow-up. A subset of participants from each arm also undergoes a qualitative semistructured interview with the aim of describing participants’ perceptions of the value and impact of each VEGA modality, as well as research burden. Scores on potential outcome measures will be mapped to excerpts of qualitative data via a mixed methods joint display to aid in the interpretation of findings.

Results:
We consented 71 individuals to participate in the RISE with Residents study. Data collection was completed on August 31, 2023, and data are currently being cleaned and prepared for analysis. As of January 15, 2024, we consented 34 individuals in the RISE with Veterans study; data collection will be completed in March 2024. For both studies, no data analysis had taken place at the time of manuscript submission. Results will be disseminated through peer-reviewed publications; academic conferences; and posting and sharing of study summaries and infographics on social media, the project website, and via professional network listserves.

Conclusions:
Reducing the impacts of family violence remains a pressing public health challenge. Both research studies will provide a valuable methodological contribution about the feasibility of trial methods in health professions education focused on family violence. They will also contribute to education science about the differences in the effectiveness of self-directed versus facilitator-led learning strategies.
Author(s):
Sheila A. Boamah, Chiedozie James Alumona, Ogochukwu Kelechi Onyeso, Oluwagbohunmi Adetunji Awosoga
BMC Nursing
Background Nursing educators play a critical role in training future nurses, and high turnover can disrupt the training quality and process. This study identified the institutional and personal factors influencing Canadian nursing educators’ job satisfaction and turnover intention. Methods This cross-sectional study used an online survey to obtain the levels of job satisfaction, turnover intention, role description, and institutional and personal/demographic characteristics of nursing faculty across Canadian institutions. Data were analysed using descriptive statistics, chi-square, bivariate linear regression, and hierarchical linear regression. Results A total of 645 participants, with a mean ± SD age of 48.82 ± 10.11 years, returned a completed questionnaire. The average/maximum job satisfaction and turnover intention scores were 12.59/20 ± 3.96 and 6.50/15 ± 3.05, respectively. Higher job satisfaction was significantly associated with lower turnover intention (β=-0.559, p < 0.001). The multivariate analysis showed that having a partner or being married (β = 0.086, p = 0.031), working ≤ 40 h weekly (β=-0.235, p < 0.001), teaching ≤ 4 courses annually (β=-0.115, p = 0.007), and having higher than bachelor’s degree qualification (β=-0.091, p = 0.042) predicted high job satisfaction, while high turnover intention was associated with faculty in the Prairie region (β = 0.135, p = 0.006) and working ≥ 41 h weekly (β = 0.151, p = 0.001). Conclusion Having a partner, manageable workload, and advanced qualifications positively influenced job satisfaction, while high turnover intention was associated with high workloads. Institutions may benefit from ensuring proportionate faculty workloads, fostering career advancement, and providing robust support systems that can stabilise the workforce and preserve the quality of nursing education.
Author(s):
Allison Williams, Reed Ciarloni
BMJ Public Health
Background This scoping review will provide an update on the availability of caregiver-friendly workplace policies (CFWPs) internationally. As the global population continues to age, there is a growing demand for unpaid care. Many individuals providing unpaid care remain in the workforce, increasing the number of carer-employees (CEs). The goal of this review is to determine how workplaces are supporting the growing number of CEs via CFWPs compared with 5 years ago, while identifying and prioritising actions that will improve workplace support for CEs. It is expected that this scoping review will provide: valuable insights on how broader social and cultural issues shape CFWPs; identification of leading workplaces that provide CFWPs, as well as; labour sectors that require improvement. Comparative analysis between the previous published scoping reviews will allow for further conclusions with respect to the changing landscape of CFWPs over time.

Methods This scoping review will be conducted with methodological guidance from the Joanna Briggs Institute (JBI) Reviewers Manual, the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews guidelines and checklist and the scoping review protocol checklist by JBI. As recommended by the JBI, this scoping review uses the Population/Context/Concept framework to identify main concepts and appropriate inclusionary/exclusionary criteria. This review will include literature (peer-reviewed and grey) published between 1 May 2019 and 31 May 2023, in the English language, that discuss the provision of unpaid care to older adults; workplaces deemed caregiver and/or family friendly related to CFWPs and explicit identification of the workplace/organisation by name. Results will be communicated via tables, diagrams and content analysis.
Author(s):
Suzanne Mills, Natalie Oswin
Economic Geography
Despite legal protections and growing acceptance in many industrialized countries, LGBTQ + workers continue to face considerable employment disadvantage. We explain this contradiction by detailing labor market processes that limit employment prospects for LGBTQ + workers in Sudbury and Windsor (both small cities with industrial histories). Drawing on 50 semistructured interviews and 662 community survey responses from LGBTQ + workers, we show how LGBTQ + employment opportunities are constrained by a constellation of multiscalar factors. These include the absence of good work opportunities outside of blue-collar work in deindustrializing labor markets, associated persistent cisnormativity and heteronormativity, and inconsistent protection from discrimination and social acceptance at work. As a result, respondents self-selected out of blue-collar workplaces, avoided and left jobs when they experienced or anticipated discrimination, and chose to remain in jobs with supportive employers rather than find a new job in a potentially homophobic or transphobic labor market. This article extends current understandings of labor markets economic geography by connecting production histories to persistent cisnormativity and heteronormitivity, and by showing how the search for emotional safety in cities with inconsistent social acceptance perpetuates economic disadvantage for queer and trans workers.
Author(s):
Regina Ding, Jenny Ploeg, Allison Williams
Journal of Family and Economic Issues
The carer-employee experience has undergone multiple shifts during the COVID-19 pandemic. This study seeks to understand how changes in the workplace as a result of the pandemic have impacted employed carers with their ability to perform both care obligations and paid work responsibilities. Using an online workplace-wide survey at a large Canadian firm, we conducted an environmental scan of: the current state of workplace supports and accommodations, supervisor attitudes, and carer-employee burden and health. Our findings demonstrate that while employees are generally in good health, care burden and time spent caregiving has been higher during COVID-19. Notably, employee presenteeism is higher during the pandemic than it was previously, with carer-employees experiencing significantly reduced levels of co-worker support. The most common workplace adaptation to COVID-19, work-from-home, was preferred by all employees as it allowed greater schedule control. However, this comes at the cost of reduced communications and sense of workplace culture, especially for carer-employees. We identified several actionable changes within the workplace, including: greater visibility of existing carer resources, and standardized training of managers on carer issues.
Author(s):
Penney Clark, Kristina Llewellyn, Rafael Capó García, Sarah Clifford
Historical Encounters
History textbooks are a tool of nation-building and often the only account of particular events, people and issues to which students will be exposed. This is one reason why it is important to examine, not only their content, but the context of their production. Research attention needs to be directed not only at disentangling the logics of textbook content, a purpose that dominates the field, but also at the social and political contexts of their development, including their production (publishing and authorship) and the processes by which they receive official approval. This work analyzed 100 history textbook studies in order to identify current trends in textbook research. This article focuses on one of the four major findings of the study: textbook studies often focus on the content of the textbook in isolation from the socio-political landscape of textbook production. The socio-political landscape refers, but is not limited to, the influence of local and geopolitics; the influence of the state, evident primarily in the official approval processes employed by governments; the economic dimension and publication parameters; and authorship factors. Among the relatively few studies that address the socio-political landscape, the authors often employ a historiographical or comparative perspective. The historiographical perspective, which is dominant, offers an analysis of textbooks over time in order to reveal both continuities and changes in the historical narratives produced by their authors. One example is a study by Yeow Tong Chia (2013), who examines conceptions of ‘Chineseness’ and China in Ontario high school history curricula and textbooks in the post Second World War to the 1980s period. More broadly, the paper locates the Ontario textbooks in the international context of the western-centric perspectives that were prevalent following the Second World War. The comparative perspective analyzes textbooks across regions in one historical moment. For example, Jason Nicholls (2006) addresses the role of national contexts in determining how the Second World War is portrayed in textbooks found in the United States, Italy, Sweden, Japan, and England.
Organizational Dynamics cover image
Author(s):
Sandra L. Fisher, Silvia Bonaccio, Catherine E. Connelly
Organizational Dynamics
Selection tools employing artificial intelligence (AI), such as automated video interviews (AVIs), chatbots, and assessment games, have become popular ways for organizations to deal with large numbers of job applicants. Vendors frequently claim that these technologies are unbiased. However, the impact of these tools on applicants with disabilities is rarely addressed. We explain how these tools may have both positive and negative impacts on applicants with disabilities. In doing so, we consider fundamental principles of selection: the reliability and validity of these tools as well as the applicant experience. We end by offering recommendations to organizations that are considering incorporating AI-based tools into their selection processes.
Author(s):
Sean O'Brady, Virginia Doellgast, David Blatter
Industrial Relations: A Journal of Economy and Society
We analyze the impact of outsourcing on the well-being of internal call center employees in the U.S. telecommunications industry. Our findings draw on mixed-methods data. The qualitative findings suggest that internal employees experienced escalating job demands connected to errors by third-party call center vendors and their employees due to additional work and intensified customer frustrations. SEM results show sequential mediation between the time internal employees spent correcting vendor errors, customer mistreatment of employees, emotional exhaustion, job satisfaction, and absenteeism. Employee autonomy over customer-related decisions appeared to help workers manage these job demands and their effects on well-being.
Author(s):
Monica L. Molinaro, Katrina Shen, Gina Agarwal, Gabrielle Inglis, Meredith Vanstone
British Journal of General Practice
Background Family physicians (GPs) working with patients experiencing social inequities have witnessed patients’ healthcare needs proliferate. Alongside increased workload demands fostered within current remuneration structures, this has generated concerning reports of family physician attrition and possible experiences of moral distress.

Aim To explore stories of moral distress shared by family physicians caring for patients experiencing health needs related to social inequities.

Design and setting A critical narrative inquiry, informed by the analytic lens of moral distress, conducted in Ontario, Canada.

Method Twenty family physicians were recruited through purposive and snowball sampling via word of mouth and email mailing lists relevant to addictions and mental health care. Physicians participated in two narrative interviews and had the opportunity to review the interview transcripts.

Results Family physicians’ accounts of moral distress were linked to policies governing physician remuneration, scope of practice, and the availability of social welfare programmes. These structural elements left physicians unable to get patients much needed support and resources.

Conclusion This study provides evidence that physicians experience moral distress when unable to offer crucial resources to improve the health of patients with complex social needs resulting from structural features of the Canadian health and social welfare system. Further research is needed to critically interrogate how health and social welfare systems around the world can be reformed to improve the health of patients and increase family physicians’ professional quality of life, potentially improving retention.
Author(s):
Casey Scheibling, Marisa Young, Melissa A. Milkie, Scott Schieman
Community, Work & Family
Dual-earner parents face the challenge of getting children ready for school or daycare while often simultaneously preparing for work. Although this morning routine is at the heart of the work–family intersection, it is understudied in relation to the gendered division of labor and as a potential stressor in parents’ lives. In this study, we examine who is responsible for and experiences strain from preparing children for the day. Drawing on a sample of 462 dual-earner parents from the Canadian Work, Stress, and Health Study (2019), we find that mothers are much more likely than fathers to perform this labor – even once controlling for work hours, schedule control, and other housework divisions. Moreover, if not for the fewer work hours, less job pressure, and more flexible shifts of parents who regularly prepare children for the day, there would be a marginally significant relationship between this parental responsibility and work-to-family conflict. Although getting children ready appears linked to work-to-family conflict for both mothers and fathers, results suggest that mothers have already sacrificed investment in paid work to take on this inflexible childcare routine. We discuss the social and health implications of temporal work structures intruding on the family’s morning rush hour.
Author(s):
Anna Garnett, Lucy Hui, Christina Oleynikov, Sheila A. Boamah
BMC Health Services Research
The detrimental impacts of COVID-19 on healthcare providers’ psychological health and well-being continue to affect their professional roles and activities, leading to compassion fatigue. The purpose of this review was to identify and summarize published literature on compassion fatigue among healthcare providers and its impact on patient care. Six databases were searched: MEDLINE (Ovid), PsycINFO (Ovid), Embase (Ovid), CINAHL, Scopus, Web of Science, for studies on compassion fatigue in healthcare providers, published in English from the peak of the pandemic in 2020 to 2023. To expand the search, reference lists of included studies were hand searched to locate additional relevant studies. The studies primarily focused on nurses, physicians, and other allied health professionals. This scoping review was registered on Open Science Framework (OSF), using the Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA) extension to scoping review. From 11,715 search results, 24 met the inclusion criteria. Findings are presented using four themes: prevalence of compassion fatigue; antecedents of compassion fatigue; consequences of compassion fatigue; and interventions to address compassion fatigue. The potential antecedents of compassion fatigue are grouped under individual-, organization-, and systems-level factors. Our findings suggest that healthcare providers differ in risk for developing compassion fatigue in a country-dependent manner. Interventions such as increasing available personnel helped to minimize the occurrence of compassion fatigue. This scoping review offers important insight on the common causes and potential risks for compassion fatigue among healthcare providers and identifies potential strategies to support healthcare providers’ psychological health and well-being.
Author(s):
Yihong Bai, Michael R. Veall
SSM - Mental Health
International evidence on the effect of minimum wages on mental health has been mixed. Estimation has used different types of variation in the minimum wage. In some countries such as the UK, the minimum wage is set nationally. In the United States, it is largely set subnationally. The resulting across state and time variation has recently been used to estimate that minimum wage increases have a positive effect on mental health. We exploit similar and substantial subnational level variation for Canada, using a longitudinal health survey panel available from 1994 to 2011. Using difference-in-difference and triple difference methods with individual fixed effects, we find that minimum wage increases are associated with modest reductions in distress and depression symptoms, largely for males.
Author(s):
Farinaz Havaei, Xuyan Tang, Nassim Adhami, Megan Kaulius, Sheila A. Boamah, Kimberly McMillan
Nursing Open
Aim
While research has demonstrated that nurses’ health and working conditions are important predictors of turnover in COVID-19, the relationship between these factors is not well understood. Our study investigated the mechanism through which working conditions and nurses’ physical and mental health could impact intent to leave the nursing profession.

Design
Secondary data from a cross-sectional survey of 3478 nurses in British Columbia administered in May 2021 were analysed using structural equation modelling.

Methods
Two models were assessed utilizing workplace conditions as the predictor, nurses’ health as the mediator, and reported turnover intent (Model 1), and anticipated time to turnover (Model 2) as the outcomes.

Results
Nurses’ health partially mediated the relationship between working conditions and turnover intent, where poorer workplace conditions were directly and indirectly associated with greater likelihood of leaving the profession. Nurses’ health fully mediated the relationship between working conditions and nurses’ anticipated time to turnover, after controlling for age. The findings from this study underscore the importance of enhancing working conditions and improving nurses’ mental health and safety on the job.

Patient or Public Contribution
The British Columbia Nurses’ Union provided the data for this study; survey data from 3478 nurses were utilized in our study.
Author(s):
Mary Crea‐Arsenio, K. Bruce Newbold, Andrea Baumann, Margaret Walton‐Roberts
Canadian Geographies
Canada’s immigration policy is regarded globally as a best practice model for selecting highly skilled migrants. Yet, upon arrival many immigrants face challenges integrating into employment. Where immigrants settle is one factor that has been shown to impact on employment integration. In Canada, regionalization policies have resulted in more immigrants settling in small to mid-sized cities. It is important to understand how these local systems are organized to promote immigrant integration into employment. Using a systems approach, this paper presents a case study of immigrant employment in a mid-sized city in Ontario, Canada. Through a document review and stakeholder interviews, a systems map was developed, and local perspectives were analyzed. Results demonstrate that in a mid-sized city, few organizations play a large role in immigrant employment. The connections between these core organizations and the local labour market are complex. Any potential challenges to the system that interfere with these connections can cause a delay for newcomers seeking employment. As cities begin to experience growth driven by immigration, there is a need to ensure local services are not only available but also working effectively within the larger employment system.
Cover of journal International Journal of Nursing Studies Advances
Author(s):
Cal Stewart, Whitney B. Berta, Audrey Laporte, Raisa Deber, Andrea Baumann
International Journal of Nursing Studies Advances
Background
Societal aging is exerting profound impacts on providers of long-term care. Nurses provide much of the direct care in the long-term care sector, and they increasingly provide unit- and facility-level leadership and fill top administrative and clinical roles.The work health and quality of work life of long-term care nurses are emergent concerns and the foci of research across multiple disciplines.

Objectives
To enhance our understanding of factors influencing long-term care nurses’ work health and quality of work life, we summarize the findings of disparate studies across diverse disciplines, time, and jurisdictions.

Eligibility criteria
No restrictions were placed on study date, design, or country. Searches were restricted to English language only or translated studies. Included studies reported associations and relationships between/amongst nurses’ work (role and work design), work environments, work attitudes, and work outcomes. Published peer-reviewed studies and reviews were included, as were reports. Editorials and opinion pieces were excluded. The search included publications up to March 2022.

Sources of evidence
Medline, CINAHL, PsychINFO, EMBASE, Scopus, PSNet

Charting methods
Data abstraction from full-text articles.

Results
The evolution of long-term care nurses’ work to include both medical and administrative responsibilities has generally not been managed well, resulting in persistent role ambiguity, job dissatisfaction, and burnout. Nurses are concerned about their capacity to provide resident care and the adequacy of their preparation. Their work environments are under-resourced, and they are at high risk for workplace injury or violence. Supervisory and organizational support can be protective of negative aspects of nurses’ work environments. Supervisory support can improve the immediate work environment, assist nurses in fulfilling their roles, and afford greater role clarity, and supervisors can influence their nursing staff’s perceptions of the work safety and the value that their organization places on them. Organizational support can reduce work stress, enhance feelings of self-worth, and mitigate some of the self-stigmatization that influences long-term care nurses’ attitudes toward themselves and their work, which influences work outcomes, including job performance and quality of resident care.

Conclusions
Work stress, burnout, increased turnover, decreased morale and work motivation, increased health and safety concerns, and decreases in job satisfaction accompanied by self-stigmatization are all indicators of a system that has failed nurses, other long-term care staff, and nursing home residents. We consider the implications of our findings for enhancing the work health and quality of life of nurses working in long-term care and identify gaps in knowledge about their psychological health that merit future study.
Author(s):
Lucas Dufour, Meena Andiappan, Arnaud Banoun
SSM - Qualitative Research in Health
The past decades have seen a significant rise in the number of large-scale commercial enterprises entering the healthcare sector, making it difficult for smaller companies and entrepreneurs to remain competitive. This change has meant that an increasing number of healthcare professionals have transitioned from being self-employed entrepreneurs to being company employees. How do healthcare professionals manage this (often reluctant) transition and its resulting tensions? Based on qualitative data (including 40 interviews, 18 ​h of observation, and 314 archival records) with French medical biologists, we employ the economies of worth framework developed by Boltanski and Thévenot (1991, 2006) to understand the strains healthcare professionals experience related to a coerced change of perspective and how their organization, in turn, uses various strategies to address these tensions. We find that medical biologists experience tensions related to their domestic perspective due to the change of their employment status (from self-employed to company employee) and related to their industrial perspective due to the repositioning of their job (from scientific expert to site manager). To address these concerns, their organization first applied a civic perspective, with mixed results. Searching for a more successful approach, the organization pivoted to a domestic perspective, which was largely counterproductive. Tensions were finally stabilized when the organization developed a structure based on both civic and network principles. Our paper contributes to the literature through demonstrating that tensions need to be resolved at an organizational level first without rushing through a compromise in order to achieve clarification at an individual level.
Author(s):
Elaine Stasiulis, Dawn Tymianski, Anna Byszewski, Isabelle Gélinas, Gary Naglie, Mark J. Rapoport, Brenda Vrkljan
Journal of the American Association of Nurse Practitioners
With a growing population of older adults living with dementia in the community, nurse practitioners (NPs) are increasingly expected to address issues of medical fitness to drive (MFTD) and driving cessation within their clinical practice. With their expertise in clinical assessment and communication skills, NPs are well suited to this area of practice. Studies that examined MFTD and/or driving cessation suggest that NPs want and need further knowledge and training with this population. As part of our aim to develop an online educational program on driving and dementia for health care providers, including NPs, this mixed-methods study explored NPs’ preferences regarding the format and content for the proposed online program. Results from an online survey completed by 90 NPs and interviews with six NPs highlighted key areas of focus for virtual modules, where communication strategies, tools to assess MFTD, and the reporting process for medically unfit drivers were emphasized. Reflecting on their team approach to care, participants in this study preferred a hybrid approach of asynchronous and synchronous learning delivery for this educational program. The next step will be to evaluate this program and its impact on both NP knowledge and skills in terms of its real-world application.
Author(s):
Natasja Looman, Noël Battal, Meredith Vanstone
Medical Education
In this commentary, the authors highlight the importance of intraprofessional communities of practice (CoPs) for specialists and family physicians practicing comprehensive evidence-based care. The authors explore how power dynamics can be meaningfully incorporated into continuing medical education to reap the multi-perspectival benefit of intraprofessional CoPs for continuing professional development and medical education.

The authors highlight how power dynamics can be meaningfully incorporated into intraprofessional communities of practice to reap benefits for comprehensive evidence-based care.