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      Experiences of a Health System’s Faculty, Staff, and Trainees’ Career Development, Work Culture, and Childcare Needs During the COVID-19 Pandemic


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          Key Points


          What are the associations of the COVID-19 pandemic with career development and what are the work culture and childcare needs of employees and trainees?


          In this survey study, most participants with children did not have childcare fully available and many considered leaving the workforce and were worried about their career. Being female with children or having a clinical job role was associated with consideration for leaving the workforce and reducing hours.


          These findings suggest that a substantial number of employees and trainees experienced major stress and work disruptions because of the COVID-19 pandemic.


          This survey study examines the career development, work culture, and childcare needs of faculty, staff, and trainees at an academic medical center during the COVID-19 pandemic,



          In March 2020, US public buildings (including schools) were shut down because of the COVID-19 pandemic, and 42% of US workers resumed their employment duties from home. Some shutdowns remain in place, yet the extent of the needs of US working parents is largely unknown.


          To identify and address the career development, work culture, and childcare needs of faculty, staff, and trainees at an academic medical center during a pandemic.

          Design, Setting, and Participants

          For this survey study, between August 5 and August 20, 2020, a Qualtrics survey was emailed to all faculty, staff, and trainees at University of Utah Health, an academic health care system that includes multiple hospitals, community clinics, and specialty centers. Participants included 27 700 University of Utah Health faculty, staff, and trainees who received a survey invitation. Data analysis was performed from August to November 2020.

          Main Outcomes and Measures

          Primary outcomes included experiences of COVID-19 and their associations with career development, work culture, and childcare needs.


          A total of 5030 participants completed the entire survey (mean [SD] age, 40 [12] years); 3738 (75%) were women; 4306 (86%) were White or European American; 561 (11%) were Latino or Latina (of any race), Black or African American, American Indian, Alaska Native, and Native Hawaiian or Pacific Islander; and 301 (6%) were Asian or Asian American. Of the participants, 2545 (51%) reported having clinical responsibilities, 2412 (48%) had at least 1 child aged 18 years or younger, 3316 (66%) were staff, 791 (16%) were faculty, and 640 (13%) were trainees. Nearly one-half of parents reported that parenting (1148 participants [49%]) and managing virtual education for children (1171 participants [50%]) were stressors. Across all participants, 1061 (21%) considered leaving the workforce, and 1505 (30%) considered reducing hours. Four hundred forty-nine faculty (55%) and 397 trainees (60%) perceived decreased productivity, and 2334 participants (47%) were worried about COVID-19 impacting their career development, with 421 trainees (64%) being highly concerned.

          Conclusions and Relevance

          In this survey of 5030 faculty, staff, and trainees of a US health system, many participants with caregiving responsibilities, particularly women, faculty, trainees, and (in a subset of cases) those from racial/ethnic groups that underrepresented in medicine, considered leaving the workforce or reducing hours and were worried about their career development related to the pandemic. It is imperative that medical centers support their employees and trainees during this challenging time.

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          Most cited references11

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          Prevalence of depression, anxiety, and insomnia among healthcare workers during the COVID-19 pandemic: A systematic review and meta-analysis

          Highlights • At least one in five healthcare professionals report symptoms of depression and anxiety. • Almost four in 10 healthcare workers experience sleeping difficulties and/or insomnia. • Rates of anxiety and depression were higher for female healthcare workers and nursing staff. • Milder mood symptoms are common and screening should aim to identify mild and sub-threshold syndromes.
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            Psychological distress, coping behaviors, and preferences for support among New York healthcare workers during the COVID-19 pandemic

            Objective The mental health toll of COVID-19 on healthcare workers (HCW) is not yet fully described. We characterized distress, coping, and preferences for support among NYC HCWs during the COVID-19 pandemic. Methods This was a cross-sectional web survey of physicians, advanced practice providers, residents/fellows, and nurses, conducted during a peak of inpatient admissions for COVID-19 in NYC (April 9th–April 24th 2020) at a large medical center in NYC (n = 657). Results Positive screens for psychological symptoms were common; 57% for acute stress, 48% for depressive, and 33% for anxiety symptoms. For each, a higher percent of nurses/advanced practice providers screened positive vs. attending physicians, though housestaff's rates for acute stress and depression did not differ from either. Sixty-one percent of participants reported increased sense of meaning/purpose since the COVID-19 outbreak. Physical activity/exercise was the most common coping behavior (59%), and access to an individual therapist with online self-guided counseling (33%) garnered the most interest. Conclusions NYC HCWs, especially nurses and advanced practice providers, are experiencing COVID-19-related psychological distress. Participants reported using empirically-supported coping behaviors, and endorsed indicators of resilience, but they also reported interest in additional wellness resources. Programs developed to mitigate stress among HCWs during the COVID-19 pandemic should integrate HCW preferences.
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              COVID‐19 and the Gender Gap in Work Hours

              School and daycare closures due to the COVID‐19 pandemic have increased caregiving responsibilities for working parents. As a result, many have changed their work hours to meet these growing demands. In this study, we use panel data from the U.S. Current Population Survey to examine changes in mothers’ and fathers’ work hours from February through April, 2020, the period of time prior to the widespread COVID‐19 outbreak in the U.S. and through its first peak. Using person‐level fixed effects models, we find that mothers with young children have reduced their work hours four to five times more than fathers. Consequently, the gender gap in work hours has grown by 20 to 50 percent. These findings indicate yet another negative consequence of the COVID‐19 pandemic, highlighting the challenges it poses to women's work hours and employment.

                Author and article information

                JAMA Netw Open
                JAMA Netw Open
                JAMA Netw Open
                JAMA Network Open
                American Medical Association
                2 April 2021
                April 2021
                2 April 2021
                : 4
                : 4
                : e213997
                [1 ]Department of Population Health Sciences, University of Utah, Salt Lake City
                [2 ]Department of Family and Preventive Medicine, University of Utah Health, Salt Lake City
                [3 ]Department of Sociology, Division of Gender Studies, University of Utah, Salt Lake City
                [4 ]Health Sciences Strategy, University of Utah, Salt Lake City
                [5 ]Department of Obstetrics and Gynecology, University of Utah, Salt Lake City
                [6 ]Office of the Senior Vice President for Health Sciences, University of Utah, Salt Lake City
                [7 ]Department of Radiology, University of Utah, Salt Lake City
                [8 ]Veterans Administration Health Services Research and Development Informatics, Decision-Enhancement and Analytic Sciences Center, Veterans Administration Salt Lake City Health Care System, Salt Lake City, Utah
                Author notes
                Article Information
                Accepted for Publication: February 8, 2021.
                Published: April 2, 2021. doi:10.1001/jamanetworkopen.2021.3997
                Open Access: This is an open access article distributed under the terms of the CC-BY License. © 2021 Delaney RK et al. JAMA Network Open.
                Corresponding Author: Angela Fagerlin, PhD, Department of Population Health Sciences, University of Utah, 295 Chipeta Way, Salt Lake City, UT 84108 ( angie.fagerlin@ 123456hsc.utah.edu ).
                Author Contributions: Drs Delaney and Fagerlin had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.
                Concept and design: Delaney, Locke, Pershing, Precourt Debbink, Tanner, Anzai, Fagerlin.
                Acquisition, analysis, or interpretation of data: Delaney, Locke, Pershing, Geist, Clouse, Precourt Debbink, Haaland, Fagerlin.
                Drafting of the manuscript: Delaney, Pershing, Fagerlin.
                Critical revision of the manuscript for important intellectual content: Delaney, Locke, Geist, Clouse, Precourt Debbink, Haaland, Tanner, Anzai.
                Statistical analysis: Delaney, Geist, Clouse, Haaland.
                Obtained funding: Fagerlin.
                Administrative, technical, or material support: Locke, Pershing, Geist, Precourt Debbink, Tanner, Anzai.
                Supervision: Locke, Geist, Fagerlin.
                Conflict of Interest Disclosures: Dr Delaney’s salary is supported by a T32 Cardiovascular Research Award outside the submitted work. Dr Precourt Debbink reported receiving grants from Reproductive Scientist Development Program Award, and her salary is supported by a K-12 Professional Development award outside the submitted work. Dr Haaland reported receiving personal fees from Prometics Life Sciences, Astra Zeneca, National Kidney Foundation, and Value Analytics Labs and nonfinancial travel support from Flatiron Health outside the submitted work. No other disclosures were reported.
                Funding/Support: This work was supported by the Jon M. Huntsman Presidential Endowed Chair (award to Dr Fagerlin).
                Role of the Funder/Sponsor: The funder had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.
                Additional Contributions: Christina Yong, MA (University of Utah), provided editing assistance and was not compensated beyond her regular salary.
                Copyright 2021 Delaney RK et al. JAMA Network Open.

                This is an open access article distributed under the terms of the CC-BY License.

                : 3 December 2020
                : 8 February 2021
                Original Investigation
                Online Only
                Public Health


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