This dissertation analyzes one state's efforts to increase the number of its primary care physicians and encourage their retention and distribution to rural underserved areas. This analysis was accomplished through an examination of physicians as they completed training in Texas family medicine, internal medicine, pediatrics, and obstetric/gynecology residency programs. State licensure data provided insights into these primary care specialties by showing which residents remained in the state to practice, and by showing the numbers and specialties of physicians who practice in rural underserved areas. The primary purpose of this study was to increase understanding and document similarities and differences in the primary care residency programs' production of physicians who remained in Texas and who practiced in a whole county HPSA following training. The following analyses were used to evaluate the research questions and hypotheses: frequency distributions, geographic depictions, Chi-Square tests and binary logistic regression. These analyses provided supporting evidence that significant differences exist among resident programs in the four primary care medical specialties. Differences were also found in residents' likelihood to remain in Texas to practice and their likelihood to practice in whole county Health Professional Shortage Areas (HPSAs). This study showed that those residents who trained in Texas largely remained in Texas and actively practiced medicine years after their residency training had been completed. The training and location of primary care physicians in Texas is influenced by what medical specialty programs are available and where. This suggests that increasing the number and type of residency programs in more remote areas may have a positive influence on the physician workforce of those regions. This study confirms the finding of other institutional and single medical specialty studies that physicians tend to remain in the state in which they complete their residency training. However, this study found that there are variations by primary care specialty, gender, ethnicity, and program location. Residency training is an essential piece in supplying the Texas physician workforce and ensuring that its stability and long-term growth will position it to be prepared to care for the population.

The purpose of this study was to determine the effects of salary, compensation and benefits, accountability, job stress, increased instructional responsibilities, changes in student demographics, lack of support, politics, advancement opportunities and promotion on tenure and turnover among high school principals in the state of Texas. The participants in the study included 60 Texas high school principals who left a high school principalship for a different high school principalship within the past 5 years. The participants completed the Texas Principal Survey and data were analyzed using binary logistic regression. The data indicated that salary, compensation and benefits was a significant factor in predicting an increase in the odds of principal turnover for principals who had been in their prior principalship 5 or more years over principals who had been in their prior principalship less than 5 years. Additionally, advancement opportunities was a significant factor in predicting a decrease in the odds of principal turnover for principals who had been in their prior principalship 5 or more years over principals who had been in their prior principalship less than 5 years. Responses from an open ended question asking principals why they left their prior principalship suggested that principals left for reasons including new challenges, lack of support and family. The results of this study support the need for continued research in the area of principal turnover and provide insight to district superintendents, school boards and principals.

Given issues in education concerning teacher shortages, the omnipresence of alternative certification programs and the growth of online programs in higher education, this study investigated teacher retention for 77 secondary education teachers who completed an online teacher preparation program in Texas. Teacher retention was examined from 2003-2013 and investigated the influence of factors such personal characteristics, working conditions and school setting characteristics on teacher retention. Data was collected electronically utilizing a survey instrument designed by two teacher education experts and I. A total of 21 variables and two open-ended questions were investigated using the survey instrument. Exploratory factor and hierarchical multiple regression analyses were conducted to identify a multi-factor model for teacher retention utilizing the participants' survey responses. These analyses yielded evidence of the program's effectiveness in preparing teachers for long careers. Specifically, the areas of program support, field experience, and classroom management were statistically significant factors that contributed positively to teacher retention. Additionally, variables outside the program, were examined. These factors included personal characteristics, working conditions, and school setting factors. The predictor model accounted for 56% of the variance; F (17, 54) = 3.015; p = < 0.001. In particular, working conditions contributed to 41% of the variance associated with the teacher retention model. A qualitative analysis of open-ended survey questions was used to further examine decisions to remain in teaching. Support of administration, colleagues, staff, and parents was shown to influence teacher retention.

Hospitals are experiencing a critical shortage of qualified registered nurses. While traditional research explored reasons why nurses choose to leave their jobs, this study examined why nurses may choose to stay. Inter-relationships among cognitive, affective, and demographic variables and their impact on hospital nurses’ affective commitment to their current jobs were assessed. Participants included 134 full-time registered nurses in Dallas, Texas. They were asked about their tenure and educational degree, and completed the following measures online: Nurses’ Affective Commitment to Their Current Jobs; Nursing Stress Scale; Work Climate Questionnaire; and Coping Response Inventory. The results supported previous findings that nurses’ affective commitment to their current jobs was positively related to perceived autonomy support, percentage of reported coping approach strategies, and number of years worked in their current hospital unit. Furthermore, nurses’ affective commitment was negatively related to the two stress-related variables: number of chronic stressors (NCS) and intensity of stressors. In the primary analysis of the proposed Model of Nurses’ Affective Commitment to Their Current Jobs, a significant three-way interaction was found among perceived autonomy support and percentage of reported coping approach strategies (RCAS) on the relationship between NCS, and nurses’ affective commitment. A post hoc analysis found that nurses with a low level of RCAS had a significant change in the relationship between NCS and nurses’ affective commitment, depending on their level of perceived autonomy support. There was a negative relationship between NCS and nurses’ affective commitment for nurses’ with low levels of perceived autonomy support; whereas, there was a positive relationship between NCS and nurses’ affective commitment for nurses’ with high levels of perceived autonomy support. In addition, a secondary analysis on the model revealed that, for nurses working in their units less than six years, there was a varying degree of a positive relationship between RCAS and nurses’ affective commitment to their current jobs depending on the level of perceived autonomy support. However for nurses working more than six years, there was a negative relationship between RCAS and nurses’ affective commitment to their current jobs for nurses with low levels of perceived autonomy support. / text

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