A qualitative narrative study of rescue and recovery workers responding to the terrorist bombing of Oklahoma City's Murrah Building.

OBJECTIVE: Much of disaster mental health research uses quantitative methods, focusing on numerical prevalence, services, and outcomes. METHODS: Qualitative methods can provide more detailed, rich, and spontaneous insights into personal disaster experiences, yielding important insights beyond deductive methods. This large-scale qualitative narrative study examined experiences of 181 OKC bombing rescue/recovery workers. RESULTS: Thematic narrative content of the bombing experience arose from personal accounts of the bomb blast by rescue/recovery workers proceeding chronologically from initial awareness and deployment to harrowing onsite search and rescue/recovery missions to the aftermath with reflections on the bombing. CONCLUSIONS: Beyond disaster recovery/rescue worker stories published in popular media, little other substantive published knowledge on this topic is available, and therefore this research study provides a wealth of new in-depth information that can provide guidance for policy and practice for disaster response.

Key Attributes of a Medical Learning Community Mentor at One Medical School: The Mentee Perspective.

To assess the elements necessary to be a successful learning community (ClinCalc) mentor to medical students from the mentee's perspective. Few such studies have utilized the in-depth and richness of detail obtained in qualitative studies. This qualitative study analyzed four focus group discussions lasting 45-90 min conducted at the University of Texas Southwestern Medical School, which has an established LC, in the year 2018. The groups included 14 pre-clerkship and 8 clerkship students. Investigators evaluated transcriptions of the focus group discussions using ATLAS.ti software. Three overarching categories of discussion emerged from the group discussions: (1) Relationship Competence, (2) Teaching Competence, and (3) Ethical and Compassionate Medical Practice Competence. Relationship Competence themes included "walk with me," relationship is most important, and one-on-one. Teaching Competence themes included above and beyond, recognize and address mentor limitations, and safe and enriching environment. Ethical and Compassionate Medical Practice Competence themes included ethical decision making and compassionate care for diverse patient populations. Mentees focused on various aspects of the mentor-mentee relationship as the single most essential competence. Themes mentees discussed as important qualities of a successful mentor may denote qualities to be prioritized in faculty development and mentor recruitment. Future studies could investigate how the LC environment informs former medical students and promotes patient outcomes.

Gamification of Primary Care in a Baccalaureate Nursing Education Program.

ABSTRACT: A grant-funded undergraduate nursing elective was designed to increase the bachelor of science in nursing-prepared nursing workforce in primary care. We created a board game to engage students to address complex needs of clients in primary care. Using patient scenario game cards, students identify and discuss levels of prevention, social determinants of health, and resiliency principles as they move along the board. Gamification challenges students to think critically and make decisions about primary care patient scenarios in a safe learning environment. Potential uses for gamification to teach students management of complex patient scenarios are identified.

Implementation of a Registered Nurse Primary Care Clinical Mentoring Academy.

Registered nurses (RNs) are pivotal team members for improving the quality of care in communities; however, they are underutilized in primary care. Two schools of nursing in Alabama partnered to develop and implement a project to build a resilient primary care RN workforce. A major component of this project is the Primary Care Clinical Mentoring Academy (PCCMA), which was designed to prepare RN clinical mentors to implement positive student learning experiences in the primary care setting. The PCCMA follows a comprehensive curriculum implementing both didactic instruction and interactive activities related to primary care competencies; interprofessional education and collaborative practice; and primary care RN mentor roles and responsibilities. Participants reported that the PCCMA was effective and useful, and they perceived that it would improve their overall job performance as a clinical mentor. The PCCMA is an effective way to produce confident and capable RN mentors in primary care. [J Contin Educ Nurs. 2022;53(7):312-320.].

Curricular and Clinical Innovation Engaging Undergraduate Nursing Students to Build a Resilient Primary Care Workforce.

BACKGROUND: Primary care health settings provide access to services for underserved populations, yet baccalaureate (BSN)-prepared nurses are currently underutilized on the primary care health care team. PROBLEM: BSN curricula often focus on acute care settings for clinical experiences, and students may not be aware of the scope and impact the RN has in a primary care setting. This gap in experiences may lead to overlooking primary care employment opportunities. PURPOSE: The purpose of this article is to describe the development, implementation, and evaluation of an innovative course that builds the primary care nurse workforce capacity. APPROACH: An undergraduate elective course focusing on primary care didactic and clinical experiences was created. OUTCOMES: Qualitative student feedback regarding the course was positive, while quantitative data revealed an above-average course outcome rating. CONCLUSIONS: An effective intervention to increase workforce capacity in primary care settings is to immerse students in primary care concepts and experiences in a formal, combined didactic and clinical course.

Personality in Combination with Alcohol and Drug Use and Psychiatric Disorders to Predict Psychosocial Characteristics and Behaviors of Hepatitis C Patients.

The objectives of this study were to assess the prevalence of personality disorders and to examine personality as a predictor of psychosocial characteristics and behaviors of HCV patients. HCV patients (n = 259) from three infectious disease and liver clinics who completed Cloninger's Temperament and Character Inventory (TCI), an inventory for personality traits, were included in the study. Patients with low scale scores in the character dimension of both cooperativeness and self-directedness (low CO/SD) were defined as having a personality disorder. Using low CO/SD in combination with demographic, psychiatric/substance use, and HCV-related variables, linear regression was used to construct separate models of risky behaviors, quality of life, functioning, burden of illness, and social support. The prevalence of low CO/SD was high in this sample of HCV patients. Low CO/SD was an independent predictor of risky behaviors, quality of life, functioning, and social support.

Quality of Life, Functioning, and Coping in HCV Patients Continuing Versus Ceasing Alcohol Use.

The purpose of this study was to compare quality of life, functioning, and coping among hepatitis C virus (HCV) patients who continued versus ceased alcohol use in the past year. HCV patients (n = 291) were recruited from three liver and infectious disease clinics. Student's t test was used to compare HCV patients who were former and active users of alcohol. The majority of HCV patients were male, African American, and without a high school degree. Compared to former users of alcohol, active users of alcohol self-reported lower ratings on home life, personal leisure, and overall quality of life. In the area of functioning, active users of alcohol self-reported lower ratings on home life, close relationships, sex life, and overall functioning. The two groups did not differ on coping. Most HCV clinicians advise HCV patients to avoid alcohol completely because of its adverse biological effects on the liver. Despite this important advice by their HCV clinicians, most HCV patients continue to use alcohol. HCV clinicians can additionally consider advising these patients that continued alcohol use is associated with lower quality of life and functioning as further evidence to convince these patients to avoid alcohol or to participate in alcohol cessation treatment.

Religious and Spiritual Aspects of Disaster Experience Among Survivors of the 9/11 Attacks on New York City's World Trade Center.

This study examined religious and spiritual aspects of disaster experience among 379 survivors of the 9/11 attacks on New York City's World Trade Center. Interviews conducted 35 months after the disaster provided structured diagnostic assessments of psychiatric disorders and specific detail of demographic characteristics, experience of the disaster, and variables related to religion and spirituality. The study participants overwhelmingly identified with a specific religion. The disaster appeared to have only modest effects on strength and importance of religion/spirituality, and changes were predominantly positive. Specific religions and faith groups differed in their disaster experience in important ways.

Key Attributes of a Medical Learning Community Mentor at One Medical School.

PURPOSE: The purpose of this study was to discover the elements required for a successful learning community (LC) faculty member educator of medical students. METHOD: The authors in this qualitative study evaluated six 90-min focus groups of faculty members. The groups included 31 experienced and 19 inexperienced LC faculty members at the University of Texas Southwestern Medical School. After achieving excellent interrater reliability, transcriptions of the discussions were subjected to thematic analysis using ATLAS.ti software. RESULTS: Five major themes emerged: (1) LC faculty characteristics/competency, (2) suggested faculty development methods, (3) factors outside the LC environment influencing student relationships, (4) student attributes influencing teaching techniques, and (5) measuring and improving history and physical skills. Faculty characteristics/competency subthemes included role-modeling, mentoring, and teaching competence. Suggested faculty development methods subthemes included assessing and giving feedback to faculty, peer development, and learning from experts. Experienced LC faculty focused more attention on teaching competence and mentoring competence than inexperienced LC faculty. DISCUSSION: The themes with the most extensive discussion among the experienced LC faculty groups may represent qualities to be sought in future mentor recruitment and faculty development. Future studies could build on this study by similarly investigating student perceptions.