Critical Incident Technique Interviews Research Articles

Driving quality in delirium care through a patient-centered monitoring system in palliative care: Protocol for the two-staged exploratory sequential mixed methods MODEL-PC study

Introduction Delirium is a serious acute neurocognitive condition that is common in palliative care units and yet under-addressed. To improve delirium care in this setting, we will develop and pilot a monitoring system that integrates the Delirium Clinical Care Standard, Palliative Care Outcomes Collaboration (PCOC) methods, and perspectives of patients, carers and staff. Methods This paper reports the protocol for a two-stage, exploratory, sequential mixed-methods implementation study. Stage 1 data collection includes Delirium Standard-aligned process mapping and clinical audits, and Critical Incident Technique interviews with patients, carers and staff with a recent experience of delirium. We will present integrated stage 1 findings to stakeholders then collaboratively develop a delirium monitoring system that aligns with the Delirium Standard and PCOC methods. In stage 2, we will pilot the new system and repeat stage 1 data collection and analyses, adding PCOC and adverse event measures. Implementation principles and strategies such as audit and feedback and education will be applied. We developed simplified participants information sheets and consent forms for interview and process mapping participants, who will provide written informed consent; and waiver of consent to collect clinical audit, PCOC and adverse event data from patients’ medical records is approved. At study end, we will report implementation, effectiveness and safety outcomes, including systemic utility of the delirium monitoring system for wider testing and use to meet the Delirium Standard in palliative care units. Quantitative data analyses will include descriptive and inferential statistics and qualitative analyses will incorporate thematic content analysis aligned to the Critical Incident Technique. Mixed methods data integration will be at the end of each stage. Discussion This protocol paper describes the mixed methods, systems integration, and innovative measures and study processes of the MODEL-PC study. We also share data collection tools and a simplified information sheet and consent form for patients.

Exploratory Study of Multidimensionality Elements of Small Entrepreneurs' Network Change and Development in the Southern Region of Malaysia

The research aims to empirically explore the multidimensionality elements in small entrepreneurs' network change and development during periods when the entrepreneurs face tipping points. Prior scholars have examined the mix of strong and weak links in small businesses and linked them to business development stages. For small firms to continue experiencing business growth, current literature must emphasize the connection between network strengths and overcoming tipping points. This research explores the multidimensional elements of small entrepreneurs' network change and development that contribute to their survival during the era of tipping points in the Southern Region of Malaysia. This qualitative research uses a multiple case study approach involving eight small firms in the southern region of Malaysia. The data collection methods include analysis of secondary documentation and in-depth interviews with the entrepreneurs using the critical incident interview technique. The data has been analyzed using NVIVO software and has employed Miles and Huberman's (1994) flows of analysis activity. Data triangulation was carried out by interviewing individuals who were seen as having strong or weak ties within the network and who were identified through interviews with the entrepreneurs. The findings enlighten two themes: the entrepreneur-level context and the dyadic-level context. The findings show that the multidimensionality of the individual entrepreneur is demonstrated through their demographic factors, personal values, experience, and capabilities. Therefore, they differ in responding to changes in their networks. Dyadic multidimensionality is found in the tie's content, structure, governance, and the dyadic life cycle. Finally, this research provides theoretical and methodological contributions and offers implications for entrepreneurs, government agencies and policy-makers.

Construction of a competency evaluation index system for front-line nurses during the outbreak of major infectious diseases: A Delphi study.

As the frequency of infectious diseases rises, it's more important than ever to pay attention to the competency level of front-line nurses as the primary force in front-line rescue, which has an impact on the quality of anti-epidemic response. This paper aims to construct the competency evaluation index system for front-line nurses during the outbreak of major infectious diseases. This study combined literature review, critical incident technique interviews, and semi-structured in-depth interviews, as well as two rounds of Delphi expert correspondence, to construct a competence evaluation index system for front-line nurses during the outbreak of major infectious diseases. The study used purposive sampling to select 26 experts from 11 provinces and cities across China to conduct two rounds of Delphi expert consultation, and the indicators were selected based on the mean importance score > 3.5 and the coefficient of variation < 0.25, and the weights of the indicators were calculated by the Analytic Hierarchy Process. The effective recovery rates of the two rounds of correspondence questionnaires were 93.1% and 96%. The effective recovery rates of the two rounds of correspondence questionnaires were 93.1% and 96%, the authority coefficients of experts were 0.96 and 0.98, the Kendall's coordination coefficients of the first, second, and third level indexes were 0.281, 0.132, and 0.285 (P < 0.001), 0.259, 0.158, and 0.415 (P < 0.001). The final index system includes 4 primary indicators (Knowledge System of Infectious Diseases, Nursing Skills for Infectious Diseases, Related Professional Abilities for Infectious Diseases, and Comprehensive Quality), 10 secondary indicators, and 64 tertiary indicators. The competency evaluation index system of front-line nurses during the outbreak of major infectious diseases is scientific, reasonable, and practical, which can provide a scientific basis for nursing managers to accurately understand, describe, analyze, and evaluate the competence level of nursing staff and scientifically implement the allocation of human resources in the future, as well as serve as a content framework for subsequent training programs.

Work Content of General Practitioners in Beijing, China: A Multi-method Study.

BackgroundDespite the dramatic growth of primary care in China, little evidence showed what general practitioner (GP) do and how GP provided medical service in Beijing.ObjectiveThis study aimed to explore the work content of GPs in primary care in Beijing.MethodsA multi-method study was conducted in five community health service institutions using non-participant observation and critical incident technique interview. Eleven GPs was recruited by purpose sampling, with each GP recording details of 100 patient encounters. Health problems of patients and activities of GPs were observed in consultations. Then, critical incident technique interviews were conducted focusing on GPs' works out of clinics and challenge.ResultsA total of 1, 100 patients encounters and 1,897 reasons for encounter (RFEs) were recorded from 11 GPs. There were 1897 RFEs (1.72 per encounter) and 2,762 health problems (2.51 per encounter) from 1,100 encounters during our observation. GPs' work related to consultation was focus on disease diagnoses and treatment. Physical examination and investigations were performed in only 15.5 and 17.1% consultations, respectively. Procedures for chronic disease management were infrequently provided to patients (0.4–26.6%). Time spent in each work process in consultations ranged from 0.68 ± 0.27 min for reservation to 4.00 ± 2.45 min for surgical treatment. In addition to clinical work, there were tasks about health files, contracted family doctor services, health education, teaching students, and scientific research.ConclusionThis study illustrated the complexity of GPs' work and heavy workload in Beijing, China. More attention and effort are needed to develop GPs performance and release GPs' work workload in primary care.

The patient's "story": an examination of patient-reported safety incidents in general practice.

Patient safety incidents (PSIs) are typically studied through engagement with healthcare providers, without input from patients despite their privileged viewpoint of care experiences. To examine the potential of the patient viewpoint as a lens for future safety improvement initiatives, by: (i) collecting and analysing patients' accounts of PSIs; and (ii) comparing patient and clinician perceptions of PSIs. Firstly, Critical Incident Technique (CIT) interviews were used to obtain rich descriptions of PSIs, which were then condensed into patient stories. Deductive content analysis was used to code the safety deficiencies described in patient stories using patient-derived safety categories. Secondly, General Practitioners (GPs) and patients individually rated the perceived severity and likelihood of each story. A total of 32 eligible patient stories were obtained from 25 interviews. Stories commonly described deficiencies related to communication, staff performance, and compassion/dignity/respect. There were significant differences in GP (n = 14) and patient (n = 11) severity and likelihood ratings. GPs were significantly more likely to consider stories to be a lower severity, and occurring with a lower frequency than patients. Elicitation of the patient perspective using the CIT allowed for the rich description of safety deficiencies that occur in general practice. Given that patients bring a unique and important viewpoint on safety, there is a need to make greater efforts to include the patient perspective of safety in healthcare.

Exploring job crafting as a response to abusive supervision

PurposeThe purpose of this qualitative exploratory study was to investigate the capacity of job crafting to serve as a viable response to abusive supervision. Although considerable literature has emerged on employee reactions to abusive supervision, the role of job crafting as a coping mechanism has received relatively little attention.Design/methodology/approachUsing qualitative exploration, we conducted semi-structured interviews to examine how individuals engage in job crafting as a means to respond to or cope with abusive supervision. Critical Incident Interview Technique (CIIT) was used to obtain in-depth details of this topic. We analyzed the interview-based data using the thematic analysis (TA) technique. We also integrated topic modeling to cluster the identified categories of job crafting behaviors within our TA. The cultural context of our findings was further analyzed using interpretive phenological analysis (IPA).FindingsThe results of our thematic analysis led to four recurring themes in the interview-data: (1) Job crafting as a viable coping response to abusive supervision; (2) The type of coping relates to the type of crafting: Approach and Avoidance; (3) The role of perceived control; (4) Emotions play a role in the type of crafting employed. Findings from our IPA generated the following super-ordinate themes. (1) Job crafting fluidity, (2) effectiveness of job crafting, (3) resilience and (4) cultural dynamics.Research limitations/implicationsThis research reveals the ways in which individuals may turn to job crafting behaviors as a means to cope following instances of abusive supervision. Given the qualitative exploration of our research approach, we identify generalizability to be an issue.Practical implicationsJob crafting is a proactive phenomenon that equips employees with coping abilities in the workplace. While Wrzesniewski and Dutton (2001) suggested that job crafting behaviors tend to be hidden from management, there may be merit in organizations explicitly acknowledging the benefits of allowing employees to be active agents in their work, capable of using multiple domains of job crafting to improve their personal and professional lives (Petrou et al., 2017).Originality/valueThe current research reveals the ways in which individuals may turn to job crafting behaviors as a means to cope, following instances of abusive supervision. We further fine-grained our analysis to explicate employee job crafting behaviors in response to abusive supervision within a cross-cultural domain.

The Urgency and Importance of an Active Information Seeking Task Influence the Interruption of Information Encountering Episodes

A Review of: Makri, S., &amp; Buckley, L. (2020). Down the rabbit hole: Investigating disruption of the information encountering process. Journal of the Association for Information Science and Technology, 71(2), 127–142. https://doi.org/10.1002/asi.24233 Abstract Objective – To understand when and why information encountering episodes are interrupted. Design – Naturalistic observational and interview study. Setting – Personal network of the study authors in London. Subjects – Fifteen personal contacts of authors, aged 22-60, recruited via word-of-mouth and social media. Methods – Each participant was asked to conduct a search on a self-chosen topic. The researchers took notes and recorded search interactions and think-aloud protocols. After the search, a follow-up interview asked whether the participant had unexpectedly encountered any interesting or useful information; if so, the researchers asked for more details about that episode. If not, they conducted a critical incident technique interview, focused on a memorable example of a past information-encountering episode. The researchers used inductive thematic analysis to analyze the data, augmented with constant comparison across the data and the themes to ensure analytical rigor. Main Results – The most frequent point at which participants interrupted an information encountering (IE) episode was near its beginning, when the searcher noted an information stimulus but then immediately returned to the active information-seeking task. IE episodes were also interrupted 1) after the searcher examined the encountered content but did not explore it further, and 2) after the searcher explored it but decided it was not useful. The factors that influenced interruptions of IE episodes included the searcher’s reluctance to invest the time and effort needed to engage with the encountered information, due to the importance or urgency of the active information-seeking task; the searcher’s reluctance to leave the active information-seeking task, seeing IE as a distraction from that task; the searcher’s reluctance to multitask, i.e., to keep track of both the IE episode and the active information-seeking task; the searcher’s reluctance to risk a dead end; the searcher’s reluctance to be seduced by the “shiny thing” of encountered information (p. 136) and to drift too far away from the active information-seeking task; and the searcher’s reluctance to get “caught up” emotionally in the IE episode (p. 138), a “temptation that is satisfying only in the short-term” (p. 138). Conclusion – Overall, the results help us understand when and why disruption of IE can occur. When an IE episode begins, the searcher is not able to estimate the time and effort required to pursue it or the fruitfulness of following it through. Thus, factors associated with the primary information-seeking task (e.g., its importance or urgency) and with the searcher (e.g., ability to multitask) tend to influence decisions about when to interrupt an IE episode.

Application of the critical incident technique in refining a realist initial programme theory

BackgroundAs realist methodology is still evolving, there is a paucity of guidance on how to conduct theory driven interviews. Realist researchers can therefore struggle to collect interview data that can make a meaningful contribution to refining their initial programme theory. Collecting data to inform realist Inital Programme Theories (IPTs) in healthcare contexts is further compounded due to the healthcare workers’ busy work schedules.In this case study of team interventions in acute hospital contexts, we explore the benefits of using the Critical Incident Technique (CIT) in order to build and refine an initial programme theory. We contend that use of the CIT helps to draw on more specific experiences of “Key Informants” and therefore elicits richer and more relevant data for realist enquiry.MethodsThe five steps of the CIT were mapped against realist methods guidance and adapted into an interview framework. Specifications to identify an incident as “critical” were agreed. Probes were embedded in the interview framework to confirm, refine and/or refute previous theories.Seventeen participants were interviewed and recordings were transcribed and imported for analysis into NVivo software. Using RAMESES guidelines, Context-Mechanism-Outcomes configurations were extrapolated from a total of 31 incidents.ResultsWe found that the CIT facilitated construction of an interview format that allowed participants to reflect on specific experiences of interest. We demonstrate how the CIT strengthened initial programme theory development as it facilitated the reporting of the specifics of team interventions and the contexts and mechanisms characteristic of those experiences. As new data emerged, it was possible to evolve previous theories synthesised from the literature as well as to explore new theories.ConclusionsUtilising a CIT framework paid dividends in terms of the relevance and usefulness of the data for refining the initial programme theory. Adapting the CIT questioning technique helped to focus the participants on the specifics relating to an incident allowing the interviewers to concentrate on probes to explore theories during the interview process. The CIT interview format therefore achieved its purpose and can be adapted for use within realist methodology.

Health Information Avoidance Behavior of Patients with Type 2 Diabetes Mellitus

Along with the convenience of receiving health information and the rise of public health consciousness, seeking health information is regarded as a common phenomenon. However, the public is seldom aware of health information avoidance behavior. As for chronic patients, the fact that they receive health information more frequently than healthy people, the act of receiving or avoiding information would more directly influence the medical decision and health maintenance. This study refers to type 2 diabetics as a target and uses the “critical incident interview technique” to collect data. There are ten patients interviewed. This study aims to explore the health information avoidance behavior and factors from the patients’ perspectives, and to investigate the strategies of decreasing health information avoidance, and to develop a framework of health information avoidance behavior. Finally, this study proposes practical suggestions for medical and health organizations regarding diabetes and is expected to remind the public to examine their own health information behavior.Keywords: Information Avoidance; Health Information Avoidance; Health Information Behavior; Type 2 Diabetes Mellitus 【摘要】隨著健康資訊取得便利，大眾健康自主權提升，健康資訊尋求被視為一個普遍的現象，但健康資訊迴避卻甚少被大眾所察覺，慢性疾病患者因接觸健康資訊頻率較高，對資訊的接受或迴避更易影響患者的醫療決策和健康維持。本研究以第二型糖尿病患者為研究對象，透過關鍵事件訪談法蒐集資料，共訪談10位患者，藉由健康資訊迴避事件探究患者的健康資訊迴避行為、原因，以及減少迴避行為之契機，並整理出一個健康資訊迴避行為框架。最後提出實務建議供醫療照護單位參考，期能減少患者因迴避健康資訊而延誤治療的情況發生，進一步提醒大眾檢視自身的健康資訊行為。關鍵字：資訊迴避、健康資訊迴避、健康資訊行為、第二型糖尿病

A mixed-methods examination of the nature and frequency of medical error among junior doctors

Purpose of the studyTo examine junior doctors’ experience and perceptions of medical errors in which they had been involved.Study designA mixed-methods design, consisting of an error survey and critical incident...

Challenging investment decision-making in pension funds

PurposeThe purpose of this study was to gain a better understanding of pension fund managers investment thinking when confronted with challenging investment decisions. The study focuses on the theoretical question of how dual thinking processes in experts’ investment decision-making emerge. This question has attracted interest in economic psychology but has not yet been answered. Here, it is explored in the context of pension funds.Design/methodology/approachThe sample included 22 pension fund managers. The authors explored their decision-making by applying the critical incident interview technique, which entailed collecting investment decisions that fund managers retrieved from recent memory (Flanagan, 1954). Questions concerned the investment situation, the decision-making process and the challenges and uncertainties the fund managers faced.FindingsMany of the 61 critical incidents examined concerned challenging (mostly stock) investments based on extensive analysis (e.g. reliance on external analysts for advice; analysis of massive amounts of hard company and stock market information; scrutiny of company reports and personal meetings with CEOs). However, fund managers to a high degree based their decisions on soft information judgments such as experience and qualitative judgements of teams. The authors found heuristics, intuitive thinking, biases (sunk cost effects) and social influences in investment decision-making.Research limitations/implicationsThe sample is small and not randomly selected.Practical implicationsThe authors suggest anti-bias training and better acquaintance with human forecasting limitations for pension fund managers.Originality/valuePension fund managers’ investment thinking has not previously been investigated. The authors show the types of investment situations in which analytical and intuitive thinking and biases occur.

An analysis of general practitioners' perspectives on patient safety incidents using critical incident technique interviews.

General practitioners report difficulty in knowing how to improve patient safety. To analyse general practitioners' perspectives of contributing factors to patient safety incidents by collecting accounts of incidents, identifying the contributory factors to these incidents, assessing the impact and likelihood of occurrence of these incidents and examining whether certain categories of contributory factors were associated with the occurrence of high-risk incidents. Critical incident technique interviews were carried out with 30 general practitioners in Ireland about a patient safety incident they had experienced. The Yorkshire Contributory Factors Framework was used to classify the contributory factors to incidents. Seven subject matter experts rated the impact and likelihood of occurrence of each incident. A total of 26 interviews were analysed. Almost two-thirds of the patient safety incidents were rated as having a major-to-extreme impact on the patient, and over a third were judged as having at least a bimonthly likelihood of occurrence. The most commonly described active failures were 'Medication Error' (34.6%) and 'Diagnostic Error' (30.8%). 'Situational Domain' was identified as a contributory domain in all patient safety incidents. 'Communication' breakdown at both practice and other healthcare-provider interfaces (69.2%) was also a commonly cited contributory factor. There were no significant differences in the levels of risk associated with the contributory factors. Critical incident technique interviews support the identification of contributory factors to patient safety incidents. There is a need to explore the use of the resulting data for quality and safety improvement in general practice.

Leadership’s Thinking Process with Contextual Intelligence in Executing Diversification Strategy

Abstract: Diversification is a popular strategy for growth in response to a volatile economy. Current research, however, devotes little attention to the leadership required to ensure successful diversification, except for theoretical contributions on leaders’ thinking processes from scholars within the strategy discipline. This study thus conducted fieldwork in South African organisations to explore empirically how senior leaders’ thinking processes, demonstrating contextual intelligence, contributing to successful diversification. A qualitative study was conducted by collecting data through semi-structured interviews from 15 executives with an average of 21 years’ experience in senior management roles, who had been involved in diversification in South Africa. A critical incident interview technique was used, and interviewees offered examples of how they changed their way of thinking in creating an environment for successful diversification. The analysis revealed that continuous change was required to successfully implement a diversification strategy. Leaders demonstrated specific thinking processes, for example: being intently aware of their context, they filtered and compared this information to their schema or preconceived cognitive representations. In case of a mismatch, they changed their way of thinking; and directed contextual information to challenge others’ current way of thinking. Surprising findings included leaders’ sensing other’s emotions and appealing to these through storytelling to elicit support for their diversification. Diversification requires organisations to invest in developing the agility and global perspective of leadership to increase awareness of trends in their context, their own biases and to shift their mindsets as well as purposefully challenging other’s thinking.

Naturalistic Decision Making by Older Adults with Chronic Heart Failure: An Exploratory Study Using the Critical Incident Technique

Older adults with chronic heart failure (CHF) make daily decisions to manage their disease, with some of these decisions resulting in major health outcomes such as acute decompensation, hospitalization, and death. To understand how older adults with CHF make these decisions in their natural sociotechnical system context, we analyzed data from critical incident technique interviews with 12 older adults with CHF and 6 (family or friend) support persons. We identified key decision-making barriers, strategies, and distributed activity in stages of monitoring information or data, interpreting the information, and acting as a result. Our findings contribute to the broader research literature on CHF self-care as a naturalistic phenomenon and can aid in the exploration of design requirements for the development of technologies and interventions to assist in heart failure self-management.

Disturbing and distressing: a mixed methods study on the psychological impact of end of life care on junior doctors.

The Irish Medical Council has identified gaps in knowledge and communications skills of new-entrant doctors in legal, ethical and practical aspects of end of life care. To determine the frequency with which junior doctors deal with end of life care and patient death and to evaluate the impact this has on their psychological wellbeing. A questionnaire was distributed to junior doctors to determine the frequency with which the participants had managed a patient at end of life. An abbreviated Posttraumatic Stress Disorder Checklist-Civilian version was used to evaluate psychological distress. Critical incident technique interviews explored the challenges of caring for patients at end of life. A total of 110 junior doctors in two teaching hospitals in Ireland completed the questionnaire: 39 (35.5%) interns and 71 (64.5%) senior house officers. In addition, 31 interviews were carried out with interns, senior house officers and registrars. The majority (81.8%) had pronounced a death with 39.4% of senior house officers doing so more than 10 times. Three quarters (75.5%) had discussed end of life with a patient's family. Of the 110 respondents that completed the posttraumatic stress disorder checklist, 11.8% screened positively for posttraumatic stress disorder. Challenges identified at interview included lack of knowledge and preparedness, difficulty communicating with family members, a lack of support and a feeling of failure. Junior doctors are regularly carrying out tasks related to end of life care, resulting in high levels of psychological distress. Further training and a change in culture are required.

Learning from the parallel pathways of Makers to broaden pathways to engineering

BackgroundMakers are a growing community of STEM-minded people who bridge technical and non-technical backgrounds to imagine, build and fabricate engineering systems. Some have engineering training, some do not. This paper presents a study to explore the educational pathways of adult Makers and how they intersect with engineering. This research is guided by the following research questions: (1) What can we learn about the educational pathways of adult Makers through the lens of constructivist grounded theory? and (2) How do the educational pathways of Makers intersect with engineering? This study relied on qualitative interviews, using artifact elicitation interviews and constructivist critical incident technique interviews, of 42 adult Makers.ResultsThrough inductive analysis of a collection of interviews with Makers, a theme emerged where Makers from different educational backgrounds and with different careers (e.g., art, STEM, business) were making artifacts that had similar purposes. We present two cases of parallel pathways, (1) musical artifacts and (2) large-scale interactive artifacts, to demonstrate the multiple, parallel life pathways that Makers take to making their artifacts and the contextual events and activities that are critical to the direction of these pathways.ConclusionsThe stories and life pathways of adult learners engaged in Making can offer valuable insight into how we might identify practices that promote the access and success of a larger and more diverse population of students for engineering. Makers are engaged in activities that embody the Engineer of 2020 (e.g., lifelong learning, creativity, and practical ingenuity). By studying Makers, we can consider the multiplicity of pathways into engineering majors and careers.

Understanding cancer survivors' information needs and information-seeking behaviors for complementary and alternative medicine from short- to long-term survival: a mixed-methods study.

ObjectiveThe research examined complementary and alternative medicine (CAM) information-seeking behaviors and preferences from short- to long-term cancer survival, including goals, motivations, and information sources.MethodsA mixed-methods approach was used with cancer survivors from the “Assessment of Patients’ Experience with Cancer Care” 2004 cohort. Data collection included a mail survey and phone interviews using the critical incident technique (CIT).ResultsSeventy survivors from the 2004 study responded to the survey, and eight participated in the CIT interviews. Quantitative results showed that CAM usage did not change significantly between 2004 and 2015. The following themes emerged from the CIT: families’ and friends’ provision of the initial introduction to a CAM, use of CAM to manage the emotional and psychological impact of cancer, utilization of trained CAM practitioners, and online resources as a prominent source for CAM information. The majority of participants expressed an interest in an online information-sharing portal for CAM.ConclusionPatients continue to use CAM well into long-term cancer survivorship. Finding trustworthy sources for information on CAM presents many challenges such as reliability of source, conflicting information on efficacy, and unknown interactions with conventional medications. Study participants expressed interest in an online portal to meet these needs through patient testimonials and linkage of claims to the scientific literature. Such a portal could also aid medical librarians and clinicians in locating and evaluating CAM information on behalf of patients.

Triggers and outcomes of customer-to-customer aisle rage

Incidents of customer-to-customer aisle rage are on the rise, which raises questions about their triggers and outcomes, including customer responses that may affect the firm where the incidents take place. The results of 329 Critical Incident Technique interviews categorize triggers as interpersonal or situational, and suggest situational triggers that are under the firm's control (e.g., hunger, crowdedness, long waits for service) frequently co-occur with behaviors that negatively impact the firm (e.g., physical expressions of rage, exit, and revenge). Another important contribution is the identification of new responses to rage, including: commiserating with other customers, responding with humor/sarcasm, and boycotting the service provider because of shame or regret about personal reactions to the rage-inducing incidents. The results build on Affective Events Theory (AET) and contribute to our understanding of customer coping in customer-to-customer interactions.

Identifying core competencies to advance female professors’ careers: an exploratory study in United States academia

This exploratory study aims to identify the core competencies necessary to successfully advance the careers of female associate professors in higher education. To ascertain these core career competencies, a critical incident interview technique was employed. One-to-one semi-structured interviews with six female full professors at a major research university in the Midwestern region of the United States were conducted. Based on participants’ career advancement experiences, the following competencies were identified: (1) making important connections, (2) fulfilling responsibilities in academia, (3) being politically savvy, (4) managing personal and professional obligations, (5) developing a sense of self-agency for one’s career, and (6) believing in one’s self in the work environment. The action-oriented findings of this research, rather than skill-based, can be easily adapted by faculty and institutions, both domestically and internationally, to improve current practices. These findings offer a unique contribution for improving the research and practice of career development among female faculty in higher education.

Explaining retention of healthcare workers in Tanzania: moving on, coming to 'look, see and go', or stay?

BackgroundIn the United Republic of Tanzania, as in many regions of Sub-Saharan Africa, staff shortages in the healthcare system are a persistent problem, particularly in rural areas. To explore staff shortages and ways of keeping workers in post, we ask, (a) Which cadres are most problematic to recruit and keep in post? (b) How and for what related reasons do health workers leave? (c) What critical incidents do those who stay face? (d) And why do they stay and cope?MethodsThis is a multi-method paper based on analysis of data collected as part of a cross-sectional health facility study supporting maternal and reproductive health services in the United Republic of Tanzania. Qualitative data were generated through semi-structured interviews with Council Health Management Teams, and Critical Incident Technique interviews with mid-level cadres. Complementary quantitative survey data were collected from district health officials, which are used to support the qualitative themes.ResultsMid-level cadres were problematic to retain and caused significant disruptions to continuity of care when they left. Shortage of highly skilled workers is not only a rural issue but also a national one. Staff were categorised into a clear typology. Staff who left soon after arrival and are described by ‘Look, See and Go’; ‘Movers On’ were those who left due to family commitments or because they were pushed to go. The remaining staff were ‘Stayers’. Reasons for wanting to leave included perceptions of personal safety, feeling patient outcomes were compromised by poor care or as a result of perceived failed promises. Staying and coping with unsatisfactory conditions was often about being settled into a community, rather than into the post.ConclusionsThe Human Resources for Health system in the United Republic of Tanzania appears to lack transparency. A centralised monitoring system could help to avoid early departures, misallocation of training, and other incentives. The system should match workers’ profiles to the most suitable post for them and track their progress and rewards; training managers and holding them accountable. In addition, priority should be given to workplace safety, late night staff transport, modernised and secure compound housing, and involving the community in reforming health services culture and practices.