Semi-structured Data Collection Research Articles

Planning for and Assessing Rigor in Rapid Qualitative Analysis (PARRQA): a consensus-based framework for designing, conducting, and reporting

BackgroundThe use of rapid qualitative methods has increased substantially over the past decade in quality improvement and health services research. These methods have gained traction in implementation research and practice, wherein real-time adjustments are often made to optimize processes and outcomes. This brisk increase begs the questions: what does rigor entail in projects that use rapid qualitative analysis (RQA)? How do we define a pragmatic framework to help research teams design and conduct rigorous and valid rapid qualitative projects? How can authors articulate rigor in their methods descriptions? Lastly, how can reviewers evaluate the rigor of rapid qualitative projects?.MethodsA team of seven interdisciplinary qualitative methods experts developed a framework for ensuring rigor and validity in RQA and methods suitable for this analytic approach. We conducted a qualitative evidence synthesis to identify gaps in the literature and then drew upon literature, standard procedures within our teams, and a repository of rapid qualitative training materials to create a planning and reporting framework. We iteratively refined this framework through 11 group working meetings (60-90 minutes each) over the course of one year and invited feedback on items to ensure their completeness, clarity, and comprehensibility.ResultsThe Planning for and Assessing Rigor in Rapid Qualitative Analysis (PARRQA) framework is organized progressively across phases from design to dissemination, as follows: 1) rigorous design (rationale and staffing), 2) semi-structured data collection (pilot and planning), 3) RQA: summary template development (accuracy and calibration), 4) RQA: matrix analysis (matrices), and 5) rapid qualitative data synthesis. Eighteen recommendations across these sections specify best practices for rigor and validity.ConclusionsRapid qualitative methods play a central role in implementation evaluations, with the potential to yield prompt information and insights about context, processes, and relationships. However, guidance on how to assess rigor is nascent. The PARRQA framework enhances the literature by offering criteria to ensure appropriate planning for and assessment of rigor in projects that involve RQA. This framework provides a consensus-based resource to support high-level qualitative methodological rigor in implementation science.

Calorie and nutrient gap analysis of jail menu and nutritional status of the prisoners of District Jail, Faisalabad, Pakistan.

Assessment of prisoners' diet showed that it is deficient in calories as well as in Recommended Daily Allowance values. Caloric value was about 64.9% deficient considering one serving (plate per time) taken. A quantitative-qualitative mixed approach was adopted. Convenient purposive sampling was employed to recruit 112 participants. For quantitative assessment a descriptive cross-sectional study design and semistructured data collection tool was used, and for qualitative evaluation, caloric and RDA value of different nutrients were calculated and in-depth interviews were conducted. Analysis showed that the diet provided was deficient in caloric and RDA values, thus the prison authority should design a proper strategy to ensure proper nutritional status of prisoners.

Significant Association of Epidemiological Factors with Hypothyroid Patients in Khulna Region: A Cross Sectional Study

Background and Objectives: Thyroid disorder is one of the most common endocrine disorders worldwide. A community‑based investigations showed that; overall occurrence of thyroid disease was 20.43%, highest incidence of diffuse goiter (7.35%), followed by sub-clinical hypothyroidism (6.59%), hypothyroidism (4.97%), hyperthyroidism (0.86%) and sub-clinical hyperthyroidism (0.65%) in Khulna, Bangladesh. High prevalence of hypothyroidism with autoimmunity are also observed in Khulna Region. The aim of this study was to conduct epidemiological survey of hypothyroid patients in Khulna region. Methods: This cross‑sectional study was done on Hypothyroid patients of Khulna Medical College Hospital and Institute of Nuclear Medicine and Allied Science (INMAS), Khulna, from July 2023 to December 2023. After having informed written consent of adult sixty hypothyroid patients, was interviewed and examined the blood sample for relevant information; data recorded in a preformed, semi-structured data collection sheet (Patient particulars form) and analyzed. Results: Out of the sixty hypothyroid patients about fifty percent was obese, eighty percent was female of 30-60 years age group. Ninety percent of them belongs to poor socioeconomic conditions and came from rural area of Khulna district. About 20 percent had positive family history of hypothyroidism, 27 percent patient was associated with other autoimmune diseases and about 80 percent was associated with anti-thyroid antibody. Conclusions: Most of the patients were rural female of low socioeconomic back ground of reproductive age groups. They also associated with other autoimmune diseases. Chronic autoimmune diseases, poverty, anti-thyroid antibody and salinity of environment may play an important role for the causation of hypothyroidism in Khulna region. Keywords: Thyroid disorder, hypothyroidism, dyslipidemia, thyroiditis.

Hypothyroid Patients Show Significant Association with Antithyroid Antibodies: A Cross Sectional Study in Khulna

Background and Objectives: A high prevalence of thyroid disorder is found worldwide and it is a serious public health problem. A community‑based investigations showed that; overall occurrence of thyroid disease was 20.43%, highest incidence of diffuse goiter (7.35%), followed by sub-clinical hypothyroidism (6.59%), hypothyroidism (4.97%), hyperthyroidism (0.86%) and sub-clinical hyperthyroidism (0.65%) in Khulna, Bangladesh. Antithyroid autoantibodies are one of the most important causes of thyroiditis resulting hypothyroidism. The aim of this study was to investigate the prevalence of antithyroid antibody to hypothyroid patients in Khulna region. Methods: This cross‑sectional study was done on Hypothyroid patients of Khulna Medical College Hospital and Institute of Nuclear Medicine and Allied Science (INMAS), Khulna, from July 2023 to December 2023. After having informed written consent of adult sixty hypothyroid patients, was interviewed and examined the blood sample for relevant information; data recorded in a preformed, semi-structured data collection sheet (Patient particulars form) and analyzed. Results: About 20 percent had positive family history of hypothyroidism, 27 percent patient was associated with other autoimmune diseases and about 80 percent was associated with anti-thyroid antibody. Out of the sixty hypothyroid patients about fifty percent was obese, eighty percent was female of 30-60 years age group. Ninety percent of them belongs to poor socioeconomic conditions and came from rural area of Khulna district. Conclusions: Most of the patients were rural female of low socioeconomic back ground of reproductive age groups. There was very significant association of anti-thyroid antibody with these patients. They also associated with chronic autoimmune diseases and poverty.

Pattern, Interventions and Outcome of Post-Dural Puncture Headache Among Obstetric Patients in Ibadan

Background: Post-dural puncture headache (PDPH) is a complication of dura mater puncture. PDPH poses a problem in postpartum women; hence, there is a need to identify and promptly treat it using highly effective, non-invasive techniques that can be easily implemented in low-resource settings to reduce the burden and associated morbidity. Objective: To examine the interventions and outcomes of PDPH among women who had a subarachnoid block for obstetric indications at the University College Hospital, Ibadan. Methods: A prospective, cross-sectional study was conducted among women with a subarachnoid block for obstetric indications. A semi-structured interviewer-administered data collection form was used to assess pain at the onset of the headache and followed up to 72 hours post-treatment. Results: This study evaluated 26 pregnant women with PDPH. Most respondents (18; 69.2%) were ≥30 years old, had a normal BMI of 11 (42.3%), and 26.9% of the women had a prior history of PDPH. Subarachnoid block was performed by a registrar in 24 (92.3%) women. The majority (22; 84.6%) had only one attempt at dural puncture, all in a sitting position with the 25G-sized spinal needle in 96.2%. The headache was incapacitating in 9 (34.6%) cases and got worse in the upright position in 23 (88.5%) women. Conclusion: PDPH is a notorious morbidity in parturients, and steps should be taken to minimise the duration and effects of the condition. Prevention, prompt identification, diagnosis, and proactive treatment are desirable.

Urban Area Policy Innovation From The Perspective of Public Policy in Serang Municipality, Indonesia

This article aims to discuss the policy implications and criteria for ideal urban area policy innovation from a public policy perspective. This research was conducted using a case study approach using semi-structured interview data collection techniques as a data collection instrument. The results of the research show that the policy implications for urban residential areas in Serang City are still not optimal due to the limited authority of the city government and the lack of integration of SiKasep policy innovations with urban needs and problems. Apart from that, SiKasep policy innovations have not been able to have an impact due to the low ability and willingness to innovate within the civil service. country. The policy innovation criteria for ideal urban residential areas in Serang City can be applied through the New Public Services (NPS) approach as a representation of policy innovation. Research findings show the importance of strengthening regulations and legitimacy, especially in formulating programs and policies for urban residential areas that are based on regional policy standards; second, the importance of encouraging policy interventions related to access to basic services for the community; third, it is important to encourage policy actors to develop integrated programs and minimize the various interests that hinder policy innovation in urban residential areas; and fourth, participation and involvement of non-governmental elements is very important to obtain broader policy support.

The myth of equality: Sexual harassment behind a woman’s desk

Sexual harassment is a significant problem in employment but is often underreported. Women are one of the most vulnerable groups to get harassment in the workplace. As well as gender inequality towards women in development, which is caused by patriarchal cultural factors, such as men are always placed above women. Sexual harassment in the work environment does not only refer to physical acts but to unwanted verbal behavior, which makes the victim feel uncomfortable. This study aims to determine the harassment that occurs in the work environment. Besides, this study also aims to show that sexual jokes during breaks, even in meetings or workspaces at a telecommunication company, are considered normal. This study used qualitative methods with five subjects. These subjects are female workers at a company in Surabaya. They were chosen based on their sexual harassment experience. The research used accidental sampling to determine the subject. This study used a semi-structured interview data collection method. This study is analyzed in the theory of power relations. The theory of power relations stands on two things: (1) the power spreads everywhere (dispersed) and cannot be localized, and (2) when there are structures and relationships between people, there is power. The result demonstrated in three founds. There are several sexual harassments that occurred in the work environment, the resistance of female workers, and the challenges they faced in carrying out their work. Sexual harassment that occurs is verbally based and disguised as a joke in the work environment.

Role of ultrasonography (USG) and color Doppler in the evaluation of thyroid nodules and its association with USG-guided FNAC - A cross-sectional study.

Thyroid diseases affect approximately 42 million people in India. The majority (15%-40%) of these cases remain asymptomatic and benign and warrant special investigations such as ultrasonography (USG) and fine-needle aspiration cytology (FNAC) for diagnosis. Early diagnosis and management of thyroid disorders determine the disease course in many patients. To determine the role of USG and color Doppler in the evaluation of thyroid nodules and its association with USG-guided FNAC. We did a cross-sectional analytical study over 2 years, where we recruited 108 patients with thyroid swelling attending the OPD. We used a semi-structured data collection proforma that captured information on sociodemographic details, clinical symptoms, physical examination, and all ne cessary laboratory investigations. All patients underwent USG, color Doppler, and FNAC as a part of the investigation of thyroid nodules. The diagnostic value of ultrasound and Doppler parameters was assessed in terms of sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy for detection of malignancy in comparison to FNAC. Approximately 155 nodules were identified from the selected 108 cases, and the prevalence of malignancy among the selected thyroid nodule patients was found to be 9.1%. We observed that malignant tumors were likely to be solitary with lobulated margins, >2 cm in size with <50% peripheral halo, with markedly hypoechoic, predominantly solid, with nodal involvement and extrathyroidal extension, microcalcifications, and central vascularity. We also observed that tumors that had USG characteristics of being taller than wide (91%), poorly defined margins (92%), marked hypoechoic (95%), and microcalcifications (96%) had the highest diagnostic accuracy in detecting malignancy when compared to FNAC. Thus, through our study findings, we conclude that USG and color Doppler can serve as vital tools for the evaluation of thyroid nodules with high sensitivity and specificity.

Phenomenological Analysis of Factors that Affect the Increase in the Willingness to Reengage Volunteer Rescuers and Saviors of the Red Crescent Society of the Islamic Republic of Iran.

The present study aimed to analyze the factors that influence the increase in the desire to re-engage volunteer rescuers and saviors of the Red Crescent Society of the Islamic Republic of Iran. This qualitative descriptive phenomenological study involved the participation of volunteers who had not volunteered in the Iranian Red Crescent Society (IRCS) for at least one year but expressed a willingness to be re-engaged. The semi-structured in-depth interview process and data collection continued until the theoretical saturation stage was reached. The collected data was analyzed using the interpretive approach and the 7-step Claesian method. The results show that several factors influence the increase in the desire to reengage volunteer rescuers and members of IRCS. These factors were categorized into 136 codes, 63 main codes, 20 clusters, 7 classes, and 3 themes, namely "organizational support and understanding," "work characteristics," and "organizational credibility." The results of the study indicate that each of the identified factors plays a significant role in the dynamics of the re-engagement process for rescuers and volunteer rescuers within the IRCS. The experiences of volunteer rescuers and members can be utilized to enhance the recruitment and retention of volunteer human resources within the IRCS.

A study on knowledge, perception, and acceptance of COVID-19 vaccines among adolescents attending Medical College, Kolkata

Background: This research attempted to understand adolescents aged 12 years and knowledge, perception, and acceptance of COVID-19 vaccines given their limited understanding of the virus and the need for vaccination. This is because the MOHFW introduced vaccines for adolescents aged 12 years and above in March 2022. Aim and Objectives: The study aimed to evaluate knowledge and perception of COVID-19 vaccines among adolescents aged 12–19 at the Adolescent Clinic of Medical College, Kolkata, and to determine their acceptance of the vaccines, as well as any relationships between the variables. Materials and Methods: An observational descriptive epidemiological study was conducted through a cross-sectional survey at the Adolescent Clinic of Medical College, Kolkata, for 2 months among adolescents attending the clinic aged 12–19 years through systematic random sampling with a sample size of 110. Interview of the study participants was done with a pre-designed, pre-tested semistructured data collection form. Results: 42.73% of participants did not have knowledge regarding the number of covid vaccines approved for their age. 51.82% had no knowledge regarding the approved gap between doses of COVID-19 vaccine for their age. 63.64% had no knowledge regarding the presence of contraindications for taking the vaccine. 49.09% of participants had no knowledge regarding digital application for vaccination registration. 65.45% had perception that the vaccine would protect them from COVID-19 infection. 55.44% had the perception that COVID-19 vaccines would control the pandemic. Seventy percent were vaccinated and 30% unvaccinated. Among vaccinated participants, 44.16% were partially vaccinated and 55.84% were completely vaccinated during the time of the study. Conclusion: Some of the participants had less knowledge regarding many aspects related to the COVID-19 vaccines. To avoid the persistence of the same, adequate and scientifically sound knowledge should have been imparted at both school and household levels.

A study on nicotine dependence among the adult tobacco users residing in the rural field practice area of Medical College, Kolkata

Background: Global adult tobacco survey-2 revealed that 42.4% of men and 14.2% of women reported currently smoking tobacco products. Every ninth adult in India (11.2%) uses khaini, the most popular tobacco product. Aim and Objectives: The objectives of this study were to estimate the level of nicotine dependence among the adult tobacco users residing in the rural field practice area of Medical College, Kolkata, and to examine the relationship between nicotine dependence and the sociodemographic characteristics. Materials and Methods: This study was an observational, descriptive type of epidemiological study performed among the adult tobacco users residing the rural field practice area of Medical College, Kolkata. A pre-designed, pre-tested semi-structured data collection form was used to collect information regarding Nicotine dependence using the Fagerström test for nicotine dependence and Fagerström test for nicotine dependence-smokeless tobacco. Results: Mean score of Nicotine dependence was 4.62 ± 2.98. Statistically significant relation was found between Nicotine dependence with the type of family, education of the participants, marital status, age of initiation of tobacco use, frequency of tobacco use, and duration of tobacco use of the study participants. Conclusion: Appropriate plan for tobacco cessation should be undertaken as per level of nicotine dependence. Interventions include counseling and pharmacotherapy. Local administration, school authority, NGOs, and healthcare workers need to be involved in conducting regular information, education, and communication activities.

Expectations from stuttering therapy: Qualitative content analysis of client's perspective in Kannada-speaking adults who stutter

PurposeThe current study was carried out to explore clients’ expectations from stuttering therapy using the qualitative content method in the Indian context. MethodTwenty-one Kannada-speaking adults who stutter between the age range of 18–33 years participated in the study. The procedure involved three phases, including the formulation of semi-structured interview questions, data collection and analysis. Inductive content analysis was used to determine the categories and sub-categories arising from the participants verbatim. The frequency count of emerging sub-categories was completed, and the data was interpreted. ResultsThe overall analysis of the data obtained from 21 participants generated three categories under the theme of expectations from speech therapy. The categories generated included beliefs and understanding of stuttering, stuttering and related behaviours, and goals and outcome of therapy. ConclusionSelecting personalised goals and techniques during therapy is necessary to improve client satisfaction. This study helps clinicians to understand the anticipatory beliefs of Kannada-speaking adults who stutter and educate them about achievable and realistic goals, leading to shared decision-making to ensure better quality of life and satisfaction in everyday speaking situations.

Personal Protective Equipment-Related Problems Experienced by Healthcare Workers, Solutions, and Recommendations: A Qualitative Study.

To understand the problems experienced by healthcare workers (HCWs) who used personal protective equipment (PPE) on their face during the COVID-19 pandemic, their interventions to prevent these problems, and their recommendations for improving the quality of PPE. This descriptive and qualitative study included HCWs (N = 29) from health institutions at different levels in Turkey. Researchers collected data using a semistructured data collection form (13 items) and in-depth individual interviews. Data were analyzed with descriptive statistics and qualitative inductive content analysis. Of the 29 participants, 15 (51.7%) were women, and 18 (62.1%) were nurses. Participants' answers regarding problems related to PPE use were grouped into four main categories, answers regarding the prevention of these problems were grouped into three main categories, and answers regarding improving the quality of PPE were grouped into three main categories. Skin concerns were the most commonly reported problems related to PPE, and interventions to prevent these problems primarily related to skin protection and care. Recommendations to improve the quality of PPE focused on using materials for masks and face shields that reduce pressure and friction; participants also suggested that face shields be produced in sterile and disposable packages. This research indicates that HCWs need support and they are able to create individual solutions for the problems with PPE that they experience. Skin-friendly PPE that ensures the safety and comfort of HCWs should be produced, and hospitals should develop policies for institutional use to prevent PPE injury.

Impact of fully online flipped classroom on academic achievement in undergraduate dental education: An experimental study.

The last two decades have seen a shift towards blended learning in education due to technological advancements. This study focuses on dental education, comparing two blended learning models -enriched virtual and fully online flipped classroom - in terms of academic achievement, aligning with the Association for Dental Education in Europe's competencies. The research was modelled in a quantitative design with a pre-post-test control group experimental design. The study was conducted at Ege University Faculty of Dentistry in Turkey for 4 weeks with the experimental (n = 44) and control (n = 39) groups divided into two groups by impartial assignment. To the experimental group, the theoretical part of the course was tried to be conveyed before each lesson with video lessons prepared with EdPuzzle containing reinforcement questions and a question set consisting of case questions. The practical learning objectives of the course were tried to be gained through the discussion of the previously presented case questions in the online synchronous course. As tools for collecting data, a unique academic achievement test, a course evaluation form and a semi-structured qualitative data collection form were used. It was seen that the flipped classroom model had a more positive effect on students' academic achievement than the enriched virtual classroom model. The general satisfaction levels of the participants regarding these two models are also higher in favour of the flipped classroom model. This study provides significant findings for educational institutions, policymakers and educators about the impact of fully online teaching methods on academic achievement. In this context, the flipped classroom method can be preferred both in cases where education is blocked and in dental education institutions that want to ensure digital transformation efficiently and partially remotely.

Clinico-Demographic Profile and Factors Affecting Duration of Hospital Stay Among Burn Patients in an Emergency Department of a Tertiary Care Center, South India: A Hospital-Based Cross-Sectional Study.

Background Burns continue to be a serious public health problem in India. It persists as an endemic disease in spite of implementing various preventive measures at the individual and community levels. Etiology and factors influencing burns are varied. There is a paucity of data regarding the clinico-demographic profile of burns disease, especially from emergency tertiary care settings in India. Objective To assess the proportion of burn patients having longer hospital stays (>1 week) and the influence of clinico-demographic factors associated with it among the burn patients presenting to the emergency department of a tertiary care institute in south India. Methodology An institution-based cross-sectional analytical study was conducted among burns patients attending the Emergency Medicine Department (EMD) of a tertiary care center between January 2017 and December 2017. Information on clinico-demographic profile and duration of hospital stay were captured using semi-structured data collection proforma. Results All the 327 burns injury patients who presented to our EMD during the study period were included. Among the 327 patients, 259 (79%) were admitted to the EMD. Among 259admitted patients, 142 (55%) patients were discharged home. Among these 142 patients, 106 (74.6%; 95%CI 66.8-81.2) had longer hospital stays (more than one week). Female gender and facial/inhalational burns were found to have an independent effect on the length of hospital stay even after adjusted analysis. Conclusion Length of hospital stay is independently influenced by female gender and facial/inhalational burns. This study also identified the need for better home safety, child-proofing, proper pre-hospital care, and dedicated burns units in the community.

Persepsi Mahasiswa terhadap Pemanfaatan Case Based Learning pada Mata Kuliah Wajib Umum

This study aims to explore the perceptions of students who take Compulsory Curriculum Courses (MKWK) courses on the application of Case Based Learning by MKWK lecturers at Tanjungpura University, especially in Indonesian Language, Islamic Religion, Catholicism, Citizenship Education, and Pancasila courses. This study applied a qualitative descriptive method with semi-structured interview data collection techniques. Using thematic data analysis techniques, this study succeeded in revealing students' perceptions of the application of the CBL learning model in MKWK lectures. They experienced a learning process in the form of affordability of knowledge towards skills, activeness in class, feelings of anxiety and a sense of empowerment, as well as professional understanding and understanding of community life. Overall students respond positively to the application of the CBL learning model.

Kasus Campur Tangan Orang Tua dalam Rumah Tangga Anak yang Menikah Usia Muda Di Desa Condong-Tasikmalaya: Suatu Tinjauan Hukum Islam

Marriage is something very sacred in Islam. In the Qur'an, Allah defines marriage as Mitsaqan Ghalidzan which means a strong agreement. In the process of marriage can not be separated from problems in the household. One of the problems that often occurs in the household is the intervention of parents. This study aims to determine: (1) the forms of parental intervention in the child's household, (2) a review of Islamic law on the forms of parental interference in the child's household. The data in this study are primary data obtained from interviews with resource persons who married at a young age and experienced parental intervention in their household. This type of research is a case study qualitative research. This research was conducted using semi-structured interview data collection techniques, so as to be able to develop answers from sources. The data analysis technique used is descriptive analysis. Based on the results of the analysis, by combining the results of interviews and theories, it is concluded that the view of Islamic law on parents who interfere in determining the place of residence for children's households is permissible

Correlation between Clinical, Operative and Histopathological Findings of Adnexal Masses – A Study of 50 Cases

Background: Adnexal mass has multidimensional diagnosis that may be related to fallopian tube, ovary etc. These masses may be benign, intermediate and malignant. The ability of clinical approach to diagnose the exact pathology of adnexal mass is still a question.&#x0D; Objective: To explore the correlation of clinical findings with operative and histopathological findings of adnexal masses.&#x0D; Method and Materials: A prospective and observational study was conducted in a tertiary hospital during the period of July 2015 to December 2015. 69 patients were selected according to purposive sampling and further scrutinized according to selection criteria, which were clinically diagnosed as adnexal mass. All the 50 patients undergone surgical intervention followed by histopathology. All the patients’ data were recorded through a semi-structured data collection sheet.&#x0D; Result: Study shows clinical and post-operative (per-operative + histopathology) findings of adnexal masses were 54% vs 50% for ovarian endometrioma, 24% vs 22% for benign ovarian tumor and 22% vs 26% for other adnexal masses respectively.&#x0D; Conclusion: Clinical findings with the help of sonography can guide effectively to the diagnosis of adnexal masses. However, per-operative and histopathological findings are required for the confirmation.&#x0D; Central Medical College Journal Vol 6 No 2 Jauly 2022 Page: 62-66

Effects of personality traits and leadership orientations of Turkish nursing students on their career adaptability: a cross-sectional study

PurposeThe purpose of this study is to evaluate the effects of nursing students' personality traits and leadership orientations on their career adaptability.Design/methodology/approachA total of 322 nursing students were enrolled in this cross-sectional study. The methods used to collect data included the semi-structured data collection form, five factors personality scale, leadership orientation scale and career adaptation-abilities scale.FindingsThe regression model created to determine the effects of personality traits and leadership orientations on the students’ career adaptability proved to be highly insightful. The students' leadership orientations have a statistically significant effect on their career adaptability score, with an explanatory coefficient of 43.1% and personality traits accounted for 18% of the career adaptability.Originality/valueThe results of this study indicated that leadership orientations and personality traits of the students exerted effects on the career adaptability of nursing students. Developing the leadership orientations of nursing students and being aware of their personality traits will contribute positively to the development of their career adaptability and strengthen the health system.

Framework and Thematic Analysis of Historical After Action Review Reports from the Australian Capital Territory Emergency Services Agency

Introduction:Emergency services organizations routinely undertake internal quality improvement activities following training and operational activities. One form of a quality improvement activity is the After Action Review (AAR). An AAR is a facilitator-led post-event review where data is collected from individuals and groups of individuals using either surveys, focus group-like meetings, or individual interviews. Data is collected using a semi-structured data collection tool which is usually customized to the specific tasks being reviewed and the priorities and goals of the organization. The quality of AARs has been noted to vary significantly across organizations with reporting biases and differences between exercise or real event AARs and biases introduced by utilization of internal rather than external evaluators, and limited justification for data selection and collection rationales. The Australian Capital Territory Emergency Services Agency (ACT ESA) has identified that interoperability and integration between internal ACT ESA sub-agencies and externally with other agencies is a key problem. The aim of this study was to identify specific areas of consistent interoperability concern through the examination of historical AARs.Method:In this qualitative study a Framework Analysis of historical AAR text documents was conducted, following the standard five step process. This was followed by detailed thematic analysis in aggregate and examined longitudinally, with emergent themes undergoing further analysis.Results:AARs relating to major emergency response and training activities 2016-2022 were examined. There was a substantial variation in quality, level of detail, completeness and structure across the different AAR documents. Consistent themes emerging from the data highlighted concerns regarding inter-agency culture, uncertainty when conducting joint activities and its impact on decision making, logistics concerns, resourcing and breakdown of shared understanding and communication between teams.Conclusion:Despite a centralized command structure, historical AAR analysis shows ACT ESA has had persistent operationally impacting interoperability and integration problems within the organization and with external agencies.