In this paper, we share the theories that guided the design of an interprofessional education course on Climate Change and Public Health Preparedness and how the course supported students’ professional interest and action competence as they move through their education and into their professional work in the context of our unfolding climate crisis. The course was guided by the public health emergency preparedness domains and was built to allow for students to explore applications of the content for themselves and their own profession. We designed the learning activities to support personal and professional interest development and help students move into perceived and demonstrated action competence. For the evaluation of our course, we asked the following research questions: What kinds of personal and professional commitments to action did students propose by the end of the course? Did these vary in depth and specificity and by the number of credits they enrolled in? In what ways did students develop personal and professional action competence over the course? Finally, how did they show personal, professional, and collective agency related to the course content on adaptation, preparedness, and mitigation of the health impacts from climate change? Using qualitative analysis guided by action competence and interest development theories, we coded student writing from course assignments. We also conducted comparative statistical analysis to assess differential impacts for students who enrolled for one versus three credits. The results show that this course design supported students’ progression of knowledge and perceived ability in specific individual and professional collective actions to reduce the health impacts of climate change.

Background: New graduate registered nurse (RN) competencies are complex and difficult to measure. Psychometrically sound tools are needed to evaluate competencies for nurses participating in nurse residencies. Purpose: Project aims were to develop an item pool for a tool to measure new graduate RN competencies for the Veterans Health Administration RN Transition-to-Practice Residency Program; validate item pool content; and use consensus methods to improve item pool content validity. Methods: A sequential, mixed-methods design was used. Item pool creation, content validation, and revisions included a collaborative process with the evaluation team, operational stakeholders, and subject matter experts (SMEs). Results: Inclusion of SMEs in item development enhanced item pool content validity to measure nurse competency. Stakeholder feedback ensured programmatic logistical and evaluation concerns were met. Conclusions: Engaging SMEs in conceptualization, item development, and aligning existing standards enhanced item pool content validity to measure nurse competencies for new graduate RNs.

Background: First-year registered nurses (RNs) have the highest turnover rate of all hospital-based RNs, and often face various challenges during their transition to practice. RN transition-to-practice programs (RNTTPs) can potentially alleviate critical RN staffing shortages and support the development of the nursing workforce’s future. Objectives: To (1) capture and critically appraise the landscape of existing synthesis efforts on RNTTPs and (2) synthesize included reviews’ findings to assess the potential benefits of RNTTPs for organizational, nursing, and patient outcomes and descriptions of RNTTPs. Research Design: We conducted a systematic review of reviews to identify published evidence syntheses evaluating RNTTPs for newly graduated RNs. Results: Nineteen evidence reviews were included. Despite having similar scopes, there was little overlap in their included literature, and no single review included the majority of identified original research studies. Two reviews with high methodological rigor and high topical relevance emphasized the methodological issues in the available evidence, which used a mix of methodological approaches, and indicated a connection between RNTTPs and increased critical thinking, competency, and retention. Published reviews suggest program lengths between 6 and 12 months, but evidence for optimal program length was inconclusive or unsupported. Conclusions: RNTTPs that have been piloted and implemented in recent years deserve more rigorous evaluation to answer critical questions about their role in organizational, nurse, and patient outcomes. However, before best practices can be ascertained to support scaling and sustainment, their potential benefits must first be verified.

People impacted by disasters may have adverse non-communicable disease health effects associated with the disaster. This research examined the independent and joint impacts of federally declared disasters on the diagnosis of hypertension (HTN), diabetes (DM), anxiety, and medication changes 6 months before and after a disaster. Patients seen in zip codes that received a federal disaster declaration for Hurricanes Gustave or Ike in 2008 and who had electronic health records captured by MarketScan^® were analyzed. The analysis included patients seen 6 months before or after Hurricanes Gustav and Ike in 2008 and who were diagnosed with HTN, DM, or anxiety. There was a statistically significant association between post-disaster and diagnosis of hypertension, X² (1, n = 19,328) = 3.985, p = 0.04. There was no association post-disaster and diabetes X² (1, n = 19,328) = 0.778, p = 0.378 or anxiety, X² (1, n = 19,328) = 0.017, p = 0.898. The research showed that there was a change in the diagnosis of HTN after a disaster. Changes in HTN are an additional important consideration for clinicians in disaster-prone areas. Data about non-communicable diseases help healthcare disaster planners to include primary care needs and providers in the plans to prevent the long-term health impacts of disasters and expedite recovery efforts.

Background/purpose: The Public Health Crisis Conceptual Model was developed to identify and address healthcare and human services needs related to a disaster. The purpose of this study was to historically apply this model to the counties and populations most affected by the first nuclear test in 1945, with a focus on community and local priorities, and to further describe this model and validate its usefulness. If the model had been applied in 1945, what might have been different with respect to research, epidemiological studies, and reparations? Methods: A historical, descriptive case study approach was used, with a focus on community and local priorities. Results: While it was deemed necessary to maintain secrecy surrounding the Trinity test during wartime efforts, scientists and the military knew of the potential dangers of radioactive fallout. However, they neglected to inform exposed New Mexicans after the information about the nature of the bombings of Hiroshima and Nagasaki had been made public. Conclusions: Research and epidemiological studies could have been implemented years before they were. Resources were not and have not been distributed equitably to those exposed to fallout from the Trinity test site. Using the Public Health Crisis Conceptual Model will help ensure that community and local priorities are an integral component of future disaster-related research.