Page 105 - JSOM Summer 2024

An Ongoing Series

Social Determinant of Unconventional Resilience

Tactical Engagement with Impression Management

Erika “Ann” Jeschke, PhD *; Jared Wyma-Bradley, MD ;
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Jay Baker, MDiv ; John Dorsch, DO ; Sarah L. Huffman, PhD 5
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ABSTRACT
Building upon our operational model, we will discuss find- impression management and the perception of competence; 2)
ings from our ethnographic study titled “The Impact of Cata- define the social determinant of impression management as ex-
strophic Injury Exposure on Resilience in Special Operations trapolated from qualitative data, as well as use qualitative data
Surgical Teams” to establish that impression management to thematize various types of impression management that op-
allows Special Operation Forces (SOF) medics to navigate timize or degrade practical performance; and 3) relate tactical
implicit social status symbols to either degrade or optimize engagement with impression to our metaphor of bag sets. We
performance. We will use qualitative quotes to explore how conclude by gesturing to the importance of impression man-
Special Operations Surgical Team (SOST) medics engage in agement in orienting SOF medics’ proprioception and kines-
impression management to establish individual, team, and/or thesia in the SOF performance space.
organizational competency to deal with ambiguity. To achieve
our goals, we will: 1) provide a background on impression The findings in this paper are taken from the study “The Im-
management and perception of competency; 2) define the so- pact of Catastrophic Injury Exposure on Resilience in Special
cial determinant of impression management extrapolated from Operations Surgical Teams.” The Air Force Research Labora-
qualitative data as well as use qualitative data to thematize tory’s Institutional Review Board approved the study as an
various types of impression management; and 3) relate tactical exempt protocol. To capture intricacies within the cultural
engagement with impression to our metaphor of bag sets. We ethos of SOST, data were collected through individual, open-
conclude by gesturing to the importance of impression man- ended interviews in which four participants from each clinical
agement in orienting SOF medics’ proprioception and kines- specialty represented in SOST were recruited to share their
thesia in the SOF performance space. individual stories. Additionally, focus groups and field obser-
vations were performed across the two SOST detachments
Keywords: unconventional resilience; social determinant; tac- to capture team and organizational dynamics. The standard
tical; impression management; practical performance; SOF practice of removing all identifying names, genders, locations,
medic medical specialties, and military ranks was followed. To fur-
ther protect the privacy and confidentiality of all participants,
themes described herein do not reflect individual commentar-
ies. All quotes are constructed of various SOST medic narra-
Introduction
tives that code under the theme discussed. As such, quotes are
In this paper, we build upon our strategic framework and op- an aggregate analysis, which not only draws a holistic blue-
erational model to explain tactical engagement within our new print of the entire data set but also represents the co-ed com-
characterization of unconventional resilience. Findings from position of the organization.
our ethnographic study entitled “The Impact of Catastrophic
Injury Exposure on Resilience in Special Operations Surgical While data in this and subsequent papers focus specifically on
Teams,” established culture as an integral aspect of SOF medic SOST, we believe our findings will have strong resonance and
practical performance. Specifically, social symbols, values, applicability to all SOF medics because our study focused on
norms, and attitudes coalesce into five social determinants that the phenomenon of catastrophic injury exposure in austere en-
orient SOF medics’ proprioception and kinesthesia in the SOF vironments. Both the phenomenon and context are fundamen-
performance space. This fifth paper will use qualitative quotes tal to the SOF medic’s practical performance. Our approach
to interpret the social determinant of impression management. to tactical engagement may be disruptive because it values the
To achieve our goals, we will: 1) provide an introduction to SOF medic’s practical skills as the most important agent of
Correspondence to: stlamazonia@gmail.com
1 Dr. Erika “Ann” Jeschke is affiliated with the SURVICE Engineering, Becamp, MD. Jared Wyma-Bradley is the Director of Spiritual Care at
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Northern Virginia Mental Health Institute, Washington, D.C. Col Jay Baker is affiliated with the U.S. Army Corps, Joint Base Lewis-McChord,
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WA. Col (Ret) John Dorsch is affiliated with the University of North Carolina Southeastern, Lumberton, NC. Lt Col Sarah L. Huffman is affil-
iated with the US Air Force School of Aerospace Medicine-Air Force Research Lab, Wright-Patterson Air Force Base, OH.
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