Suicide and suicide attempts are significant issues for military, Veterans Affairs (VA), and civilian healthcare systems. The lack of uniform terms related to self-directed violence (SDV) has inhibited epidemiological surveillance efforts, limited the generalizability of empirical studies of suicide and non-lethal forms of SDV, and complicated the implementation of evidence-based assessment and treatment strategies for individuals with suicidal thoughts and/or behaviors. The Department of Veterans Affairs recently adopted the Centers for Disease Control and Prevention's (CDC) SDV Classification System (SDVCS). This paper describes an implementation study of the SDVCS in two VA Medical Centers. The Veterans Integrated Service Network (VISN) 19 Mental Illness Research, Education and Clinical Center (MIRECC) training program for the SDVCS, including the SDVCS Clinical Tool (CT), will be discussed. Although preliminary data suggest that the CT and SDVCS are generally perceived as being acceptable and useful, further work will likely be required to facilitate widespread adoption. Potential next steps in this process are presented.

Twenty-two parents, representing 15 GLBTQ-parent families living in nonmetropolitan communities in Illinois, were interviewed about their interactions with others in community settings. A total of 345 interactions were coded by sexual orientation salience (no, yes) and setting (private, public, organizational). Roughly half of the interactions (N = 156, 45%) were those in which parents said that their sexual orientation did not matter; nonsalience was more likely to occur in private or organizational settings rather than public. Regarding salience, parents described a slightly higher proportion of interactions in which their sexual orientation did matter (N = 189, 55%). Of these, salience was most likely to occur in organizational settings rather than public or private. Parents most commonly described salience that occurred in organizational settings as negative rather than positive. Regarding desired resources, parents prioritized support and socialization for their children rather than for themselves, but they desired resources that clearly identified their children as having GLBTQ parents (i.e., resources where parental sexual orientation was salient). These findings suggest a strong recommendation for improving organizational policies related to education, health care, employment, and family services so that GLBTQ parents and their children are openly acknowledged by staff without negative overtones.

Background: Teaching students how to create assessments, such as those involving multiplechoice questions (MCQs), has the potential to be a useful active learning strategy. In order to optimize students' learning, it is essential to understand how they engage with such activities. Objective: To explore medical students' perceptions of how completing rigorous MCQ training and subsequently writing MCQs affects their learning. Design: In this mixed methods exploratory qualitative study, eighteen second-year medical students, trained in MCQ-writing best practices, collaboratively generated a question bank. Subsequently, the authors conducted focus groups with eight students to probe impressions of the process and the effect on learning. Responses partially informed a survey consisting of open-ended and Likert rating scale questions that the remaining ten students completed. Focus group and survey data from the eighteen participants were iteratively coded and categorized into themes related to perceptions of training and of collaborative MCQ writing. Results: Medical students felt that training in MCQ construction affected their appreciation for MCQ examinations and their test-taking strategy. They perceived that writing MCQs required more problem-solving and content-integration compared to their preferred study strategies. Specifically, generating plausible distractors required the most critical reasoning to make subtle distinctions between diagnoses and treatments. Additionally, collaborating with other students was beneficial in providing exposure to different learning and questionwriting approaches. Conclusions: Completing MCQ-writing training increases appreciation for MCQ assessments. Writing MCQs requires medical students to make conceptual connections, distinguish between diagnostic and therapeutic options, and learn from colleagues, but requires extensive time and knowledge base.

Workplace climate matters significantly for lesbian, gay, bisexual, queer, or other sexual minority (LGBQ) employees, given that the presence of workplace hostility or support can affect well-being. The Lesbian, Gay, Bisexual, and Transgender Climate Inventory (LGBTCI) is a measure of workplace climate for LGBQ individuals, intended to capture the full range of workplace climate from hostility to support. The purpose of this article is to provide evidence that the recommended scoring approach of the LGBTCI needs to be reconsidered. We used latent class analysis to estimate classes of work-related experiences in our sample of 442 LGBQ employees who completed the LGBTCI. A four-class solution fit the data best. Characteristics of each class were identified and consequently labeled: supportive work climate, tolerant work climate, ambiguous work climate, and hostile work climate. Findings suggest that a more accurate measure of workplace climate would include independent scales for support and hostility.

Minority stress theory posits that stress processes specific to a sexual minority orientation can affect the psychological health and well-being of lesbian, gay, bisexual, or queer-identified (LGBQ)