Mass casualty education for undergraduate nursing students in Australia

Effectiveness of a Fire Disaster PFA Simulation Game: A Single-Blinded Trial

OBJECTIVE

As societies become more complex, disasters are increasing in frequency and magnitude. To respond to the psychological problems that may arise in such situations, it is necessary to develop the psychological first aid (PFA) training program that is more engaging for disaster relief workers and less limited in time and space. This study aimed to investigate the effectiveness of a web-based PFA simulation game for disaster relief workers to provide to fire disaster victims.

METHODS

This was a non-randomized controlled experimental study with 30 participants in the experimental and control groups. The experimental group learned through the web-based PFA simulation game developed in this study, and the control group was provided with written educational materials regarding general disaster. The effects of time between groups and interaction between groups were tested.

RESULTS

Compared to the control group, the experimental group showed significant effects on core competencies in disaster response, self-efficacy, and problem-solving process, and the persistence of the effects was also significantly different.

CONCLUSION

The web-based PFA simulation game was found to be effective in improving core competencies in disaster response, self-efficacy, and problem-solving process of disaster relief workers. These results suggest that simulation games can be an effective learning method for learning PFA for disaster relief workers. Since it is difficult to learn through direct participation in disaster situations, a web-based simulation game may be a more effective way to improve and maintain the competence of PFA.

Development and Effect of a Simulation-Based Disaster Nursing Education Program for Nursing Students Using Standardized Patients

BACKGROUND

Disaster nursing deploys professional nursing knowledge and skills systematically to reduce disaster-related risks to life and health. Disaster nursing education requires providing simulations using standardized patients.

PURPOSE

The purpose of this study was to develop, based on the International Council of Nurses' Framework of Disaster Nursing Competencies, a simulation-based disaster nursing education program for nursing students that employed standardized patients.

METHODS

A nonequivalent, control group, pretest-and-posttest design was used. Participants were senior nursing students from two universities, with 70 assigned to the experimental group, 35 assigned to the comparison group, and 35 assigned to the control group. Data were collected from January 25 to April 3, 2019. The simulation-based disaster nursing education program consisted of a 60-minute theoretical lecture on disaster management and two scenarios. The effectiveness of the simulation-based disaster nursing education program was measured using levels of disaster nursing competencies, disaster triage competency, disaster preparedness, critical thinking disposition, and confidence in disaster nursing.

RESULTS

Significant differences were found between the experimental and comparison/control groups in terms of disaster nursing competencies ( F = 20.06, p < .001), nursing triage ( F = 17.35, p < .001), disaster preparedness ( F = 60.37, p < .001), critical thinking disposition ( F = 19.63, p < .001), and confidence in disaster nursing ( F = 20.24, p < .001).

CONCLUSIONS

Simulation-based disaster nursing education programs using standardized patients can be useful in disaster nursing education. They can contribute to future changes in nursing education and practice by improving the disaster nursing capabilities and preparedness of students.

Health Care Simulation as a Training Tool for Epidemic Management: A Systematic Review

SUMMARY STATEMENT

The objective of this research was to identify and review studies that have evaluated the impact of simulation-based training on health care professionals during epidemics.All studies in health care simulation-based training published during the last 5 epidemics with a global impact (SARS-CoV, H1N1, MERS, Ebola, SARS-CoV-2; through July 2021) were selected from a systematic search of PUBMED, EMBASE, and key journals.The search strategy identified 274 studies; 148 met the inclusion criteria and were included. Most of the studies were developed in response to SARS-CoV-2 infection (n = 117, 79.1%), used a descriptive approach (n = 54, 36.5%), and were used to train technical skills (n = 82, 55.4%).This review demonstrates a growing interest in publications related to health care simulation and epidemics. Most of the literature is marked by limited study designs and outcome measurements, although there is a trend toward the use of more refined methodologies in the most recent publications. Further research should seek the best evidence-based instructional strategies to design training programs in preparation for future outbreaks.

Design, Implement, and Evaluate a Short-term Blended Training Program on Nursing Students' Disaster Response Self-efficacy in Iran

OBJECTIVE

This study aimed to design, implement, and evaluate a training program on nursing students' disaster response self-efficacy.

METHODS

This study was conducted using a pre-test, post-test, and follow up design. A total of 92 nursing students participated in the study. The developed program was implemented both theoretically (online) and practically (in person). Nursing students' disaster response self-efficacy was measured using the Disaster Response Self-Efficacy Scale that was filled out 1 week before the intervention, and 2 months after the intervention by the students. The students' satisfaction with the program and their views on the program were also surveyed.

RESULTS

Overall score and all items score had significant improvement in short-, and long-term except in 1 item (item 22). The highest increase in score was related to practical items and referral for psychiatric treatment (items 7, 8, 10, and 18) and the lowest increase was related to communication and ethical skill items (items 20, 21, and 22). It is possible that the students had a higher perception of communication and ethical skills even before the training. Most of the students were satisfied with the program.

CONCLUSIONS

A training intervention that can provide theoretical materials online, as well as face-to-face practical programs, can increase nursing students' disaster response self-efficacy.

Sustainable disaster risk reduction training model for nurses: A descriptive qualitative approach

AIM

To develop a sustainable disaster risk reduction training model for nurses and identify its key features.

BACKGROUND

Available disaster nursing education and training programmes have focused on improving the competency of nurses in all four disaster phases, including mitigation, preparedness, response and recovery. However, a limited programme is available that integrates nurses' competencies for all four disaster phases within one training system. Moreover, no training system exists to ensure the sustainability of the programme to reduce disaster risks.

METHODS

Three methods were used to develop the model: (1) literature review, (2) focus group discussion, and (3) expert panel. Seven participants were involved in the focus group discussion, while five joined the expert panel discussion. Different criteria of participants were invited for focus groups and expert panel discussions. The data were collected from August to September, 2022. A descriptive qualitative approach was used to analyse the data.

RESULTS

The model is a 3-level training consisting of (1) master of trainer training (MOT), (2) training of trainer (TOT), and (3) training of providers (TOP). Professional governance is a key chain that integrates and connects these 3-level training. The model has six pillars, including (1) leadership, (2) resources, (3) intervention, (4) cultural and spiritual approach, (5) motivation, and (6) policy alignment.

CONCLUSIONS

Sustainable disaster risk reduction training model provides a potential conceptual framework that may assist the continuity of educational intervention related to disaster nursing training.

Developing pre-registration nurses' resilience to mass casualty situations through the pedagogy of simulation

Simulation has become a core component of nursing curricular worldwide. Within a three-year, pre-registration degree typically students would not be exposed to disaster type situations and it was believed that a well-coordinated simulation exercise could replicate this. It was hoped that the simulation would require students to think quickly on their feet and transfer acquired skills. Worldwide disasters including the current novel coronavirus have, heightened the need for well-prepared resilient health professionals capable of responding to many different types of emergencies including mass casualty situations. The simulated event involved 80 adult field student nurses, 19 probationer police officers, 6 photojournalism students, 2 Welsh Ambulance paramedics, 5 staff from 203 Field Hospital, 2 St John Cymru Wales Officers, 1 community first responder and 6 Fire and Rescue personnel. All these individuals came together to undertake a simulated emergency response to a mass casualty incident. Behaviours and clinical skills were observed throughout the event along with interprofessional interactions.

Determinants of Nurse Preparedness in Disaster Management: A Cross-Sectional Study Among the Community Health Nurses in Coastal Areas

Purpose

Because Indonesia has a high risk of natural disasters, nurse preparedness is necessary to reduce and prevent deaths in the aftermath of such disasters. The aim of this study was to determine the factors associated with nurse preparedness in disaster management among a sample of community health nurses in coastal areas.

Patients and Methods

A cross-sectional study was undertaken from May to August 2020. The sample consisted of 142 nurses who worked at six Public Health Centers in Pangandaran, West Java, Indonesia. Participants were recruited using the total sampling technique. The data were collected using the Emergency Preparedness Information Questionnaire and analyzed using Chi-Square and binary logistic regression.

Results

Of the 142 respondents, 54.24% had a high level of preparedness. Multivariate analysis showed that nurses with higher levels of preparedness had worked between 6 and 10 years (adjusted odds ratio (AOR): 12.755, 95% confidence interval (CI): 2.653-61.314). Respondents who lacked disaster training were less likely to have a high level of disaster preparedness (AOR: 4.631, 95% CI: 1.604-13.367). Respondents who had never served as disaster volunteers were also less likely to have disaster preparedness (AOR: 0.18, 95% CI: 0.053-0.616).

Conclusion

With nearly half of the respondents (45.77%) having a low level of disaster preparedness, this topic needs more attention from the government and healthcare workers. Several actions are needed to improve community nurses' disaster preparedness: providing them with routine disaster-related training, encouraging them to serve as volunteers in various disaster conditions, and offering them useful disaster-related information.

Development of disaster nursing education and training programs in the past 20 years (2000-2019): A systematic review

BACKGROUND

Nurses play a pivotal role in disaster management across the globe. With the call for all nurses to be prepared for disasters, disaster nursing education and training programs have expanded globally. However, a clear picture of the development and coverage of disaster nursing education and training programs is lacking.

OBJECTIVES

This study aimed to establish an overall picture of the development of disaster nursing education and training programs in the last 20 years, outline the contents included, approaches adopted and outcomes reported.

METHODS

A systematic search for relevant literature published between January 2000 to December 2019 was conducted using electronic databases including the CINAHL, MEDLINE, PubMed, Web of Science, and Scopus with the keywords on disaster nursing education and training.

FINDINGS

A total of 75 eligible studies were identified from 3395 potentially relevant articles. The numbers of disaster nursing education and training programs increased gradually over the past 20 years. They were offered in various countries with an unbalanced geographical distribution. Most of the existing programs focused on disaster preparedness and response, especially on the skills of triage during disaster response, instead of addressing the full spectrum of disaster management that included mitigation, preparedness, response, and recovery phases. Multiple approaches and technologies were adopted, including competency-based, all-hazard, inter-professional, flipped classroom, simulation, tabletop exercises, and virtual reality ones. Nearly half of the included programs adopted a pre- and post-test evaluation to examine the outcomes of learning and all of the programs reported significant increases in nursing professionals' knowledge and skills of related content on disaster management covered in the training programs.

CONCLUSIONS

This review provides nurse leaders, educators and researchers in nursing with an understanding of the state-of-art of the existing disaster nursing education and training programs. More disaster nursing research are necessary to enhance the knowledge, skills and readiness of the nursing professionals for disaster management in meeting global disaster challenges.

Motivations and Career Decisions in Occupational Therapy Course: A Qualitative Inquiry of Asia-Pacific International Students in Australia

PURPOSE

This study aims to understand the motivations of academic voyage and post-graduation career decisions of occupational therapy international students in Australia. The following two research questions guided this study: why do international students choose to study in Australia instead of ones in their own countries? And why do international students choose to study occupational therapy program(s) in Australia instead of ones in their own countries?

PATIENTS AND METHODS

A qualitative design with phenomenology was employed to recruit 20 participants for the data collection procedures, including interview sessions, focus group activity, and member checking interview. The participants were studying one of the accredited occupational therapy programs in Australia as international students.

RESULTS

Six themes were yielded. All participants expressed that due to the excellent education, reasonable tuition fees and living standard, and the positive career opportunities, almost all expressed their positive experiences of their Australian voyage as international students and tended to stay in Australia after they gained the registration career development. More importantly, the notions of contribution to Australian communities are captured as many considered Australia as an important place in their lives.

CONCLUSION

University leaders may wish to take action in upgrading their international students' services, particularly career development services. Government agencies may take this study as a blueprint for upgrading the current regulations for international students, particularly in establishing a targeted immigration visa for recent graduates who want to establish their own businesses or invest in Australia.

Obstetric simulation for a pandemic

OBJECTIVE

In the middle of the COVID-19 pandemic, guidelines and recommendations are rapidly evolving. Providers strive to provide safe high-quality care for their patients in the already high-risk specialty of Obstetrics while also considering the risk that this virus adds to their patients and themselves. From other pandemics, evidence exists that simulation is the most effective way to prepare teams, build understanding and confidence, and increase patient and provider safety.

FINDING

Practicing in-situ multidisciplinary simulations in the hospital setting has illustrated key opportunities for improvement that should be considered when caring for a patient with possible COVID-19.

CONCLUSION

In the current COVID-19 pandemic, simulating obstetrical patient care from presentation to the hospital triage through postpartum care can prepare teams for even the most complicated patients while increasing their ability to protect themselves and their patients.

Interprofessional education in the U.S. military: harnessing simulation for team readiness

Research into military interprofessional healthcare teams (MIHTs) is rarely reported in the interprofessional literature. MIHTs must effectively collaborate in the low resource and chaotic contexts of humanitarian and combat deployments; however, we have yet to study how MIHTs learn to work in these contexts. To address this gap, we investigated military interprofessional education (MIPE). Using an ethnographic approach, we conducted non-participant observations (n = 30.5 hours) of a specific platoon (n = 32 participants) during an MIPE simulation called Operation Bushmaster - a large-scale immersive simulation of battlefield deployment. Findings indicated three aspects of MIPE: (1) a culture where flailing isn't failing; (2) the importance of followership; and (3) an interprofessional respect fostered by role adoption. Considering these findings through Dweck's fixed vs growth mind-set conceptualization, we suggest that - although unusual when compared with traditional IPE - MIPE's teaching and learning methods provide developmental opportunities for team members. We also suggest why Dweck's mind-set conceptualizations could be usefully extended from an individual-focus to also include a collaborative-team-focus. We contend that the findings developed from this research could be transferred to civilian contexts so that the lessons learned by those who serve on the war front could inform those who serve at home.

Effects of a simulation-based education program for nursing students responding to mass casualty incidents: A pre-post intervention study

BACKGROUND

The necessity of disaster preparedness among nursing students has been continuously emphasized.

OBJECTIVES

This study aimed to verify the effectiveness of a simulation-based education program for nursing students responding to mass casualty incidents (MCI) from the perspectives of triage accuracy, response attitude, teamwork, and program satisfaction.

DESIGN

This study employed a pre-post intervention design.

SETTINGS

Disaster Simulation Lab and a debriefing room in the University Nursing Simulation Center in South Korea.

PARTICIPANTS

The participants were 34 graduating nursing students attending a university in Seoul.

METHODS

The program consisted of lectures on disaster nursing, group discussions, practice, debriefings, and a pre- and post-test, conducted over 180 min. Simulation-based training was conducted using the Emergo Train System®. The simulation environment comprised pre-hospital and hospital sections, with videos displayed on a large screen and sound effects played on loudspeakers.

RESULTS

Participants were likely to undertriage. There was a significant increase in positive attitudes after the intervention (p < .001). Self-reported teamwork was high, and among its subfactors, "leadership and team coordination" scored the highest. Participants' satisfaction with the program was high (4.5/5.0).

CONCLUSIONS

The simulation-based MCI program was effective in boosting positive attitudes among nursing students. In future, comparative studies including control groups and different instructional methods should be conducted. A patient bank should also be developed considering participants' knowledge levels and the circumstances of each country.