Proposals for Aligning Disaster Health Competency Models

Characterizing the Current State of Training Courses Available to US Disaster Professionals

Objective:

The objective of this study is to characterize US-based disaster training courses available to disaster response and disaster health professionals. Its purpose is to better inform policies and decision-making regarding workforce and professional development to improve performance.

Methods:

Courses were identified from 4 inventories of courses: (1) National Library of Medicine Disaster Lit database; (2) TRAIN National Learning Network; (3) Federal Emergency Management Agency (FEMA) National Preparedness Course Catalog; and (4) Preparedness and Emergency Response Learning Centers. An online search used 30 disaster-related key words. Data included the course title, description, target audience, and delivery modality. Levels of learning, target capability, and function were categorized by 3 expert reviewers. Descriptive statistics were used.

Results:

There were 3662 trainings: 2380 (65%) for professionals (53% for public health); 83% of the courses were distance learning, with 16% via classroom. Half of all trainings focused on 3 of 37 disaster capabilities and 38% of them were related to chemical, biological, radiological, nuclear, and explosives (CBRNE). The educational approach was knowledge-based for all courses and 99.6% imparted only lower levels of learning.

Conclusion:

Despite thousands of courses available, there remain significant gaps in target audience, subject matter content, educational approaches, and delivery modalities, particularly for health and public health professionals.

Preparing Health Care Professionals for Public Health Disaster Management

Introduction:

Disasters are a major challenge for public health because of damage caused by death, injury, or illness that exceeds health services’ ability to respond. Health professionals and students require awareness and understanding of particular aspects of disaster planning, mitigation, response, or recovery. In Brazil, despite the increase in the number and intensity of disasters, there is no formal acceptance regarding the need to integrate disaster content into curriculum guidelines (1)

Aim:

To develop and test referential and models for disaster management health professional education.

Methods:

Competence-based education has been proposed. The methodology adopted was developed by the Association (2) and adapted to be used in the Brazilian context. An initial literature search was performed in MEDLINE via PubMed, Google Scholar, Lilacs, and Scielo databases using disaster and competencies as descriptors.

Results:

Articles and documents in Portuguese, Spanish, and English were identified for: public health (21), nursing (20), multi-professional (16), psychology (4), pharmacy (4), dentistry (2), medicine (1), veterinary (2), and nutrition (1). Data were organized according to a proposal from the literature (3) Selection of benchmarks for the preparation of education models identified 27 referential, three of them developed in Brazil.

Discussion:

Application and evaluation of the methodology developed with undergraduate students of the Federal University of Rio Grande do Sul consisted of an initiative to prepare health care professionals for disaster management.

Education and Training of Emergency Medical Teams: Recommendations for a Global Operational Learning Framework

An increasing number of international emergency medical teams are deployed to assist disaster-affected populations worldwide. Since Haiti earthquake those teams have been criticised for ill adapted care, lack of preparedness in addition to not coordinating with the affected country healthcare system. The Emergency Medical Teams (EMTs) initiative, as part of the Word Health Organization’s Global Health Emergency Workforce program, aims to address these shortcomings by improved EMT coordination, and mechanisms to ensure quality and accountability of national and international EMTs. An essential component to reach this goal is appropriate education and training. Multiple disaster education and training programs are available. However, most are centred on individuals’ professional development rather than on the EMTs operational performance. Moreover, no common overarching or standardised training frameworks exist. In this report, an expert panel review and discuss the current approaches to disaster education and training and propose a three-step operational learning framework that could be used for EMTs globally. The proposed framework includes the following steps: 1) ensure professional competence and license to practice, 2) support adaptation of technical and non-technical professional capacities into the low-resource and emergency context and 3) prepare for an effective team performance in the field. A combination of training methodologies is also recommended, including individual theory based education, immersive simulations and team training. Agreed curriculum and open access training materials for EMTs need to be further developed, ideally through collaborative efforts between WHO, operational EMT organizations, universities, professional bodies and training agencies.  Keywords: disasters; education; emergencies; global health; learning

Development of an assessment instrument to evaluate performance of the skill of decontamination

BACKGROUND AND PURPOSE

Nurses must competently demonstrate psychomotor skills. Few reliable and valid instruments are available for psychomotor evaluation for disaster skills, including the skill of decontamination.

OBJECTIVES

The purpose of this study was to develop and refine an instrument to measure the skill of decontamination.

DESIGN

A seven step instrument development design was implemented that included content validity and reliability as well as inter-rater reliability analysis.

SETTING AND PARTICIPANTS

A convenience sample of approximately 140 participants was drawn from two colleges of nursing at two large academic universities. The sample included senior nursing students in either their community or final practicum nursing course.

METHODS

Based on a sample of 140 students who participated in a decontamination training experience using virtual reality simulation, a seven step established process for assessment of reliability and validity was implemented to develop a checklist for the skill of decontamination.

RESULTS

The final instrument statistics: Content Validity Index for the overall instrument score was 0.94, Internal consistency coefficient=0.607(KR-20) and Inter-rater reliability=0.9114.

CONCLUSIONS

This instrument provides a reliable and valid assessment of nurses' competency in performing the skill of decontamination offering a template for educators to develop similar tools.

Building health care system capacity: training health care professionals in disaster preparedness health care coalitions

INTRODUCTION

This study aimed to learn from the experiences of well-established, disaster preparedness-focused health care coalition (HCC) leaders for the purpose of identifying opportunities for improved delivery of disaster-health principles to health professionals involved in HCCs. This report describes current HCC education and training needs, challenges, and promising practices.

METHODS

A semi-structured interview was conducted with a sample of leaders of nine preparedness-focused HCCs identified through a 3-stage purposive strategy. Transcripts were analyzed qualitatively.

RESULTS

Training needs included: stakeholder engagement; economic sustainability; communication; coroner and mortuary services; chemical, biological, radiological, nuclear, and explosives (CBRNE); mass-casualty incidents; and exercise design. Of these identified training needs, stakeholder engagement, economic sustainability, and exercise design were relevant to leaders within HCCs, as opposed to general HCC membership. Challenges to education and training included a lack of time, little-to-no staff devoted to training, and difficulty getting coalition members to prioritize training. Promising practices to these challenges are also presented.

CONCLUSIONS

The success of mature coalitions in improving situational awareness, promoting planning, and enabling staff- and resource-sharing suggest the strengths and opportunities that are inherent within these organizations. However, offering effective education and training opportunities is a challenge in the absence of ubiquitous support, incentives, or requirements among health care professions. Notably, an online resource repository would help reduce the burden on individual coalitions by eliminating the need to continually develop learning opportunities.

Nursing and complex humanitarian emergencies: Ebola is more than a disease

To effectively address the Ebola outbreak in West Africa, it must be viewed in terms of the connections between health, politics, security, the environment, and poverty. For the people in the countries involved and those responding, it is more than the viral illness. Although the medical management of the disease is far from simple, it is really only the proximal event of much greater social upheaval in the region, creating what is known as a complex humanitarian emergency (CHE). This article describes a course to introduce nursing students to CHEs and the role of nurses in the field of global response. CHEs are becoming more frequent with high death and disease rates. Nurses must become familiar with their complexity and multifaceted response. Although the planning for the course predated the current epidemic, the Ebola outbreak in West Africa served as an excellent exemplar for the health sector response in CHEs.