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Bugli D, Dick L, Wingate KC, Driscoll S, Beck D, Walsh B, Greiner AL. Training the public health emergency response workforce: a mixed-methods approach to evaluating the virtual reality modality. BMJ Open 2023; 13:e063527. [PMID: 37160399 PMCID: PMC10173982 DOI: 10.1136/bmjopen-2022-063527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/11/2023] Open
Abstract
OBJECTIVES To produce and evaluate a novel virtual reality (VR) training for public health emergency responders. DESIGN Following a VR training designed to test key public health emergency responder competencies, a prospective cohort of participants completed surveys rating self-assessed skill levels and perceptions of training methods. SETTING The VR training sessions were administered in a quiet room at the US Centers for Disease Control and Prevention (CDC), Atlanta, Georgia. PARTICIPANTS All participants volunteered from a list of CDC emergency international surge responders. OUTCOME MEASURES Perceived impact of the training on responder skills was self-reported via a Likert 5-point scale questionnaire. Assessments were modelled according to the Expanded Technology Acceptance Model measuring participant perceived usefulness of and intention to use the new technology. Inductive coding of qualitative feedback resulted in the identification of central themes. RESULTS From November 2019 to January 2020, 61 participants were enrolled. Most (98%) participants self-rated above neutral for all skills (mean 4.3; range 1.21-5.00). Regression modelling showed that the perceived ease of use of the VR and ability to produce demonstrable results as likely drivers of further use. Participants agreed that others would benefit from the training (97%), it was representative of actual response scenarios (72%) and they would use lessons learnt in the field (71%). Open-response feedback highlighted feeling being immersed in the training and its utility for public health responders. CONCLUSIONS At a time when a trained emergency public health workforce is a critical need, VR may be an option for addressing this gap. Participants' impressions and feedback, in the setting of their high skill level and experience, highlighted the utility and benefit of using VR to deliver training. Further research is needed to determine skill acquisition through VR training among a pool of future responders with limited to no response experience.
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Affiliation(s)
- Dante Bugli
- Division of Global Health Protection, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Leah Dick
- Division of Global Health Protection, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Kaitlin C Wingate
- Division of Global Health Protection, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | | | | | - Bridget Walsh
- Division of Global Health Protection, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Ashley Lauren Greiner
- Division of Global Health Protection, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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Nguyen L, Brown MS, Couture A, Krishnan S, Shamout M, Hernandez L, Beaver J, Gomez Lopez A, Whitson C, Dick L, Greiner AL. Global Health Security Preparedness and Response: An Analysis of the Relationship between Joint External Evaluation Scores and COVID-19 Response Performance. BMJ Open 2021; 11:e050052. [PMID: 34857565 PMCID: PMC8640194 DOI: 10.1136/bmjopen-2021-050052] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES The COVID-19 pandemic has highlighted the importance and complexity of a country's ability to effectively respond. The Joint External Evaluation (JEE) assessment was launched in 2016 to assess a country's ability to prevent, detect and respond to public health emergencies. We examined whether JEE indicators could be used to predict a country's COVID-19 response performance to tailor a country's support more effectively. DESIGN From April to August 2020, we conducted interviews with Centers for Disease Control and Prevention country offices that requested COVID-19 support and previously completed the JEE (version 1.0). We used an assessment tool, the 'Emergency Response Capacity Tool' (ERCT), to assess COVID-19 response performance. We analysed 28 ERCT indicators aligned with eight JEE indicators to assess concordance and discordance using strict agreement and weighted kappa statistics. Generalised estimating equation (GEE) models were used to generate predicted probabilities for ERCT scores using JEE scores as the independent model variable. RESULTS Twenty-three countries met inclusion criteria. Of the 163 indicators analysed, 42.3% of JEE and ERCT scores were in agreement (p value=0.02). The JEE indicator with the highest agreement (62%) was 'Emergency Operations Center (EOC) operating procedures and plans', while the lowest (16%) was 'capacity to activate emergency operations'. Findings were consistent with weighted kappa statistics. In the GEE model, EOC operating procedures and plans had the highest predicted probability (0.86), while indicators concerning response strategy and coordination had the lowest (≤0.5). CONCLUSIONS Overall, there was low agreement between JEE scores and COVID-19 response performance, with JEE scores often trending higher. JEE indicators concerning coordination and operations were least predictive of COVID-19 response performance, underscoring the importance of not inferring country response readiness from JEE scores alone. More in-depth country-specific investigations are likely needed to accurately estimate response capacity and tailor countries' global health security activities.
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Affiliation(s)
- Laura Nguyen
- COVID-19 International Task Force Emergency Response Capacity Team, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
- Emergency Response Capacity Team, Emergency Response and Recovery Branch, Division of Global Health Protection, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Morgan Sydney Brown
- Global Health Security Agenda Team, Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Alexia Couture
- COVID-19 International Task Force Emergency Response Capacity Team, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
- Emergency Response and Recovery Branch, Division of Global Health Protection, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Sharanya Krishnan
- COVID-19 International Task Force Emergency Response Capacity Team, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
- Global Emergency Management Capacity Development Team, Division of Emergency Operations, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Mays Shamout
- COVID-19 International Task Force Emergency Response Capacity Team, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
- Emergency Response Capacity Team, Emergency Response and Recovery Branch, Division of Global Health Protection, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Luis Hernandez
- COVID-19 International Task Force Emergency Response Capacity Team, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
- Emergency Response Capacity Team, Emergency Response and Recovery Branch, Division of Global Health Protection, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Jennifer Beaver
- COVID-19 International Task Force Emergency Response Capacity Team, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
- Emergency Response Capacity Team, Emergency Response and Recovery Branch, Division of Global Health Protection, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Arianna Gomez Lopez
- COVID-19 International Task Force Emergency Response Capacity Team, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
- Emergency Response Capacity Team, Emergency Response and Recovery Branch, Division of Global Health Protection, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Cassidy Whitson
- COVID-19 International Task Force Emergency Response Capacity Team, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
- Emergency Response Capacity Team, Emergency Response and Recovery Branch, Division of Global Health Protection, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Leah Dick
- COVID-19 International Task Force Emergency Response Capacity Team, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
- Emergency Response Capacity Team, Emergency Response and Recovery Branch, Division of Global Health Protection, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Ashley Lauren Greiner
- COVID-19 International Task Force Emergency Response Capacity Team, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
- Emergency Response Capacity Team, Emergency Response and Recovery Branch, Division of Global Health Protection, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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