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Buléon C, Minehart RD, Rudolph JW, Blanié A, Lilot M, Picard J, Plaud B, Pottecher J, Benhamou D. Strategy to Develop a Common Simulation Training Program: Illustration with Anesthesia and Intensive Care Residency in France. TEACHING AND LEARNING IN MEDICINE 2023; 35:537-549. [PMID: 36251797 DOI: 10.1080/10401334.2022.2127730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 08/03/2022] [Indexed: 06/16/2023]
Abstract
Phenomenon: The urgency of having fair and trustworthy competency-based assessment in medical training is growing. Simulation is increasingly recognized as a potent method for building and assessing applied competencies. The growing use of simulation and its application in summative assessment calls for comprehensive and rigorously designed programs. Defining the current baseline of what is available and feasible is a crucial first step. This paper uses anesthesia and intensive care (AIC) in France as a case study in how to document this baseline. Approach: An IRB-approved, online anonymous closed survey was submitted to AIC residency program directors and AIC simulation program directors in France from January to February 2021. The researcher-developed survey consisted of 65 questions across five sections: centers' characteristics, curricular characteristics, courses' characteristics, instructors' characteristics, and simulation perceptions and perspectives. Findings: The participation rate was 31/31 (100%) with 29 centers affiliated with a university hospital. All centers had AIC simulation activities. Resident training was structured in 94% of centers. Simulation uses were training (100%), research and development (61%), procedural or organizational testing (42%), and summative assessment (13%). Interprofessional full-scale simulation training existed in 90% of centers. Procedural training on simulators prior to clinical patients' care was performed "always" in 16%, "most often" in 45%, "sometimes" in 29% and "rarely" or "not" in 10% of centers. Simulated patients were used in 61% of centers. Main themes were identified for procedural skills, full-scale and simulated patient simulation training. Simulation activity was perceived as increasing in 68% of centers. Centers expressed a desire to participate in developing and using a national common AIC simulation program. Insights: Based on our findings in AIC, we demonstrated a baseline description of nationwide simulation activities. We now have a clearer perspective on a decentralized approach in which individual institutions or regional consortia conduct simulation for a discipline in a relatively homogeneous way, suggesting the feasibility for national guidelines. This approach provides useful clues for AIC and other disciplines to develop a comprehensive and meaningful program matching existing expectations and closing the identified gaps.
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Affiliation(s)
- Clément Buléon
- Department of Anesthesiology, Intensive Care and Perioperative Medicine, Caen Normandy University Hospital, Caen, France
- Medical School, University of Caen Normandy, Caen, France
- Center for Medical Simulation, Boston, MA, USA
| | - Rebecca D Minehart
- Center for Medical Simulation, Boston, MA, USA
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Jenny W Rudolph
- Center for Medical Simulation, Boston, MA, USA
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Antonia Blanié
- Department of Anesthesiology, Intensive Care and Perioperative Medicine, Kremlin Bicêtre University Hospital, APHP, Paris, France
| | - Marc Lilot
- Department of Anesthesiology, Intensive Care and Perioperative Medicine, Edouard Herriot University Hospital, HCL, Lyon, France
| | - Julien Picard
- Department of Anesthesiology, Intensive Care and Perioperative Medicine, Grenoble University Hospital, Grenoble, France
| | - Benoît Plaud
- Department of Anesthesiology, Intensive Care and Perioperative Medicine, Saint-Louis University Hospital, APHP, Paris, France
| | - Julien Pottecher
- Department of Anesthesiology, Intensive Care and Perioperative Medicine, Strasbourg University Hospital, Strasbourg, France
| | - Dan Benhamou
- Department of Anesthesiology, Intensive Care and Perioperative Medicine, Kremlin Bicêtre University Hospital, APHP, Paris, France
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Zhang C. A Literature Study of Medical Simulations for Non-Technical Skills Training in Emergency Medicine: Twenty Years of Progress, an Integrated Research Framework, and Future Research Avenues. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4487. [PMID: 36901496 PMCID: PMC10002261 DOI: 10.3390/ijerph20054487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 02/26/2023] [Accepted: 03/01/2023] [Indexed: 06/18/2023]
Abstract
Medical simulations have led to extensive developments in emergency medicine. Apart from the growing number of applications and research efforts in patient safety, few studies have focused on modalities, research methods, and professions via a synthesis of simulation studies with a focus on non-technical skills training. Intersections between medical simulation, non-technical skills training, and emergency medicine merit a synthesis of progress over the first two decades of the 21st century. Drawing on research from the Web of Science Core Collection's Science Citation Index Expanded and Social Science Citation Index editions, results showed that medical simulations were found to be effective, practical, and highly motivating. More importantly, simulation-based education should be a teaching approach, and many simulations are utilised to substitute high-risk, rare, and complex circumstances in technical or situational simulations. (1) Publications were grouped by specific categories of non-technical skills, teamwork, communication, diagnosis, resuscitation, airway management, anaesthesia, simulation, and medical education. (2) Although mixed-method and quantitative approaches were prominent during the time period, further exploration of qualitative data would greatly contribute to the interpretation of experience. (3) High-fidelity dummy was the most suitable instrument, but the tendency of simulators without explicitly stating the vendor selection calls for a standardised training process. The literature study concludes with a ring model as the integrated framework of presently known best practices and a broad range of underexplored research areas to be investigated in detail.
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Affiliation(s)
- Cevin Zhang
- School of Media and Design, Beijing Technology and Business University, Sunlight South Road 1, Beijing 102488, China
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Kao CL, Chien LC, Wang MC, Tang JS, Huang PC, Chuang CC, Shih CL. The development of new remote technologies in disaster medicine education: A scoping review. Front Public Health 2023; 11:1029558. [PMID: 37033011 PMCID: PMC10080133 DOI: 10.3389/fpubh.2023.1029558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Accepted: 02/27/2023] [Indexed: 04/11/2023] Open
Abstract
Background Remote teaching and online learning have significantly changed the responsiveness and accessibility after the COVID-19 pandemic. Disaster medicine (DM) has recently gained prominence as a critical issue due to the high frequency of worldwide disasters, especially in 2021. The new artificial intelligence (AI)-enhanced technologies and concepts have recently progressed in DM education. Objectives The aim of this article is to familiarize the reader with the remote technologies that have been developed and used in DM education over the past 20 years. Literature scoping reviews Mobile edge computing (MEC), unmanned aerial vehicles (UAVs)/drones, deep learning (DL), and visual reality stimulation, e.g., head-mounted display (HMD), are selected as promising and inspiring designs in DM education. Methods We performed a comprehensive review of the literature on the remote technologies applied in DM pedagogy for medical, nursing, and social work, as well as other health discipline students, e.g., paramedics. Databases including PubMed (MEDLINE), ISI Web of Science (WOS), EBSCO (EBSCO Essentials), Embase (EMB), and Scopus were used. The sourced results were recorded in a Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) flowchart and followed in accordance with the PRISMA extension Scoping Review checklist. We included peer-reviewed articles, Epubs (electronic publications such as databases), and proceedings written in English. VOSviewer for related keywords extracted from review articles presented as a tabular summary to demonstrate their occurrence and connections among these DM education articles from 2000 to 2022. Results A total of 1,080 research articles on remote technologies in DM were initially reviewed. After exclusion, 64 articles were included in our review. Emergency remote teaching/learning education, remote learning, online learning/teaching, and blended learning are the most frequently used keywords. As new remote technologies used in emergencies become more advanced, DM pedagogy is facing more complex problems. Discussions Artificial intelligence-enhanced remote technologies promote learning incentives for medical undergraduate students or graduate professionals, but the efficacy of learning quality remains uncertain. More blended AI-modulating pedagogies in DM education could be increasingly important in the future. More sophisticated evaluation and assessment are needed to implement carefully considered designs for effective DM education.
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Affiliation(s)
- Chia-Lung Kao
- Department of Emergency Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Regional Emergency Medical Operations Center-Tainan Branch, Ministry of Health and Welfare, Taipei City, Taiwan
| | - Li-Chien Chien
- Department of Emergency Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Regional Emergency Medical Operations Center-Tainan Branch, Ministry of Health and Welfare, Taipei City, Taiwan
| | - Mei-Chin Wang
- Department of Nursing, Chung Hwa University of Medical Technology, Tainan, Taiwan
| | - Jing-Shia Tang
- Department of Nursing, Chung Hwa University of Medical Technology, Tainan, Taiwan
| | - Po-Chang Huang
- Department of Emergency Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chia-Chang Chuang
- Department of Emergency Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Regional Emergency Medical Operations Center-Tainan Branch, Ministry of Health and Welfare, Taipei City, Taiwan
- *Correspondence: Chia-Chang Chuang
| | - Chung-Liang Shih
- Department of Medical Affairs, Ministry of Health and Welfare, Taipei City, Taiwan
- Department of Emergency Medicine, College of Medicine, National Taiwan University, Taipei City, Taiwan
- Chung-Liang Shih
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Baetzner AS, Wespi R, Hill Y, Gyllencreutz L, Sauter TC, Saveman BI, Mohr S, Regal G, Wrzus C, Frenkel MO. Preparing medical first responders for crises: a systematic literature review of disaster training programs and their effectiveness. Scand J Trauma Resusc Emerg Med 2022; 30:76. [PMID: 36566227 PMCID: PMC9789518 DOI: 10.1186/s13049-022-01056-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 11/30/2022] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Adequate training and preparation of medical first responders (MFRs) are essential for an optimal performance in highly demanding situations like disasters (e.g., mass accidents, natural catastrophes). The training needs to be as effective as possible, because precise and effective behavior of MFRs under stress is central for ensuring patients' survival and recovery. This systematic review offers an overview of scientifically evaluated training methods used to prepare MFRs for disasters. It identifies different effectiveness indicators and provides an additional analysis of how and to what extent the innovative training technologies virtual (VR) and mixed reality (MR) are included in disaster training research. METHODS The systematic review was conducted according to the PRISMA guidelines and focused specifically on (quasi-)experimental studies published between January 2010 and September 2021. The literature search was conducted via Web of Science and PubMed and led to the inclusion of 55 articles. RESULTS The search identified several types of training, including traditional (e.g., lectures, real-life scenario training) and technology-based training (e.g., computer-based learning, educational videos). Most trainings consisted of more than one method. The effectiveness of the trainings was mainly assessed through pre-post comparisons of knowledge tests or self-reported measures although some studies also used behavioral performance measures (e.g., triage accuracy). While all methods demonstrated effectiveness, the literature indicates that technology-based methods often lead to similar or greater training outcomes than traditional trainings. Currently, few studies systematically evaluated immersive VR and MR training. CONCLUSION To determine the success of a training, proper and scientifically sound evaluation is necessary. Of the effectiveness indicators found, performance assessments in simulated scenarios are closest to the target behavior during real disasters. For valid yet inexpensive evaluations, objectively assessible performance measures, such as accuracy, time, and order of actions could be used. However, performance assessments have not been applied often. Furthermore, we found that technology-based training methods represent a promising approach to train many MFRs repeatedly and efficiently. These technologies offer great potential to supplement or partially replace traditional training. Further research is needed on those methods that have been underrepresented, especially serious gaming, immersive VR, and MR.
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Affiliation(s)
- Anke S. Baetzner
- grid.7700.00000 0001 2190 4373Institute of Sports and Sports Sciences, Heidelberg University, Heidelberg, Germany
| | - Rafael Wespi
- grid.5734.50000 0001 0726 5157Department of Emergency Medicine, Inselspital, University Hospital, University of Bern, Bern, Switzerland ,grid.5734.50000 0001 0726 5157Graduate School for Health Sciences, University of Bern, Bern, Switzerland
| | - Yannick Hill
- grid.12380.380000 0004 1754 9227Department of Human Movement Sciences, Faculty of Behavioral and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, Netherlands ,Institute of Brain and Behaviour Amsterdam, Amsterdam, Netherlands ,Lyda Hill Institute for Human Resilience, Colorado Springs, USA
| | - Lina Gyllencreutz
- grid.12650.300000 0001 1034 3451Department of Nursing, Umeå University, Umeå, Sweden ,grid.12650.300000 0001 1034 3451Department of Surgical and Perioperative Sciences, Umeå University, Umeå, Sweden
| | - Thomas C. Sauter
- grid.5734.50000 0001 0726 5157Department of Emergency Medicine, Inselspital, University Hospital, University of Bern, Bern, Switzerland
| | - Britt-Inger Saveman
- grid.12650.300000 0001 1034 3451Department of Nursing, Umeå University, Umeå, Sweden ,grid.12650.300000 0001 1034 3451Department of Surgical and Perioperative Sciences, Umeå University, Umeå, Sweden
| | - Stefan Mohr
- grid.5253.10000 0001 0328 4908Department of Anesthesiology, University Hospital Heidelberg, Heidelberg, Germany
| | - Georg Regal
- grid.4332.60000 0000 9799 7097Center for Technology Experience, AIT Austrian Institute of Technology, Vienna, Austria
| | - Cornelia Wrzus
- grid.7700.00000 0001 2190 4373Psychological Institute and Network Aging Research, Heidelberg University, Heidelberg, Germany
| | - Marie O. Frenkel
- grid.7700.00000 0001 2190 4373Institute of Sports and Sports Sciences, Heidelberg University, Heidelberg, Germany
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Henze SM, Fellmer F, Wittenberg S, Höppner S, Märdian S, Willy C, Back DA. Digital adaptation of teaching disaster and deployment medicine under COVID-19 conditions: a comparative evaluation over 5 years. BMC MEDICAL EDUCATION 2022; 22:717. [PMID: 36224618 PMCID: PMC9554383 DOI: 10.1186/s12909-022-03783-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 09/29/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND The COVID-19 pandemic has not only brought many aspects of disaster medicine into everyday awareness but also led to a massive change in medical teaching due to the necessity of contact restrictions. This study aimed to evaluate student acceptance of a curricular elective module on disaster and deployment medicine over a 5-year period and to present content adjustments due to COVID-19 restrictions. METHODS Since 2016, 8 semesters of the curricular elective module took place in face-to-face teaching (pre-COVID-19 group). From the summer semester of 2020 to the summer semester of 2021, 3 semesters took place as online and hybrid courses (mid-COVID-19 group). Student attitudes and knowledge gains were measured using pretests, posttests, and final evaluations. These data were statistically compared across years, and new forms of teaching under COVID-19 conditions were examined in more detail. RESULTS A total of 189 students participated in the module from the summer semester of 2016 through the summer semester of 2021 (pre-COVID-19: n = 138; mid-COVID-19: n = 51). There was a high level of satisfaction with the module across all semesters, with no significant differences between the groups. There was also no significant difference between the two cohorts in terms of knowledge gain, which was always significant (p < 0.05). COVID-19 adaptations included online seminars using Microsoft Teams or Zoom, the interactive live-streaming of practical training components, and digital simulation games. CONCLUSION The high level of satisfaction and knowledge gained during the module did not change even under a digital redesign of the content offered. The curricular elective module was consistently evaluated positively by the students, and the adaptation to online teaching was well accepted. Experiences with digital forms of teaching should also be used after the COVID-19 pandemic to create digitally supported blended learning concepts in the field of deployment and disaster medicine and thus further promote the expansion of teaching in this important medical field.
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Affiliation(s)
- S M Henze
- Clinic for Traumatology and Orthopedics, Military Academic Hospital Berlin, Scharnhorststrasse 13, 10115, Berlin, Germany
| | - F Fellmer
- Clinic for Traumatology and Orthopedics, Military Academic Hospital Berlin, Scharnhorststrasse 13, 10115, Berlin, Germany
| | - S Wittenberg
- Center for Musculoskeletal Surgery, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
| | - S Höppner
- Clinic for Anesthesiology, Intensive Care, Emergency Medicine and Rescue Service, Military Academic Hospital Berlin, Scharnhorststrasse 13, 10115, Berlin, Germany
| | - S Märdian
- Center for Musculoskeletal Surgery, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
| | - C Willy
- Clinic for Traumatology and Orthopedics, Military Academic Hospital Berlin, Scharnhorststrasse 13, 10115, Berlin, Germany
| | - D A Back
- Clinic for Traumatology and Orthopedics, Military Academic Hospital Berlin, Scharnhorststrasse 13, 10115, Berlin, Germany.
- Center for Musculoskeletal Surgery, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Augustenburger Platz 1, 13353, Berlin, Germany.
- Dieter Scheffner Center for Medical Education and Educational Research, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charité Platz 1, 10117, Berlin, Germany.
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Wisnesky UD, Kirkland SW, Rowe BH, Campbell S, Franc JM. A Qualitative Assessment of Studies Evaluating the Classification Accuracy of Personnel Using START in Disaster Triage: A Scoping Review. Front Public Health 2022; 10:676704. [PMID: 35284379 PMCID: PMC8907512 DOI: 10.3389/fpubh.2022.676704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Accepted: 01/31/2022] [Indexed: 11/18/2022] Open
Abstract
Background Mass casualty incidents (MCIs) can occur as a consequence of a wide variety of events and often require overwhelming prehospital and emergency support and coordinated emergency response. A variety of disaster triage systems have been developed to assist health care providers in making difficult choices with regards to prioritization of victim treatment. The simple triage and rapid treatment (START) triage system is one of the most widely used triage algorithms; however, the research literature addressing real-world or simulation studies documenting the classification accuracy of personnel using START is lacking. Aims and Objectives To explore the existing literature related to the current state of knowledge about studies assessing the classification accuracy of the START triage system. Design Scoping review based on Arksey and O'Malley's methodological framework and narrative synthesis based on methods described by Popay and colleagues were performed. Results The literature search identified 1,820 citations, of which 32 studies met the inclusion criteria. Thirty were peer-reviewed articles and 28 published in the last 10 years (i.e., 2010 and onward). Primary research studies originated in 13 countries and included 3,706 participants conducting triaging assessments involving 2,950 victims. Included studies consisted of five randomized controlled trials, 17 non-randomized controlled studies, eight descriptive studies, and two mixed-method studies. Simulation techniques, mode of delivery, contextual features, and participants' required skills varied among studies. Overall, there was no consistent reporting of outcomes across studies and results were heterogeneous. Data were extracted from the included studies and categorized into two themes: (1) typology of simulations and (2) START system in MCIs simulations. Each theme contains sub-themes regarding the development of simulation employing START as a system for improving individuals' preparedness. These include types of simulation training, settings, and technologies. Other sub-themes include outcome measures and reference standards. Conclusion This review demonstrates a variety of factors impacting the development and implementation of simulation to assess characteristics of the START system. To further improve simulation-based assessment of triage systems, we recommend the use of reporting guidelines specifically designed for health care simulation research. In particular, reporting of reference standards and test characteristics need to improve in future studies.
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Affiliation(s)
- Uirá Duarte Wisnesky
- Department of Emergency Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Scott W. Kirkland
- Department of Emergency Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Brian H. Rowe
- Department of Emergency Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
- School of Public Health, University of Alberta, Edmonton, AB, Canada
| | - Sandra Campbell
- J.W. Scott Health Sciences Library, University of Alberta, Edmonton, AB, Canada
| | - Jeffrey Michael Franc
- Department of Emergency Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
- *Correspondence: Jeffrey Michael Franc
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METASTART: A Systematic Review and Meta-Analysis of the Diagnostic Accuracy of the Simple Triage and Rapid Treatment (START) Algorithm for Disaster Triage. Prehosp Disaster Med 2021; 37:106-116. [PMID: 34915954 DOI: 10.1017/s1049023x2100131x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
INTRODUCTION The goal of disaster triage at both the prehospital and in-hospital level is to maximize resources and optimize patient outcomes. Of the disaster-specific triage methods developed to guide health care providers, the Simple Triage and Rapid Treatment (START) algorithm has become the most popular system world-wide. Despite its appeal and global application, the accuracy and effectiveness of the START protocol is not well-known. OBJECTIVES The purpose of this meta-analysis was two-fold: (1) to estimate overall accuracy, under-triage, and over-triage of the START method when used by providers across a variety of backgrounds; and (2) to obtain specific accuracy for each of the four START categories: red, yellow, green, and black. METHODS A systematic review and meta-analysis was conducted that searched Medline (OVID), Embase (OVID), Global Health (OVID), CINAHL (EBSCO), Compendex (Engineering Village), SCOPUS, ProQuest Dissertations and Theses Global, Cochrane Library, and PROSPERO. The results were expanded by hand searching of journals, reference lists, and the grey literature. The search was executed in March 2020. The review considered the participants, interventions, context, and outcome (PICO) framework and followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Accuracy outcomes are presented as means with 95% confidence intervals (CI) as calculated using the binomial method. Pooled meta-analyses of accuracy outcomes using fixed and random effects models were calculated and the heterogeneity was assessed using the Q statistic. RESULTS Thirty-two studies were included in the review, most of which utilized a non-randomized study design (84%). Proportion of victims correctly triaged using START ranged from 0.27 to 0.99 with an overall triage accuracy of 0.73 (95% CI, 0.67 to 0.78). Proportion of over-triage was 0.14 (95% CI, 0.11 to 0.17) while the proportion of under-triage was 0.10 (95% CI, 0.072 to 0.14). There was significant heterogeneity of the studies for all outcomes (P < .0001). CONCLUSION This meta-analysis suggests that START is not accurate enough to serve as a reliable disaster triage tool. Although the accuracy of START may be similar to other models of disaster triage, development of a more accurate triage method should be urgently pursued.
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Hermann S, Gerstner J, Weiss F, Aichele S, Stricker E, Gorgati E, Rosenberger P, Wunderlich R. Presentation and evaluation of a modern course in disaster medicine and humanitarian assistance for medical students. BMC MEDICAL EDUCATION 2021; 21:610. [PMID: 34893083 PMCID: PMC8661312 DOI: 10.1186/s12909-021-03043-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 11/17/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND Disaster medicine is a component of the German medical education since 2003. Nevertheless, studies have shown some inconsistencies within the implementation of the national curriculum, and limits in the number of students trained over the years. Recently, the SARS-CoV-2 pandemic and other disasters have called attention to the importance of training medical students in disaster medicine on a coordinated basis. The aim of this study is to present and evaluate the disaster medicine and humanitarian assistance course, which was developed in the University of Tübingen, Germany. METHODS The University Clinic for Anesthesiology and Intensive Care Medicine in Tübingen expanded the existing curriculum of undergraduate disaster medicine training with fundamentals of humanitarian medicine, integrating distance learning, interactive teaching and simulation sessions in a 40 h course for third-, fourth- and fifth- year medical students. This prospective and cross-sectional study evaluates the Disaster Medicine and Humanitarian Assistance course carried out over five semesters during the period between 2018 and 2020. Three survey tools were used to assess participants' previous experiences and interest in the field of disaster medicine, to compare the subjective and objective level of knowledge before and after training, and to evaluate the course quality. RESULTS The total number of medical students attending the five courses was n = 102 of which n = 60 females (59%) and n = 42 males (41%). One hundred two students entered the mandatory knowledge assessment, with the rate of correct answers passing from 73.27% in the pre-test to 95.23% in the post-test (t [101] = 18.939, p < .001, d = 1.88). To determine the subjective perception of knowledge data were collected from 107 observations. Twenty-five did not complete the both questionnaires. Out of a remaining sample of 82 observations, the subjective perception of knowledge increased after the course (t [81] = 24.426, p < .001, d = 2.69), alongside with the interest in engaging in the field of disaster medicine (t [81] = 7.031, p < .001, d = .78). The 93.46% of the medical students (n = 100) graded the training received with an excellent overall score (1.01 out of 6). CONCLUSION The study indicates a significant increase in students' understanding of disaster medicine using both subjective and objective measurements, as well as an increase interest in the field of disaster medicine and humanitarian assistance. Whereas former studies showed insufficient objective knowledge regarding disaster medical practices as well as subjective insecurities about their skills and knowledge to deal with disaster scenarios, the presented course seems to overcome these deficiencies preparing future physicians with the fundamentals of analysis and response to disasters. The development and successful implementation of this course is a first step towards fulfilling disaster medicine education requirements, appearing to address the deficiencies documented in previous studies. A possible adaptation with virtual reality approaches could expand access to a larger audience. Further effort must be made to develop also international training programs, which should be a mandatory component of medical schools' curricula.
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Affiliation(s)
- Sabine Hermann
- University Department of Anesthesiology and Intensive Care Medicine of Tübingen, Hoppe- Seyler- Straße 3, 72076, Tübingen, Germany
| | - Jessica Gerstner
- Psychological Institute, Department of Biological and Personality Psychology, University of Freiburg, Freiburg, Germany
| | - Florian Weiss
- University Department of Anesthesiology and Intensive Care Medicine of Tübingen, Hoppe- Seyler- Straße 3, 72076, Tübingen, Germany
| | - Simon Aichele
- University Department of Anesthesiology and Intensive Care Medicine of Tübingen, Hoppe- Seyler- Straße 3, 72076, Tübingen, Germany
| | - Eric Stricker
- University Department of Anesthesiology and Intensive Care Medicine of Tübingen, Hoppe- Seyler- Straße 3, 72076, Tübingen, Germany
| | - Eleonora Gorgati
- University Department of Anesthesiology and Intensive Care Medicine of Tübingen, Hoppe- Seyler- Straße 3, 72076, Tübingen, Germany
| | - Peter Rosenberger
- University Department of Anesthesiology and Intensive Care Medicine of Tübingen, Hoppe- Seyler- Straße 3, 72076, Tübingen, Germany
| | - Robert Wunderlich
- University Department of Anesthesiology and Intensive Care Medicine of Tübingen, Hoppe- Seyler- Straße 3, 72076, Tübingen, Germany.
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European Educational Programmes in Health Emergency and Disaster Management: An Integrative Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182111455. [PMID: 34769972 PMCID: PMC8583199 DOI: 10.3390/ijerph182111455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 10/28/2021] [Accepted: 10/29/2021] [Indexed: 11/17/2022]
Abstract
There is a need for trained health professionals who can swiftly respond to disasters occurring worldwide. Little is known about whether the currently available programmes in disaster management are in line with the recommendations of expert researchers. Our objective was to qualitatively review the characteristics of European educational programmes in health emergency and disaster management and to provide guidance to help improve their curricula. We carried out an integrative review to extract the main characteristics of the 2020/21 programmes available. We identified 34 programmes, the majority located in Spain, the UK or France. The primary qualification types awarded were master’s degrees, half of them lasting one year, and the most common teaching method was in person. Almost all of the programmes used a virtual university classroom, a third offered multidisciplinary disaster management content and teachers, and half of them employed situational simulations. The quality of European educational programmes in health emergency and disaster management has improved, especially in terms of using more practical and interactive teaching methodologies and in the inclusion of relevant topics such as communication, psychological approaches and evaluation of the interventions. However, generally, the educational programmes in disaster management have not yet incorporated the skills related to the intercultural and interprofessional awareness aspects.
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Hung MSY, Lam SKK, Chow MCM, Ng WWM, Pau OK. The Effectiveness of Disaster Education for Undergraduate Nursing Students' Knowledge, Willingness, and Perceived Ability: An Evaluation Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph181910545. [PMID: 34639845 PMCID: PMC8508175 DOI: 10.3390/ijerph181910545] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 09/30/2021] [Accepted: 10/03/2021] [Indexed: 01/04/2023]
Abstract
As future healthcare professionals, nursing students should possess the appropriate knowledge, skills, and positive attitude to respond to public health emergencies or disasters worldwide. This study evaluated the effectiveness of a disaster management training course at improving Hong Kong nursing students' disaster knowledge, willingness, and perceived ability. A mixed-method design using a single group with pre- and post-intervention comparisons followed by qualitative focus group interviews, was conducted. A 45-h disaster management training course with theoretical and practical inputs was conducted. A total of 157 students participated in and completed the pre- and post-intervention questionnaires. Positive significant results in disaster knowledge (t(156) = -8.12, p < 0.01, d = -0.84) and perceived ability (t(156) = -7.95, p < 0.01, d = -0.72) were found, but no substantial change in willingness to respond to disasters was observed. The participants expressed various concerns regarding their willingness to respond, which can be summarized and grouped as (1) personal risk perceptions, (2) contextual factors of the disaster events, and (3) organizational support. Incorporating disaster training into the tertiary education curricula for basic nursing professionals' training could be a long-term strategy to prepare and expand the competent workforce for future disasters. Government or healthcare organizations are recommended to provide strategies and adequate support to alleviate nursing professionals' concerns and enhance their willingness.
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Affiliation(s)
- Maria Shuk Yu Hung
- School of Nursing, Tung Wah College, Hong Kong, China; (M.C.M.C.); (O.K.P.)
- Correspondence: ; Tel.: +852-3468-6804
| | - Stanley Kam Ki Lam
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong, China;
| | | | - Winnie Wing Man Ng
- Division of Science, Engineering and Health Studies, College of Professional and Continuing Education, The Hong Kong Polytechnic University, Hong Kong, China;
| | - Oi Kiu Pau
- School of Nursing, Tung Wah College, Hong Kong, China; (M.C.M.C.); (O.K.P.)
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Chou WK, Cheng MT, Lin CH, Shih FY. The Effectiveness of Functional Exercises for Teaching Method Disaster Medicine to Medical Students. Cureus 2021; 13:e15151. [PMID: 34178486 PMCID: PMC8216576 DOI: 10.7759/cureus.15151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Introduction Functional exercises are effective for testing disaster management training. Previously, we found that functional exercises promote student engagement and improve the perception of learning after exercise. Objective The study objective is to investigate whether functional exercise is effective for teaching disaster medicine. Methods Students who partook in a two-day course of disaster medicine were recruited. The course consisted of lectures and workshops followed by a half-day functional exercise and was designed based on four core competency domains which included major disaster medicine concepts. After the lectures and workshops, participants completed a test to assess their knowledge of the core competency domains and a questionnaire to evaluate their willingness to pursue further training and participate in a disaster medical assistance team (DMAT) and their interest in disaster exercises. The functional exercise involved the scenario of an earthquake and mass-casualty incident and participants acted as DMAT members in the exercise. A post-exercise debrief was conducted by the evaluators to discuss performance and evaluate the results of the exercise. Participants then completed the same tests and questionnaires as before the exercise. Results Ninety-seven students were recruited, 72 of which were medical students. Pre- and post-exercise tests and questionnaires were completed by 48. We found disaster scene safety knowledge to be significantly improved after the functional exercise. Students’ willingness for further training and participation in a DMAT as well as their interest in disaster training was high before and after the exercise. Conclusion Disaster scene safety is a vital element of disaster medicine training but it is difficult to teach. Functional exercises represent a good tool for this purpose and can maintain enthusiasm for learning and participating in disaster medicine-related activities.
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Affiliation(s)
- Wei-Kuo Chou
- Department of Emergency Medicine, National Taiwan University Hospital, Taipei, TWN
| | - Ming-Tai Cheng
- Department of Emergency Medicine, National Taiwan University Hospital, Taipei, TWN
| | - Chien-Hao Lin
- Department of Emergency Medicine, National Taiwan University Hospital, Taipei, TWN
| | - Fuh-Yuan Shih
- Department of Emergency Medicine, National Taiwan University Hospital, Taipei, TWN
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Kasselmann N, Willy C, Domres BD, Wunderlich R, Back DA. Implementation of disaster medicine education in German medical schools - a nationwide survey. GMS JOURNAL FOR MEDICAL EDUCATION 2021; 38:Doc79. [PMID: 34056068 PMCID: PMC8136347 DOI: 10.3205/zma001475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Figures] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 10/03/2020] [Accepted: 01/25/2021] [Indexed: 06/12/2023]
Abstract
Objectives: Floods, earthquakes and terror attacks in recent years emphasize the importance of disaster preparedness for the medical community. To best prepare doctors for providing optimal care in disaster situations, specific education and training should start at the medical school level. This study containes an online survey among German medical schools to evaluate the status quo of teaching disaster medicine and to reveal potential obstacles. Methods: The dean's offices of 36 German medical schools were contacted from April 2016 to May 2017. Via an e-mail link, recipients could anonymously and voluntarily access an online questionnaire (74 items, 42 with a four-point "Likert-like" scale, 12 yes/no questions and 20 with listed items to choose from). The answers were analyzed by descriptive statistics. Results: A total of 25 medical schools participated in the survey. Twenty respondents were in favor of expanding disaster medicine teaching at their institutions. Incorporating single topics ranging from triage (n=21) to accidents involving radioactive materials (n=4) into the curriculum varied widely. Only two schools had established a teaching coordinator for disaster medicine and only one e-learning course had been established. Twenty-one respondents regarded funding issues and 18 regarded organizational matters to be major hurdles in the future. Conclusion: Though most faculty representatives indicated that they favor expanding and implementing disaster medicine education, German medical schools still have a lot of room for enhancement in this field. The incorporation of e-learning tools could facilitate the expansion of disaster medicine teaching while simultaneously addressing the expressed concerns of the survey's participants and guarantee nationwide standardization.
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Affiliation(s)
- Nils Kasselmann
- Bundeswehr Hospital Berlin, Clinic of Traumatology and Orthopedics, Septic and Reconstructive Surgery, Berlin, Germany
| | - Christian Willy
- Bundeswehr Hospital Berlin, Clinic of Traumatology and Orthopedics, Septic and Reconstructive Surgery, Berlin, Germany
| | - Bernd D. Domres
- Foundation of the German Institute for Disaster Medicine,Tübingen,Germany
| | - Robert Wunderlich
- University Hospital Tübingen, University Department of Anesthesiology and Intensive Care Medicine, Tübingen, Germany
| | - David A. Back
- Bundeswehr Hospital Berlin, Clinic of Traumatology and Orthopedics, Septic and Reconstructive Surgery, Berlin, Germany
- Charité - Universitätsmedizin Berlin, Dieter Scheffner Center for Medical Education and Research, Berlin, Germany
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Planning for Chaos: Developing the Concept of Emergency Preparedness through the Experience of the Paramedic. J Emerg Nurs 2021; 47:487-502. [PMID: 33832738 DOI: 10.1016/j.jen.2021.02.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 02/11/2021] [Accepted: 02/11/2021] [Indexed: 11/23/2022]
Abstract
OBJECTIVE Emergency preparedness is a developing specialty with a limited evidence base. Published literature primarily offers a retrospective view of experience, with few studies examining and understanding the individual lived experience of practitioners prospectively. This study explores paramedics' lived experience of emergency preparedness and applies that learning. METHODS Thirteen paramedics were recruited through purposive sampling. Face-to-face semi-structured interviews explored their individual experiences of emergency preparedness, in line with the idiographic focus of Interpretative Phenomenological Analysis. RESULTS Through data analysis, the following superordinate themes were identified for further discussion: self-determination, control, and experience-based practice. Participants appeared to value their role and the unpredictable environment in which they worked. Personal resilience, an area that they suggested is not covered effectively within individual preparation, was viewed as important. The participants articulated that risk, threat, uncertainty, safety, trust, and control were important concepts within individual preparedness. These paramedics valued practice-based knowledge and education as credible and transferrable to their clinical work. CONCLUSION Evidence from this study suggests that standard emergency preparedness, with the focus at organizational level, is not sufficient for the individual workers or for an overall effective response. Dimensions of individual preparedness are presented, with the paramedic central to the experience within a conceptual model (the DiEP model), creating a new form of emergency preparedness that reflects the individual paramedic's experience.
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Hu H, Xiao Y, Li H. The Effectiveness of a Serious Game Versus Online Lectures for Improving Medical Students' Coronavirus Disease 2019 Knowledge. Games Health J 2021; 10:139-144. [PMID: 33434099 DOI: 10.1089/g4h.2020.0140] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Objective: The sudden disruption of university teaching caused by the coronavirus disease 2019 (COVID-19) pandemic has forced universities to switch to online teaching. It is vital for graduating medical students to learn about COVID-19 because they are likely to treat COVID-19 patients after graduation. We developed a COVID-19 lesson for medical students that used either an online lecture or a serious game that we designed. The aim of this study is to explore the effectiveness of a serious game versus online lectures for improving medical students' COVID-19 knowledge. Materials and Methods: From our university's database of knowledge scores, we collected the prelesson, postlesson, and final test knowledge scores of the students who participated in the lesson and conducted a retrospective comparative analysis. Results: An analysis of scores concerning knowledge of COVID-19 from prelesson and postlesson tests shows that both teaching methods produce significant increases in short-term knowledge, with no statistical difference between the two methods (P > 0.05). The final test scores, however, show that the group of students who used the game-based computer application scored significantly higher in knowledge retention than did the online lecture group (P = 0.001). Conclusion: In the context of the disruption of traditional university teaching caused by the COVID-19 pandemic, the serious game we designed is potentially an effective option for online medical education about COVID-19, particularly in terms of its capacity for improved knowledge retention.
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Affiliation(s)
- Hai Hu
- Emergency Management Office, West China Hospital, Sichuan University, Sichuan, P.R. China.,National Emergency Medical Rescue Base of China, Sichuan University, Sichuan, P.R. China.,International Emergency Medical Team (Type III), Sichuan, P.R. China
| | | | - Hao Li
- Institute for Disaster Management and Reconstruction, Sichuan University and the Hong Kong Polytechnic University, Sichuan, P.R. China.,Disaster Medicine Center of Sichuan University, Sichuan, P.R. China
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Kasselmann N, Bickelmayer J, Peters H, Wesemann U, Oestmann JW, Willy C, Back DA. [Relevance of disaster and deployment medicine for medical students : A pilot study based on an interdisciplinary lecture series]. Unfallchirurg 2020; 123:464-472. [PMID: 31696247 DOI: 10.1007/s00113-019-00738-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND The global rise of conflicts and catastrophes causes new challenges for western healthcare systems. There are obvious parallels between civilian disaster medicine and military combat care. The integration of disaster and deployment medicine into the medical curriculum thus seems necessary. OBJECTIVE What do medical students think about disaster and deployment medicine as part of the curriculum? Does participation in a voluntary disaster medicine course affect their view? MATERIAL AND METHODS While participating in an extracurricular lecture series on disaster and deployment medicine students (group 1) were asked about their personal views and prior experience in disaster medicine (20 questions). Students who did not attend the lecture (group 2) functioned as the control group. The statistical evaluation was performed descriptively and using Student's t test for independent subgroups. RESULTS The questionnaire was completed by 152 students (group 1: n = 78, group 2: n = 74). Only 10 students in group 1 and none in group 2 felt they had received an adequate amount of teaching in the field of disaster medicine. Medical students in both groups considered disaster medicine to be inadequately represented in the medical curriculum (group 1: 64% and group 2: 66%). Both groups were in favor of further expanding teaching in the field of disaster medicine (group 1: 72%, group 2: 54%, p = 0.001) and the development of e‑learning tools (group 1: 73%, group 2: 72%). DISCUSSION The medical students questioned considered disaster and deployment medicine to be an integral part of the curriculum. Despite some statistical differences between the two groups, the survey showed that medical students possess a great interest in disaster medicine. Both groups were in favor of further integrating e‑learning tools. A regular inclusion of disaster and deployment medicine into the spectrum of medical student teaching is warranted.
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Affiliation(s)
- N Kasselmann
- Klinik für Unfallchirurgie und Orthopädie, Septische und Rekonstruktive Chirurgie, Bundeswehrkrankenhaus Berlin, Scharnhorststr. 13, 10115, Berlin, Deutschland
| | - J Bickelmayer
- Klinik für Anästhesie, Intensivmedizin, Notfallmedizin und Rettungsdienst, Bundeswehrkrankenhaus Berlin, Berlin, Deutschland
| | - H Peters
- Dieter Scheffner Fachzentrum für medizinische Hochschullehre und evidenzbasierte Ausbildungsforschung, Charité - Universitätsmedizin Berlin, Berlin, Deutschland
| | - U Wesemann
- Psychotraumazentrum Berlin, Bundeswehrkrankenhaus Berlin, Berlin, Deutschland
| | - J W Oestmann
- Klinik für diagnostische Radiologie, Charité - Universitätsmedizin Berlin, Campus Mitte, Berlin, Deutschland
| | - C Willy
- Klinik für Unfallchirurgie und Orthopädie, Septische und Rekonstruktive Chirurgie, Bundeswehrkrankenhaus Berlin, Scharnhorststr. 13, 10115, Berlin, Deutschland
| | - D A Back
- Klinik für Unfallchirurgie und Orthopädie, Septische und Rekonstruktive Chirurgie, Bundeswehrkrankenhaus Berlin, Scharnhorststr. 13, 10115, Berlin, Deutschland. .,Dieter Scheffner Fachzentrum für medizinische Hochschullehre und evidenzbasierte Ausbildungsforschung, Charité - Universitätsmedizin Berlin, Berlin, Deutschland.
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Ashcroft J, Byrne MHV, Brennan PA, Davies RJ. Preparing medical students for a pandemic: a systematic review of student disaster training programmes. Postgrad Med J 2020; 97:368-379. [PMID: 32518075 PMCID: PMC7316122 DOI: 10.1136/postgradmedj-2020-137906] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 05/12/2020] [Accepted: 05/20/2020] [Indexed: 12/31/2022]
Abstract
OBJECTIVE To identify pandemic and disaster medicine-themed training programmes aimed at medical students and to assess whether these interventions had an effect on objective measures of disaster preparedness and clinical outcomes. To suggest a training approach that can be used to train medical students for the current COVID-19 pandemic. RESULTS 23 studies met inclusion criteria assessing knowledge (n=18, 78.3%), attitude (n=14, 60.9%) or skill (n=10, 43.5%) following medical student disaster training. No studies assessed clinical improvement. The length of studies ranged from 1 day to 28 days, and the median length of training was 2 days (IQR=1-14). Overall, medical student disaster training programmes improved student disaster and pandemic preparedness and resulted in improved attitude, knowledge and skills. 18 studies used pretest and post-test measures which demonstrated an improvement in all outcomes from all studies. CONCLUSIONS Implementing disaster training programmes for medical students improves preparedness, knowledge and skills that are important for medical students during times of pandemic. If medical students are recruited to assist in the COVID-19 pandemic, there needs to be a specific training programme for them. This review demonstrates that medical students undergoing appropriate training could play an essential role in pandemic management and suggests a course and assessment structure for medical student COVID-19 training. REGISTRATION The search strategy was not registered on PROSPERO-the international prospective register of systematic reviews-to prevent unnecessary delay.
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Affiliation(s)
- James Ashcroft
- Cambridge Colorectal Unit, Addenbrooke's Hospital, Cambridge, UK
| | | | - Peter A Brennan
- Maxillofacial Surgery, Queen Alexandra Hospital, Portsmouth, UK
| | - Richard Justin Davies
- Cambridge Colorectal Unit, Addenbrooke's Hospital, Cambridge, UK.,School of Clinical Medicine, University of Cambridge, Cambridge, Cambridgeshire, UK
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Suda AJ, Höppchen I. [Terror awareness of 5th year medical students in the Mannheim reformed curriculum medicine plus]. Unfallchirurg 2020:10.1007/s00113-020-00808-4. [PMID: 32347370 DOI: 10.1007/s00113-020-00808-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND The treatment of gunshot wounds and wounds caused by explosive devices as used in terrorist attacks is not currently an issue for education in most medical faculties; however, because of the increasing number of terrorist attacks in Germany and Europe this is becoming more important. The aim of this study was to evaluate the knowledge of dealing with and treatment of patients as victims of terrorist attacks of 5th year medical students at the Mannheim Medical Faculty of Heidelberg University prior to and after a specific seminar. METHODS All students offered to participate voluntarily. Before the seminar a questionnaire with six questions about previous knowledge on terror awareness was distributed. After the seminar another almost identical questionnaire with six questions was distributed and completed by the students. RESULTS A total of 97 medical students agreed to take part in the study of whom 53 were female. The mean age was 25.4 years (SD 2.75 years). After the seminar the students wanted to statistically significantly intensify the topic and believed that hospitals should be prepared for the treatment of victims of terrorism. CONCLUSION With the seminar "Military Medicine", which was held as part of the Mannheim reformed curriculum of medicine (MaReCuM plus) in the 5th year, the interest of medical students could be significantly increased. This study could show for the first time that terrorist attacks and the resulting injuries have significant relevance for medical students. Consideration of this topic in all medical school curricula would be justified.
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Affiliation(s)
- Arnold J Suda
- AUVA Unfallkrankenhaus Salzburg, Akademisches Lehrkrankenhaus der Paracelsus Universität, Doktor-Franz-Rehrl-Platz 5, 5010, Salzburg, Österreich.
- Medizinische Fakultät Mannheim der Universität Heidelberg, Orthopädisch-Unfallchirurgisches Zentrum, Universitätsmedizin Mannheim, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Deutschland.
| | - Isabel Höppchen
- Abteilung Allgemeinmedizin und Versorgungsforschung, Universitätsklinikum Heidelberg, Marsilius-Arkaden, Turm West. Im Neuenheimer Feld 130.3, 69120, Heidelberg, Deutschland
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Back DA, Lembke V, Fellmer F, Kaiser D, Kasselmann N, Bickelmayer J, Willy C. Deployment and Disaster Medicine in an Undergraduate Teaching Module. Mil Med 2020; 184:e284-e289. [PMID: 30281084 DOI: 10.1093/milmed/usy250] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Revised: 08/22/2018] [Accepted: 08/30/2018] [Indexed: 11/14/2022] Open
Abstract
INTRODUCTION Modern health systems have to respond to a wide variety of catastrophic scenarios, from natural disasters to terror attacks. It is reasonable to already start educational approaches for physicians in this field at medical school level. An approach combining civilian disaster medicine and military deployment medicine can be beneficial both for clinical strategies and in undergraduate teaching. MATERIALS AND METHODS A curricular 4-week teaching module on "deployment and disaster medicine," interdisciplinarily combining over 12 medical specialties, was launched in the summer semester of 2016 at a civilian medical school. The course was integrated into the undergraduate curriculum by learning spirals. Teaching formats encompassed a total of 72 hours of seminars, clinical case discussions, group work, e-Learning, and practical training. The students' gain in knowledge was analyzed with pre/post-multiple-choice tests and their attitude towards the offer was evaluated. RESULTS A total of 51 students participated in the module over three semesters. The evaluation revealed that the students were highly satisfied with the offer and felt motivated to increase their engagement with the topic. The students additionally valued the course as a good means of deepening the core curriculum. The pre/post-tests showed a significant gain in knowledge among the students (p < 0.001). CONCLUSIONS The course presented received an overall highly positive feedback from the participating students. The experience of this approach suggests that the combination of civilian and military knowledge and expertise in deployment and disaster medicine may lead to the creation of effective interdisciplinary course concepts.
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Affiliation(s)
- David Alexander Back
- Clinic for Traumatology and Orthopedics, Septic-Reconstructive Surgery, Research and Treatment Center for Complex Combat Injuries, Bundeswehr Hospital Berlin, Scharnhorststrasse 13, Berlin, Germany.,Dieter Scheffner Center for Medical Education and Educational Research, Charité - Universitätsmedizin Berlin, Charitéplatz 1, Berlin, Germany
| | - Vanessa Lembke
- Center for Muskuloskeletal Surgery, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, Berlin, Germany
| | - Felix Fellmer
- Clinic for Traumatology and Orthopedics, Septic-Reconstructive Surgery, Research and Treatment Center for Complex Combat Injuries, Bundeswehr Hospital Berlin, Scharnhorststrasse 13, Berlin, Germany
| | - Daniel Kaiser
- Clinic for Traumatology and Orthopedics, Septic-Reconstructive Surgery, Research and Treatment Center for Complex Combat Injuries, Bundeswehr Hospital Berlin, Scharnhorststrasse 13, Berlin, Germany
| | - Nils Kasselmann
- Clinic for Traumatology and Orthopedics, Septic-Reconstructive Surgery, Research and Treatment Center for Complex Combat Injuries, Bundeswehr Hospital Berlin, Scharnhorststrasse 13, Berlin, Germany
| | - Jens Bickelmayer
- Clinic for Anesthesiology and Intensive Care Medicine, Emergency Department, Bundeswehr Hospital Berlin, Scharnhorststrasse 13, Berlin, Germany.,European Master in Disaster Medicine Alumni Association Network, CRIMEDIM, Via Lanino 1, Novara, Italy
| | - Christian Willy
- Clinic for Traumatology and Orthopedics, Septic-Reconstructive Surgery, Research and Treatment Center for Complex Combat Injuries, Bundeswehr Hospital Berlin, Scharnhorststrasse 13, Berlin, Germany
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Noh J, Oh EG, Kim SS, Jang YS, Chung HS, Lee O. Development and evaluation of a multimodality simulation disaster education and training program for hospital nurses. Int J Nurs Pract 2020; 26:e12810. [DOI: 10.1111/ijn.12810] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Revised: 11/11/2019] [Accepted: 11/18/2019] [Indexed: 11/30/2022]
Affiliation(s)
- Jiyoung Noh
- Center for Disaster Relief, Training, and ResearchYonsei University Severance Hospital Seoul South Korea
| | - Eui Geum Oh
- College of NursingYonsei University Seoul South Korea
| | - So Sun Kim
- College of NursingYonsei University Seoul South Korea
| | - Yeon Soo Jang
- College of NursingYonsei University Seoul South Korea
| | - Hyun Soo Chung
- Department of Emergency Medicine, College of MedicineYonsei University Seoul South Korea
| | - Ogcheol Lee
- Red Cross College of NursingChung‐Ang University Seoul South Korea
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A nationwide peer-assisted learning program in disaster medicine for medical students. Eur J Emerg Med 2020; 27:290-297. [DOI: 10.1097/mej.0000000000000668] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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French AJ. Simulation and Modeling Applications in Global Health Security. ADVANCED SCIENCES AND TECHNOLOGIES FOR SECURITY APPLICATIONS 2020. [PMCID: PMC7123972 DOI: 10.1007/978-3-030-23491-1_13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Global health security (GHS) is dependent upon having an adequate and prepared health security workforce. There are currently numerous challenges in establishing and maintaining a health security workforce. The frequency and magnitude of disasters have increased significantly over the past 30 years. Current and future GHS threats, both manmade and natural, require a prepared and flexible healthcare provider workforce ready to respond to current or emerging GHS threats. Developing and maintaining GHS -specific skills in the healthcare workforce is a tremendous logistical challenge. Innovative education technologies, including simulation and digital learning, can be leveraged to achieve preparedness for GHS threats. This chapter focuses on the application of modeling and simulation to support Global Health Security planning, preparedness and operations.
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Wang J, Li C, Zou S, Chen H, Xiang J, Hu Y, Huang H, Tan Y. Psychometric evaluation of undergraduate student nurses' learning perceived needs in disaster nursing: Two cross-sectional studies. NURSE EDUCATION TODAY 2020; 84:104208. [PMID: 31706206 DOI: 10.1016/j.nedt.2019.104208] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Revised: 06/05/2019] [Accepted: 09/06/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Disaster nursing education is a necessity for nurses and students to improve their disaster relief competencies. Determining undergraduate student nurses' learning perceived needs for disaster nursing can help improve curricula construction. In China there is currently no valid instrument available for the evaluation of influencing factors. A disaster nursing course content system was developed using the Delphi method in 2011. However, this system was unformed and lacked psychometric evaluation. OBJECTIVES To adapt the disaster nursing course content system into an instrument, to evaluate its psychometric properties, and to investigate undergraduate student nurses' learning perceived needs for disaster nursing. DESIGN, SETTINGS AND PARTICIPANTS Two cross-sectional studies were conducted in public higher education institutions in China. In the first study, a total of 1714 undergraduate student nurses were recruited in May to October 2016; in the second study, 68 were recruited in May 2019. METHODS The instrument was adapted through literature review, face validity and pilot testing in preliminary studies. The construct validity and reliability of the instrument were tested using exploratory factor analysis, parallel analysis, confirmatory factor analysis, internal consistency reliability and test-retest reliability. RESULTS The exploratory factor analysis and parallel analysis extracted a three-factor solution comprising 19 items that accounted for 71.69% of the total variance, including discipline introduction, skills and knowledge in disaster relief, and disaster management. The fit indices indicated a good fit. The internal consistency and test-retest reliability was good, as indicated by a Cronbach's alpha of 0.89 and an intraclass correlation coefficient of 0.87. CONCLUSION The Learning Needs for Disaster Nursing questionnaire exhibited good psychometric properties, thereby proving itself a valuable instrument for evaluating learning perceived needs in undergraduate student nurses.
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Affiliation(s)
- Jia Wang
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China.
| | - Chun Li
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Shengqiang Zou
- Disaster Nursing Office, School of Medicine, Jiangsu University, Zhenjiang, Jiangsu, China
| | - Hanxi Chen
- Burns and Wound Repair Surgery, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
| | - Jiagen Xiang
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Yanan Hu
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Hong Huang
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Yibing Tan
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China.
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Ready to Respond: A Survey of Interdisciplinary Health-Care Students and Administrators on Disaster Management Competencies. Disaster Med Public Health Prep 2019; 14:705-712. [PMID: 31566165 DOI: 10.1017/dmp.2019.96] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
BACKGROUND A sense of competency and confidence in disaster management is linked to response willingness and efficacy. This study assessed current health-care student disaster competency curricula and resultant confidence. METHODS A survey was sent to students and administrators in nurse practitioner (NP), master of public health (MPH), and medical/osteopathic schools (MD/DO), assessing curriculum coverage of 15 disaster management competencies (1-4, total 15-60), and confidence in performing 15 related behaviors (1-7, total 15-105). One-way analysis of variance with Tukey's post-hoc and Mann-Whitney U-tests were used to examine group differences. RESULTS A total of 729 students and 72 administrators completed the survey. Low coverage of all topics was reported by both students and administrators (mean 24.4; SD 9.6). Among students, NP students (21.66 ± 8.56) scored significantly lower than MD/DO (23.32 ± 8.19; P < 0.001) and MPH students (26.58 ± 9.06; P < 0.001) on curriculum coverage. Both administrators and students expressed low confidence in competence, with students significantly lower (P < 0.001). NP students scored higher (63.12 ± 20.69; P < 0.001) than both MPH (54.85 ± 17.82) and MD/DO (51.17 ± 19.71; P < 0.001) students. CONCLUSIONS Health-care students report low coverage of topics considered to be necessary disaster response competencies, as well as their confidence to execute functions. This may negatively impact willingness and ability of these professionals to respond effectively in a disaster.
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Core Disaster Medicine Education (CDME) for Emergency Medicine Residents in the United States. Prehosp Disaster Med 2019; 34:473-480. [PMID: 31455462 DOI: 10.1017/s1049023x19004746] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVES Disaster Medicine (DM) education for Emergency Medicine (EM) residents is highly variable due to time constraints, competing priorities, and program expertise. The investigators' aim was to define and prioritize DM core competencies for EM residency programs through consensus opinion of experts and EM professional organization representatives. METHODS Investigators utilized a modified Delphi methodology to generate a recommended, prioritized core curriculum of 40 DM educational topics for EM residencies. RESULTS The DM topics recommended and outlined for inclusion in EM residency training included: patient triage in disasters, surge capacity, introduction to disaster nomenclature, blast injuries, hospital disaster mitigation, preparedness, planning and response, hospital response to chemical mass-casualty incident (MCI), decontamination indications and issues, trauma MCI, disaster exercises and training, biological agents, personal protective equipment, and hospital response to radiation MCI. CONCLUSIONS This expert-consensus-driven, prioritized ranking of DM topics may serve as the core curriculum for US EM residency programs.
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Abstract
OBJECTIVES To provide scientific, theoretical support for the improvement of medical disaster training, we systematically analyzed the National Disaster Life Support (NDLS) Course and established a training curriculum with feedback based on the current status of disaster medicine in China. METHODS The gray prediction model is applied to long-term forecast research on course effect. In line with the hypothesis, the NDLS course with feedback capability is more scientific and standardized. RESULTS The current training NDLS course system is suitable for Chinese medical disasters. After accepting the course training, audiences' capabilities were enhanced. In the constructed GM (1,1) model prediction, the developing coefficients of the pretest and the posttest are 0.04 and 0.057, respectively. In light of the coefficient, the model is appropriate for the long-term prediction. The predicted results can be used as the basis for constructing training closed-loop optimization feedback. It can indicate that the course system has a good effect as well. CONCLUSIONS According to the constructed GM model, the NDLS course system is scientific, practical, and operational. The research results can provide reference for relevant departments and be used for the construction of similar training course systems.
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Disaster Preparedness Medical School Elective: Bridging the Gap Between Volunteer Eagerness and Readiness. Pediatr Emerg Care 2018; 34:492-496. [PMID: 27455344 DOI: 10.1097/pec.0000000000000806] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Eager medical students may not be prepared for unanticipated complexities of disaster response. This study aimed to answer 2 questions: does an online disaster preparedness curriculum create a convenient method to educate medical students and motivate them to be better prepared to volunteer? METHODS An online disaster preparedness elective was created for medical students. Four modules were created using Softchalk and hosted on the Blackboard Learning Management System. Students completed embedded pre-elective, post-lesson, and post-elective surveys. RESULTS Fifty-five students completed the elective. When posed with the statement, "I feel prepared for an emergency at the University or the immediate area," 70% stated that they disagreed or strongly disagreed before the elective. Subsequently, only 11% claimed to disagree after the elective. At the conclusion of the elective, 13% of students had prepared a personal emergency kit and 28% had prepared a family communication plan for reunification. Students were surveyed on the statement "I would like to be involved in a community disaster response while continuing my medical training." Ninety-four percent claimed to agree or strongly agree before the elective, and 93% stated the same after elective completion. CONCLUSIONS This disaster preparedness elective was envisioned to be a resource for students. Advantages of online availability are ease of student access and minimal demand on faculty resources. A voluntary, self-paced online elective in disaster preparedness has shown to create a stronger interest in disaster participation in medical students. Student readiness to volunteer improved; however, willingness remained stagnant.
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Wiesner L, Kappler S, Shuster A, DeLuca M, Ott J, Glasser E. Disaster Training in 24 Hours: Evaluation of a Novel Medical Student Curriculum in Disaster Medicine. J Emerg Med 2018; 54:348-353. [DOI: 10.1016/j.jemermed.2017.12.008] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2016] [Revised: 09/11/2017] [Accepted: 12/01/2017] [Indexed: 11/28/2022]
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Cavicchia ML, Cusumano AM, Bottino DV. Problem-based learning implementation in a health sciences blended-learning program in Argentina. INTERNATIONAL JOURNAL OF MEDICAL EDUCATION 2018; 9:45-47. [PMID: 29476666 PMCID: PMC5834822 DOI: 10.5116/ijme.5a7e.d85c] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2017] [Accepted: 02/10/2018] [Indexed: 06/08/2023]
Affiliation(s)
- María L. Cavicchia
- School of Medicine, Instituto Universitario CEMIC, Buenos Aires, Argentina
| | - Aana M. Cusumano
- School of Medicine, Instituto Universitario CEMIC, Buenos Aires, Argentina
| | - Daniela V. Bottino
- School of Medicine, Instituto Universitario CEMIC, Buenos Aires, Argentina
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Veterans Health Administration's Disaster Emergency Medical Personnel System (DEMPS) Training Evaluation: Potential Implications for Disaster Health Care Volunteers. Disaster Med Public Health Prep 2018; 12:744-751. [PMID: 29458449 DOI: 10.1017/dmp.2018.6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE The US Veterans Health Administration's Disaster Emergency Medical Personnel System (DEMPS) is a team of employee disaster response volunteers who provide clinical and non-clinical staffing assistance when local systems are overwhelmed. This study evaluated attitudes and recommendations of the DEMPS program to understand the impact of multi-modal training on volunteer perceptions. METHODS DEMPS volunteers completed an electronic survey in 2012 (n=2120). Three training modes were evaluated: online, field exercise, and face-to-face. Measures included: "Training Satisfaction," "Attitudes about Training," "Continued Engagement in DEMPS." Data were analyzed using χ2 and logistic regression. Open-ended questions were evaluated in a manner consistent with grounded theory methodology. RESULTS Most respondents participated in DEMPS training (80%). Volunteers with multi-modal training who completed all 3 modes (14%) were significantly more likely to have positive attitudes about training, plan to continue as volunteers, and would recommend DEMPS to others (P-value<0.001). Some respondents requested additional interactive activities and suggested increased availability of training may improve volunteer engagement. CONCLUSIONS A blended learning environment using multi-modal training methods, could enhance satisfaction and attitudes and possibly encourage continued engagement in DEMPS or similar programs. DEMPS training program modifications in 2015 expanded this blended learning approach through new interactive online learning opportunities. (Disaster Med Public Health Preparedness. 2018;12:744-751).
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Jonson CO, Pettersson J, Rybing J, Nilsson H, Prytz E. Short simulation exercises to improve emergency department nurses' self-efficacy for initial disaster management: Controlled before and after study. NURSE EDUCATION TODAY 2017; 55:20-25. [PMID: 28505521 DOI: 10.1016/j.nedt.2017.04.020] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2016] [Revised: 03/10/2017] [Accepted: 04/20/2017] [Indexed: 06/07/2023]
Abstract
INTRODUCTION Head nurses at emergency departments often assume responsibility for managing the initial response to a major incident, and to create surge capacity. Training is essential to enable these nurses to perform an effective disaster response. Evaluating the effects of such training is however complicated as real skill only can be demonstrated during a real major incident. Self-efficacy has been proposed as an alternative measure of training effectiveness. PURPOSE The aim of this study was to examine if short, small-scale computer-based simulation exercises could improve head emergency nurses' general and specific self-efficacy and initial incident management skills. METHOD A within-group pretest-posttest design was used to examine 13 head nurses' general and specific self-efficacy before and after an intervention consisting of three short computer based simulation exercises during a 1-h session. Management skills were assessed using the computer simulation tool DigEmergo. RESULTS The exercises increased the head nurses' general self-efficacy but not their specific self-efficacy. After completing the first two exercises they also exhibited improved management skills as indicated by shorter time to treatment for both trauma and in-hospital patients. CONCLUSION This study indicates that short computer based simulation exercises provide opportunities for head nurses to improve management skills and increase their general self-efficacy.
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Affiliation(s)
- Carl-Oscar Jonson
- Center for Disaster Medicine and Traumatology, and Department of Clinical and Experimental Medicine, Centre for Teaching & Research in Disaster Medicine and Traumatology, Linköping University, Johannes Magnus väg 11, SE-583 30 Linköping, Sweden.
| | - Jenny Pettersson
- Center for Disaster Medicine and Traumatology, and Department of Clinical and Experimental Medicine, Centre for Teaching & Research in Disaster Medicine and Traumatology, Linköping University, Johannes Magnus väg 11, SE-583 30 Linköping, Sweden.
| | - Jonas Rybing
- Department of Computer and Information Science, Linköping University, SE-581 83 Linköping, Sweden.
| | - Heléne Nilsson
- Center for Disaster Medicine and Traumatology, and Department of Clinical and Experimental Medicine, Centre for Teaching & Research in Disaster Medicine and Traumatology, Linköping University, Johannes Magnus väg 11, SE-583 30 Linköping, Sweden.
| | - Erik Prytz
- Center for Disaster Medicine and Traumatology, and Department of Clinical and Experimental Medicine, Centre for Teaching & Research in Disaster Medicine and Traumatology, Linköping University, Johannes Magnus väg 11, SE-583 30 Linköping, Sweden; Department of Computer and Information Science, Linköping University, SE-581 83 Linköping, Sweden.
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Self-Perception of Medical Students' Knowledge and Interest in Disaster Medicine: Nine Years After the Approval of the Curriculum in German Universities. Prehosp Disaster Med 2017; 32:374-381. [PMID: 28376940 DOI: 10.1017/s1049023x17000280] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Following the recommendations of the World Association for Disaster and Emergency Medicine (WADEM; Madison, Wisconsin USA) to develop standards for training the undergraduates in disaster-relevant fields (2004), a German curriculum was approved in 2006. This paper aims to describe the level of training and interest of medical students nine years later. Problem The aim of this study was to assess the self-perception of medical students' knowledge and interest in disaster medicine nine years after the implementation of a standardized disaster medicine curriculum in German medical schools. METHODS This prospective, cross-sectional, observational study was conducted with medical students in Germany using a web-based, purpose-designed questionnaire consisting of 27 mandatory and 11 optional questions. RESULTS Nine hundred ninety-two students from 36 of 37 medical schools in Germany participated. More than one-half of medical students were aware of the field of disaster medicine. One hundred twenty-one students undertook training internally within their university and 307 undertook training externally at other institutions. Only a small content of the curriculum was taught. A difference in self-perception of knowledge between trained and untrained participants was found, despite the level of training being low in both groups. Participants were generally highly motivated to learn disaster medicine in a variety of institutions. CONCLUSION German students are still largely not well educated regarding disaster medicine, despite their high motivation. The curriculum of 2006 was not implemented as originally planned and the number of trained students still remains low as the self-perception of knowledge. Currently, there is no clear and standardized training concept in place. A renewal in the agreement of implementation of the curriculum at medical schools should be targeted in order to follow the recommendation of WADEM. Wunderlich R Ragazzoni L Ingrassia PL Della Corte F Grundgeiger J Bickelmayer JW Domres B . Self-perception of medical students' knowledge and interest in disaster medicine: nine years after the approval of the curriculum in German universities. Prehosp Disaster Med. 2017;32(4):374-381.
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Thomas G, Duddu V, Gater R. Blending an e-learning package into a problem-based learning module. INTERNATIONAL JOURNAL OF MEDICAL EDUCATION 2016; 7:279-280. [PMID: 27571022 PMCID: PMC5018352 DOI: 10.5116/ijme.5787.617d] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/03/2016] [Accepted: 07/14/2016] [Indexed: 06/06/2023]
Affiliation(s)
- Gareth Thomas
- Lancashire Care NHS Foundation Trust, Lancashire, UK
| | - Venugopal Duddu
- Institute of Medical Psychology, Asha Hospital, Hyderabad, India
| | - Richard Gater
- Faculty of Medical and Human Sciences, University of Manchester, UK
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Bajow N, Djalali A, Ingrassia PL, Ragazzoni L, Ageely H, Bani I, Corte FD. Evaluation of a new community-based curriculum in disaster medicine for undergraduates. BMC MEDICAL EDUCATION 2016; 16:225. [PMID: 27562428 PMCID: PMC5000399 DOI: 10.1186/s12909-016-0746-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/09/2015] [Accepted: 08/18/2016] [Indexed: 06/06/2023]
Abstract
BACKGROUND Nowadays, many medical schools include training in disaster medicine in undergraduate studies. This study evaluated the efficacy of a disaster medicine curriculum recently designed for Saudi Arabian medical students. METHODS Participants were 15 male and 14 female students in their fourth, fifth or sixth year at Jazan University Medical School, Saudi Arabia. The course was held at the Research Center in Emergency and Disaster Medicine and Computer Sciences Applied to the Medical Practice in Novara, Italy. RESULTS The overall mean score on a test given before the course was 41.0 % and it increased to 67.7 % on the post-test (Wilcoxon test for paired samples: z = 4.71, p < 0.0001). There were no significant differences between the mean scores of males and females, or between students in their fourth, fifth or sixth year of medical school. CONCLUSIONS These results show that this curriculum is effective for teaching disaster medicine to undergraduate medical students. Adoption of this course would help to increase the human resources available for dealing with disaster situations.
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Affiliation(s)
- Nidaa Bajow
- CRIMEDIM - Research Centre in Emergency and Disaster Medicine and Computer Science Applied to Medical Practice, University of Eastern Piedmont, Novara, Italy.
- Disaster Medicine Unit, Mohammad Bin Naif Medical Center, King Fahd Security College, P O Box 89489, Riyadh, 11682, Saudi Arabia.
| | - Ahmadreza Djalali
- CRIMEDIM - Research Centre in Emergency and Disaster Medicine and Computer Science Applied to Medical Practice, University of Eastern Piedmont, Novara, Italy
| | - Pier Luigi Ingrassia
- CRIMEDIM - Research Centre in Emergency and Disaster Medicine and Computer Science Applied to Medical Practice, University of Eastern Piedmont, Novara, Italy
| | - Luca Ragazzoni
- CRIMEDIM - Research Centre in Emergency and Disaster Medicine and Computer Science Applied to Medical Practice, University of Eastern Piedmont, Novara, Italy
| | | | - Ibrahim Bani
- Medical School of Jazan University, Jazan, Saudi Arabia
| | - Francesco Della Corte
- CRIMEDIM - Research Centre in Emergency and Disaster Medicine and Computer Science Applied to Medical Practice, University of Eastern Piedmont, Novara, Italy
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Case-based Learning Outperformed Simulation Exercises in Disaster Preparedness Education Among Nursing Trainees in India: A Randomized Controlled Trial. Prehosp Disaster Med 2016; 31:516-23. [DOI: 10.1017/s1049023x16000789] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractObjectiveIn resource-constrained environments, appropriately employing triage in disaster situations is crucial. Although both case-based learning (CBL) and simulation exercises (SEs) commonly are utilized in teaching disaster preparedness to adult learners, there is no substantial evidence supporting one as a more efficacious methodology. This randomized controlled trial (RCT) evaluated the effectiveness of CBL versus SEs in addition to standard didactic instruction in knowledge attainment pertaining to disaster triage preparedness.MethodsThis RCT was performed during a one-day disaster preparedness course in Lucknow, India during October 2014. Following provision of informed consent, nursing trainees were randomized to knowledge assessment after didactic teaching (control group); didactic plus CBL (Intervention Group 1); or didactic plus SE (Intervention Group 2). The educational curriculum used the topical focus of triage processes during disaster situations. Cases for the educational intervention sessions were scripted, identical between modalities, and employed structured debriefing. Trained live actors were used for SEs. After primary assessment, the groups underwent crossover to take part in the alternative educational modality and were re-assessed. Two standardized multiple-choice question batteries, encompassing key core content, were used for assessments. A sample size of 48 participants was calculated to detect a ≥20% change in mean knowledge score (α=0.05; power=80%). Robustness of randomization was evaluated using X2, anova, and t-tests. Mean knowledge attainment scores were compared using one- and two-sample t-tests for intergroup and intragroup analyses, respectively.ResultsAmong 60 enrolled participants, 88.3% completed follow-up. No significant differences in participant characteristics existed between randomization arms. Mean baseline knowledge score in the control group was 43.8% (standard deviation=11.0%). Case-based learning training resulted in a significant increase in relative knowledge scores at 20.8% (P=0.003) and 10.3% (P=.033) in intergroup and intragroup analyses, respectively. As compared to control, SEs did not significantly alter knowledge attainment scores with an average score increase of 6.6% (P=.396). In crossover intra-arm analysis, SEs were found to result in a 26.0% decrement in mean assessment score (P < .001).ConclusionsAmong nursing trainees assessed in this RCT, the CBL modality was superior to SEs in short-term disaster preparedness educational translation. Simulation exercises resulted in no detectable improvement in knowledge attainment in this population, suggesting that CBL may be utilized preferentially for adult learners in similar disaster training settings.AluisioAR, DanielP, GrockA, FreedmanJ, SinghA, PapanagnouD, ArquillaB. Case-based learning outperformed simulation exercises in disaster preparedness education among nursing trainees in India: a randomized controlled trial. Prehosp Disaster Med. 2016;31(5):516–523.
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Mortelmans LJM, Lievers J, Dieltiens G, Sabbe MB. Are Belgian military students in medical sciences better educated in disaster medicine than their civilian colleagues? J ROY ARMY MED CORPS 2016; 162:383-386. [PMID: 26759501 PMCID: PMC5099320 DOI: 10.1136/jramc-2015-000563] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2015] [Accepted: 12/08/2015] [Indexed: 11/17/2022]
Abstract
Introduction Historically, medical students have been deployed to care for disaster victims but may not have been properly educated to do so. A previous evaluation of senior civilian medical students in Belgium revealed that they are woefully unprepared. Based on the nature of their military training, we hypothesised that military medical students were better educated and prepared than their civilian counterparts for disasters. We evaluated the impact of military training on disaster education in medical science students. Methods Students completed an online survey on disaster medicine, training, and knowledge, tested using a mixed set of 10 theoretical and practical questions. The results were compared with those of a similar evaluation of senior civilian medical students. Results The response rate was 77.5%, mean age 23 years and 59% were males. Overall, 95% of military medical students received some chemical, biological, radiological and nuclear training and 22% took part in other disaster management training; 44% perceived it is absolutely necessary that disaster management should be incorporated into the regular curriculum. Self-estimated knowledge ranged from 3.75 on biological incidents to 4.55 on influenza pandemics, based on a 10-point scale. Intention to respond in case of an incident ranged from 7 in biological incidents to 7.25 in chemical incidents. The mean test score was 5.52; scores improved with educational level attained. A comparison of survey data from civilian senior medical master students revealed that, except for influenza pandemic, military students scored higher on knowledge and capability, even though only 27% of them were senior master students. Data on willingness to work are comparable between the two groups. Results of the question/case set were significantly better for the military students. Conclusions The military background and training of these students makes them better prepared for disaster situations than their civilian counterparts.
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Affiliation(s)
- Luc J M Mortelmans
- Department of Emergency Medicine, ZNA Camp Stuivenberg, Antwerp, Belgium Center for Research and Education in Emergency Care, University of Leuven, Leuven, Belgium
| | - J Lievers
- Medical Services, Belgian Military, Brussels, Belgium Department of Emergency Medicine, University Hospital Gasthuisberg, Leuven, Belgium
| | - G Dieltiens
- Department of Emergency Medicine, ZNA Camp Stuivenberg, Antwerp, Belgium
| | - M B Sabbe
- Center for Research and Education in Emergency Care, University of Leuven, Leuven, Belgium Department of Emergency Medicine, University Hospital Gasthuisberg, Leuven, Belgium
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Mortelmans LJM, Bouman SJM, Gaakeer MI, Dieltiens G, Anseeuw K, Sabbe MB. Dutch senior medical students and disaster medicine: a national survey. Int J Emerg Med 2015; 8:77. [PMID: 26335099 PMCID: PMC4558995 DOI: 10.1186/s12245-015-0077-0] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2015] [Accepted: 07/16/2015] [Indexed: 11/15/2022] Open
Abstract
Background Medical students have been deployed in victim care of several disasters throughout history. They are corner stones in first-line care in recent pandemic planning. Furthermore, every physician and senior medical student is expected to assist in case of disaster situations, but are they educated to do so? Being one of Europe’s densest populated countries with multiple nuclear installations, a large petrochemical industry and also at risk for terrorist attacks, The Netherlands bear some risks for incidents. We evaluated the knowledge on Disaster Medicine in the Dutch medical curriculum. Our hypothesis is that Dutch senior medical students are not prepared at all. Methods Senior Dutch medical students were invited through their faculty to complete an online survey on Disaster Medicine, training and knowledge. This reported knowledge was tested by a mixed set of 10 theoretical and practical questions. Results With a mean age of 25.5 years and 60 % females, 999 participants completed the survey. Of the participants, 51 % considered that Disaster Medicine should absolutely be taught in the regular medical curriculum and only 2 % felt it as useless; 13 % stated to have some knowledge on disaster medicine. Self-estimated capability to deal with various disaster situations varied from 1.47/10 in nuclear incidents to 3.92/10 in influenza pandemics. Self-estimated knowledge on these incidents is in the same line (1.71/10 for nuclear incidents and 4.27/10 in pandemics). Despite this limited knowledge and confidence, there is a high willingness to respond (ranging from 4.31/10 in Ebola outbreak over 5.21/10 in nuclear incidents to 7.54/10 in pandemics). The case/theoretical mix gave a mean score of 3.71/10 and raised some food for thought. Although a positive attitude, 48 % will place contaminated walking wounded in a waiting room and 53 % would use iodine tablets as first step in nuclear decontamination. Of the participants, 52 % even believes that these tablets protect against external radiation, 41 % thinks that these tablets limit radiation effects more than shielding and 57 % believes that decontamination of chemical victims consists of a specific antidote spray in military cabins. Conclusions Despite a high willingness to respond, our students are not educated for disaster situations. Electronic supplementary material The online version of this article (doi:10.1186/s12245-015-0077-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Luc J M Mortelmans
- Department of Emergency Medicine ZNA camp Stuivenberg, Lange Beeldekensstraat 267, B2060, Antwerp, Belgium,
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Bajow N, Djalali A, Ingrassia PL, Ageely H, Bani I, Corte FD. Disaster medicine curricula in Saudi Arabian medical schools. JOURNAL OF EMERGENCY MEDICINE, TRAUMA AND ACUTE CARE 2015. [DOI: 10.5339/jemtac.2015.8] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Background:Disaster medicine training in medical school is a key element of disaster preparedness, and several international educational authorities have called for an increase in this specific type of training. The objective of this study was to assess the current state of disaster medicine education in the Kingdom of Saudi Arabia.Methods:All 30 medical schools in Saudi Arabia were invited to participate in the study, and a 25-item online survey was sent to those that consented.Results:The response rate was 67%. Only three of the responding 20 universities currently have disaster medicine programs, and they spend an average of three hours per year on the subject. Respondents without disaster medicine curricula indicated that a mandatory, accredited course in the final three years of the six-year program was their preferred method for implementation, and most favored a blended approach.Conclusions:The study found that there is a paucity of disaster medicine programs in Saudi Arabia. Most schools indicated a willingness to implement such training in their undergraduate programs but cited lack of an adequate number of relevant professionals as a major impediment.
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Affiliation(s)
- Nidaa Bajow
- 1Prince Mohammed Bin Naif Medical Center, Riyadh, Saudi Arabia
| | - Ahmadreza Djalali
- 2Università del Piemonte Orientale “A. Avogadro,” Research Center in Emergency and Disaster Medicine and Computer Science Applied to Medical Practice (CRIMEDIM), Novara, Italy
| | - Pier Luigi Ingrassia
- 2Università del Piemonte Orientale “A. Avogadro,” Research Center in Emergency and Disaster Medicine and Computer Science Applied to Medical Practice (CRIMEDIM), Novara, Italy
| | - Hussein Ageely
- 3College of Medicine, Jazan University, Jazan Saudi Arabia
| | - Ibrahim Bani
- 3College of Medicine, Jazan University, Jazan Saudi Arabia
| | - Francesco Della Corte
- 2Università del Piemonte Orientale “A. Avogadro,” Research Center in Emergency and Disaster Medicine and Computer Science Applied to Medical Practice (CRIMEDIM), Novara, Italy
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Nationwide Program of Education for Undergraduates in the Field of Disaster Medicine: Development of a Core Curriculum Centered on Blended Learning and Simulation Tools. Prehosp Disaster Med 2014; 29:508-15. [DOI: 10.1017/s1049023x14000831] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractIn recent years, effective models of disaster medicine curricula for medical schools have been established. However, only a small percentage of medical schools worldwide have considered at least basic disaster medicine teaching in their study program. In Italy, disaster medicine has not yet been included in the medical school curriculum. Perceiving the lack of a specific course on disaster medicine, the Segretariato Italiano Studenti in Medicina (SISM) contacted the Centro di Ricerca Interdipartimentale in Medicina di Emergenza e dei Disastri ed Informatica applicata alla didattica e alla pratica Medica (CRIMEDIM) with a proposal for a nationwide program in this field. Seven modules (introduction to disaster medicine, prehospital disaster management, definition of triage, characteristics of hospital disaster plans, treatment of the health consequences of different disasters, psychosocial care, and presentation of past disasters) were developed using an e-learning platform and a 12-hour classroom session which involved problem-based learning (PBL) activities, table-top exercises, and a computerized simulation (Table 1). The modules were designed as a framework for a disaster medicine curriculum for undergraduates and covered the three main disciplines (clinical and psychosocial, public health, and emergency and risk management) of the core of “Disaster Health” according to the World Association for Disaster and Emergency Medicine (WADEM) international guidelines for disaster medicine education. From January 2011 through May 2013, 21 editions of the course were delivered to 21 different medical schools, and 524 students attended the course. The blended approach and the use of simulation tools were appreciated by all participants and successfully increased participants’ knowledge of disaster medicine and basic competencies in performing mass-casualty triage. This manuscript reports on the designing process and the initial outcomes with respect to learners' achievements and satisfaction of a 1-month educational course on the fundamentals of disaster medicine. This experience might represent a valid and innovative solution for a disaster medicine curriculum for medical students that is easily delivered by medical schools.Table 1List of Modules and TopicsModuleTopics1. Introduction to disaster medicine and public health during emergencies- Modern taxonomy of disaster and common disaster medicine definitions- Differences between disaster and emergency medicine- Principles of public health during disasters- Different phases of disaster management2. Prehospital disaster management- Mass-casualty disposition, treatment area, and transport issues- Disaster plans and command-and-control chain structure- Functional response roles3. Specific disaster medicine and triage procedures in the- Mass-casualty triage definitions and principlesmanagement of disasters- Different methodologies and protocols- Patient assessment, triage levels and tags4. Hospital disaster preparedness and response- Hospital disaster laws- Hospital preparedness plans for in-hospital and out-hospital disasters with an all-hazard approach- Medical management for a massive influx of casualties5. Health consequences of different disasters- Characteristics of different types of disasters- Health impact of natural and man-made disasters- Disaster-related injury after exposure to a different disasters with an all-hazard approach6. Psychosocial care- Techniques to deal with psychic reactions caused by exposure to disaster scenarios- Treatment approaches to acute and delayed critical incident stress reactions7. Presentation of past disasters and public health emergencies, andCase study:review of assistance experiences- Haiti earthquake- Cholera outbreaks in Haiti- National and international disaster response mechanismIngrassiaPL, RagazzoniL, TengattiniM, CarenzoL, Della CorteF. Nationwide program of education for undergraduates in the field of disaster medicine: development of a core curriculum centered on blended learning and simulation tools. Prehosp Disaster Med. 2014;29(5):1-8.
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