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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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Staben M, Raiten J, Lane-Fall M, Scott M. Development of an Anesthesiology Disaster Response Plan. Anesthesiol Clin 2021; 39:245-253. [PMID: 34024428 PMCID: PMC8053004 DOI: 10.1016/j.anclin.2021.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Mac Staben
- Department of Anesthesiology and Critical Care, Perelman School of Medicine of the University of Pennsylvania, 3400 Spruce Street, Dulles 6, Philadelphia, PA 19104, USA
| | - Jesse Raiten
- Department of Anesthesiology and Critical Care, Perelman School of Medicine of the University of Pennsylvania, 3400 Spruce Street, Dulles 6, Philadelphia, PA 19104, USA.
| | - Meghan Lane-Fall
- Department of Anesthesiology and Critical Care, Perelman School of Medicine of the University of Pennsylvania, 3400 Spruce Street, Dulles 6, Philadelphia, PA 19104, USA
| | - Michael Scott
- Department of Anesthesiology and Critical Care, Perelman School of Medicine of the University of Pennsylvania, 3400 Spruce Street, Dulles 6, Philadelphia, PA 19104, USA
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Anaesthesia in austere environments: literature review and considerations for future space exploration missions. NPJ Microgravity 2018; 4:5. [PMID: 29507873 PMCID: PMC5824960 DOI: 10.1038/s41526-018-0039-y] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2017] [Revised: 01/30/2018] [Accepted: 01/31/2018] [Indexed: 01/28/2023] Open
Abstract
Future space exploration missions will take humans far beyond low Earth orbit and require complete crew autonomy. The ability to provide anaesthesia will be important given the expected risk of severe medical events requiring surgery. Knowledge and experience of such procedures during space missions is currently extremely limited. Austere and isolated environments (such as polar bases or submarines) have been used extensively as test beds for spaceflight to probe hazards, train crews, develop clinical protocols and countermeasures for prospective space missions. We have conducted a literature review on anaesthesia in austere environments relevant to distant space missions. In each setting, we assessed how the problems related to the provision of anaesthesia (e.g., medical kit and skills) are dealt with or prepared for. We analysed how these factors could be applied to the unique environment of a space exploration mission. The delivery of anaesthesia will be complicated by many factors including space-induced physiological changes and limitations in skills and equipment. The basic principles of a safe anaesthesia in an austere environment (appropriate training, presence of minimal safety and monitoring equipment, etc.) can be extended to the context of a space exploration mission. Skills redundancy is an important safety factor, and basic competency in anaesthesia should be part of the skillset of several crewmembers. The literature suggests that safe and effective anaesthesia could be achieved by a physician during future space exploration missions. In a life-or-limb situation, non-physicians may be able to conduct anaesthetic procedures, including simplified general anaesthesia.
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