Training medical staff for pediatric disaster victims: A comparison of different teaching methods

Solomon Behar, MD, Jeffrey S. Upperman, MD, Marizen Ramirez, PhD, Fred Dorey, PhD, Alan Nager, MD

Abstract


Objective: The goal of this study was to assess the effectiveness of the different types of healthcare worker training in pediatric disaster medicine knowledge over time and to analyze the effects of training type on healthcare workers’ attitude toward pediatric disaster medicine.
Design: Prospective randomized controlled longitudinal study.
Setting: Large, urban, tertiary academic children’s hospital.
Subjects: Physicians and nurses employed at Children’s Hospital Los Angeles randomly selected from a global hospital e-mail server over a 3-week time frame were invited to participate and receive an incentive on completion. Forty-three controls and 42 intervention subjects (22 lecture _ tabletop exercise, 20 lecture only) completed the study. Subjects with disaster training in the prior 6 months were excluded.
Interventions: Subjects underwent a didactic lecture or a combination of didactic lecture and tabletop exercise. Preintervention and postintervention testing took place using a 37-question multiple-choice test on pediatric disaster medical topics. Posttesting took place immediately after intervention and then 1, 3, and 6 months after the intervention. Subjects also were surveyed before and after intervention regarding their attitudes toward pediatric disaster medicine.
Main outcome measures: (1) Scores on a 37- question knowledge test and (2) Likert scores on selfperceptions of knowledge, comfort, and interest in pediatric disaster medicine.
Results: Regardless of intervention type, participant scores on a postintervention pediatric disaster medicine tests over a 6-month period increased and remained well above pretest means for intervention and control pretest scores. There were no differences in scores comparing type of intervention. However, subjects who underwent the tabletop simulation had a better sense of knowledge and comfort with the topics compared with those who only underwent a didactic lecture.
Conclusions: Didactic lecture and tabletop exercises both increase healthcare worker’s knowledge of pediatric disaster medical topics. This knowledge seems to be retained for at least 6 months postintervention. The addition of the tabletop exercise to a standard didactic lecture may increase a learner’s sense of knowledge and comfort with disaster topics, which may in turn lead to increased staff participation in the event of an actual disaster.


Keywords


disaster, training, child, education, teaching methods, healthcare workers

Full Text:

PDF

References


Rico E, Trepka M, Zhang G, et al.: Knowledge and attitudes about bioterrorism and smallpox: A survey of physicians and nurses. Epidemiol Mon Rep. 2002; 3: 1-7.

Chen F, Hickner J, Fink K, et al.: On the front line: Family physicians’ preparedness for bioterrorism. J Fam Pract. 2002; 51: 745- 750.

Treat KN,Williams JM, Furbee PM, et al.: Hospital preparedness for weapons of mass destruction incidents: An initial assessment. Ann Emerg Med. 2001; 38(5): 562-565.

Mann NC, MacKenzie E, Anderson C: Public health preparedness for mass casualty events: A 2002 state-by-state assessment. Prehospital Disaster Med. 2004; 19(3): 245-245.

Aharonson-Daniel L,Waisman Y, Dannon Y, et al.: Epidemiology of Terror-Related Versus Non-Terror-Related Traumatic Injury in Children. Pediatrics Vol. 112 No. 4 October 2003, pp. e280-e280.

Waisman Y, Aahronson-Daniel L, Mor M, et al.: The impact of terrorism on children: A two year experience. Prehospital Disaster Med. 2003; 18(3): 242-248.

Hsu EB, Jenckes MW, Catlett CL, et al.: Training of hospital staff to respond to a mass casualty incident. Evidence Report/Technology Assessment No. 95. (Prepared by the Johns Hopkins University Evidence-based Practice Center under Contract No. 290-02-0018.) AHRQ Publication No. 04-E015-2, July 2004. Rockville, MD:Agency for Healthcare Research and Quality.

Johannigman, J: Disaster preparedness: It’s all about me. Crit Care Med. 2005; 33(1) (Suppl.): S22-S28.

Hsu EB, Jenckes MW, Catlett CL, et al.: Effectiveness of hospital staff mass-casualty incident training methods: A systematic literature review. Prehospital Disaster Med. 2004; 19(3): 191-199.

Greenberg M, Jurgens SM, Gracely EJ, et al.: ED preparedness for the evaluation and treatment of victims of bioterrorism. J Emerg Med. 2002; 30: 273-278.

Cosgrove SE, Perl TM, Song X, et al.: Ability of physicians to diagnose and manage illness due to category A bioterror agents. Arch Intern Med. 2005; 165(17): 2002-2006.

Inglesby TV, Grossman R, O’Toole, et al.: A plague on your city: Observations from TOPOFF. Clin Infect Dis. 2001; 32(3): 436-445.

Levy K, Aghbabian RV, Hirsch EF, et al.: An Internet-based exercise as a component of an overall training program addressing medical aspects of radiation emergency management. Prehospital Disaster Med. 2000; 15(2): 18-25.

Gray, D.: Disaster plan education: How we made and tested a video. J Accid Emerg Med. 1996; 13(1): 21-22.

Alexander AJ, Banderia GW, Mazurik L: A multiphase disaster training exercise for emergency medicine residents: Opportunity knocks. Acad Emerg Med. 2005, 12: 404-411.

Gausche-Hill M, Schmitz C, Lewis RJ: Pediatric preparedness of U.S. Emergency Departments: A 2003 Survey. Pediatrics. 2007; 120(6): 1229-1237.

Gnauck KA, Nufer KE, LaValley JM, et al.: Do pediatric and adult disaster victims differ? A descriptive analysis of clinical encounters from four natural disasters DMAT deployments. Prehospital Disaster Med. 2007; 22(1): 67-71.

Rassin M, Avraham M, Nasi-Bashari N, et al.: Emergency department staff preparedness for mass casualty events involving children. Disaster Manag Response. 2007; 5(2): 36-44.

Martin SD, Buh AC, Lynch JA: A national survey of terrorism preparedness training among pediatric, family practice, and emergency medicine programs. Pediatrics. 2006; 118(3): e620-e626.

Shirm S, Liggin R, Dick R, et al.: Prehospital preparedness for pediatric mass-casualty events. Pediatrics. 2007; 120: e756-e761.

California Emergency Medical Service Agency. Disaster Pediatric Survey: Results and Recommendations, August 31, 2006.

Future of Emergency Care. Emergency Care for Children: Growing Pains. Committee on the Future of Emergency Care in the United States Health System Board on Health Care Services Institute of Medicine of the National Academies.Washington, DC: The National Academies Press. Available at http://books.nap.edu/ openbook.php?record_id_11655&page_232 on 12/20/07.

Jasper EJ, Sweeney B, Willams E, et al.: Value of an unannounced drill in preparing hospitals for a terrorism attack or other mass casualty event. Acad Emerg Med. 2004; 11(5): 562.

Qureshi K, et al.: Health care workers’ ability and willingness to report to duty during catastrophic disasters. J Urban Health. 2005; 82(3): 378-388.

Choksi N, Behar SM, Nager AL, et al.: Disaster management among pediatric surgeons: Preparedness, training and involvement. Am J Disaster Med. 2008; 3(1): 5-14.

Asch SM, Stoto M, Mendes M, et al.:A review of instruments assessing public health preparedness. Public Health Rep. 2005; 18: 532-542.

Gebbie K, Merrill J: Public health worker competencies for emergency response. J Public Health Manag Pract. 2002; 8(3): 73-81.

Psoter WJ, Herman NG, More FG, et al.: Proposed educational objectives for hospital-based dentists during catastrophic events and disaster response. J Dent Educ. 2006; 70(8): 835-843.

International Nursing Coalition for Mass Casualty Education. Educational Competencies for Registered Nurses Responding to Mass Casualty Incidents. Available at http://www.mc.vanderbilt. edu/nursing/incmce/competencies.html. Accessed on June 20, 2007.

Markenson D, DiMaggio C, Redlener I: Preparing health professional students for terrorism, disaster, and public health emergencies: Core competencies. Acad Med. 2005; 80(6): 517-526.

Markenson D, Redlener I: Pediatric terrorism preparedness national guidelines and recommendations: Findings of an evidencedbased consensus process. Biosecur Bioterror. 2004; 2(4): 301-319.

Hsu EB, Thomas TL, Bass EB, et al.: Healthcare worker competencies for disaster training. Biomed Centr Med Educ. 2006; 6: 19.




DOI: https://doi.org/10.5055/ajdm.2008.0026

Refbacks

  • There are currently no refbacks.