A comprehensive disaster training program to improve emergency physicians’ preparedness: A 1-year pilot study

Dino P. Rumoro, DO, Jamil D. Bayram, MD, MPH, EMDM, Mamta Malik, MD, MPH, Yanina A. Purim-Shem-Tov, MD, MS

Abstract


Objectives: The main objective of this pilot study was to measure the effectiveness of a 1-year comprehensive training program on the long-term cognitive competence in disaster preparedness among attending emergency physicians (EPs).
Design: Ten attending EPs participated in a yearlong training program in disaster preparedness and management. A baseline pretraining test and self-evaluation questionnaire were administered to the participants. Post-training written test and self-evaluation questionnaire were repeated at 12 months after the completion of the program.
Setting: The study took place at an urban tertiary care medical center from July 2007 to June 2008.
Interventions: The training program was divided into three main categories: didactic core topics, formally recognized courses, and a practicum (drill).
Main outcome measures: Pretraining and posttraining test scores in addition to pretraining and posttraining self-assessments were compared for disaster preparedness in various areas.
Results: There was a statistically significant increase in the overall post-test versus pretest scores on the written examination for the entire group (44.4 vs 29.8, p < 0.005). In addition, statistically significant increases in each area of disaster preparedness were noted for the self-assessments (2.7 _ 0.82 vs 3.9 _ 0.56, p _ 0.01), where 1 means not prepared at all and 5 means extremely well prepared.
Conclusions: Disaster preparedness is an essential area of clinical competence for EPs. Participation in a yearlong pilot training program demonstrated a statistically significant increase in cognitive competence among a pilot sample of EPs. More research is needed to validate the content of the training program and its instruments of evaluation.


Keywords


disaster training, emergency physicians, emergency preparedness, medical education, clinical competence

Full Text:

PDF

References


American College of Emergency Physicians: ACEP Policy Statements. Disaster Medical Services, 2000. Available at http:// www3.acep.org/practres.aspx?id=29176. Accessed February 2, 2009.

Feldstein BD, Gallery ME, Sanner PH, et al.: Disaster training for emergency physicians in the United States: A systems approach. Ann Emerg Med. 1985; 14(1): 36-40.

Pesik N, Keim M, Sampson TR: Do US emergency medicine residency programs provide adequate training for bioterrorism? Ann Emerg Med. 1999; 34(2): 173-1766.

Scott JA, Miller GT, Issenberg SB, et al.: Skill improvement during emergency response to terrorism training. Prehosp Emerg Care. 2006; 10(4): 507-514.

Miller GE: The assessment of clinical skills/competence/performance. Acad Med. 1990; 65: S63-S67.

Norcicin JJ: ABC of learning and teaching in medicine: Work based assessment. BMJ. 2003; 326: 753-755.

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

Seynaeve G, Archer F, Fisher J, et al.: Education Committee Working Group, World Association for Disaster and Emergency Medicine. International standards and guidelines on education and training for the multi-disciplinary health response to major events that threaten the health status of a community. Prehosp Disaster Med. 2004; 19(3): 186-187.

Alexander AJ, Bandiera GW, Mazurik L: A multiphase disaster training exercise for emergency medicine residents: Opportunity knocks. Acad Emerg Med. 2005; 12(5): 404-409.

Murray V, Clifford J, Seynaeve G, et al.: Disaster health education and training: A pilot questionnaire to understand current status. Prehosp Disaster Med. 2006; 21(3): 156-167.

American Medical Association: National Disaster Life Support (NDLS). Available at http://www.ama-assn.org/ama/pub/physicianresources/ public-health/center-public-health-preparedness-disasterresponse/ national-disaster-life-support.shtml. Accessed February 2, 2009.

Advanced HAZMAT Life Support (AHLS).Website: Available at http:// www.ahls.org. Accessed February 2, 2009.

Hsu EB, Jenckes MW, Catlett CL, et al.: Training of hospital staff to respond to a mass casualty incident. Evidence Report/Technology Assessment Number 95. Rockville, MD: Agency for Healthcare Research and Quality, 2004.

Seynaeve G, Archer F, Fisher J, et al.: Education Committee Working Group, World Association for Disaster and Emergency Medicine. International standards and guidelines on education and training for the multi-disciplinary health response to major events that threaten the health status of a community. Prehosp Disaster Med. 2004; 19(2): S17-S30.

Columbia School of Nursing: Emergency preparedness training for hospital clinicians—Are you ready to respond? Available at http://www.nursing.columbia.edu/chp/pdfArchive/EmerPrepTrng HospiClin.pdf. Accessed February 2, 2009.

International Nursing Coalition for Mass Casualty Education: Educational competencies for registered nurses responding to mass casualty incidents.Available at http://www.aacn.nche.edu/Education/ pdf/INCMCECompetencies.pdf. Accessed February 2, 2009.

Columbia School of Nursing: Competency-to-curriculum toolkit. Available at http://www.nursing.columbia.edu/chp/pdfArchive/ Toolkit05_08.pdf. Accessed February 2, 2009.

Center for Disaster Control and Prevention (CDC): Bioterrorism and emergency readiness: Competencies for all public health workers. Available at https://www.train.org/Competencies/btcomps.pdf. Accessed February 2, 2009.

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

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

Gebbie K, Merrill J, Hwang I, et al.: Identifying individual competency in emerging areas of practice: An applied approach. Qual Health Res. 2002; 12(7): 990-999.

Rottman SJ, Shoaf KI, Dorian A: Development of a training curriculum for public health preparedness. J Public Health Manag Pract. 2005; 11(6 Suppl): S128-S131.

Horney JA, Sollecito W, Alexander LK: Competency-based preparedness training for public health practitioners. J Public Health Manag Pract. 2005; 11(6 Suppl): S147-S149.

Association of American Medical Colleges: Training future physicians about weapons of mass destruction: Report of the Expert Panel on Bioterrorism Education for Medical Students.Washington, DC: Association of American Medical Colleges, 2003.

American College of Emergency Physicians: Final report: Developing objectives, content, and competencies for the training of emergency technicians, emergency physicians and emergency nurses to care for casualties resulting from nuclear, biological, or chemical incidents. Washington, DC: Department of Health and Human Services, Office of Emergency Preparedness, 2001.

Joint Commission on Accreditation of Healthcare Organizations: Comprehensive Accreditation Manual for Hospitals: The Official Handbook. Oakbrook Terrace, IL: Joint Commission Resources, 2003.

Federal Emergency Management Agency (FEMA) Web site. Available at http://www.fema.gov/index.shtm. Accessed February 2, 2009.

Center for Disaster Control and Prevention (CDC): Emergency preparedness and response. Available at http://emergency.cdc.gov/. Accessed February 2, 2009.




DOI: https://doi.org/10.5055/ajdm.2010.0039

Refbacks

  • There are currently no refbacks.