2 results
Securing the Second Front: Achieving First Receiver Safety and Security through Competency-based Tools
- Jamal Jones, Judith Staub, Andrew Seymore, Lancer A. Scott
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- Journal:
- Prehospital and Disaster Medicine / Volume 29 / Issue 6 / December 2014
- Published online by Cambridge University Press:
- 14 October 2014, pp. 643-647
- Print publication:
- December 2014
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Introduction
Limited research has focused on the safety and security of First Responders and Receivers, including clinicians, hospital workers, public safety officials, community volunteers, and other lay personnel, during public health emergencies. These providers are, in some cases, at greater peril during large-scale disasters due to their lack of training and inadequate resources to handle major influxes of patients. Exemplified in the 1995 Tokyo sarin gas attacks and the 2008 Wenchuan earthquakes, lack of training results in poor outcomes for both patients and First Receivers.
ObjectiveThe improvement of knowledge and comfort level of First Receivers preparing for a medical disaster via an affordable, repeatable emergency preparedness training (EPT) curriculum.
MethodsA 5-hour EPT curriculum was developed including nine learning objectives, 18 competencies, and 34 performance objectives. Following brief didactic and small group sessions, interprofessional teams of four to six trainees were observed in a large patient simulator designed to recreate environmentally challenging (ie, flood evacuation), multi-patient scenarios using a novel technique developed to utilize trainees as actors. Trained observers assessed successful completion of 16 individual and 18 team performance objectives. Prior to training, team members completed a 24-question knowledge assessment, a demographic survey, and a comfort level self-assessment. Following training, trainees repeated the 24 questions, self-assessment, and course assessment.
ResultsOne hundred ninety-five participants completed the course between November 2012 and August 2013. One hundred ninety-one (98.5%), 150 (76.9%), and 66 (33.8%) participants completed the pretest, post-test, and course assessment, respectively. The mean (SD) percentage of correct answers between the pretest and post-test increased from 46.3 (13.4) to 75.3 (12.2), P < .0001. Thirty-eight participants (19.5%) reported more than three hours of disaster EPT each year while 157 participants (80.5%) reported three hours or less of yearly EPT. Sixty-six (100%) reported the course relevant to care providers and 61 (92.4%) highly recommended the course. Comfort level increased from 37.0/100 (n = 192) before training to 76.3/100 (n = 145) after training.
ConclusionThe Center for Health Professional Training and Emergency Response's (CHPTER's) 5-hour EPT curriculum for patient care providers recreates simultaneous multi-actor disasters, measures EPT performance, and improves trainee knowledge and comfort level to save patient and provider lives during a disaster, via an affordable, repeatable EPT curriculum. A larger-scale study, or preferably a multi-center trial, is needed to further study the impact of this curriculum and its potential to enhance the safety and security of the “Second Front.”
. ,Jones J ,Staub J ,Seymore A .Scott LA Securing the Second Front: Achieving First Receiver Safety and Security through Competency-based Tools . Prehosp Disaster Med.2014 ;29 (6 ):1 -5
Competency in Chaos: Lifesaving Performance of Care Providers Utilizing a Competency-Based, Multi-Actor Emergency Preparedness Training Curriculum
- Lancer A. Scott, Derrick A. Swartzentruber, Christopher Ashby Davis, P. Tim Maddux, Jennifer Schnellman, Amy E. Wahlquist
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- Journal:
- Prehospital and Disaster Medicine / Volume 28 / Issue 4 / August 2013
- Published online by Cambridge University Press:
- 26 April 2013, pp. 322-333
- Print publication:
- August 2013
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Objective
Providing comprehensive emergency preparedness training (EPT) to care providers is important to the future success of disaster operations in the US. Few EPT programs possess both competency-driven goals and metrics to measure performance during a multi-patient simulated disaster.
MethodsA 1-day (8-hour) EPT course for care providers was developed to enhance provider knowledge, skill, and comfort necessary to save lives during a simulated disaster. Nine learning objectives, 18 competencies, and 34 performance objectives were developed. During the 2-year demonstration of the curriculum, 24 fourth-year medical students and 17 Veterans Hospital Administration (VHA) providers were recruited and volunteered to take the course (two did not fully complete the research materials). An online pre-test, two post-tests, course assessment, didactic and small group content, and a 6-minute clinical casualty scenario were developed. During the scenario, trainees working in teams were confronted with three human simulators and 10 actor patients simultaneously. Unless appropriate performance objectives were met, the simulators “died” and the team was exposed to “anthrax.” After the scenario, team members participated in a facilitator-led debriefing using digital video and then repeated the scenario.
ResultsTrainees (N = 39) included 24 (62%) medical students; seven (18%) physicians; seven (18%) nurses; and one (3%) emergency manager. Forty-seven percent of the VHA providers reported greater than 16 annual hours of disaster training, while 15 (63%) of the medical students reported no annual disaster training. The mean (SD) score for the pre-test was 12.3 (3.8), or 51% correct, and after the training, the mean (SD) score was 18.5 (2.2), or 77% (P < .01). The overall rating for the course was 96 out of 100. Trainee self-assessment of “Overall Skill” increased from 63.3 out of 100 to 83.4 out of 100 and “Overall Knowledge” increased from 49.3 out of 100 to 78.7 out of 100 (P < .01). Of the 34 performance objectives during the disaster scenario, 23 were completed by at least half of the teams during their first attempt. All teams except one (8 of 9) could resuscitate two simulators and all teams (9 of 9) helped prevent anthrax exposure during their second scenario attempt.
ConclusionsThe 1-day EPT course for novice and experienced care providers recreated a multi-actor clinical disaster and enhanced provider knowledge, comfort level, and EPT skill. A larger-scale study, or multi-center trial, is needed to further study the impact of this curriculum and its potential to protect provider and patient lives.
. ,Scott LA ,Swartzentruber D ,Davis CA ,Maddux PT ,Schnellman J .Wahlquist AE Competency in Chaos: Lifesaving Performance of Care Providers Utilizing a Competency-Based, Multi-Actor Emergency Preparedness Training Curriculum . Prehosp Disaster Med.2013 ;28 (4 ):1 -12