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Disaster Preparedness Medical School Elective: Bridging the Gap Between Volunteer Eagerness and Readiness
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.
... Of the 25 studies included, nine [8,11,[17][18][19][20][21][22][23] described the curriculum development process in such a way that the study could be replicated, twelve [10,[24][25][26][27][28][29][30][31][32][33][34] mentioned the methods that were used without an explanation of how these methods were implemented to develop the curriculum, and four [7,[35][36][37] did not provide any description of the methodology used to develop the curriculum. Therefore, 16 of the included studies do not explain their curriculum development methodology in a replicable manner. ...
... The 18 courses were analyzed in terms of duration of the training, number of students and experience of the trainers. Five courses were shorter than 10 h [21,23,30,35,37], eight were between 11 and 50 h long [10,11,24,25,27,29,31,36], while four comprised over 50 h of training [7,[32][33][34]. One study did not mention the duration of the training [26]. ...
... One study did not mention the duration of the training [26]. The number of students reached was heterogeneous as well, with three courses targeting less than 20 students [23,25,36], six targeting between 21 and 50 students [11,27,31,34,35,37], and nine targeting over 50 students [7,10,21,24,26,29,30,32,33]. ...
Disaster Medicine (DM) is currently underrepresented in medical schools’ curricula worldwide, and existing DM courses for medical students are extremely heterogeneous due to the lack of pragmatic and standardized guidelines. Moreover, there is a gap in knowledge regarding the curriculum development methodology used for DM courses. This study aims to identify DM courses for medical students worldwide and to map their curriculum development methodologies by reviewing available literature. The search was conducted on three databases using terms “Disaster medicine” AND “Education”. Following the PRISMA approach, twenty-five articles that described the content and implementation of DM curricula were included in the analysis. Nine studies thoroughly described the curriculum development process. Expert opinion and literature review were the methodologies mostly used to develop DM curricula. Only four studies followed a multi-method process made up of four different methodologies, including expert opinion, literature review, survey, and Delphi methodology. Most of the courses adopted a face-to-face approach combining different training modalities, including the use of virtual reality simulations and drills. Overall, this systematic review highlights the need for evidence-based educational curricula in DM and provides recommendations for developing DM courses following a scientific approach.
... Therefore, healthcare providers with experience in caring for patients during disaster situations are more willing to participate in providing healthcare during future disasters because they have gained evidencebased knowledge and training in disaster management and response strategies [35]. Clinical training can help students prepare for and respond to disasters when they enter the professional workforce [36]. Moreover, since regular modes of training may not be feasible in disaster situations, educators in the healthcare field must develop new approaches to clinical training that can function even during disaster situations. ...
... This may be why they showed higher willingness to care for patients with COVID-19. Additionally, the implementation of appropriate educational programs can strengthen students' ability to manage, prepare for, and respond to disasters [36]. Attending courses on disaster preparedness and early training can enhance students' awareness and risk perception, thereby preparing them for potential disasters [41]. ...
... Attending courses on disaster preparedness and early training can enhance students' awareness and risk perception, thereby preparing them for potential disasters [41]. However, the disaster preparedness curriculum is deficient compared with that of other public health issues; there are insufficient disaster education and training programs for medical students [36,41]. Low levels of knowledge regarding COVID-19 due to an inadequate curriculum and lack of clinical practice opportunities, as well as negative attitudes and insufficient preventive behaviors may cause students to avoid caring for COVID-19 patients [15]. ...
Background
The COVID-19 pandemic has threatened the stability and adequacy of the global healthcare system. In this situation, authorities have considered engaging medical and nursing students to address the shortage of frontline healthcare workers. This study investigated the effect of COVID-19-related knowledge, attitudes, and preventive behaviors on medical and nursing students’ willingness to care for COVID-19 patients.
Methods
Medical and nursing students from universities in two regions of South Korea participated in this cross-sectional study. A total of 330 questionnaires were distributed; of them, 99.3% were collected, and 315 questionnaires were analyzed. Data were collected on participants’ general characteristics, COVID-19-related knowledge, attitudes, and preventive behaviors, and willingness to care for COVID-19 patients.
Results
In total, 66.3% of the participants were willing to care for patients during the COVID-19 pandemic. Students in higher grades and those with more clinical practice experience showed higher levels of willingness to care. Specifically, willingness to care was correlated with the senior year (OR = 3.58, 95% CI = 1.24 − 10.37, p = .019), a high level of COVID-19-related knowledge (OR = 1.03, 95% CI = 1.00 − 1.05, p = .041), an optimistic attitude that COVID-19 can be overcome (OR = 1.63, 95% CI = 1.24 − 2.14, p < .001), and increased engagement in infection prevention behaviors (OR = 1.41, 95% CI = 1.16 − 1.71, p < .001).
Conclusions
The findings indicated that a high level of knowledge regarding the COVID-19 pandemic, having an optimistic attitude, and engaging in preventive behaviors affected students’ willingness to care for COVID-19 patients. Integrating disaster preparedness courses in the early years of their curriculum could increase future healthcare providers’ willingness to care for patients.
... In Ireland, one school found 69% of their medical students were willing to volunteer during a national disaster but only a minority of students felt their skill level was useful in such emergency situations [8]. In order to support students willing to volunteer during a pandemic, medical schools should integrate emergency preparedness training into their curriculums to increase self-efficacy and skills related to engagement during such events [13,14]. One U.S. medical school was successful in improving emergency preparedness through a voluntary, self-paced online elective, which allowed flexibility in scheduling and minimal demands on faculty [14]. ...
... In order to support students willing to volunteer during a pandemic, medical schools should integrate emergency preparedness training into their curriculums to increase self-efficacy and skills related to engagement during such events [13,14]. One U.S. medical school was successful in improving emergency preparedness through a voluntary, self-paced online elective, which allowed flexibility in scheduling and minimal demands on faculty [14]. Such training could also be helpful for just-in-time training opportunities during emergency events. ...
Public health crises require individuals, often volunteers, to help minimize disasters. The COVID-19 pandemic required such activation of individuals, but little is known about medical students’ preferences of such engagement. We investigated potential variations in medical students’ educational preferences, attitudes, and volunteerism during the COVID-19 pandemic based on socio-demographics to better prepare for future activation scenarios. A web-based, anonymous survey of U.S. medical students at a single institution was conducted in May 2020. Across four training year, 518 (68% response rate) students completed the survey. During the pandemic, 42.3% (n = 215) wanted to discontinue in-person clinical experiences, 32.3% (n = 164) wanted to continue, and 25.4% (n = 129) were neutral. There was no gender effect for engagement in volunteer activities or preference to engage in clinical activities during the pandemic. However, second-year (n = 59, 11.6%) and third-year students (n = 58, 11.4%) wanted to continue in-person clinical experiences at a greater proportion than expected, while a small proportion of fourth-year students (n = 17, 3.3%) wanted to continue, χ2(6) = 43.48, p < .001, φ = 0.29. Majority of respondents (n = 287, 55.5%) volunteered in clinical and non-clinical settings. A lower proportion of fourth-year (n = 12, 2.3%) and first-year students (n = 50, 9.7%) volunteered than expected. Likelihood to volunteer during a pandemic varied by gender, training year, and/or prior experience with disaster event depending on the type of volunteer-site setting. Our findings suggest socio-demographic factors may impact medical student engagement and volunteerism during a public health crisis. Educational leadership should be sensitive to such variations and can facilitate volunteer activities that allow student engagement during future pandemics.
... Our curriculum incorporated adult learning theory principles of experiential and self-directed learning and delivers content in accordance with the ACGME's Systems-Based Practice Core Competency. The modular curriculum incorporates unique in-situ experiences that complement and enhance foundational knowledge and allows for real and simulated application of these knowledge gains [9,10,20]. ...
Background:
The coronavirus disease 2019 (COVID-19) pandemic has prompted pediatric residency programs to adjust the delivery of educational curricula and to update content relevant to the pandemic.
Objective:
In this descriptive paper, we present how we rapidly developed and implemented a COVID-19 pandemic elective for pediatric residents.
Methods:
This curriculum was established at a single tertiary care children's hospital in June 2020. We used the ADDIE (analysis, design, development, implementation, evaluation) framework to develop a two-week elective (30 hours) consisting of six flexibly scheduled modules. We administered post-elective surveys and exit interviews to solicit feedback to improve the elective and obtain effectiveness of our educational interventions.
Results:
We developed an asynchronous online COVID-19 Elective for Pediatric Residents. The curriculum modules focus on pathophysiology of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the disaster management ecosystem, simulation of clinical care, mental health ramifications, and public health consequences. We also include six in-situ experiences (visits to a drive-through COVID-19 testing site, testing laboratory and local public health department, a simulation of a critically ill child, and meetings with emergency managers and social workers) to solidify learning and allow for further reflection. To date, eight participants have taken the elective. All participants strongly agreed on a five-point Likert item survey that the elective enhanced their knowledge in current evidence-based literature for COVID-19, disaster preparedness, hospital response, management of the critically ill child, and mental and public health ramifications. All participants agreed this curriculum was relevant to and will change their practice.
Conclusions:
We demonstrate how a COVID-19 elective for pediatric residents could be quickly developed and implemented. The pilot results show that pediatric trainees value asynchronous learning, supplemented by relevant in-situ experiences. Moreover, these results suggest that this curriculum provides needed disaster response and resiliency education for pediatric residents.
... As means of improving the competencies of nurses and students in the context of disaster management, disaster nursing education has become increasingly important worldwide (Patel and Dahl-Grove, 2018). For instance, Italy has established disaster courses for medical students that offer requisite integrated knowledge and simulation training (Ingrassia et al., 2014). ...
... The scores have changed significantly with time. Therefore, education and modifying attitudes can positively impact performance, influencing positively personnel's preparedness [28,29]. Besides, nurses' positive attitude towards preparedness against disasters indicate their improper knowledge and performance; thus, preparing the personnel by providing theoretical and practical programs along with holding operational exercises with an emphasis on repetition could be useful [30]. ...
Introduction: Hospitals are the first-line care providers in natural disasters. Nurses, as one of the critical health professional groups, require adequate peroration for responding to natural disasters. Due attention has to be paid to various teaching methods to improve the level of nurses’ preparedness.
Objective: This study compared the effect of lecturing and lecturing-tabletop exercise methods on the level of nurses’ preparedness against natural disasters.
Materials and Methods: In this quasi-experimental study, 74 nurses were randomly selected from different wards at a hospital in Yazd City, Iran, in 2017. Nurses’ preparedness level was measured with the 72-item Scale for Nurses’ Preparedness against Natural Disasters, including three areas of knowledge, attitude, and performance. The study participants were assigned into group A (lecturing method, n=37) and group B (lecturing-tabletop exercise method, n=37) using a simple random sampling technique. Nurses’ level of preparedness was measured three times (pre- and post-intervention, and follow-up) using the Preparedness for Disasters questionnaire. The obtained data were analyzed applying repeated measures Analysis of Variance (ANOVA) and Paired Samples t-test.
Results: The mean scores of nurses’ knowledge, attitude, and performance were increased by 4.94, 7.38, and 5.59 in group A as well as 6.56, 11.43, and 6.08 in group B. Additionally, the total score of nurses’ preparedness in group B was significantly higher at Pre-test, post-test, and one-month follow-up (107.89±7.50) (P=0.0001).
Conclusion: Education ( lecturing and lecturing-tabletop exercise methods) positively affected nurses’ preparedness. However, it was more effective through lecturing-tabletop exercise methods due to having a scenario and the better participation of nurses in the learning process. This finding emphasizes the positive effect of participants’ interactions in the tabletop exercise method on the quality of education, critical skill, and increased level of nurses’ preparedness against natural disasters.
... Subsequently, only 11% claimed to feel unprepared after training. 34 Given the current thinking that further pandemics are likely, 35 it befits medical educators to ensure that all prospective healthcare personnel are prepared. To date, however, few universities embed pandemic preparedness or disaster medicine training into undergraduate training. ...
The COVID-19 pandemic has prompted unprecedented global disruption. For medical schools, this has manifested as examination and curricular restructuring as well as significant changes to clinical attachments. With the available evidence suggesting that medical students’ mental health status is already poorer than that of the general population, with academic stress being a chief predictor, such changes are likely to have a significant effect on these students. In addition, there is an assumption that these students are an available resource in terms of volunteerism during a crisis. This conjecture should be questioned; however, as those engaging in such work without sufficient preparation are susceptible to moral trauma and adverse health outcomes. This, in conjunction with the likelihood of future pandemics, highlights the need for ‘pandemic preparedness’ to be embedded in the medical curriculum.
... Patel and Dahl-Grove in 2018 assessed the medical students' preparedness for a community event disaster as part of an elective study module and reported that 70% of the students felt unprepared to manage the event before Arunachalam S, Sharan J MedEdPublish https://doi.org/10.15694/mep.2020.000265.1 Page | 3 the module. However, after the module, only 11% felt incompetent in disaster management (Patel and Dahl-Grove, 2018). To date, only a few universities have incorporated disaster medicine or bio event preparedness in their curriculum as an elective or extra-curricular program (Smith et al., 2012;Kommor, Hodge and Ciottone, 2019). ...
The coronavirus disease 2019 (COVID-19) outbreak has shaken the entire human race with its unprecedented health and economic outcomes. Researchers and clinicians are trying to get an insight into various aspects of the COVID-19 disease and related aspects, and to some extent, they have succeeded too, but a lot more is yet to be discovered and disclosed. However, it appears that the pandemic is going to stay for a longer duration with varied expressions. In these testing and challenging times when the entire world is battling the massive public health crises, the healthcare workers remain the most vulnerable targets. The current situation unleashes adoption of new structures and processes, but often gloomed with ethical dilemmas. The COVID-19 is not going to be the last major pandemic in the history of human civilization. Henceforth, the million-dollar questions we face now and forever are: How are we planning to prepare the workforce for an health crisis of this cataclysmic proportions? Can we reimagine a curricular framework that could address public health crises arising from epidemics and pandemics? What model could facilitate for advancement in crisis preparedness and management? Do we need an orchestrated team approach in managing and containing any public health crisis of global concern like the COVID-19? What about the entrustable professional activities for a team task? These pertinent questions do not have straight forward answers. It requires a great effort at various levels, but such a change in curricular framework appears to be the need of the hour.
... The evidence of shortages of well prepared healthcare workforce during crisis situations especially in low-and-middle income countries pin points the need of pandemic preparedness in undergraduate medical curriculum with the aim above educational benefit and getting them prepared to deal during pandemic. A study on a disaster preparedness medical school elective in the USA showed that the training for the preparedness decreased the claim of unpreparedness during emergency among students from 70% to 11% (Patel et al., 2018). Given the thinking that further pandemics are likely to occur in future,it befits healthcare educators to ensure that all prospective healthcare personnel are well prepared during their educational training including undergraduate medical and nursing training (O'Byrne, 2020). ...
Introduction: Coronavirus disease (COVID-19) pandemic has created dilemma among medical and nursing educators in Nepal for bringing students in clinical setting for continuing clinical education. The objective of this study was to assess undergraduate medical and nursing students' preference for returning to clinical setting during COVID-19 pandemic in Nepal, and to explore factors associated with that preference. Methods: A cross-sectional electronic survey was carried out among 379 undergraduate medical and nursing students enrolled in different colleges in Nepal. The survey used semi-structured questionnaire in Google form to collect data. The link of the Google form was send to the potential participants through email and social media. Both descriptive (frequency, percentage, mean and SD) and inferential statistics (Chi-square test, independent t-test and binary logistic regression) were used to analyze data in SPSS vs20. Ethical approval was sought from Institutional Review Committee of National Medical College to carry out this study. Results: Around 2/5 th of the students preferred not to return to clinical setting. Multivariable analysis depicted students preferring not to return with lower sense of professionalism, lower autonomous motivation and a higher perception of self-risk to COVID-19. Conclusions: The preference to return to clinical settings among students is dependent of several factors including but not limiting to professionalism during pandemic. Medical and nursing educators need to consider these factors while making decision and preparing these prospective healthcare professionals to serve wisely during pandemic in resource poor settings like in Nepal.
... Hence, it is imperative for medical institutions to integrate student-centred and systematic courses to the undergraduate curriculaboth in preclinical and clinical stages, to ensure that prospective health professionals are adequately prepared for future public health emergencies [8,9]. These courses should strive to develop skills on multidisciplinary preparedness, health information management, emergency decision making, and leadership during crisis, in addition to basic knowledge and competencies related to global health emergency preparedness, such as basic life support, vaccination, and triage [9,31,39]. Furthermore, emphasis should be placed on integrating global health and disaster preparedness courses with the current available programs while still explicitly maintaining the curriculum process to achieve relevant competencies [40]. In the context of Indonesia, with a large number of highlydiverse medical schools, recognition of global health emergency-related competencies in the national competency standards and other learning resources are essential to tackle the need of a more sustainable medical curricula [40,41]. ...
Background
The question to involve or restrict medical students’ involvement in the coronavirus disease 2019 (COVID-19) pandemic response remains contentious. As their state of preparation and perceptions in volunteering during this pandemic have yet to be investigated, this study aims to evaluate Indonesian medical students’ willingness to volunteer and readiness to practice during the COVID-19 pandemic.
Methods
A web-based survey was conducted among undergraduate medical students throughout Indonesia. Socio-demographic and social interaction information, in addition to willingness to volunteer and readiness to practice, were obtained using a self-reported questionnaire. The significance level was set at 5%.
Results
Among 4870 participants, 2374 (48.7%) expressed their willingness to volunteer, while only 906 (18.6%) had adequate readiness to practice. Male students, students with prior volunteering experience in health or non-health sectors, and students from public universities or living in Central Indonesia (vs Java) had higher scores of willingness and readiness to volunteer. Students from Sumatra also had better preparedness (odds ratio [OR] 1.56, 95% confidence interval [CI] 1.15–2.12, p = 0.004), while the opposite occurred for students from Eastern Indonesia (OR 0.63, 95% CI: 0.44–0.89, p = 0.002)–when compared to students from Java. In addition, compared to students with high family income, students from lower-middle income families were less willing to volunteer (OR 0.76, 95% CI: 0.59–0.98, p = 0.034), though those with low family income had better readiness (OR 1.51, 95% CI: 1.10–2.08, p = 0.011). Shortage of medical personnel, sense of duty, and solicitation by stakeholders were the main reasons increasing the students’ willingness to volunteer; whereas contrarily fear for own’s health, absence of a cure, and fear of harming patients were the primary factors diminishing their willingness to volunteer.
Conclusion
Our findings indicated that many Indonesian medical students are willing to volunteer, yet only few of them were ready to practice, indicating that further preparations are required to maximize their potentials and minimize their exposure to hazards. We suggest that their potentials as a firm support system during the pandemic should not be overlooked, and that the integration of relevant courses to the medical curricula are imperative to prepare for future public health emergencies.
... A study from the US revealed that 70% of medical students felt unready to take part in a crisis before taking a training course whereas, only 11% felt unskilled after training. 19 Recently, a study from Spain highlighted that the majority of final year medical students working during the COVID-19 pandemic felt suboptimal in their skills and distressed. 18 Therefore, to curb the emotional and physical adverse effects incurred by such crises it is equally important to provide psychological support as well. ...
Purpose: During the timeline of twenty years, several epidemics and pandemics have occurred. Yet, a consistent feature of these public health crises is the surge in the demand for healthcare services exceeds the availability.
Materials and Methods: A cross-sectional web-based survey was conducted in the month of June and July 2020 in Karachi, Pakistan. The study participants included doctors and medical students residing in Karachi.
Results: Out of 187 doctors, 74.3% were working during the COVID-19 pandemic, of which 58.3% were willing to work. Out of 200 medical students, 93.5% were not volunteering during the COVID-19 pandemic, of which 46% were willing to volunteer. Doctors strongly agreed that they would be willing to work during the COVID-19 pandemic if they were healthy and able to do so (57.2%), if they were provided personal protective equipment (PPE) (51.3%), and if they were guaranteed coverage of treatment cost if they get infected while working (57.8%). Medical students strongly agreed that they would be willing to volunteer during the COVID-19 pandemic if they were provided PPE (49.0%), and if their parents were supportive of their decision to volunteer (44.5%). Most doctors (54.5%) felt that they were extremely likely to get infected while working during the COVID-19 pandemic and 59.4% felt that in turn, they were extremely likely to infect their families as well. Most medical students (40.5%) felt that they were somewhat likely to get infected while volunteering during the COVID-19 pandemic and 55.5% felt that in turn, they were extremely likely to infect their family as well. In the event of infection with COVID-19, 51.3% doctors and 42.0% medical students felt that they would recover without hospitalization.
Conclusion: Since future pandemics are likely, we encourage health-care policymakers to utilize the findings of this study to create a sustainable pandemic response.
... A study from the US revealed that 70% of medical students felt unready to take part in a crisis before taking a training course whereas, only 11% felt unskilled after training. 19 Recently, a study from Spain highlighted that the majority of final year medical students working during the COVID-19 pandemic felt suboptimal in their skills and distressed. 18 Therefore, to curb the emotional and physical adverse effects incurred by such crises it is equally important to provide psychological support as well. ...
Purpose: During the timeline of twenty years, several epidemics and pandemics have occurred. Yet, a consistent feature of these public health crises is the surge in the demand for healthcare services exceeds the availability.
Materials and Methods: A cross-sectional web-based survey was conducted in the month of June and July 2020 in Karachi, Pakistan. The study participants included doctors and medical students residing in Karachi.
Results: Out of 187 doctors, 74.3% were working during the COVID-19 pandemic, of which 58.3% were willing to work. Out of 200 medical students, 93.5% were not volunteering during the COVID-19 pandemic, of which 46% were willing to volunteer. Doctors strongly agreed that they would be willing to work during the COVID-19 pandemic if they were healthy and able to do so (57.2%), if they were provided personal protective equipment (PPE) (51.3%), and if they were guaranteed coverage of treatment cost if they get infected while working (57.8%). Medical students strongly agreed that they would be willing to volunteer during the COVID-19 pandemic if they were provided PPE (49.0%), and if their parents were supportive of their decision to volunteer (44.5%). Most doctors (54.5%) felt that they were extremely likely to get infected while working during the COVID-19 pandemic and 59.4% felt that in turn, they were extremely likely to infect their families as well. Most medical students (40.5%) felt that they were somewhat likely to get infected while volunteering during the COVID-19 pandemic and 55.5% felt that in turn, they were extremely likely to infect their family as well. In the event of infection with COVID-19, 51.3% doctors and 42.0% medical students felt that they would recover without hospitalization.
Conclusion: Since future pandemics are likely, we encourage health-care policymakers to utilize the findings of this study to create a sustainable pandemic response.
... Patel and Dahl-Grove in 2018 assessed the medical students' preparedness for a community event disaster as part of an elective study module and reported that 70% of the students felt unprepared to manage the event before the module. However, after the module, only 11% felt incompetent in disaster management (Patel and Dahl-Grove, 2018). To date, only a few universities have incorporated disaster medicine or bioevent preparedness in their curriculum as an elective or extra-curricular program (Smith et al., 2012;Kommor, Hodge and Ciottone, 2019). ...
Objective
The purpose of this pilot study was to evaluate whether physician assistant (PA) programs in the Midwest integrate both disabilities and emergency preparedness education into 1 curriculum.
Methods
A convenience sample was utilized to survey program directors and deans of PA programs. Emails were obtained from the Physician Assistant Education Association. A 26, closed-ended question Qualtrics survey was based on an original study by Tanenhaus et al. ¹
Results
Out of 43 accredited physician assistant programs surveyed, 9 programs replied (21%), and 1 program did not complete the survey. Six of the 10 programs (66%) responded that their program provided lectures specific to emergency preparedness. All 9 programs responded they do not offer a graduate-level track or concentration in emergency/disaster preparedness, and they do not offer a dual degree or a multidisciplinary program that highlights emergency/disaster preparedness.
Conclusions
This study was conducted to bring awareness to physician assistant students’ education regarding disabilities and emergency preparedness. As public health crises continue to arise, such as coronavirus disease (COVID-19), it is critical to have appropriately trained health care professionals. The study revealed that most programs lack a graduate-level track or concentrations, dual degrees, or extracurricular opportunities related to disabilities and emergency and disaster preparedness.
Objective: To determine the instructional programs required by volunteers based on the studies carried out worldwide.
Methods: A systematic search was carried out by PubMed, Cochran Library, Scopus, EMBASE, Science Direct, Web of Science and ProQuest databases between January 1970 and the end of June 2019. The articles were selected based on the keywords chosen by the author. In the end, the volunteer’s instructional titles were extracted from the articles in disasters.
Results: Eleven articles were chosen for final analysis after studying the titles, abstracts, and complete articles texts which 45 instructional titles were extracted. The most frequent scales in terms of repetition were ethics, kinds of exercises, personal protection instruments, general hygiene, awareness of certain disasters, accident command system, disaster triage and emergency planning.
Conclusion: Governments should offer programs that can best serve the improvement of their performance by considering the daily increasing growth in the number of volunteers and in natural and manmade disasters. Universities and schools play determinant roles in this regard. It is hoped that the present study findings can be effective in codify an efficient instructional program for elevating the performance of the volunteers by taking part in disasters response.
Introduction: COVID-19 has caused major disruptions to healthcare, with voluntary opportunities offered to medical students to provide clinical support. We used the conceptual framework of prosocial behavior during an emergency - behaviors whose primary focus is benefiting others - to examine volunteering during COVID-19.
Methods: We conducted an in-depth, mixed-methods cross-sectional survey, from 2nd May to 15th June 2020, of medical students studying at UK medical schools. Data analysis was informed by Latane and Darley's theory of prosocial behavior during an emergency and aimed to understand students' decision-making processes.
Results: A total of 1145 medical students from 36 medical schools completed the survey. While 947 (82.7%) of students were willing to volunteer, only 391 (34.3%) had volunteered. The majority (92.7%) of students understood that they may be asked to volunteer; however, we found that deciding one's responsibility to volunteer was mitigated by a complex interaction between the interests of others and self-interest. Further, concerns revolving around professional role boundaries influenced students' decisions over whether they had the required skills and knowledge to volunteer. Deciding to volunteer depended not only on possession of necessary skills, but also seniority and identification with the nature of volunteering roles offered.
Conclusions: We propose two additional domains to Latane and Darley's theory of prosocial behavior during an emergency that students consider before making their final decision to volunteer. These are 'logistics' - whether it is logistically feasible to volunteer - and 'safety' - whether it is safe to volunteer. This study highlights a number of modifiable barriers to prosocial behavior that medical students encounter and provides suggestions regarding how Latane and Darley's theory of prosocial behavior can be operationalized within educational strategies to address these barriers. Optimizing the process of volunteering can aid healthcare provision and may facilitate a safer volunteering process for all.
Background
Despite a 2009 recommendation from the AMA that disaster medicine and public health response training should be implemented in medical schools, anywhere from 31% to 47% of medical education programs lack a formalized disaster medicine curriculum. A need for disaster medicine response training for University of Alabama medical students in an appropriately socially distanced format was identified during the COVID-19 pandemic.
Methods
Our emergency medicine faculty in collaboration with the Federal Emergency Management Agency Center for Disaster Preparedness (FEMA CDP) created and implemented a novel virtual disaster medicine and pandemic response course for third year medical students at the University of Alabama at Birmingham. The course was administered via a teleconferencing platform (Zoom, Zoom Video Communications, Inc.) in the spring of 2020 to greater than 130 medical students.
Results
Using pre and post course surveys, we assessed a change in student confidence levels for their ability to explain topics covered in the course and their understanding of a chosen disaster. The students reported an average increase of 2.183 on a 5-point scale, with a score of 5 representing “completely confident” and a score of 1 representing “not at all confident”. This course established the feasibility of a virtual instructor led training (VILT) format for disaster medicine education and provided a template for the delivery of over 300 courses to more than 4,000 first responders and medical professionals through the FEMA CDP.
Conclusions
Through collaboration with the FEMA CDP, our UAB faculty were able to successfully deliver a novel virtual disaster preparedness and response course. The course resulted in subjective improvement of students’ content understanding while also establishing the feasibility and effectiveness of a VILT format that could be readily applied to future courses in undergraduate medical education and beyond.
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.
Introduction
The recent increase in natural disasters and mass shootings highlights the need for medical providers to be prepared to provide care in extreme environments. However, while physicians of all specialties may respond in emergencies, disaster medicine training is minimal or absent from most medical school curricula in the United States. A voluntary Disaster Medicine Certificate Series (DMCS) was piloted to fill this gap in undergraduate medical education.
Report
Beginning in August of 2017, second- and third-year medical students voluntarily enrolled in DMCS. Students earned points toward the certificate through participation in activities and membership in community organizations in a flexible format that caters to variable schedules and interests. Topics covered included active shooter training, decontamination procedures, mass-casualty triage, Incident Command System (ICS) training, and more. At the conclusion of the pilot year, demographic information was collected and a survey was conducted to evaluate student opinions regarding the program.
Results
Sixty-eight second- and third-year medical students participated in the pilot year, with five multi-hour skills trainings and five didactic lectures made available to students. Forty-eight of those 68 enrolled in DMCS completed the retrospective survey. Student responses indicated that community partners serve as effective means for providing lectures (overall mean rating 4.50/5.0) and skills sessions (rating 4.58/5.0), and that the program created avenues for real-world disaster response in their local communities (rating 4.40/5.0).
Conclusions
The DMCS voluntary certificate series model served as an innovative method for providing disaster medicine education to medical students.
In 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 1 List of Modules and Topics
PL Ingrassia, L Ragazzoni, M Tengattini, L Carenzo, F Della Corte. 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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Disaster medicine education is an enormous challenge, but indispensable for disaster preparedness.
We aimed to develop and implement a disaster medicine curriculum for medical student education that can serve as a peer-reviewed, structured educational guide and resource. Additionally, the process of designing, approving and implementing such a curriculum is presented.
The six-step approach to curriculum development for medical education was used as a formal process instrument. Recognized experts from professional and governmental bodies involved in disaster health care provided input using disaster-related physician training programs, scientific evidence if available, proposals for education by international disaster medicine organizations and their expertise as the basis for content development.
The final course consisted of 14 modules composed of 2-h units. The concepts of disaster medicine, including response, medical assistance, law, command, coordination, communication, and mass casualty management, are introduced. Hospital preparedness plans and experiences from worldwide disaster assistance are reviewed. Life-saving emergency and limited individual treatment under disaster conditions are discussed. Specifics of initial management of explosive, war-related, radiological/nuclear, chemical, and biological incidents emphasizing infectious diseases and terrorist attacks are presented. An evacuation exercise is completed, and a mass casualty triage is simulated in collaboration with local disaster response agencies. Decontamination procedures are demonstrated at a nuclear power plant or the local fire department, and personal decontamination practices are exercised. Mannequin resuscitation is practiced while personal protective equipment is utilized. An interactive review of professional ethics, stress disorders, psychosocial interventions, and quality improvement efforts complete the training.
The curriculum offers medical disaster education in a reasonable time frame, interdisciplinary format, and multi-experiential course. It can serve as a template for basic medical student disaster education. Because of its comprehensive but flexible structure, it should also be helpful for other health-care professional student disaster education programs.
Various organizations and universities have developed competencies for health professionals and other emergency responders. Little effort has been devoted to the integration of these competencies across health specialties and professions. The American Medical Association Center for Public Health Preparedness and Disaster Response convened an expert working group (EWG) to review extant competencies and achieve consensus on an educational framework and competency set from which educators could devise learning objectives and curricula tailored to fit the needs of all health professionals in a disaster.
The EWG conducted a systematic review of peer-reviewed and non-peer reviewed published literature. In addition, after-action reports from Hurricane Katrina and relevant publications recommended by EWG members and other subject matter experts were reviewed for congruencies and gaps. Consensus was ensured through a 3-stage Delphi process.
The EWG process developed a new educational framework for disaster medicine and public health preparedness based on consensus identification of 7 core learning domains, 19 core competencies, and 73 specific competencies targeted at 3 broad health personnel categories.
The competencies can be applied to a wide range of health professionals who are expected to perform at different levels (informed worker/student, practitioner, leader) according to experience, professional role, level of education, or job function. Although these competencies strongly reflect lessons learned following the health system response to Hurricane Katrina, it must be understood that preparedness is a process, and that these competencies must be reviewed continually and refined over time.
Contemporary disasters, like the outbreak of Ebola in West Africa, have piqued the interest of medical students in disaster preparedness. The topic is also a requirement of undergraduate medical education.(1) Yet current literature suggests that disaster preparedness education is lacking. Our objective was to pilot a curriculum to augment medical students' disaster preparedness education by marshalling local resources to provide practical hands-on experiences.
This pilot curriculum consisted of lectures; simulations; asynchronous learning materials; a large-scale, regional disaster exercise; and preparation for and participation in a real-time mass gathering. Outcomes were measured by student performance on written tests and evaluations of each activity.
Academic Health Center with associated medical school.
Fifty-two medical students participated in at least one of the six activities during this voluntary pilot program. Premedical students and residents (n = 57) participated in some activities.
Forty-one medical students took either the pretest or the post-test over the curriculum. Only eight students took both. A paired t test comparing pretest to post-test scores using imputed missing data (t = -11.72, df = 40, p ≤ 0.001) was consistent with an analysis using only complete data (t = -2.35, df = 7, p = 0.05), implying that student scores improved significantly over time. Evaluations indicated a student preference for hands-on over didactic or independent learning activities.
This pilot curriculum was designed to capitalize on practical hands-on training opportunities for our medical students, including participation in a disaster exercise and a mass-gathering event. These opportunities provided effective and engaging disaster preparedness education.
This study assessed disaster medicine knowledge and competence and perceived self-efficacy and motivation for disaster response among medical, nursing, and dental students.
Survey methodology was used to evaluate knowledge, comfort, perceived competency, and motivation. Also, a nonresponder survey was used to control for responder bias.
A total of 136 responses were received across all 3 schools. A nonresponder survey showed no statistical differences with regard to age, gender, previous presence at a disaster, and previous emergency response training. In spite of good performance on many knowledge items, respondent confidence was low in knowledge and in comfort to perform in disaster situations. Knowledge was strong in areas of infection control, decontamination, and biological and chemical terrorism but weak in areas of general emergency management, role of government agencies, and radiologic events. Variations in knowledge among the different health professions were slight, but overall the students believed that they required additional education. Finally, students were motivated not only to acquire more knowledge but to respond to disaster situations.
Health care students must be adequately educated to assume roles in disasters that are a required part of their professions. This education also is necessary for further disaster medicine education in either postgraduate or occupational education. As students' performance on knowledge items was better than their perceived knowledge, it appears that a majority of this education can be achieved with the use of existing curricula, with minor modification, and the addition of a few focused subjects, which may be delivered through novel educational approaches. (Disaster Med Public Health Preparedness. 2013;7:499-506).
Disaster preparedness training is a critical component of medical student education. Despite recent natural and man-made disasters, there is no national consensus on a disaster preparedness curriculum. The authors designed a survey to assess prior disaster preparedness training among incoming interns at an academic teaching hospital. In 2010, the authors surveyed incoming interns (n = 130) regarding the number of hours of training in disaster preparedness received during medical school, including formal didactic sessions and simulation, and their level of self-perceived proficiency in disaster management. Survey respondents represented 42 medical schools located in 20 states. Results demonstrated that 47% of interns received formal training in disaster preparedness in medical school; 64% of these training programs included some type of simulation. There is a need to improve the level of disaster preparedness training in medical school. A national curriculum should be developed with aspects that promote knowledge retention.
The objective of this study was to examine factors associated with pediatric nurse practitioners (PNPs) reporting to work in the event of a disaster.
An anonymous national survey of PNPs was conducted. Several domains were explored, including demographics, personal preparedness plans, disaster training, prior disaster experience, and likelihood of responding in the event of a disaster. A logistic regression analysis was conducted to determine which factors were associated with the respondent's likelihood of responding in the event of a disaster.
Factors associated with increased likelihood of responding included gender (being a male PNP), military experience, and disaster training. The most significant factor associated with an increased likelihood of responding to work during a disaster was having a specified role in the workplace disaster plan. PNPs with a specified role were three times more likely to respond than were those without a specified role.
PNPs are health care workers with advanced skill sets. This untapped resource is available to provide care for a vulnerable population: our children. Disaster planners should explore the possibility of utilizing these highly skilled health care workers in their disaster plans.
As part of a 2010 conference entitled "Patients and Populations: Public Health in Medical Education," faculty from four U.S. medical schools (Case Western Reserve University, Harvard Medical School, the University of Colorado School of Medicine, and the University of Vermont College of Medicine), collaborated on a workshop to help other medical educators develop scenario-based learning experiences as practical, engaging, and effective mechanisms for teaching public health principles to medical school students. This paper describes and compares four different medical schools' experiences using a similar pandemic exercise scenario, discusses lessons learned, and suggests a curricular framework for medical schools adding such exercises to their population health curriculum. Different strategies to create realistic scenarios and engage students, including use of professionals and stakeholders from the community, are described.
Introduction: Due to recent disasters, disaster planners increasingly are focusing on healthcare worker preparedness and response in the event of a disaster. In this study, factors associated with pediatric healthcare workers’ willingness to respond are identified.
Hypothesis: It was hypothesized that personal factors may affect a pediatric healthcare worker’s willingness to respond to work in the event of a disaster.
Methods: Employees of a tertiary, pediatric care hospital in Los Angeles were asked to complete a brief, 24-question online survey to determine their willingness to respond in the event of a disaster. Information on demographics, employment, disaster-related training, personal preparedness, and necessary resources was collected. A logistic regression model was performed to derive adjusted odds ratios (OR) and their corresponding 95% confidence intervals (95% CI).
Results: Eight hundred seventy-seven pediatric healthcare employees completed the survey (22% response rate). Almost 50% (n = 318) expressed willingness to respond in the event of a disaster. Men were more likely to be willing to respond to a disaster than were women (OR = 2.4; 95%CI = 1.6–3.6), and single/divorced/widowed employees were more willing to respond than married or partnered employees (OR = 1.5; 95%CI = 1.1–2.1). An inverse relationship was observed between number of dependents and willingness to respond (OR = 0.45; 95%CI = 0.25–0.80, ≥3 dependents compared to 0). An inverse dose response relationship between commuting distance and number of necessary resources ( p trend = 0.0485 and 0.0001, respectively) was observed. There was no association between previous disaster experience, disaster training, or personal preparedness and willingness to respond.
Conclusions: Number of dependents and resources were major factors in willingness to respond. Healthcare facilities must clearly communicate their disaster plans as well as any provisions they may make for their employees’ families in order to improve willingness among hospital employees.
To describe the level of preparedness in performing medical procedures of medical students at one allopathic medical school and to determine the level of willingness to perform these procedures in the event of a disaster.
Cross-sectional survey.
US allopathic medical school associated with a county hospital.
All third- and fourth-year medical students (344) in the 2007-2008 academic year were invited to participate. One hundred ninety-five students participated in this study (response rate = 57.6 percent).
Information on demographic characteristics, personal disaster experience, personal disaster preparedness, and overall preparedness level and willingness to perform various medical procedures was collected. Multiple regression analysis was used to identify the factors predicting procedural willingness during a disaster.
Demographics and personal disaster preparedness were not statistically significant between third-year medical students (M3) and fourth-year medical students (M4). Although procedural preparedness was significantly higher in M4 than M3, willingness to perform these procedures in a disaster was not different. Fourth-year students, first receivers (students' anticipated field is in emergency medicine or surgery), not having had a personal disaster experience, and increased procedural preparedness independently impact procedural willingness in a disaster However, when controlled for the covariate effects in the regression model, only first receivers, no past personal disaster experience, and increased procedural preparedness predicted willingness to perform medical procedures during a disaster.
Third- and fourth-year students possess skills that may prove useful in a disaster response. Further investigations are necessary to determine how medical students may be utilized during these events.
War, as a major human disaster, affects many aspects of life, including medical education. This report describes curricular and extracurricular activities of the students at the Zagreb University School of Medicine during the wars in Croatia and neighboring Bosnia and Herzegovina. Although condensed versions of the curricula were prepared in case of a major breakdown in civilian life, the school maintained the continuity and quality of its curriculum throughout the war. Students engaged in extracurricular activities related to medical aspects of the war, including organization of resuscitation and first aid courses, collecting medical documentation on war victims, humanitarian help to refugees, and peace-promoting activities. Some students joined mobile surgical teams on the battlefronts. After army service, most of them returned to the school and successfully continued with their studies. The school also accepted guest-students from other new states emerged from former Yugoslavia. The authors found that the students' engagement in extracurricular activities related to medicine was enormously beneficial both to the psychological well-being of the students and to the region's peace-building efforts.
The recent increased threat of terrorism, coupled with the ever-present dangers posed by natural disasters and public health emergencies, clearly support the need to incorporate bioterrorism preparedness and emergency response material into the curricula of every health professions school in the nation. A main barrier to health care preparedness in this country is a lack of coordination across the spectrum of public health and health care communities and disciplines. Ensuring a unified and coordinated approach to preparedness requires that benchmarks and standards be consistent across health care disciplines and public health, with the most basic level being education of health professions students. Educational competencies establish the foundation that enables graduates to meet occupational competencies. However, educational needs for students differ from the needs of practitioners. In addition, there must be a clear connection between departments of public health and all other health care entities to ensure proper preparedness. The authors describe both a process and a list of core competencies for teaching emergency preparedness to students in the health care professions, developed in 2003 and 2004 by a team of experts from the four health professions schools of Columbia University in New York City. These competencies are directly applicable to medical, dental, nursing, and public health students. They can also easily be adapted to other health care disciplines, so long as differences in levels of proficiency and the need for clinical competency are taken into consideration.
The events of 9/11 highlighted the limitations of the United States health care system in responding to large-scale public health emergencies. The key for an effective response to any mass casualty event is preparedness; thus, the education of medical students has become a priority. The Association of American Medical Colleges (AAMC) recommended that the nation's medical schools should thoroughly educate students about the public health and emergency services systems to ensure coordinated responses to weapons of mass destruction or other public health threats. In response, The Texas A&M University System Health Science Center College of Medicine, partnering with the Defense Institute for Medical Operations (DIMO), developed a one-week block of required (but not graded) instruction, the "Leadership Course in Disaster Response," first given in 2003-04 to 72 second-year students and taught by six military experts from DIMO. The course goal is to (1) educate students on resources available for regional disaster response; (2) define principles of resource management in disaster response; (3) identify specific agents associated with bioterrorism; and (4) understand the psychosocial aspects of disasters. The course was well received, and the 2004-05 session was improved, based on student and faculty feedback. The authors describe the details of the course (specifically, how the course was tailored to fit the AAMC guidelines), changes in students' knowledge and attitudes, and how the course was improved.