Preparing health care students for mass casualty events

How are healthcare provider systems preparing for health emergency situations?

Natural disasters, disease outbreaks, famine, and human conflict have strained communities everywhere over the course of human existence. However, modern changes in climate, human mobility, and other factors have increased the global community's vulnerability to widespread emergencies. We are in the midst of a disruptive health event, with the COVID-19 pandemic testing our health provider systems globally. This study presents a qualitative analysis of published literature, obtained systematically, to examine approaches health providers are taking to prepare for and respond to mass casualty incidents around the globe. The research reveals emerging trends in the weaknesses of systems' disaster responses while highlighting proposed solutions, so that others may better prepare for future disasters. Additionally, the research examines gaps in the literature, to foster more targeted and actionable contributions to the literature.

Role of Student Nurse in the Prehospital Medical Teams Responding to the Scene of A Terrorist Attack in France

BACKGROUND

The terrorist attacks in Paris and in Saint-Denis in November 2015 were unprecedented events involving various human and material resources. These events question the role of nurse students in prehospital teams.

PURPOSE

To investigate nursing students' preference about whether they wished to participate in the prehospital care during a terrorist attack.

METHODS

This cross-sectional study was conducted with student nurses, from two nursing schools in the Greater Paris area. They completed an anonymous survey assessing the desire to be called to help the mobile intensive care units (MICU) or another ward; whether their presence should be mandatory, and the feelings associated with their experience. The responses were collected with a visual analogue scale and could range from 1 (yes, very much) to 10 (no, not at all). A Chi-square test was performed for qualitative variables and a Mann-Whitney test for quantitative variables.

FINDINGS

Among 225 students, 205 (91%) responded, 133 (65%) were women. When on duty, 169 (82%) would have preferred to accompany the MICU team, compared with 31 (15%) who would have preferred not to go. Overall, 146 students (71%) considered that this presence should be optional. Only gender was significantly associated with the choice to accompany the MICU team (W = 87% vs. M = 13%; p = .002). Students expressed a moderate feeling of frustration and fear.

DISCUSSION

Students would prefer to assist the MICU team responding to the scene of a terrorist attack but feel this choice should be optional. A discussion in nursing schools and universities should be considered for the implementation of a "systematic" procedure to ensure the student's willingness to participate in such interventions.

Nationwide Program of Education for Undergraduates in the Field of Disaster Medicine: Development of a Core Curriculum Centered on Blended Learning and Simulation Tools

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

IngrassiaPL, RagazzoniL, TengattiniM, CarenzoL, Della CorteF. 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.