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Mass-Casualty Triage Training for International Healthcare Workers in the Asia-Pacific Region Using Manikin-Based Simulations

Published online by Cambridge University Press:  28 June 2012

Dale S. Vincent ,
Benjamin W. Berg  and
Keiichi Ikegami
Dale S. Vincent*
Affiliation:
John A. Burns School of Medicine, University of Hawaii, Honolulu, Hawaii, USA
Benjamin W. Berg
Affiliation:
John A. Burns School of Medicine, University of Hawaii, Honolulu, Hawaii, USA
Keiichi Ikegami
Affiliation:
Dokkyo Medical University, Koshigaya Hospital, Koshigaya, Japan
*
Medical Education Building, 212 651 Ilalo StreetHonolulu, Hawaii 96813USA E-mail: dvincent@hawaii.edu
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Abstract

Introduction:

More than half of the world's disasters occur in the Asia-Pacific region. A simulation-based exercise to teach healthcare workers prehospital triage, tagging, and treatment methods was used to link disaster management theory to practice with a student-centered, hands-on educational activity. Various strategies for teaching disaster health education have been advocated, and best-practice disaster education models continue to be sought.

Methods:

A manikin-based, primary triage and treatment course was adapted for international healthcare providers in the Asia-Pacific region using symbolic representations of triage categories and physical findings. The pedagogical construct that was used was an interactive, formative assessment in which faculty members mediated learner information gathering and interpretation during four simulation scenarios. After establishing a multi-casualty disaster context, a wireless, audience response system anonymously collected learner responses to four clinical situations: (1) leg wound (hemorrhagic shock/immediate); (2) chest wound (tension pneumothorax/immediate); (3) head wound (traumatic brain injury/expectant); and (4) limb trauma (leg fracture/delayed).

Results:

There were 182 healthcare providers from eight Asia-Pacific countries (including the US) that participated in four simulation seminars. The simulation sessions were successfully tailored to groups of learners that varied in size and professional composition.Expectant and delayed triage categories posed the greatest challenge to learners. In one of two groups that were queried, learner self-confidence in applying principles of triage and treatment improved significantly. At the conclusion of the simulation sessions, learners strongly agreed that manikin-based simulation improved their understanding of triage, and should be used to teach principles of primary triage and treatment.

Conclusions:

Simulation training represents an opportunity to engage learners regardless of language and cultural barriers. Simulation-based training can be effective in introducing healthcare professionals to principles of primary triage and treatment in an effective and culturally sensitive manner.The characteristics of the course with respect to planned formative assessment and culturally competent scholarship were reviewed.

Keywords

Asia-Pacifichealthcare providersmanikinmass-casualty incidentsimulationtrainingtriage
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 24 , Issue 3 , June 2009 , pp. 206 - 213
Copyright
Copyright © World Association for Disaster and Emergency Medicine 2009

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References

1.WHO pamphlet. Strategic plan for injury prevention and control in South-East Asia: WHO Project: ICP DPR 001; 2001.Google Scholar
2.Murray, V, Clifford, J, Seynaeve, G, Fisher, JM: Disaster health education and training: A pilot questionnaire to understand current status. Prehospital Disast Med 2006;21(3):156–167.CrossRefGoogle ScholarPubMed
3.Subbarao, I, Lyznicki, JM, Hsu, EB, et al. : A consensus-based educational framework and competency set for the discipline of disaster medicine and public health preparedness. Disaster Med Public Health Prep 2008;2(1):57–68.CrossRefGoogle ScholarPubMed
4.Grube, JA: A systems perspective on healthcare safety initiatives. J Healthc Qual 2004;26(2):2,19.Google Scholar
5.Forrest, F, Taylor, M: High level simulators in medical education. Hosp Med 1998;59(8):653–655.Google ScholarPubMed
6.Seynaeve, G, Archer, F, Fisher, J, et al. : 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. Prehospital Disast Med 2004;19(2):s17–s30.Google Scholar
7.Coelho, E: Crystal Clear. Available at http://commons.wikimedia.org/wiki/Crystal_Clear. Accessed 04 August 2008.Google Scholar
8.Jenkins, JL, McCarthy, ML, Sauer, LM, et al. : Mass-casualty triage: Time for an evidence-based approach. Prehospital Disast Med 2008;23(1):3–8.Google Scholar
9.Felder, RM, Brent, R: Cooperative Learning in Technical Courses: Procedures, Pitfalls, and Payoffs. Raleigh, NC: North Carolina State University; 1994.Google Scholar
10.Prince, M, Felder, R: The many faces of inductive teaching and learning. J Coll Scie Teach 2007;36(5):14–20.Google Scholar
11.Crooks, T: The validity of formative assessments. Paper presented to British Educational Research Association Annual Conference. University of Leeds; 2001.Google Scholar
12.Cowie, B, Bell, B: A model of formative assessment in science education. Assessment in Education: Principles, Policy, & Practice 1999;6(1):101–116.Google Scholar
13.Meleis, AI: Culturally competent scholarship: Substance and rigor. Adv Nurs Sci 1996;19(2):1–16.CrossRefGoogle ScholarPubMed
14.Pradhan, A, Sparano, D, Ananth, CV:The influence of an audience response system on knowledge retention: An application to resident education. Am J Obstet Gynecol 2005;193(5):1827–1830.CrossRefGoogle ScholarPubMed
15.Paschal, CB: Formative assessment in physiology teaching using a wireless classroom communication system. Adv Physiol Educ 2002;26(1-4):299–308.CrossRefGoogle ScholarPubMed
16.Collins, LJ: Livening up the classroom: Using audience response systems to promote active learning. Med Ref Serv Q 2007;26(1):81–88.Google Scholar
17.Torbeck, L: Enhancing programme evaluation using the Audience Response System. Med Educ 2007;41(11):1088–1089.CrossRefGoogle ScholarPubMed
18.Latessa, R, Mouw, D: Use of an audience response system to augment interactive learning. Fam Med 2005;37(1):12–14.Google Scholar
19.Jacobs, DG, Sarafin, JL, Huynh, T, et al. : Audience response system technology improves accuracy and reliability of trauma outcome judgments. J Trauma 2006;61(1):135–141.CrossRefGoogle ScholarPubMed
20.Soh, EK, Vincent, DS, Berg, BW, et al. : An international landmine telehealth symposium between Hawaii and Thailand using an Internet2 and multi-protocol videoconferencing bridge. Hawaii Med J 2004;63(10):294–295.Google ScholarPubMed
21.Vincent, DS, Berg, BW, Chitpatima, S, et al. : International distance education and the transition from ISDN to high-bandwidth Internet connectivity. J Telemed Telecare 2002;8(S3):71–73.CrossRefGoogle ScholarPubMed
22.Vincent, DS, Berg, BW, Hudson, DA, et al. : International medical education between Hawaii and Thailand over Internet2. JTelemed Telecare 2003;9(S2):71–72.Google Scholar
23.Sharma, BR: Triage in trauma-care system: A forensic view. J Clin Forensic Med 2005;12(2):64–73.CrossRefGoogle ScholarPubMed
24.Garner, A, Lee, A, Harrison, K, et al. : Comparative analysis of multiple-casualty incident triage algorithms. Ann Emerg Med 2001;38(5):541–548.CrossRefGoogle ScholarPubMed
25.Garner, A: Documentation and tagging of casualties in multiple casualty incidents. Emerg Med (Fremantle) 2003;15(5–6):475–479.CrossRefGoogle ScholarPubMed
26.Kobayashi, L, Shapiro, MJ, Gutman, DC, et al. : Multiple encounter simulation for high-acuity multipatient environment training. Acad Emerg Med 2007;14(12):1141–1148.Google Scholar