Hostname: page-component-cd9895bd7-mkpzs Total loading time: 0 Render date: 2024-12-26T06:31:41.809Z Has data issue: false hasContentIssue false
  • English
  • Français

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

Published online by Cambridge University Press:  22 August 2014

Pier Luigi Ingrassia ,
Luca Ragazzoni ,
Marco Tengattini ,
Luca Carenzo  and
Francesco Della Corte
Pier Luigi Ingrassia
Affiliation:
Università del Piemonte Orientale “A. Avogadro,” Research Center in Emergency and Disaster Medicine and Computer Science Applied to Medical Practice (CRIMEDIM), Novara, Italy
Luca Ragazzoni
Affiliation:
Università del Piemonte Orientale “A. Avogadro,” Research Center in Emergency and Disaster Medicine and Computer Science Applied to Medical Practice (CRIMEDIM), Novara, Italy
Marco Tengattini
Affiliation:
Università del Piemonte Orientale “A. Avogadro,” Research Center in Emergency and Disaster Medicine and Computer Science Applied to Medical Practice (CRIMEDIM), Novara, Italy
Luca Carenzo
Affiliation:
Università del Piemonte Orientale “A. Avogadro,” Research Center in Emergency and Disaster Medicine and Computer Science Applied to Medical Practice (CRIMEDIM), Novara, Italy
Francesco Della Corte*
Affiliation:
Università del Piemonte Orientale “A. Avogadro,” Research Center in Emergency and Disaster Medicine and Computer Science Applied to Medical Practice (CRIMEDIM), Novara, Italy
*
Correspondence: Francesco Della Corte, MD Università del Piemonte Orientale “A. Avogadro” CRIMEDIM Via Lanino 1 Novara 28100, Italy E-mail dellacorte.f@gmail.com
Get access Rights & Permissions [Opens in a new window]

Abstract

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

ModuleTopics
1. Introduction to disaster medicine and public health during emergencies- Modern taxonomy of disaster and common disaster medicine definitions
- Differences between disaster and emergency medicine
- Principles of public health during disasters
- Different phases of disaster management
2. Prehospital disaster management- Mass-casualty disposition, treatment area, and transport issues
- Disaster plans and command-and-control chain structure
- Functional response roles
3. Specific disaster medicine and triage procedures in the- Mass-casualty triage definitions and principles
management of disasters- Different methodologies and protocols
- Patient assessment, triage levels and tags
4. Hospital disaster preparedness and response- Hospital disaster laws
- Hospital preparedness plans for in-hospital and out-hospital disasters with an all-hazard approach
- Medical management for a massive influx of casualties
5. Health consequences of different disasters- Characteristics of different types of disasters
- Health impact of natural and man-made disasters
- Disaster-related injury after exposure to a different disasters with an all-hazard approach
6. Psychosocial care- Techniques to deal with psychic reactions caused by exposure to disaster scenarios
- Treatment approaches to acute and delayed critical incident stress reactions
7. Presentation of past disasters and public health emergencies, andCase study:
review of assistance experiences- Haiti earthquake
- Cholera outbreaks in Haiti
- National and international disaster response mechanism

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.

Keywords

computer user trainingcurriculumdisaster medicinedistance learningmedical students
Type
Special Report
Information
Prehospital and Disaster Medicine , Volume 29 , Issue 5 , October 2014 , pp. 508 - 515
Copyright
Copyright © World Association for Disaster and Emergency Medicine 2014 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Schiermeier, Q. Climate and weather: extreme measures. Nature. 2011;477(7363):148-149.CrossRefGoogle ScholarPubMed
2.Bartels, SA, VanRooyen, MJ. Medical complications associated with earthquakes. Lancet. 2012;379(9817):748-757.Google Scholar
3.Rosborough, S. A tale of two responses: Haiti earthquake highlights the need for training in international disaster response. Disaster Med Public Health Prep. 2010;4(1):21-23.Google Scholar
4.Auf der Heide, E. The importance of evidence-based disaster planning. Ann Emerg Med. 2006;47(1):34-49.Google Scholar
5.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; 2003. https://members.aamc.org/eweb/upload/Training%20Future%20Physicians%20About%20Weapons.pdf. Accessed February 6, 2014.Google Scholar
6.Report 15 of the Council on medical education. Education in disaster medicine and public health preparedness during medical school and residency training. http://www.ama-assn.org/resources/doc/council-on-med-ed/cme-report-15a-09.pdf. Accessed February 6, 2014.Google Scholar
7.FitzGerald, GJ, Aitken, P, Arbon, P, et al. A national framework for disaster health education in Australia. Prehosp Disaster Med. 2010;25(1):4-11.Google Scholar
8.Archer, F, Seynaeve, G. International guidelines and standards for education and training to reduce the consequences of events that may threaten the health status of a community. A report of an Open International WADEM Meeting, Brussels, Belgium, October 29-31, 2004. Prehosp Disaster Med. 2007;22(2):120-130.CrossRefGoogle Scholar
9.Pfenninger, EG, Domres, BD, Stahl, W, Bauer, A, Houser, CM, Himmelseher, S. Medical student disaster medicine education: the development of an educational resource. Int J Emerg Med. 2010;3(1):9-20.Google Scholar
10.Parrish, AR, Oliver, S, Jenkins, D, Ruscio, B, Green, JB, Colenda, C. A short medical school course on responding to bioterrorism and other disasters. Acad Med. 2005;80(9):820-823.CrossRefGoogle Scholar
11.Kaji, AH, Coates, W, Fung, CC. A disaster medicine curriculum for medical students. Teach Learn Med. 2010;22(2):116-122.Google Scholar
12.Bristol, N, Marcozzi, D. New presidential directive targets academic approaches to disasters. Disaster Med Public Health Prep. 2008;2(1):13-14.CrossRefGoogle ScholarPubMed
13.Scott, LA, Carson, DS, Greenwell, IB. Disaster 101: a novel approach to disaster medicine training for health professionals. J Emerg Med. 2010;39(2):220-226.CrossRefGoogle ScholarPubMed
14.Carney, JK, Schilling, LM, Frank, SH, et al. Planning and incorporating public health preparedness into the medical curriculum. Am J Prev Med. 2011;41(4 Suppl 3):S193-S199.Google Scholar
15.Silenas, R, Akins, R, Parrish, AR, Edwards, JC. Developing disaster preparedness competence: an experiential learning exercise for multiprofessional education. Teach Learn Med. 2008;20(1):62-68.Google Scholar
16.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.Google Scholar
17.Pelaccia, T. Preparing health care students for mass casualty events. Med Educ. 2008;42(11):1135.CrossRefGoogle ScholarPubMed
18.Kaiser, HE, Barnett, DJ, Hsu, EB, Kirsch, TD, James, JJ, Subbarao, I. Perspectives of future physicians on disaster medicine and public health preparedness: challenges of building a capable and sustainable auxiliary medical workforce. Disaster Med Public Health Prep. 2009;3(4):210-216.Google Scholar
19.Mortelmans, LJ, De Cauwer, HG, Van Dyck, E, et al. Are Belgian senior medical students ready to deliver basic medical care in case of a H5N1 pandemic? Prehosp Disaster Med. 2009;24(5):438-442.Google Scholar
20.Sauser, K, Burke, RV, Ferrer, RR, Goodhue, CJ, Chokshi, NC, Upperman, JS. Disaster preparedness among medical students: a survey assessment. Am J Disaster Med. 2010;5(5):275-284.Google Scholar
21.Rega, P, Bork, C, Chen, Y, Woodson, D, Hogue, P, Batten, S. Using an H1N1 vaccination drive-through to introduce healthcare students and their faculty to disaster medicine. Am J Disaster Med. 2010;5(2):129-136.Google ScholarPubMed
22.Sapp, RF, Brice, JH, Myers, JB, Hinchey, P. Triage performance of first year medical students using a multiple-casualty scenario, paper exercise. Prehosp Disaster Med. 2010;25(3):239-245.Google Scholar
23.Katz, CL, Gluck, N, Maurizio, A, DeLisi, LE. The medical student experience with disasters and disaster response. CNS Spectr. 2002;7(8):604-610.CrossRefGoogle ScholarPubMed
24.International Federation of Medical Students’ Associations (IFMSA) Web site. http://www.ifmsa.org. Accessed February 6, 2014.Google Scholar
25.International Federation of Medical Students’ Associations (IFMSA). IFMSA Policy Statement on Disasters and Emergencies 2012. http://imccam2012.files.wordpress.com/2012/07/ps-am12-disasters-and-emergencies.pdf. Accessed February 6, 2014.Google Scholar
26.Smith, J, Levy, MJ, Hsu, EB, Lee Levy, J. Disaster curricula in medical education: pilot survey. Prehosp Disaster Med. 2012;27(5):492-494.Google Scholar
27.Cummings, GE, Della Corte, F, Cummings, GG. Disaster Medicine education in Canadian medical schools before and after September 11, 2001. CJEM. 2005;7(6):399-405.Google Scholar
28. Centro di Ricerca Interdipartimentale in Medicina di Emergenza e dei Disastri ed Informatica applicata alla didattica e alla pratica medica (CRIMEDIM) Web site. https://crimedim.med.unipmn.it. Accessed February 6, 2014.Google Scholar
29.Della Corte, F. A single European response to disasters. Paper presented at: 14th ICEM 2012; June 27-30, 2012; Dublin, Ireland. http://imgpublic.mci-group.com/ie/ICEM2012/Friday/F_Della_Corte.pdf. Accessed February 6, 2014.Google Scholar
30.Ragazzoni, L, Ingrassia, PL, Gugliotta, G, Tengattini, M, Franc, JM, Della Corte, F. Italian medical students and disaster medicine: awareness and formative needs. Am J Disaster Med. 2013;8(2):127-136.CrossRefGoogle ScholarPubMed
31. Segretariato Italiano Studenti in Medicina Web site. http://www.nazionale.sism.org. Accessed February 6, 2014.Google Scholar
32.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. Prehosp Disaster Med. 2004;19(2):S17-30.Google ScholarPubMed
33.Kern, DE, Thomas, PA, Howard, DM, Bass, EB eds. Curriculum Development for Medical Education: A Six-step Approach. Baltimore, Maryland USA: The Johns Hopkins University Press; 1998.CrossRefGoogle Scholar
34. German Society of Disaster Medicine website. http://www.dgkm.org. Accessed July 22, 2014.Google Scholar
35. Federal Office of Civil Protection and Disaster Assistance (BBK) website. http://www.bbk.bund.de. Accessed July 22, 2014.Google Scholar
36.Abrami, PC, Bernard, RM, Bures, EM, Borokhovski, E, Tamim, RM. Interaction in distance education and online learning: using evidence and theory to improve practice. J Comput High Educ. 2011;23:82-103.CrossRefGoogle Scholar
37.Maciel, DT, Soares, W, Amaral, E. Moodle platform for online tutoring during internships. Med Educ. 2009;43(11):1113-1114.Google Scholar
38.Bollela, VR, Grec, W, Matias, AA. Shortening distances: a Moodle platform supports programme evaluation in internship. Med Educ. 2009;43(11):1114-1115.CrossRefGoogle ScholarPubMed
39. START - Simple Triage And Rapid Treatment Web site. http://www.start-triage.com. Accessed February 6, 2014.Google Scholar
40.Delooz, H, Debacker, M, Moens, G, Johannik, K. European survey on training objectives in disaster medicine. Eur J Emerg Med. 2007;14(1):25-31.Google Scholar
41.Kneebone, R. Evaluating clinical simulations for learning procedural skills: a theory-based approach. Acad Med. 2005;80(6):549-553.CrossRefGoogle ScholarPubMed
42.Fanning, RM, Gaba, DM. The role of debriefing in simulation-based learning. Simul Healthc. 2007;2(2):115-125.Google Scholar
43.Gryth, D, Rådestad, M, Nilsson, H, et al. Evaluation of medical command and control using performance indicators in a full-scale, major aircraft accident exercise. Prehosp Disaster Med. 2010;25(2):118-123.Google Scholar
44.Kirkpatrick, DL. Evaluating Training Programs: the Four Levels, 2nd ed. San Francisco, California USA: Berrett-Koehler; 1998.Google Scholar
45.Bradt, DA, Abraham, K, Franks, R. A strategic plan for disaster medicine in Australasia. Emerg Med (Fremantle). 2003;15(3):271-282.Google Scholar
46.Bradt, DA, Drummond, CM. Professionalization of disaster medicine: an appraisal of criterion-referenced qualifications. Prehosp Disaster Med. 2007;22(5):360-368.Google Scholar
47.Ruiz, JG, Mintzer, MJ, Leipzig, RM. The impact of e-learning in medical education. Acad Med. 2006;81(3):207-212.Google Scholar
48.Choules, AP. The use of e-learning in medical education: a review of the current situation. Postgrad Med J. 2007;83(978):212-216.CrossRefGoogle Scholar
49.Della Corte, F, La Mura, F, Petrino, R. E-learning as educational tool in emergency and disaster medicine teaching. Minerva Anestesiol. 2005;71(5):181-195.Google ScholarPubMed
50.Chandler, T, Qureshi, K, Gebbie, KM, Morse, SS. Teaching emergency preparedness to public health workers: use of blended learning in web-based training. Public Health Rep. 2008;123(5):676-680.Google Scholar
51.Gray, K, Tobin, J. Introducing an online community into a clinical education setting: a pilot study of student and staff engagement and outcomes using blended learning. BMC Med Educ. 2010;10:6.Google Scholar
52.Srinivasan, M, Wilkes, M, Stevenson, F, Nguyen, T, Slavin, S. Comparing problem-based learning with case-based learning: effects of a major curricular shift at two institutions. Acad Med. 2007;82(1):74-82.Google Scholar
53.Woltering, V, Herrler, A, Spitzer, K, Spreckelsen, C. Blended learning positively affects students' satisfaction and the role of the tutor in the problem-based learning process: results of a mixed-method evaluation. Adv Health Sci Educ Theory Pract. 2009;14(5):725-738.Google Scholar
54.McGaghie, WC, Issenberg, SB, Petrusa, ER, Scalese, RJ. A critical review of simulation-based medical education research: 2003-2009. Med Educ. 2010;44(1):50-63.CrossRefGoogle ScholarPubMed
55.Grant, DJ, Marriage, SC. Training using medical simulation. Arch Dis Child. 2012;97(3):255-259.Google Scholar
56.Olson, DK, Hoeppner, MM, Scaletta, K, Peck, M, Newkirk, R. Games, simulations, and learning in emergency preparedness: a review of the literature. Am J Disaster Med. 2012;7(2):145-154.CrossRefGoogle ScholarPubMed
57.Montán, KL, Khorram-Manesh, A, Ortenwall, P, Lennquist, S. Comparative study of physiological and anatomical triage in major incidents using a new simulation model. Am J Disaster Med. 2011;6(5):289-298.Google Scholar
58.Sapp, RF, Brice, JH, Myers, JB, Hinchey, P. Triage performance of first-year medical students using a multiple-casualty scenario, paper exercise. Prehosp Disaster Med. 2010;25(3):239-245.CrossRefGoogle ScholarPubMed
59.Kaji, AH, Coates, WC, Fung, CC. Medical student participation in a disaster seminar and drill: brief description of activity and report of student experiences. Teach Learn Med. 2010;22(1):28-32.Google Scholar
60.Pelaccia, T, Delplancq, H, Triby, E, et al. Can teaching methods based on pattern recognition skill development optimize triage in mass-casualty incidents? Emerg Med J. 2009;26(12):899-902.Google Scholar
61.Franc-Law, JM, Ingrassia, PL, Ragazzoni, L, Della Corte, F. The effectiveness of training with an emergency department simulator on medical student performance in a simulated disaster. CJEM. 2010;12(1):27-32.Google Scholar
62.Wilkerson, W, Avstreih, D, Gruppen, L, Beier, KP, Woolliscroft, J. Using immersive simulation for training first responders for mass casualty incidents. Acad Emerg Med. 2008;15(11):1152-1159.CrossRefGoogle ScholarPubMed
63.Cone, DC, Serra, J, Kurland, L. Comparison of the SALT and Smart triage systems using a virtual reality simulator with paramedic students. Eur J Emerg Med. 2011;18(6):314-321.Google Scholar
64.Cohen, D, Sevdalis, N, Taylor, D, et al. Emergency preparedness in the 21st century: training and preparation modules in virtual environments. Resuscitation. 2013;84(1):78-84.CrossRefGoogle ScholarPubMed
65.Vincent, DS, Sherstyuk, A, Burgess, L, Connolly, KK. Teaching mass casualty triage skills using immersive three-dimensional virtual reality. Acad Emerg Med. 2008;15(11):1160-1165.CrossRefGoogle ScholarPubMed
66.Wiecha, J, Barrie, N. Collaborative online learning: a new approach to distance CME. Acad Med. 2002;77(9):928-929.CrossRefGoogle ScholarPubMed
67.Wiecha, JM, Gramling, R, Joachim, P, Vanderschmidt, H. Collaborative e-learning using streaming video and asynchronous discussion boards to teach the cognitive foundation of medical interviewing: a case study. J Med Internet Res. 2003;5(2):e13.Google Scholar
68.Barnett-Vanes, A, Luis Guinto, RL. Disaster curricula in medical and health care education: adopting an interprofessional approach. Prehosp Disaster Med. 2013;28(6):644-645.CrossRefGoogle ScholarPubMed
69.International Federation of Medical Students’ Associations (IFMSA) General Assembly 2011 Web site. http://www.am2011denmark.com. Accessed February 6, 2014.Google Scholar