Disaster health workers currently have no common standard based on a shared set of competencies, learning objectives, and performance metrics with which to develop courses or training materials relevant to their learning audience. We examined how existing competency sets correlate within the 2012 pyramidal learning framework of competency sets in disaster medicine and public health criteria and describe how this exercise can guide curriculum developers.

We independently categorized 35 disaster health-related competency sets according to the 4 levels and criteria of the pyramidal learning framework of competency sets in disaster medicine and public health.

Using the hierarchical learning framework of competency sets in disaster medicine and public health criteria as guidance, we classified with consistency only 10 of the 35 competency sets.

The proposed series of minor modifications to the framework should allow for consistent classification of competency sets. Improved education and training of all health professionals is a necessary step to ensuring that health system responders are appropriately and adequately primed for their role in disasters. Revising the organizing framework should assist disaster health educators in selecting competencies appropriate to their learning audience and identify gaps in current education and training. (Disaster Med Public Health Preparedness. 2014;8:70-78)

The March 11, 2011 disaster was unparalleled in the disaster history of Japan. There is still enormous effort required in order for Japan to recover from the damage, not only financially, but psychosocially. This paper is a review of the studies that have been undertaken since this disaster, from after the March 11th disaster in 2011 to the end of 2012, and will provide an overview of the disaster-health research literature published during this period.

The Japanese database Ichushi Ver. 5 was used to review the literature. This database is the most frequently used database in Japanese health-sciences research. The keywords used in the search were “Higashi Nihon Dai-shinsai” (The Great East Japan Earthquake).

A total of 5,889 articles were found. Within this selection, 163 articles were categorized as original research (gencho ronbun). The articles were then sorted and the top four key categories were as follows: medicine (n = 98), mental health (n = 18), nursing (n = 13), and disaster management (n = 10). Additional categories were: nutrition (n = 4), public health (n = 3), radiology, preparedness, and pharmacology (n = 2 for each category). Nine articles appeared with only one category label and were grouped as “others.”

This review provides the current status of disaster-health research following the Great East Japan Earthquake. The research focus over the selected period was greatly directed towards medical considerations, especially vascular conditions and renal dialysis. Considering the compounding factors of the cold temperatures at the time of the disaster, the geography, the extensive dislocation of the population, and the demographics of an aging community, it is noteworthy that the immediate and acute impact of the March 11th disaster was substantial compared with other events and their studies on the impact of disaster on chronic and long-term illness. The complexity of damage caused by the earthquake event and the associated nuclear power plant event, which possibly affected people more psychologically than physically, might also need to be investigated with respect to long term objectives for improving disaster preparedness and management.

KakoM , ArbonP , MitaniS . Disaster Health After The 2011 Great East Japan Earthquake. Prehosp Disaster Med. 2014;29(1):1-6.

In order to prepare the healthcare system and healthcare personnel to meet the health needs of populations affected by disasters, educational programs have been developed by numerous academic institutions, hospitals, professional organizations, governments, and non-government organizations. Lacking standards for best practices as a foundation, many organizations and institutions have developed “core competencies” that they consider essential knowledge and skills for disaster healthcare personnel.

The Nursing Section of the World Association for Disaster and Emergency Medicine (WADEM) considered the possibility of endorsing an existing set of competencies that could be used to prepare nurses universally to participate in disaster health activities. This study was undertaken for the purpose of reviewing published disaster health competencies to determine commonalities and universal applicability for disaster preparedness.

In 2007, a review of the electronic literature databases was conducted using the major keywords: disaster response competencies; disaster preparedness competencies; emergency response competencies; disaster planning competencies; emergency planning competencies; public health emergency preparedness competencies; disaster nursing competencies; and disaster nursing education competencies. A manual search of references and selected literature from public and private sources also was conducted. Inclusion criteria included: English language; competencies listed or specifically referred to; competencies relevant to disaster, mass-casualty incident (MCI), or public health emergency; and competencies relevant to healthcare.

Eighty-six articles were identified; 20 articles failed to meet the initial inclusion criteria; 27 articles did not meet the additional criteria, leaving 39 articles for analysis. Twenty-eight articles described competencies targeted to a specific profession/discipline, while 10 articles described competencies targeted to a defined role or function during a disaster. Four of the articles described specific competencies according to skill level, rather than to a specific role or function. One article defined competencies according to specific roles as well as proficiency levels. Two articles categorized disaster nursing competencies according to the phases of the disaster management continuum. Fourteen articles described specified competencies as “core” competencies for various target groups, while one article described “cross-cutting” competencies applicable to all healthcare workers.

Hundreds of competencies for disaster healthcare personnel have been developed and endorsed by governmental and professional organizations and societies. Imprecise and inconsistent terminology and structure are evident throughout the reviewed competency sets. Universal acceptance and application of these competencies are lacking and none have been validated. Further efforts must be directed to developing a framework and standardized terminology for the articulation of competency sets for disaster health professionals that can by accepted and adapted universally.

Recent events have heightened awareness of disaster health issues and the need to prepare the health workforce to plan for and respond to major incidents. This has been reinforced at an international level by the World Association for Disaster and Emergency Medicine, which has proposed an international educational framework.

The aim of this paper is to outline the development of a national educational framework for disaster health in Australia.

The framework was developed on the basis of the literature and the previous experience of members of a National Collaborative for Disaster Health Education and Research. The Collaborative was brought together in a series of workshops and teleconferences, utilizing a modified Delphi technique to finalize the content at each level of the framework and to assign a value to the inclusion of that content at the various levels.

The framework identifies seven educational levels along with educational outcomes for each level. The framework also identifies the recommended contents at each level and assigns a rating of depth for each component. The framework is not intended as a detailed curriculum, but rather as a guide for educationalists to develop specific programs at each level.

This educational framework will provide an infrastructure around which future educational programs in Disaster Health in Australia may be designed and delivered. It will permit improved articulation for students between the various levels and greater consistency between programs so that operational responders may have a consistent language and operational approach to the management of major events.

“Cultural Competency” is an increasingly important skill required by the humanitarian workforce. Reviews and evaluations of recent major international events criticize tiie lack of cultural competency skills among foreign aid workers. This paper reviews two frameworks in the international literature to propose a model for cultural competency education in the humanitarian workforce.

The framework for disaster health, developed by the World Association for Disaster and Emergency Medicine (WADEM) Education Committee, and the Australian National Health and Medical Research Councils (NHMCR) “Cultural Competency in Health: A Guide for Policy, Partnership and Preparation” (2006) were used as frameworks for this review. A meta-review of the literature was conducted to identify cultural considerations in disaster management.

A definition of cultural competence was adopted from a range of theoretical models. Both the WADEM model, which includes the “Socio political, cultural context”, and the NHMRC model, which describes four dimensions for actions (systemic, organizational, professional, and the individual), identify key principles. Using these principles informed by the literature review, a model is proposed to foster culturally competent behavior incorporating all four dimensions.

The model argues that “everyone” is responsible for culturally appropriate and responsive management. This review makes explicit the importance of cultural competency skills in the humanitarian workforce and provides a model, underpinned by contemporary frameworks, to address this challenge.

The World Association for Disaster and Emergency Medicine (WADEM) Education Committee recommends that all health professionals be exposed to a core program in disaster health. This paper describes the framework, implementation, and evaluation of a Graduate Certificate in Emergency Preparedness and Disaster Health designed for health professionals.

Based on the WADEM Education Committee's framework for disaster health and the structure of the World Health Organization (WHO) Health Action in Crises Unit, a four-unit Graduate Certificate in Emergency Preparedness and Disaster Heath was developed, implemented and evaluated.

This Graduate Certificate evolved over diree years and includes four units: (1) an introduction to emergency preparedness and disaster health; (2) emergency preparedness; (3) response and major incident management, and (4) disaster recovery. Each unit has national and international perspectives.

Appropriate conceptual models provided the content and process of the course, although these have been difficult to locate. Delivery is largely on-campus with pre-reading and post-course assignments. A faculty of national and international leaders enriches delivery. Assessment largely has been assignment-based, with participation in one “Emergotrain” exercise required. Students may take the full Graduate Certificate or individual units only, either for credit or not-for-credit professional development.

Student feedback has been positive, with the introductory unit being rated as amongst the top 10% of units conducted in the faculty for two years in a row. The content, process, and assessments have been well supported with only few suggestions made for future modifications. An online option will now be offered in 2009, and a Graduate Diploma and Masters also will be available in 2009.

This Graduate Certificate has been evaluated positively by participants. The conceptual modeling has been validated and the model may be of interest to other WADEM members.