Integrating an Exercise on Mass Casualty Response into the Curriculum

Decker, Sharon; Galvan, Toni J.; Sridaromont, Kathryn

doi:10.3928/01484834-20050701-12

Cited by 11 publications

(3 citation statements)

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“…For example, the Long Island University School of Nursing involves senior nursing students in a 3-hour lecture covering basic disaster management principles and a 1-day symposium as part of their community health experience [10]. Another school, the Texas Tech University Health Sciences Center School of Nursing, had nursing students participate in a simulated mass causality drill to allow students an opportunity to practice skills [11]. The question remains, however, how much and what type of content is sufficient?…”

Section: Educational Demandmentioning

confidence: 99%

Directions for Disaster Nursing Education in the United States

Littleton-Kearney

Slepski

2008

Critical Care Nursing Clinics of North America

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Because of their diverse education, experience, and practice settings, nurses are uniquely qualified to be first receivers, care givers, and leaders in any large-scale public health emergency. Many nurses, however, continue to feel inadequately prepared to function effectively in these types of situations. Great strides have been made since 2001, but much work remains to be accomplished. This article focuses on newer approaches used to teach nurses the principles of disaster preparedness. It also addresses the need to incorporate mass casualty care and disaster management skills into undergraduate curricula, continuing nurse education, and advanced degree programs for nurses in the United States.

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Section: Educational Demandmentioning

confidence: 99%

Directions for Disaster Nursing Education in the United States

Littleton-Kearney

Slepski

2008

Critical Care Nursing Clinics of North America

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“…59 Other descriptions of simulation in emergency and military medicine are available. 9,13,28,57,[60][61][62][63][64][65][66][67] Recently a comprehensive list of disaster core competencies for acute care providers was published, but it provides little guidance as to how to incorporate simulation into the disaster classroom. 68 A literature search in the PubMed database was performed.…”

Section: Discussionmentioning

confidence: 99%

Competency in Chaos: Lifesaving Performance of Care Providers Utilizing a Competency-Based, Multi-Actor Emergency Preparedness Training Curriculum

Scott

Swartzentruber

Davis

et al. 2013

Prehosp. Disaster med.

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Objective Providing comprehensive emergency preparedness training (EPT) to care providers is important to the future success of disaster operations in the US. Few EPT programs possess both competency-driven goals and metrics to measure performance during a multi-patient simulated disaster. Methods A 1-day (8-hour) EPT course for care providers was developed to enhance provider knowledge, skill, and comfort necessary to save lives during a simulated disaster. Nine learning objectives, 18 competencies, and 34 performance objectives were developed. During the 2-year demonstration of the curriculum, 24 fourth-year medical students and 17 Veterans Hospital Administration (VHA) providers were recruited and volunteered to take the course (two did not fully complete the research materials). An online pre-test, two post-tests, course assessment, didactic and small group content, and a 6-minute clinical casualty scenario were developed. During the scenario, trainees working in teams were confronted with three human simulators and 10 actor patients simultaneously. Unless appropriate performance objectives were met, the simulators “died” and the team was exposed to “anthrax.” After the scenario, team members participated in a facilitator-led debriefing using digital video and then repeated the scenario. Results Trainees (N = 39) included 24 (62%) medical students; seven (18%) physicians; seven (18%) nurses; and one (3%) emergency manager. Forty-seven percent of the VHA providers reported greater than 16 annual hours of disaster training, while 15 (63%) of the medical students reported no annual disaster training. The mean (SD) score for the pre-test was 12.3 (3.8), or 51% correct, and after the training, the mean (SD) score was 18.5 (2.2), or 77% (P <.01). The overall rating for the course was 96 out of 100. Trainee self-assessment of “Overall Skill” increased from 63.3 out of 100 to 83.4 out of 100 and “Overall Knowledge” increased from 49.3 out of 100 to 78.7 out of 100 (P <.01). Of the 34 performance objectives during the disaster scenario, 23 were completed by at least half of the teams during their first attempt. All teams except one (8 of 9) could resuscitate two simulators and all teams (9 of 9) helped prevent anthrax exposure during their second scenario attempt. Conclusions The 1-day EPT course for novice and experienced care providers recreated a multi-actor clinical disaster and enhanced provider knowledge, comfort level, and EPT skill. A larger-scale study, or multi-center trial, is needed to further study the impact of this curriculum and its potential to protect provider and patient lives.

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“…25 Multipatient disaster medical management exercises featuring highfidelity manikin systems have also been reported. [26][27][28][29] Educational and Training Opportunities Unique to Multipatient SIM Scenarios Teamwork lapses, breakdowns in communication, worker task overload, and time pressure have contributed prominently to patient safety failures. [30][31][32] These cultural and institutional problems, highlighted in the Institute of Medicine report To Err is Human, 33 are predictably magnified in ED and disaster environments.…”

Section: Prior and Ongoing Multiple Patient Sim Programsmentioning

confidence: 99%

Multiple Encounter Simulation for High‐acuity Multipatient Environment Training

Kobayashi

Shapiro

Gutman

et al. 2007

Academic Emergency Medicine

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Patient safety interventions for multitasking, multipatient, error-prone work settings such as the emergency department (ED) must improve assorted clinical abilities, specific cognitive strategies, and teamwork functions of the staff to be effective. Multiple encounter simulation scenarios explore and convey this specialized mental work-set through use of multiple high-fidelity medical simulation (SIM) manikins in realistic surroundings. Multipatient scenarios reflect the work situations being targeted yet have the benefit of scripted control and instructor guidance to advance specific educational objectives. The use of two or more SIM patients promotes the exploration not only of multiple distinct clinical issues but also of interdependent processes pervasive in EDs. Cascading shortages of time, personnel, equipment, and supplies are re-created, thereby replicating process limitations at various levels, in a safe environment in which compensatory actions and adaptive behaviors can be learned. Distinguishing features of multipatient exercises include 1) broadened educational scope and expanded indications for SIM application, 2) enhanced scenario complexity, 3) controlled exposure to high workload environments, 4) expanded communication requirements, and 5) increased potential for reflective learning. Widespread and effective training in well-replicated, carefully coordinated representations of complex multipatient work environments may strengthen educational interventions for personnel working in high acuity and work-overloaded settings such as the ED. The use of concurrent patient encounter SIM exercises to elicit calculated stressors and to foster compensatory staff behaviors is an educational advance toward this objective. The authors present SIM methodology using concurrent patient encounters to replicate these environments.

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Integrating an Exercise on Mass Casualty Response into the Curriculum

Cited by 11 publications

References 0 publications

Directions for Disaster Nursing Education in the United States

Directions for Disaster Nursing Education in the United States

Competency in Chaos: Lifesaving Performance of Care Providers Utilizing a Competency-Based, Multi-Actor Emergency Preparedness Training Curriculum

Multiple Encounter Simulation for High‐acuity Multipatient Environment Training

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