Angel A. Brotons

Skill Improvement During Emergency Response to Terrorism Training

Objectives. To assess the individual andteam skills acquired from an interactive training program to prepare emergency personnel to respond to terrorist acts. Methods. We developed a 16-hour, two-day, multimedia- andsimulation-enhanced course that places learners in realistic situations using the equipment required to respond to various chemical, biologic, radiologic, andexplosive acts of terrorism. Small-group sessions anddrills were conducted. Errors in skill performance were corrected immediately, andthen skills were repeated to achieve mastery. Participants included emergency medical technicians, paramedics, nurses, andphysicians. Team performance was assessed over four successive scenarios using a 100-mm visual analog scale. Individual learner skill acquisition was assessed with precourse andpostcourse evaluation of selected skills in a randomized sampling of consenting learners. Results. Nearly all teams achieved mastery of the required skills by the second assessment rotation. Individual learners demonstrated significant gains in the ability to emergently don personal protective equipment andadminister a nerve agent antidote kit. Conclusions. An interactive, simulation-enhanced curriculum of terrorism response training for emergency responders can produce significant, quantifiable individual andteam skill gain. Future studies should further address performance benchmarks for these newly acquired skills.

Development, implementation and outcomes of a training program for responders to acts of terrorism

Introduction. Responding to acts of terrorism requires the effective use of public-safety andmedical-response resources. The knowledge, skills andattitudes necessary to respond to future threats is unfamiliar to most emergency responders. Objectives. The purpose of this report to describe the development, implementation andevaluation of a multidisciplinary, interactive andsimulation-enhanced course to prepare responders to acts of terrorism. Methods. We used a 5-step systematic process to develop a blended-learning, simulation-enhanced training program. Learners completed a self-confidence questionnaire andwritten examination prior to the course anda self-confidence questionnaire, written examination andcourse evaluation when they finished the course. Results. From July 7, 2003 to March 8, 2005, 497 consenting learners completed the course. After course completion, learners demonstrated significant increases in their knowledge of terrorism response (t = −64.3, df = 496, p < 0.05) andtheir confidence in responding to terrorist events (t = −45.5, df = 496, p < 0.05). Learner feedback about the course was highly positive. Conclusions. We successfully implemented a two-day course for professionals likely to respond to terrorist acts that included scenario-based performance training andassessment. Course participants increased their knowledge andwere more confident in their ability to respond to acts of terrorism after participating in this course.

Collaboration between Civilian and Military Healthcare Professionals: A Better Way for Planning, Preparing, and Responding to All Hazard Domestic Events

Collaboration is used by the US National Security Council as a means to integrate inter-federal government agencies during planning and execution of common goals towards unified, national security. The concept of collaboration has benefits in the healthcare system by building trust, sharing resources, and reducing costs. The current terrorist threats have made collaborative medical training between military and civilian agencies crucial. This review summarizes the long and rich history of collaboration between civilians and the military in various countries and provides support for the continuation and improvement of collaborative efforts. Through collaboration, advances in the treatment of injuries have been realized, deaths have been reduced, and significant strides in the betterment of the Emergency Medical System have been achieved. This review promotes collaborative medical training between military and civilian medical professionals and provides recommendations for the future based on medical collaboration.

Just-in-time learning is effective in helping first responders manage weapons of mass destruction events

BACKGROUND Chemical, biologic, radiologic, nuclear, and explosive (CBRNE) incidents require specialized training. The low frequency of these events leads to significant skill decay among first responders. To address skill decay and lack of experience with these high-impact events, educational modules were developed for mobile devices to provide just-in-time training to first responders en route to a CBRNE event. This study assessed the efficacy and usability of the mobile training. METHODS Ninety first responders were randomized to a control or an intervention group. All participants completed a pretest to measure knowledge of CBRNE topics. The intervention group then viewed personal protective equipment and weapons of mass destruction field management videos as an overview. Both groups were briefed on a disaster scenario (chemical nerve agent, radiologic, or explosives) requiring them to triage, assess, and manage a patient. Intervention group participants watched a mobile training video corresponding to the scenario. The control group did not receive prescenario video training. Observers rated participant performance in each scenario. After completing the scenarios, all participants answered a cognitive posttest. Those in the intervention group also answered a questionnaire on their impressions of the training. RESULTS The intervention group outperformed the control group in the explosives and chemical nerve agent scenarios; the differences were statistically significant (explosives, mean of 26.32 for intervention and 22.85 for control, p < 0.01; nerve agent, mean of 23.14 for intervention and 16.61 for control, p < 0.01). There was no statistically significant difference between the groups in the radiologic scenario (mean, 12.7 for intervention and 11.8 for control; p = 0.51). The change in pretest to posttest cognitive scores was significantly higher in the intervention group than in the control group (t = 3.28, p < 0.05). CONCLUSION Mobile just-in-time training improved first-responder knowledge of CBRNE events and is an effective tool in helping first responders manage simulated explosive and chemical agent scenarios. LEVEL OF EVIDENCE Therapeutic/care management study, level II.