Pediatric disaster preparedness curriculum across emergency medicine residencies.

OBJECTIVE: To assess pediatric disaster medicine (PDM) instruction in emergency medicine (EM) residency programs and to identify barriers to integrating these skills into EM training. METHODS: National survey study of United States EM Residency Program Directors (PDs) and Assistant PDs during the 2021-2022 academic year. RESULTS: Of the 186 EM residency programs identified, a total of 24 responses were recorded with a response rate of 12.9 percent. Importance of training was rated 5.79 (standard deviation 2.51) using the Likert scale ranging from 1 to 10. Out of 24 programs, 17 (70.8 percent) do not have any PDM training as part of residency training. Live drill, simulation, and tabletop were identified as most effective methods to deliver PDM training with the Likert scale score of 4.78, 4.6, and 4.47, respectively. Senior trainees' level of -knowledge/skills with family reunification (Likert 2.09/5; chemical-biological-radiological-nuclear explosive 2.95/5) and mass casualty preparation of the emergency department (3.3/5) as assessed by the respondents. The main barrier to education included logistics, eg, space and costs (Likert 3.7/5), lack of didactic time (3.7/5), and limited faculty knowledge, skill, or experience (3.3/5). CONCLUSION: PDM training is lacking and requires standardization. This study highlights the opportunity for the creation of a model for EM resident education in PDM.

The Critical Need for Disaster Medicine in Modern Medical Education.

Current escalation of natural disasters, pandemics, and humanitarian crises underscores the pressing need for inclusion of disaster medicine in medical education frameworks. Conventional medical training often lacks adequate focus on the complexities and unique challenges inherent in such emergencies. This discourse advocates for the integration of disaster medicine into medical curricula, highlighting the imperative to prepare health-care professionals for an effective response in challenging environments. These competencies encompass understanding mass casualty management, ethical decision-making amidst resource constraints, and adapting health-care practices to varied emergency contexts. Therefore, we posit that equipping medical students with these specialized skills and knowledge is vital for health-care delivery in the face of global health emergencies.

Components of an Updated Disaster Medicine Curriculum Included in Emergency Medicine Residency and Emergency Medical Services Fellowship in the United States.

INTRODUCTION: Disaster medicine (DM) is a unique field that has undergone significant development as disaster events become increasingly complicated to respond to. However, DM is not recognized by the American Board of Medical Specialties (ABMS) or Accreditation Committee of Graduate Medical Education (ACGME), and therefore lacks board certification. Furthermore, prior studies have shown that there is unique body of DM knowledge not being addressed in emergency medicine (EM) residency or Emergency Medical Services (EMS) fellowship, resulting in fundamental DM topics not being covered amongst graduate medical education (GME) programs most prepared to produce DM physicians. A recently published DM core curriculum addresses this knowledge gap and seeks to promote standardization of DM training. STUDY OBJECTIVE: The objective of this study is to analyze EM residency and EMS fellowship curricula for the inclusion of DM major curriculum topics and subtopics, using the most recently published DM core curriculum as a control. METHODS: Both EM residency and EMS fellowship curricula were analyzed for inclusion of DM curriculum topics and subtopics, using the DM curriculum recommendations published by Wexler, et al as a control. A major curriculum topic was deemed covered if at least one related subtopic was described in the curricula. The included and excluded DM topics and subtopics were analyzed using descriptive statistics. RESULTS: While all the DM major curriculum topics were covered by either EM residency or EMS fellowship, EMS fellowship covered more major curriculum topics (14/15; 93%) than EM residency (12/15; 80%) and EMS fellowship covered more DM curriculum subtopics (58/153; 38%) than EM residency (24/153; 16%). Combined, EM residency and EMS fellowship covered 65 out of 153 (42%) of the DM curriculum subtopics. CONCLUSION: Although this study finds that all the DM major curriculum topics will be covered in EM residency followed by EMS fellowship, over one-half of the subtopics are not covered by either program (16% and 38%, respectively) or both programs combined (42%). Increasingly relevant subtopics, such as climate change, droughts, and flooding, are amongst those not covered by either curriculum. Even amongst the DM topics included in GME curricula, an emphasis on themes such as mass treatment, preparedness, and mitigation is likely under-represented. Accreditation from ACGME for DM fellowship would further promote uniform implementation of the updated core curriculum and ensure optimal training of disaster-ready physicians.

Editorial Comments: The 2023 Model Core Content of Disaster Medicine.

The recently published Model Core Content of Disaster Medicine introduces proposed curriculum elements for specialized education and training in Disaster Medicine. This editorial comments on the publishing decision for the manuscript.

A disaster medicine course for Canadian medical students: first implementation of a large-scale mass-casualty simulation.

Mass-casualty incidents have a significant global impact. Despite calls for improved disaster-preparedness training, most medical curriculums do not include formal disaster-medicine education. In 2021, the Medical Council of Canada introduced new disaster-medicine learning objectives. This article presents a mass-casualty-incident course for 3rd-year Canadian medical students. The course includes lectures, and a large-scale simulation of an explosion scene, field triage zone, and simulated emergency department (ED). The simulation incorporated "Dark-team-member" facilitators and 17 live actor and 8 mannequin patients with moulage. Pre-/post-event evaluation data was collected. One-hundred and twenty medical students participated in the course. Confidence in managing a real mass-casualty incident, on a scale from 1 to 10 (no-confidence to completely confident) significantly improved based on a Mann-Whitney U test, p < 0.05. Few formal medical student mass-casualty-incident courses exist. Combining "Dark-team-members" with live actors, imbedding clinician facilitators with medical students, and having a simulation with a continuous disaster scene to the ED are unique to this course. The methodology is presented for future replication.

RéSUMé: Les incidents faisant de nombreuses victimes ont un impact mondial significatif. Malgré les appels à l'amélioration de la formation à la préparation aux catastrophes, la plupart des cursus médicaux n'incluent pas de formation formelle à la médecine des catastrophes. En 2021, le Conseil médical du Canada a introduit de nouveaux objectifs d'apprentissage en médecine de catastrophe. Cet article présente un cours sur les accidents de masse destiné aux étudiants en médecine canadiens de troisième année. Le cours comprend des cours magistraux et une simulation à grande échelle d'une scène d'explosion, d'une zone de triage sur le terrain et d'un service d'urgence (SU) simulé. La simulation comprenait des facilitateurs "Dark-team-member" et 17 acteurs réels et 8 patients mannequins avec moulage. Des données d'évaluation avant/après l'événement ont été collectées. Cent vingt étudiants en médecine ont participé au cours. La confiance dans la gestion d'un véritable incident de masse, sur une échelle de 1 à 10 (aucune confiance à une confiance totale), s'est améliorée de manière significative d'après un test U de Mann-Whitney p<0,05. Il existe peu de cours formels sur les accidents de masse à l'intention des étudiants en médecine. La combinaison de " Dark-team-member " avec des acteurs en chair et en os, l'intégration d'animateurs cliniciens avec des étudiants en médecine et la simulation d'une scène de catastrophe continue au service des urgences sont des éléments uniques de ce cours. La méthodologie est présentée pour être reproduite à l'avenir.

The 2023 Model Core Content of Disaster Medicine.

INTRODUCTION: Disaster Medicine (DM) is the clinical specialty whose expertise includes the care and management of patients and populations outside conventional care protocols. While traditional standards of care assume the availability of adequate resources, DM practitioners operate in situations where resources are not adequate, necessitating a modification in practice. While prior academic efforts have succeeded in developing a list of core disaster competencies for emergency medicine residency programs, international fellowships, and affiliated health care providers, no official standardized curriculum or consensus has yet been published to date for DM fellowship programs based in the United States. STUDY OBJECTIVE: The objective of this work is to define the core curriculum for DM physician fellowships in the United States, drawing consensus among existing DM fellowship directors. METHODS: A panel of DM experts was created from the members of the Council of Disaster Medicine Fellowship Directors. This council is an independent group of DM fellowship directors in the United States that have met annually at the American College of Emergency Physicians (ACEP)'s Scientific Assembly for the last eight years with meeting support from the Disaster Preparedness and Response Committee. Using a modified Delphi technique, the panel members revised and expanded on the existing Society of Academic Emergency Medicine (SAEM) DM fellowship curriculum, with the final draft being ratified by an anonymous vote. Multiple publications were reviewed during the process to ensure all potential topics were identified. RESULTS: The results of this effort produced the foundational curriculum, the 2023 Model Core Content of Disaster Medicine. CONCLUSION: Members from the Council of Disaster Medicine Fellowship Directors have developed the 2023 Model Core Content for Disaster Medicine in the United States. This living document defines the foundational curriculum for DM fellowships, providing the basis of a standardized experience, contributing to the development of a board-certified subspecialty, and informing fellowship directors and DM practitioners of content and topics that may appear on future certification examinations.

Teaching extent and military service improve undergraduate self-assessed knowledge in disaster medicine: An online survey study among Swedish medical and nursing students.

Background: The purpose of this study was to identify the possible needs for undergraduate disaster medicine education in Sweden and to make informed recommendations for the implementation of disaster medicine content in medical and nursing schools in Sweden. Methods: An online survey was distributed to undergraduate medical and nursing students through the directors of all medical and nursing programs at Swedish universities. The survey contained demographic questions, as well as questions about the amount of disaster medical education and previous experience with rescue, police, or military services. The final survey page contained self-assessments of disaster medical knowledge. Comparative statistics were applied between nursing and medical students, those with previous military service, and those without, as well as between universities. Results: A total of 500 medical and 408 nursing students participated in this study. A median of 2 h of disaster medicine education was provided to senior medical students and 4 h was provided to senior nursing students. Senior medical students scored their disaster medical knowledge lower than nursing students (t-test, p < 0.001). A proportion of 1% had served in rescue services or police, and 7% of the participants had a history of military service, of which 67% served in a medical role. Those who had served in rescue services, police, or the armed forces had a higher self-assessed disaster medical knowledge base than those who had not (p < 0.007 and p < 0.001, respectively). Conclusion: Most medical and nursing students in this study rated their disaster medical knowledge as insufficient. The correlation between the amount of disaster medical education and self-assessed disaster medical knowledge should influence and help direct Swedish educational policies.

Disaster Medicine Education for Israeli Medical Response Teams to the Ukrainian Refugee Crisis.

INTRODUCTION: Disaster Medicine (DM) requires skills, knowledge, and prior experience that are rarely put to test by health care providers. Pediatric DM presents unique challenges in terms of both knowledge and practice. METHODS: An anonymous survey consisting of demographic and five-point Likert scale questions was administered to physicians, nurses, and other medical personnel from Israel's major medical emergency teams who were deployed to respond to the refugee crisis in Ukraine. This included teams from the Hadassah and Tel Aviv Sourasky Medical Centers and the Israel Ministry of Health. RESULTS: Of the 171 members of the medical teams deployed on the Ukraine border, a total of 105 responses were obtained (61.4%) from 61 physicians, 50 nurses, and 12 other health care providers. The teams were composed of pediatricians (31.6%), internal medicine physicians (21.6%), Emergency Medicine and intensive care physicians (18.0%), and 31.0% other specialties.For 60% of the participants, this was their first deployment, and 78% had received no training in DM. Members rated the need for DM training at 4/5 (IQR 3-5). Forty-nine (49) members (46.6%) were not briefed on situational awareness and 97 members (89.5%) were not trained in the recognition of acute stress reactions. The responders also rated their concerns about providing medical aid to children at 2/5 (IQR 1-3). A medical clown was part of the teams 42.8% of the time; the presence of clowns was rated at a median of 4/5 (IQR 4-5). The team members underscored the need for more targeted training in DM at 5/5 (IQR 3-5). CONCLUSION: The findings highlight the need for the formulation of a disaster education model that includes pediatric DM.

Comparison of Disaster Medicine Education in Emergency Medicine Residency and Emergency Medical Services Fellowship in the United States.

INTRODUCTION: Disaster Medicine (DM) is defined by Koenig and Shultz as the "disciplines and organizations involved with governmental public health, public and private medical delivery including Emergency Medical Services (EMS), and governmental emergency management." The Accreditation Council for Graduate Medical Education (ACGME) sets curriculum requirements and standards for Emergency Medicine (EM) residencies and EMS fellowships, which include a limited portion of the DM curriculum topics recommended by the Society of Academic Emergency Medicine (SAEM). The ACGME does not currently approve DM fellowships, as DM is not recognized as a subspecialty by the American Board of Medical Specialties (ABMS). This lack of nationally standardized guidelines for DM training leads to variability in disaster-related knowledge and skills, even among physicians trained by ACGME-accredited programs. STUDY OBJECTIVE: The objective of this study is to analyze the DM components covered in EM residency and EMS fellowship in the United States and compare those to SAEM DM fellowship curriculum guidelines. METHODS: The DM curriculum components of EM residencies and EMS fellowships were evaluated, using the SAEM DM curriculum as a control. Overlapping topics, as well as gaps between the programs, were analyzed using descriptive statistics. RESULTS: Of the DM curriculum components developed by SAEM, EMS fellowship covered 15 of 19 (79%) major curriculum components and 38 of 99 (38%) subtopics, while EM residency covered seven of 19 major curriculum components (37%) and 16 of 99 (16%) subtopics. Together, EM residency and EMS fellowship cover 16 of 19 (84%) major curriculum components and 40 of 99 (40%) subtopics. CONCLUSION: While EMS fellowship covers a large portion of the DM major curriculum components recommended by SAEM, there are several important DM subtopics that are not covered either in EM residency or EMS fellowship. Furthermore, there is no standardization for the depth and manner that DM topics are addressed in either curriculum. Time constraints in EM residency and EMS fellowship may also prevent extensive review of important DM topics. Disaster Medicine covers a distinct body of knowledge, represented in the curriculum subtopics, that are not covered in either EM residency or EMS fellowship. The development of an ACGME-accredited DM fellowship and recognition of DM as a distinct subspecialty could allow for more effective DM graduate medical education.

Examining the disaster medicine curriculum in Canadian Emergency Medicine enhanced skills programs.

OBJECTIVES: Disaster medicine teaching is an important, and understudied, component of EM residency training programs. Little is known about disaster medicine training in Canadian EM programs, particularly within the 1-year EM enhanced skills programs. The purpose of this study is to (1) understand which disaster medicine topics are currently taught in EM enhanced skills programs and (2) establish a list of the highest priority disaster medicine teaching topics for those programs. METHODS: We distributed an eight-question survey to all 31 EM enhanced skills site directors across Canada by email. Questions on the survey asked which of 39 disaster medicine subtopics were (1) currently taught and (2) should be taught to EM enhanced skills residents. RESULTS: Of 31 invited participants, 16 completed the study (52% response rate). The most taught topic was introduction to disaster medicine/nomenclature (13/16 programs), while 11/16 programs currently teach decontamination indications and issues, personal protective equipment, prehospital disaster management, and trauma mass casualty incidents. Topics reported high or essential priority for teaching included introduction to disaster medicine/nomenclature (12/16 programs), decontamination indications and issues, personal protective equipment, and prehospital disaster management (11/16 programs). CONCLUSIONS: This study identified disaster medicine topics currently taught at Canadian EM enhanced skills programs, along with recommending a list of priority teaching topics. These findings can inform future disaster medicine content in EM training program curricula.

RéSUMé: OBJECTIFS: L'enseignement de la médecine de catastrophe est une composante importante et peu étudiée des programmes de résidence en MU. On sait peu de choses sur la formation à la médecine de catastrophe dans les programmes canadiens de MU, en particulier dans les programmes d'un an visant à améliorer les compétences en MU. L'objectif de cette étude est de 1) comprendre quels sujets relatifs à la médecine de catastrophe sont actuellement enseignés dans les programmes d'amélioration des compétences en MU et 2) d'établir une liste des sujets d'enseignement de la médecine de catastrophe les plus prioritaires pour ces programmes. MéTHODES: Nous avons distribué par courriel un questionnaire de huit questions aux 31 directeurs de sites d'amélioration des compétences en MU au Canada. Les questions de l'enquête portaient sur les 39 sous-thèmes de la médecine de catastrophe qui 1) sont actuellement enseignés et 2) devraient être enseignés aux résidents ayant des compétences renforcées en MU. RéSULTATS: Sur les 31 participants invités, 16 ont terminé l'étude (taux de réponse de 52 %). Le sujet le plus enseigné était l'introduction à la médecine de catastrophe/la nomenclature (13/16 programmes), tandis que 11/16 programmes enseignent actuellement les indications et les problèmes de décontamination, l'équipement de protection individuelle, la gestion préhospitalière des catastrophes et les traumatismes liés aux incidents de masse. Les sujets considérés comme prioritaires ou essentiels pour l'enseignement comprenaient l'introduction à la médecine de catastrophe/la nomenclature (12/16 programmes), les indications et les problèmes de décontamination, l'équipement de protection individuelle et la gestion préhospitalière des catastrophes (11/16 programmes). CONCLUSIONS: Cette étude a permis d'identifier les sujets relatifs à la médecine de catastrophe actuellement enseignés dans les programmes canadiens d'amélioration des compétences en MU, et de recommander une liste de sujets d'enseignement prioritaires. Ces résultats peuvent éclairer le contenu futur de la médecine de catastrophe dans les programmes de formation en médecine d'urgence.

The Involvement of the European Master in Disaster Medicine (EMDM) Alumni in the COVID-19 Pandemic Response: An Example of the Perceived Relevance of Disaster Medicine Education during Disasters.

INTRODUCTION: The coronavirus disease 2019 (COVID-19) pandemic has revealed a gap in disaster preparedness of health workers globally. Disaster medicine education is a key element to fill this gap. OBJECTIVES: This study evaluated the involvement of the European Master in Disaster Medicine (EMDM) Alumni in the current COVID-19 pandemic response and their self-perceived value of the EMDM educational program in accomplishing their tasks during the disaster. METHODS: An online survey targeting the EMDM Alumni was conducted from January through March 2021. Quantitative data were described using percentages or means, as appropriate, while qualitative data were categorized using deductive thematic analysis. RESULTS: In total, 259 Alumni completed the survey. Most of the Alumni (88.03%; standard error of the proportion [SEp] = 0.02) participated directly in the COVID-19 pandemic response - nationally or internationally - with different roles and responsibilities at different levels and sectors. Around 25% of the Alumni reported an increase in their tasks and responsibilities due to COVID-19 response, but few worked beyond their main specialization (5.26%) or expertise (2.19%). Moreover, Alumni shifted their role from clinical practice to managerial, public health, education and training, and policymaking roles during COVID-19 (P <.001). Participants believed that the EMDM study program and the competencies acquired during the course were relevant and useful to perform their tasks during the COVID-19 pandemic response (mean = 5.26; 5.17 standard error of the mean [SEM] = 0.108, 0.107), respectively. Around 36% (SEp = 0.03) of the participants deemed that some contents were not sufficient for COVID-19 response. CONCLUSION: Most of the EMDM Alumni were involved in the COVID-19 pandemic response, playing diverse roles with an increased level of responsibility compared to those played before the pandemic. Moreover, the Alumni perceived the EMDM curriculum as relevant for accomplishing their tasks. However, they also reported gaps within the curriculum, especially topics related to outbreak and pandemic response. The findings of the study stress the value of investing in disaster medicine education world-wide and of pushing to update and standardize post-graduate disaster medicine curricula.

Utilization of the TRAIN Learning Network for Online Disaster Medicine and Public Health Training During the COVID-19 Pandemic.

OBJECTIVE: The coronavirus disease 2019 (COVID-19) pandemic dramatically accelerated a growing trend toward online and asynchronous education and professional training, including in the disaster medicine and public health sector. This study analyzed the impact of the COVID-19 pandemic on the growth of the TRAIN Learning Network (TRAIN) for the year 2020 and evaluated pandemic-related changes in use patterns by disaster and public health professionals. METHODS: The TRAIN database was queried to determine the change in the number of registered users, total courses completed, and courses completed related to COVID-19 during 2020. RESULTS: In 2020, a total of 755,222 new users joined the platform - nearly 3 times the average added annually over the preceding 5 y (2015-2019). TRAIN users completed 3,259,074 training courses in 2020, more than double the average number of training courses that were completed annually from 2015-2019. In addition, 17.8% of all newly added disaster and public health training courses in 2020 were specifically related to COVID-19. CONCLUSION: Online education provided by TRAIN is a critical tool for just-in-time disaster health training following a disaster event or public health emergency, including in a global health crisis such as a pandemic.

Before Disaster Strikes: A Pilot Intervention to Improve Pediatric Trainees' Knowledge of Disaster Medicine.

OBJECTIVE: Because training in pediatric disaster medicine (PDM) is neither required nor standardized for pediatric residents, we designed and integrated a PDM course into the curriculum of a pediatric residency program and assessed if participation increased participants' knowledge of managing disaster victims. METHODS: We adapted and incorporated a previously studied PDM course into a small-sized pediatric residency program. The curriculum consisted of didactic lectures and experiential learning via simulation with structured debriefing. With IRB approval, the authors conducted a longitudinal series of pretests and posttests to assess knowledge and perceptions. RESULTS: Sixteen eligible residents completed the intervention. Before the course, none of the residents reported experience treating disaster victims. Pairwise comparison of scores revealed a 35% improvement in scores immediately after completing the course (95% confidence interval, 22.73%-47.26%; P < 0.001) and a 23.73% improvement 2 months later (95% confidence interval, 7.12%-40.34%; P < 0.01). CONCLUSIONS: Residents who completed this course increased their knowledge of PDM with moderate retention of knowledge gained. There was a significant increase in perceived ability to manage patients in a disaster situation after this educational intervention and the residents' confidence was preserved 2 months later. This PDM course may be used in future formulation of a standardized curriculum.

Implementation of disaster medicine education in German medical schools - a nationwide survey.

Objectives: Floods, earthquakes and terror attacks in recent years emphasize the importance of disaster preparedness for the medical community. To best prepare doctors for providing optimal care in disaster situations, specific education and training should start at the medical school level. This study containes an online survey among German medical schools to evaluate the status quo of teaching disaster medicine and to reveal potential obstacles. Methods: The dean's offices of 36 German medical schools were contacted from April 2016 to May 2017. Via an e-mail link, recipients could anonymously and voluntarily access an online questionnaire (74 items, 42 with a four-point "Likert-like" scale, 12 yes/no questions and 20 with listed items to choose from). The answers were analyzed by descriptive statistics. Results: A total of 25 medical schools participated in the survey. Twenty respondents were in favor of expanding disaster medicine teaching at their institutions. Incorporating single topics ranging from triage (n=21) to accidents involving radioactive materials (n=4) into the curriculum varied widely. Only two schools had established a teaching coordinator for disaster medicine and only one e-learning course had been established. Twenty-one respondents regarded funding issues and 18 regarded organizational matters to be major hurdles in the future. Conclusion: Though most faculty representatives indicated that they favor expanding and implementing disaster medicine education, German medical schools still have a lot of room for enhancement in this field. The incorporation of e-learning tools could facilitate the expansion of disaster medicine teaching while simultaneously addressing the expressed concerns of the survey's participants and guarantee nationwide standardization.

Disaster Preparedness Training for Emergency Medicine Residents Using a Tabletop Exercise.

Introduction: Emergency medicine (EM) physicians serve at the frontline of disasters in our communities. The 2016 Model of Clinical Practice according to the American Board of EM identifies disaster management as an integral task of EM physicians. We described a low-cost and feasible tabletop exercise to implement such training for EM residents. Methods: The exercise took place during 2 hours of resident didactic time. A lecture introduced the incident command system (ICS) and triage concepts, followed by a tabletop scenario with a map of a disaster scene or emergency department. Facilitators presented situational prompts of tasks for residents to address during the exercise. These exposed residents to challenges in disaster scenarios, such as surge and limited resources. The exercise concluded with a debrief and short lecture reviewing scenario-specific topics and challenges. Residents completed an online pre- and postexercise assessment, evaluating knowledge and perceptions of disaster scenario management. Results: Eighteen residents participated in this exercise. The response rates to the pre- and postsurvey were 76% and 72% respectively. Using a Mann Whitney U test, no statistically significant difference was demonstrated on the medical knowledge component of the survey. There was, however, a statistically significant increase in perceived confidence of the residents' ability to manage disaster incidents. Discussion: We developed a simple exercise that is an easily adaptable and practical option for introduction to disaster preparedness training. These concepts are difficult to teach and assess among learners, however it remains an important component of education for EM physicians-in-training.

Nurse Leaders' Knowledge and Confidence Managing Disasters in the Acute Care Setting.

Whether natural or human-induced, disasters are a global issue that impact health care systems' operations, especially in the acute care setting. The current COVID-19 pandemic is a recent illustration of how health care systems and providers, especially nurses, respond to a rapidly evolving crisis. Nurse leaders in the acute care setting are pivotal in responding to the multifactorial challenges caused by a disaster. A quality improvement project was developed to increase nurse leaders' knowledge and confidence in disaster management during the COVID-19 pandemic at 2 Magnet-designated acute care hospitals within the John Muir Health system in Northern California. A total of 50 nurse leaders initially participated in this project, with 33 participants completing the postintervention survey. Results indicated significant improvement in perceived knowledge and confidence in disaster management after the intervention. Qualitative responses from project participants highlighted the need to annualize educational opportunities to sustain knowledge and consistently review emergency management operations plans. This quality improvement project provided an approach to educating nurse leaders in disaster management to promote resilience, support of employees, and optimal patient outcomes during disasters.

Preparing medical students for a pandemic: a systematic review of student disaster training programmes.

OBJECTIVE: To identify pandemic and disaster medicine-themed training programmes aimed at medical students and to assess whether these interventions had an effect on objective measures of disaster preparedness and clinical outcomes. To suggest a training approach that can be used to train medical students for the current COVID-19 pandemic. RESULTS: 23 studies met inclusion criteria assessing knowledge (n=18, 78.3%), attitude (n=14, 60.9%) or skill (n=10, 43.5%) following medical student disaster training. No studies assessed clinical improvement. The length of studies ranged from 1 day to 28 days, and the median length of training was 2 days (IQR=1-14). Overall, medical student disaster training programmes improved student disaster and pandemic preparedness and resulted in improved attitude, knowledge and skills. 18 studies used pretest and post-test measures which demonstrated an improvement in all outcomes from all studies. CONCLUSIONS: Implementing disaster training programmes for medical students improves preparedness, knowledge and skills that are important for medical students during times of pandemic. If medical students are recruited to assist in the COVID-19 pandemic, there needs to be a specific training programme for them. This review demonstrates that medical students undergoing appropriate training could play an essential role in pandemic management and suggests a course and assessment structure for medical student COVID-19 training. REGISTRATION: The search strategy was not registered on PROSPERO-the international prospective register of systematic reviews-to prevent unnecessary delay.