bluuebunny/crossref_metadata_2025_split huggingface dataset:
Development and Evaluation of Scenario-based E-Simulation for Humanitarian Health Training
Authors: Bahattab Awsan , Zain Omar , Linty Monica , Camacho Nieves Amat , Schreeb Johan von , Hubloue Ives , Corte Francesco Della , Ragazzoni Luca 
Published: June 2023

Introduction:In response to the global upward trend of humanitarian emergencies, the humanitarian health workforce has grown substantially in the last decades. Still, humanitarian education and training programs are limited in availability, geographical locations, and teaching methods, and are too expensive for local respondents. To address these gaps, an e-learning tool for humanitarian public health has been developed and evaluated.Method:Action research was used to develop the e-Learning tool. Rapid prototyping–a modified analysis, design, development, implementation, and evaluation (ADDIE) model, was used to identify the content and instructional design. This iterative process involved consultations and feedback from public health and disaster medicine instructors and students at different levels and training programs from within and outside CRIMEDIM. Qualitative data were analyzed using thematic analysis. Quantitative data were appropriately summarized. Pre/post-test change in knowledge score was tested with paired t-test.Results:Although different levels of training are needed, targeting health professionals at the entry-level in the humanitarian field is identified as a priority. Scenario-based e-Simulation covers health needs assessment, essential health services, communicable diseases standards, and the health system was developed and evaluated. Trainees were highly satisfied by the clear objectives, the realism of the simulated scenarios, quizzes, and interactivity. In the 1-7 numerical scale, the median for overall experience satisfaction was 6.3 (IQR=5.3-7, N=35). The mean of the post-test score was 7.71, which was significantly higher than the mean of the pre-test score of 5.88. The large effect size of 1.179 indicates the training effectiveness. Poor internet was identified as a potential barrier to delivering the training.Conclusion:This participatory study resulted in the development of effective Scenario-based e-Simulation. Offline mode of training will be adapted for trainees with poor internet connection settings. Successful factors in instructional design will be used to inform the development of advanced training in the field.
Virtual Interprofessional Education (VIPE)–The VIPE Program: VIPE Security, a Multi-sectoral Approach to Dealing with Complex Wicked Problems
Authors: Showstark Mary , Wiss Andrew , Cavezza Renee , Joosten-Hagye Dawn , Richards Julian , Brooks Patti , Wulfplimpton Julie , Acheson Ian , Kelshall Candyce , Gray Libby , Zschaebitz Elke , Embry Erin , Resnik Cheryl , An Iris , Sutherland Mark , Arcos Ruben , Kenley David , Bennett Dorine , Dobson Melina , Bergler Serge 
Published: June 2023

Introduction:The Virtual Interprofessional Education program is a multi-institutional consortium collaborative formed between five universities across the United States. As of January 2022, the collaborative includes over 60 universities in 30 countries. The consortium brings healthcare students together for a short-term immersive team experience that mimics the healthcare setting. The VIPE program has hosted over 5,000 students in healthcare training programs. The VIPE program expanded to a VIPE Security model to host students across multiple disciplines outside the field of healthcare to create a transdisciplinary approach to managing complex wicked problems.Method:Students receive asynchronous materials ahead of a synchronous virtual experience. VIPE uses the Interprofessional Education Competencies (IPEC) competencies (IPEC, 2016) and aligns with The Health Professions Accreditors Collaborative (HPAC) 2019 guidelines. VIPE uses an active teaching strategy, problem or case-based learning (PBL/CBL), which emphasizes creating an environment of psychological safety and its antecedents (Frazier et al., 2017 and Salas, 2019, Wiss, 2020). Following this model, VIPE Security explores whether the VIPE model can be tailored to work across multiple sectors to discuss management of complex wicked problems to include: climate change, disaster, cyber attacks, terrorism, pandemics, conflict, forced migration, food/water insecurity, human/narco trafficking etc. VIPE Security has hosted two events to include professionals in the health and security sectors to work through complex wicked problems to further understand their roles, ethical and responsible information sharing, and policy implications.Results:VIPE demonstrates statistically significant gains in knowledge towards interprofessional collaborative practice as a result of participation. VIPE Security results are currently being analyzed.Conclusion:This transdisciplinary approach to IPE allows for an all-hands-on-deck approach to security, fostering early education and communication of students across multiple sectors. The VIPE Security model has future implications to be utilized within multidisciplinary organizations for practitioners, governmental agencies, and the military.
The Quality of Hospital Disaster Plans in Belgium: Evaluation Research. Development and Content Validity of a Questionnaire to Define the Quality Key Performance Indicators Influencing Hospital Disaster Preparedness: A Modified Delphi Study
Authors: Hendrickx Christel , van Delft Brenda , Demeyer Ignace , Mortelmans Luc , Peremans Lieve , Sabbe Marc , Colombo Davide 
Published: June 2023

Introduction:Emergency and disaster situations have a major impact on hospitals, some of which are already overloaded daily. The recent COVID-19 outbreak, attacks in Brussels, floods in Wallonia and influx of Ukrainian refugees show that the risk of facing a disaster and involvement of local hospitals (and stakeholders) is real. However, how hospitals implement their own hospital disaster plan (HDP), the position of the hospital disaster coordinator (HDC) and the real efficacy of these measures remain unclear. Therefore, an evaluation tool with an expert-consensus set of Key Performance Indicators (KPIs) and an evaluation of the HDC position is neededMethod:A semi-quantitative survey, as part of evaluation research, was designed by a research group. This questionnaire was based on the document analysis of the main topics of the national template and accompanying legislation. To establish consensus on the importance of the KPIs concerning the HDP, a three-round email-based modified Delphi study (Policy Delphi) was undertaken.Results:For a task group, 15 qualified multidisciplinary professionals (in-hospital) agreed to participate, 11 completed all rounds. As a pilot group, a total of 25 ‘experts on the field’, were purposively selected from Belgian hospitals, nine of them completed the questionnaire. The modified Delphi reached the agreed consensus threshold (i.e.75%), resulting in five main themes: demographic characteristics/profile HDC, hospital incident management system (HIMS), pre-incident phase, incident phase, post-incident phase. Collectively including a core set of 289 KPIs (29 indicators to assess progress concerning the HDC position).Conclusion:This study employed a modified Delphi approach to establish consensus, resulting in the development of an evaluation tool to measure hospital disaster preparedness and to evaluate progress of the HDC position within Belgian hospitals. All indicators were considered relevant and immediately implementable. When the implementation of KPIs is completed, the statement is that a HIMS exists within the hospitals.
Participants' Experience of Completing Trauma and Critical Skills Training in a Resource-Limited Environment
Authors: O'Leary Anna , Breslin Deirdre , Mulcaire Jeffrey , Eager Meabh , O'Sullivan Jean 
Published: June 2023

Introduction:Global Emergency Care Skills, an Irish-based NGO, provided a five-day intensive training course to 24 local healthcare professionals in Nyabondo, Kenya in November 2022, in advance of the opening of a new major trauma center which will serve the greater Kisumu region. The pre-participation knowledge, experience and skills base was surveyed. Following the completion of didactic, workshop and simulation-based training, the perceived acquired competence and applicability of skills were surveyed. The ability to provide ongoing teaching of skills acquired within local healthcare settings was evident.Method:Nine emergency medicine and two anesthesia doctors currently working in the Irish healthcare system traveled to Nyabondo in the Kisumu region in Kenya for one week in November 2022. A five-day course based on providing practical training addressing comprehensive trauma and acute deteriorating patient knowledge and skills was provided. This included extensive focus on the primary survey approach. A quantitative survey of 22 questions with binary answering options was used. 19 participants completed the survey, and qualitative data on the applicability of the training provided to the local healthcare resource environment was gathered.Results:Following surveying participants we found that the majority of participants had no previous experience or knowledge of simulation based learning. Further, a vast majority had no formal skills or educational training post completing their medical qualification.Conclusion:The overwhelming majority of participants felt that this training improved their confidence and competence in managing trauma and assessment of the critically unwell adult and child. 100% of participants stated they gained new skills and were confident in their ability following this training to deliver local training on an ongoing basis in their own healthcare settings.
Exploring Irish Faculty Members' Experiences of Delivering a Multi-modal Medical Education Course in a Resource-limited Environment
Authors: Breslin Deirdre , Mulcaire Jeffrey , O'Leary Anna , McKenna Roy , MacManus Bronagh , O'Sullivan Jean 
Published: June 2023

Introduction:In November 2022, a group of eleven Irish doctors traveled to St. Joseph’s Hospital, Nyabondo, Kenya with Global Emergency Care Skills (GECS), an Irish NGO. The group delivered a training course to healthcare staff in the hospital, in advance of the scheduled opening of a regional Major Trauma Center on site. This course incorporated didactic lectures, skills stations and simulated clinical scenarios and covered commonly encountered emergency presentations in low and middle income countries (LMICs).Method:A qualitative study was conducted using a free text questionnaire with faculty, exploring their experiences of education in a resource-limited environment. Responses were interpreted by performing thematic analysis to identify recurring themes.Results:All eleven faculty members completed the survey in full. An interrogation of the responses identified commonalities across the majority of faculty members. The main themes encountered were increased recognition of the lack of postgraduate training in LMICs, the challenge of devising material appropriate to a resource-limited setting, a growth in confidence and individual teaching ability, and a reaffirmation of the effectiveness of simulation teaching in medical education.Conclusion:This survey demonstrates the significant impact of teaching such a course on faculty members. Despite the challenges encountered, faculty members strongly felt that simulation training offered significant benefits. Survey respondents noted that moulage could be adapted to suit the needs of course participants without compromising on educational goals. In the absence of formal postgraduate education in LMICs, external agencies continue to play an important role in the delivery of structured training programs.
Novel Design of an Austere Medicine Elective
Authors: Pandit Kiran , Kingon Ashley , Todman Raleigh , Wright Melissa , Raymond Marc , Tedeschi Christopher 
Published: June 2023

Introduction:Clinicians with knowledge, skills and attitudes required in austere environments better serve their patients regardless of setting. Few opportunities traditionally exist for medical students to learn about wilderness, disaster medicine, or environmental illness. Events related to climate, disasters, and COVID-19 reinforce the need for physicians to develop tools for practice in resource-limited settings. We created a medical student elective which delivered core content related to wilderness medicine, environmental illness and disaster preparedness and response, along with overarching skills including improvisation, teamwork, and resource allocation.Method:Content experts partnered with educational design specialists to create a new student experience. We identified key impact areas using an analysis of courses at peer institutions, informal surveys, and published literature. Learning objectives were informed by relevant skills and content, as well as the cross-cutting goal of teaching students to perform in resource-limited settings.A four-week curriculum was conceptualized, including lectures, workshops and skill sessions, synchronous and asynchronous online experiences, and a five-day backcountry trip focusing on in situ simulation and skills training. The course was offered in May 2021 and May 2022. Students completed post-course surveys regarding the utility of course elements, as well as teaching effectiveness.Results:Overall satisfaction was 3.64/4.00. Self-reported competence increased in the domains of diagnosis and pathophysiology, treatment, teamwork, and resource management and improvisation. Qualitative data suggested that students are generally under-exposed to wilderness, environmental and disaster content. Self-reported helpfulness of learning activities was greatest for small-group outdoor workshops, and least for large teleconference-based sessions.Conclusion:Strengths included interactive coursework reflecting teamwork, open access learning modules, and rubric-based assessment structures. Limitations include pandemic-related restrictions in group activities as well as limited objective measurements of knowledge and skills. Future goals include increasing in-person learning, dissemination of the curriculum to larger groups of learning, and development of reproducible performance measures.
Collapse of the Hard Rock Hotel in Downtown New Orleans
Authors: Maslanka Meghan , Niemeck William 
Published: June 2023

Introduction:On October 12, 2019, an 18-story building under construction collapsed in downtown New Orleans. Three construction workers were killed in the incident and their bodies were trapped in the rubble of the unstable structure.Method:This presentation includes public information on how and why the structure collapsed, the timeline of events for the protracted response, and feedback provided by the Urban Search and Rescue medical team about their experience and lessons learned.Results:The scene included a partially collapsed building still under construction, two construction cranes that were destabilized in the incident, two major roadways that required closure, several surrounding buildings impacted by debris, multiple injured workers, and three missing workers later determined to be deceased. Only two of three deceased individuals were able to be located on scene. One victim was safely recovered one day after the collapse. One victim was partially visible to the public but in an area of extreme danger to responders. His recovery required partial deconstruction of the building, which was significantly delayed due to safety, infrastructure, legal, and insurance concerns. The body of the third victim was located and recovered on day 310 of the response.Conclusion:The prolonged demolition of the Hard Rock collapse site resulted in emotional anguish for affected families, public anger about the perceived lack of response, and significant impacts for local businesses in the area. This event offers many lessons learned about prevention and response of urban structural collapse incidents.
You Want Me to Treat What?
Authors: Klein Kelly , Garcia Lawrence , Fogelberg Katherine 
Published: June 2023

Introduction:There are only two medical practitioners who are genuinely generalists. The confirmed generalist is the one who has been trained and credentialed to perform prenatal care, deliver babies and perform c-sections, take care of young children, perform simple surgeries, perform palliative care, and hold a patient's hand and hug the family after the death of a loved one. In the human world, that medical provider is a family practice physician. In the animal world, that provider is the veterinarian, who cares for all species that are not human and covers their medical needs, from preventive care to surgical needs, dentistry to dermatology, internal medicine to cardiology. As such, veterinarians are indeed generalist medical providers. In disasters, veterinarians are often pushed aside by their human medical counterparts. In doing so, there are a lot of learning opportunities missed on both sides.Method:A literature review was conducted.Results:n/aConclusion:In learning the skills that are unique and overlapping, physicians and veterinarians will be better able to respond to disasters anywhere and will be positioned to help the displaced and injured get better so they may return to normalcy as quickly as possible. It is time that disaster teams and planning sessions stop being siloed and think about how medical generalists can team up and work together.
Medics, Mercenaries and Miscreants — A review of Canadian Medical Assistance Teams' EMT Type 1 response to the conflict in Ukraine
Authors: Fong Anthony , Rzepka Valerie , LeBlanc Jeanne , Thanh David , Scott Sarah , Kollek Daniel , Kelly Nathan 
Published: June 2023

Introduction:On February 24, 2022, Russia invaded Ukraine, resulting in Europe’s largest refugee crisis since World War II. More than six million Ukrainians fled the country—half of these to Poland—and one-third of the population was internally displaced.Border points became bottlenecks where fatalities were reported—people risked their lives in long queues and subzero temperatures.Method:This presentation focuses on experiential information obtained during a 17-week deployment of EMT Type 1 both at border points (fixed) and in northwestern Ukraine (mobile). Quantitative and qualitative data were obtained after deployment by online survey with 75 medical, logistical and interpreter volunteers.Results:Initial teams experienced extremely fluid demands and numerous challenges with security, team adherence to COVID-19 protocols, behavioral issues with less experienced volunteers, and collaboration with novel governmental and non-governmental partners to achieve objectives.Conclusion:1. Deployment to a conflict setting requires adherence to the Incident Command System, with daily security briefings and structured handover between teams at the beginning of each deployment.2. Strict adherence to well-defined protocols for the prevention and management of emerging infectious risks such as COVID-19 is necessary, along with contingency plans to isolate infected team members.3. There is a need for standardized pre-deployment vetting, training and orientation of all volunteers—particularly team leaders.4. Identification of international partners should start pre-deployment and remain a continuous process during deployment.
When the Tertiary Care Hospital Becomes Technologically Austere: Communication Lessons Learned from an American Health System Cyberattack
Authors: Klemann Kylie , Tackett Sierra , Seitz Daniel 
Published: June 2023

Introduction:Cyberattacks continue to plague medical systems across the world with nearly 24% of all cyber breaches impacting health systems. In Fall 2021, a large, tertiary care county hospital in Indianapolis, Indiana, USA suffered a cyberattack, causing over four weeks of downtime, forcing the system to revert to paper charting and to operate without the electronic medical record (EMR) or internet. Communication in the Emergency Department is structured through the EMR system or wireless local area network (WLAN) phones, causing communication difficulties when online systems are disrupted.Method:In the twelve months following the breach, a series of communications-focused interviews with stakeholders including residents, faculty, nurses, and consultants were analyzed using a thematic analysis.Results:Through interviews, four key themes and recommendations were identified for every internet-dependent tertiary care system to establish and maintain communication links when the primary form of communication is compromised and access to internet is limited or nonexistent:
Expect systems to fail–plan aheadDevelop multilayered communication tools that are stored and structured at different sitesNotify all affected teams immediately and initiate the downtime action planReassess and adapt the downtime action plan as information becomes availableConclusion:While every system is going to experience different struggles during cyberattacks and downtime, all hospitals can benefit from improving communication structures when the established communication pathways are no longer available. Consider cybersecurity threats in your emergency planning meetings and designate systems to protect your communication abilities during downtime.
Patient Distribution Tool for Mass Casualty Incidents in a Large Metropolitan Setting
Authors: Booth Kathryn , Daniels Mackenzie 
Published: June 2023

Introduction:During a mass casualty incident (MCI), activating resources for response and equitable patient distribution is paramount. The Regional Hospital Coordination Center (RHCC) of a large US city lacked an objective tool readily available to manage patient distribution to area hospitals during an MCI. In a hospital-rich community, spreading the patient distribution throughout the region decreases the impact to one hospital. A tool was needed to equitably distribute patients across the healthcare system without added burden or demand to the hospitals nearest the MCI.Method:This tool was developed using Excel and regional hospital capability information including trauma or burn center status, pediatric designation, etc. These capabilities and geographic distances from the MCI were the driving factors of the tool development.The city has several high-visibility, large event locations. These locations were added into the tool and can be selected as MCI origin points. From here, the tool organizes hospitals by distance from the designated point. Since the formulas were programmed into the tool, it can be easily and quickly adapted to any MCI in the area and reflect relevant resources and limitations.Results:Equitable patient distribution to area hospitals during an MCI is a best practice. Advance preparation is key to ensuring quick response and effective utilization of resources. Having a custom tool pre-programmed with relevant, regional hospital capabilities expedited this process and streamlined patient distribution efforts and, ultimately, improved emergency care coordination and patient outcomes.Conclusion:During a Mass Casualty Incident, distributing patients equitably across the healthcare system without added burden to the hospitals nearest the event is critical. Having a custom tool pre-programmed with regional hospital capabilities expedites and streamlines patient distribution efforts, ultimately improving emergency care coordination and patient outcomes.