Understanding quality: a guide for developers and consumers of public health emergency preparedness trainings.

State and local public health departments are continually searching for training that builds competency in public health emergency preparedness (PHEP) response capability. Given the scarcity of departmental resources, when possible, this training is done within the health department. However, internal training development and conduct is logically constrained by the resources and skills at hand, resulting in varying quality of courses and educational materials. The end result is that development and delivery of training is often outsourced, again with widely varying quality levels noted in trainings received, making it difficult to select training with any assurance that it will meet local needs. This was an observation made by a nationwide group of evaluators who were charged with assessing state public health preparedness centers funded by the Centers for Disease Control and Prevention (CDC). Indeed, it was a major concern in group discussions from 2005 to 2007. Adding to the complexity of course selection for health departments is the vast number of organizations offering training materials—each difficult to differentiate from the other. For example, incident command training is offered by a variety of federal agencies (e.g., Federal Emergency Management Agency and CDC), private industry, and academic institutions, such as those within CDC's Centers for Public Health Preparedness (CPHP) program.1 PHEP courses vary widely in modality of delivery (e.g., online, live satellite broadcast, or face-to-face), level of knowledge required, length of time required, and structure. The plethora of options can be a help and a hindrance. While it is useful for public health agencies to have a wide array of options, that array poses a challenge for training directors and others who need to quickly ascertain which courses will best help their staff members. Thus, CDC requested the assistance of the CPHP National Collaborative Network of Public Health Evaluators (hereafter, Collaborative Group) to address the issue. Individuals in the Collaborative Group came from 23 schools of public health across the United States and included 32 evaluators with backgrounds in psychology, sociology, anthropology, education, and public health. After deliberation, the Collaborative Group decided they could best assist public health agencies by identifying the characteristics that determine quality in PHEP training courses. Understanding the characteristics would better position agencies to develop or sort through available training options. Once the Collaborative Group identified the key aspects of quality, they converted them into an instrument, or checklist, for utilization. The quality criteria, the Training Selection System (TSS), and preliminary feedback from PHEP practice partners about its perceived utility are described in this article. The ideas and concepts presented represent a consensus of ideas and practice on the part of the Collaborative Group and are drawn from the literally hundreds of years of combined experience and evaluation wisdom possessed by this group.