NCDMPH Annotated Bibliographies Disaster Health Learning

ncdmph banner

Annotated Bibliographies - Disaster Health Learning

Competency & Curriculum Toolkit / Models

1. Association for Prevention Teaching and Research. Center for Health Policy: Columbia University School of Nursing. Competency-to-curriculum toolkit. Available at: PDF. Accessed: July 30, 2012.

The Competency-to-Curriculum Toolkit serves as an instructional guide for trainers and educators in the public health workforce. The authors instruct on the development of competencies as well as translating competencies into curriculum. This resource aims to assist in the development of a workforce that "has the basic knowledge, skills, abilities and attitudes that allow for delivery of essential public health services in all program areas." This document is available online for free.

2. Miner K, Childers W, Alperin M, Cioffi J, Hunt N. The MACH model: from competencies to instruction and performance of the public health workforce. Public Health Rep. 2005; 120 (suppl): 9-15.

The authors of this paper discuss the MACH (Miner, Alperin, Cioffi, Hunt) Model, a system developed at the Rollins School of Public Health to address imperative 5 inA National Public Health Strategy for Terrorism Preparedness and Response 2003-2008. Imperative 5, Competent and Sustainable Workforce, identifies the need for a larger preparedness and response workforce and the certification and competency-based training of that workforce. The MACH Model is applicable to both the employee in need of training as well as institutions that face work-environment deficiencies. The model consists of eight components: instructional competencies; curriculum process; individual performance; organizational performance; accreditation; credentialing; and intervening variables. The authors argue that the MACH Model guides instructors to train in a systematic and consistent way, a key element in training a prepared workforce. 
Link to article

3. ten Cate O, Scheele F. Competency-based postgraduate training: can we bridge the gap between theory and clinical practice? Acad Med. June 2007; 82: 542-547.

This paper proposes solutions to the problems in implementing curriculum for competency-based postgraduate medical training. The authors focus on clinicians' struggle with producing clinical teaching from general competencies. A central issue for educators when creating competency-based curriculum is discerning the difference between a competency and an activity related to the competency ("the ability to execute activity X" vs. "activity x"). To resolve this confusion, the authors suggest fusing general competencies with "entrustable professional activities" (EPAs). Authors claim that postgraduate program planners can most effectively create their clinical practice curriculum via this model. 
Link to abstract

4. Institute for Clinical Research Education. University of Pittsburgh. What is competency-based education? Available at: Accessed: November 9, 2013.

This website focuses on the facets of competency-based education and how to incorporate it into learning. The Institute for Clinical Research Education introduces competency-based education through a two-step process: teach and assess. Teaching for competence involves the combination of knowledge, skills, and attitudes through methods like discussion, lab, and small group work. The learner can then apply their knowledge and skills through assessment, whether it is through homework or tests. The website provides further guidance regarding competency-based education by supplying multiple rubrics designed to test different strengths.

Empirical Studies on Training/Exercises in Disaster Health

5. Cicero M, Blake E, Gallant N, Chen L, Esposito L, Guerrero M, Baum C. Impact of an educational intervention on residents' knowledge of pediatric disaster medicine. Pediatr Emerg Care. November 2009; 25: 447-451.

This article evaluates the authors' pediatric disaster medicine course and measures its efficacy through residents' participation. Authors claim that course participants increased their knowledge of pediatric disaster medicine. Pediatric disaster medicine training is lacking in most resident training programs, despite the importance placed on it by residents. This study also claims that residents prefer experiential -based learning over class-based work. 
Link to abstract

6. Behar S, Upperman J, Ramirez M, Dorey F, Nager A. Training medical staff for pediatric disaster victims: a comparison of different teaching methods. Am J Disaster Med. July/August 2008; 3: 189-199.

This article explores the effectiveness of various training methods in pediatric disaster medicine. The authors determined effectiveness by measuring trainee confidence with material and the amount of knowledge retained over time. Researchers hypothesized that a combination of didactic lecture and tabletop exercise would result in a higher degree of retained learning. The study compares two training methods: didactic lecture and didactic lecture with a tabletop exercise. Through an analysis of pre and post tests, the authors determined that a tabletop and didactic lecture combination resulted in increased self-confidence and comfort with material. The combined training did not significantly impact knowledge retention or scores in comparison with didactic lecture training. The authors emphasize the importance of establishing "a set of core competencies based on available evidence-based literature and expert opinion" for pediatric disaster medicine. They conclude that these competencies will contribute to more effective training in pediatric disaster medicine in the future. 
Link to abstract

7. Savoia E, Biddinger P, Fox P, Levin D, Stone L, Stoto M. Impact of tabletop exercises on participants' knowledge of and confidence in legal authorities for infectious disease emergencies. Disaster Med Pub Health Prep. December 2009; 3: 104-110.

This article assesses the effectiveness of didactic lecture combined with tabletop exercise in imparting knowledge and confidence to learners. The Harvard School of Public Health combined these two instructional models in sessions devoted to learning about legal resources in disaster preparedness. The study finds that the combination of tabletop with didactic lecture improves learner confidence in the availability of local legal authorities. Trainees also found gaps in existing policies and procedures, which reduced their confidence in those resources. Overall, the training increased trainees' fluency in legal issues and resources in disaster preparedness. 
Link to abstract

8. Gershon R, Vandelinde N, Magda L, Pearson J, Werner A, Prezant D. Evaluation of a pandemic preparedness training intervention for emergency medical services personnel. Prehosp Disaster Med. January 2010; 24: 508-511.

The article evaluates a training program designed to increase emergency services personnel's knowledge for and comfort with responding to an influenza pandemic. An analysis of the pre- / post- test results revealed that learners' knowledge improved and their intention to respond in the future to a pandemic also increased. The authors encourage further training evaluations to determine whether or not such trainings actually lead to a change in EMS personnel response behavior during a pandemic. 
Link to abstract

9. Heinrichs W, Youngblood P, Harter P, Kusumoto L, Dev P. Training healthcare personnel for mass-casualty incidents in a virtual emergency department: VED II. Prehosp Disaster Med. September 2010; 25: 424-432.

The authors of this article assess the effectiveness of training emergency department physicians and nurses for mass-casualty incidents via a Virtual Emergency Department (VED), a virtual simulation-based training. They conclude that a VED is a useful and powerful training tool that resulted in an increase of trainee confidence and knowledge. The article claims that continued development of VED technology can help prepare hospital staff for mass-casualty incidents. 
Link to abstract

10. Hoeppner M, Olson D, Larson S. A longitudinal study of the impact of an emergency preparedness curriculum. Public Health Rep. 2010; 125 (suppl): 24-32.

The article reports the results of a longitudinal study evaluating a competency-based curriculum's impact on learners. Researchers surveyed public health practitioners as well as learners in certificate programs at the Minnesota School of Public Health. Surveys sent to learners after the course evaluated the curriculum by assessing changes in learners' behavior and their application of the learned competencies. By analyzing five years of data, the authors concluded that the majority of learners successfully developed competencies via this curriculum. Barriers to learning included limited financial and human resources and lack of time. 
Link to article

11. Biddinger P, Savoia E, Massin-Short S, Preston J, Stoto M. Public health emergency preparedness exercises: lessons learned. Public Health Rep. 2010; 125 (suppl): 100-106.

The Harvard School of Public Health Center for Public Health Preparedness created an exercise program that aimed to educate the public-health workforce and to highlight specific organizational issues within the public health system. This article argues that these exercises were effective in accomplishing both their goals. The authors based their evaluation on assessments of evaluations, after action reports and statistical analysis. The authors concluded that these exercises imparted knowledge and identified organizational challenges in the field. 
Link to article

-- Training Lessons Learned --

12. Waltz E, Maniccia D, Bryde R, Murphy K, Brett H, Waldenmaier M. Training the public health workforce from Albany to Zambia: technology lessons learned along the way. Pub Health Rep. 2010; 125 (suppl): 61-69.

This article is a summary of lessons learned by the University at Albany Center for Public Health Preparedness (UA-CPHP) in regards to three different learning technologies. The authors assess the effectiveness of audience response systems (ARS), satellite broadcast programs, and interactive online courses through learner evaluations, affordability of technology, and their transferability to other institutions. All learning technologies were found beneficial, with each method providing different levels of cost and evaluation feedback. ARS provided the most evaluation feedback with the smallest cost. Satellite broadcast and interactive online courses had a high cost with fairly little opportunities for learner evaluative feedback, but remained effective in imparting learning. Overall, UA-CPHP recommends all three of these methods to other institutions to increase the efficacy of their learning programs. 
Link to article

-- Mapping to Competencies --

13. Montgomery J, Durbeck H, Thomas D, Beck A, Sarigiannis A, Boulton M. Mapping student response team activities to public health competencies: are we adequately preparing the next generation of public health practitioners? Public Health Rep. 2010; 125 (suppl): 78-86.

This article evaluates an immersive exercise program based at the University of Michigan School of Public Health. The authors concluded that the Public Health Action Support Teams (PHAST) were effective in incorporating the Centers for Disease Control and Prevention/Council of State and Territorial Epidemiologists Applied Epidemiology Competencies (AECs). Although these competencies center on a skill-sets for epidemiologists, they are applicable to general public health work. The authors studied data from PHAST trips that took place during 2006-2009. Each trip addressed at least 10 of the 34 competencies. This article concludes that PHAST trips effectively address these competencies and offer benefits for both students and host sites. In addition, many students left these exercises more interested in preparedness work. 
Link to article

-- Review of Training --

14. Potter M, Miner K, Barnett D, Cadigan R, Lloyd L, Olson D, Parker C, Savoia E, Shoaf K. The evidence base for effectiveness of preparedness training: a retrospective analysis. Public Health Rep. 2010; 125 (suppl): 15-23.

The Centers for Disease Control and Prevention's evidence-based gaps collaboration group (EBGC Group) performed a literature review on preparedness training articles published in 2003-2007. EBGC Group studied the articles through quantitative and qualitative-thematic methods and revealed that the majority of the publications did not significantly add to current knowledge regarding preparedness training. The group found that preparedness training articles overly focused on career-specific training, which limited the applicability of the article to the public health preparedness community. The article recommends that publications on preparedness-training should continue as well as government investment in this area.
Link to article

-- Learning --

15. Zull J. Key aspects of how the brain learns. New Dir Adult Cont Educ. Summer 2006; 110: 3-8.

James E. Zull encourages educators in this article to incorporate basic knowledge on cognitive neuroscience into their practice. Zull explains specifically the role of the neurocortex in learning, highlighting the four key areas of this region: sensory, back integrative, front integrative, and motor. These areas are connected into what Zull calls the "Four Pillars" of learning: gathering, reflecting, creating, and telling. According to Zull, a persistent flaw in educational practice is the emphasis on data gathering versus challenging students to create their own experiences and theories. Zull argues that by engaging more actively with the biology of the brain, educators can create a more effective learning experience. 
Link to article

16. Nothnagle M, Anandarajah G, Goldman R, Reis S. Struggling to be self-directed: residents' paradoxical beliefs about learning. Acad Med. December 2011; 86: 1539-1544.

This article examines the experiences of third-year residency students with self-directed learning (SDL). Their findings reveal that these students found managing their own learning difficult and they required more formal learning along with patient care. Residents believed they had more control over their learning abilities, but still lacked confidence in their lifelong learning skills. The article suggests that residency programs can improve SDL by providing more direct guidance on developing this skill set. With SDL incorporated in their curriculum, residents could potentially have reduced stress and improved life-long learning skills. 
Link to abstract

17. Gonzalez C, Brunstein A. Training for emergencies. J. Trauma. August 2009; 67 (suppl): S100-S105.

This article explores new theories for approaching training for disaster response and triage techniques. Disaster response and triage trainings involve dynamic decision making (DDM), which proves to be a difficult skill-set to teach. The authors explore instance based learning theory which suggests that a slow-paced, low-workflow with a diverse amount of experiences fosters a better environment for DDM development. In an additional study with a medical diagnosis microworld, the authors found that even highly-educated adults like medical students struggle with understanding a simple dynamic system. Further research is required to approach this deficiency. 
Link to abstract