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Training medical staff for pediatric disaster victims: a comparison of different teaching methods
Solomon Behar1, Jeffrey S Upperman, Marizen Ramirez
1Department of Pediatrics, Children's Hospital Los Angeles, University of Southern California/Keck School of Medicine, Los Angeles, California, USA.
Objective:
The goal of this study was to assess the effectiveness of the different types of healthcare worker training in pediatric disaster medicine knowledge over time and to analyze the effects of training type on healthcare workers' attitude toward pediatric disaster medicine.
Design:
Prospective randomized controlled longitudinal study.
Setting:
Large, urban, tertiary academic children's hospital.
Subjects:
Physicians and nurses employed at Children's Hospital Los Angeles randomly selected from a global hospital e-mail server over a 3-week time frame were invited to participate and receive an incentive on completion. Forty-three controls and 42 intervention subjects (22 lecture + tabletop exercise, 20 lecture only) completed the study. Subjects with disaster training in the prior 6 months were excluded.
Interventions:
Subjects underwent a didactic lecture or a combination of didactic lecture and tabletop exercise. Preintervention and postintervention testing took place using a 37-question multiple-choice test on pediatric disaster medical topics. Posttesting took place immediately after intervention and then 1, 3, and 6 months after the intervention. Subjects also were surveyed before and after intervention regarding their attitudes toward pediatric disaster medicine.
Main Outcome Measures:
(1) Scores on a 37-question knowledge test and (2) Likert scores on self-perceptions of knowledge, comfort, and interest in pediatric disaster medicine.
Results:
Regardless of intervention type, participant scores on a postintervention pediatric disaster medicine tests over a 6-month period increased and remained well above pretest means for intervention and control pretest scores. There were no differences in scores comparing type of intervention. However, subjects who underwent the tabletop simulation had a better sense of knowledge and comfort with the topics compared with those who only underwent a didactic lecture.
Conclusions:
Didactic lecture and tabletop exercises both increase healthcare worker's knowledge of pediatric disaster medical topics. This knowledge seems to be retained for at least 6 months postintervention. The addition of the tabletop exercise to a standard didactic lecture may increase a learner's sense of knowledge and comfort with disaster topics, which may in turn lead to increased staff participation in the event of an actual disaster.
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