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Core Competencies for Pediatric Disaster Medicine: An International Modified Delphi Study
Schyler Zane Grodman1,2, Attila J Hertelendy1,2, Fadi Issa1,2
1Division of Disaster Medicine, Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA.
Insights
This study established 57 core competencies for pediatric disaster response, crucial for healthcare providers. These competencies aim to improve care for children affected by disasters, enhancing preparedness and training.
Area of Science:
- Disaster medicine
- Pediatric emergency care
- Public health preparedness
Background:
- Children are uniquely vulnerable during disasters.
- A lack of standardized competencies for pediatric disaster response exists for healthcare providers.
- This gap hinders effective care for children impacted by disasters.
Purpose of the Study:
- To establish international consensus on core competencies for pediatric disaster response.
- To guide the development of training and preparedness for healthcare professionals.
- To ensure adequate care for pediatric populations during emergencies.
Main Methods:
- A modified Delphi study involving international disaster medicine experts.
- Utilized a comprehensive scoping review to generate initial competency statements.
- Experts rated statements using a 7-point scale, with consensus defined by standard deviation (SD) ≤ 1.0.
Main Results:
- 57 core competencies achieved consensus across three Delphi rounds.
- Highly ranked competencies included recognizing pediatric vulnerabilities, transport management, identification/tracking, and reunification.
- Decontamination initiation was also identified as a key competency.
Conclusions:
- The 57 consensus-based competencies provide a foundational framework for pediatric disaster medicine.
- These competencies can inform standardized curricula, preparedness strategies, and training requirements.
- They aim to enhance the capacity of healthcare providers to care for children in disaster settings.
Objectives:
Children are disproportionately affected by disasters and represent a vulnerable population in such settings. However, no internationally recognized core competencies exist to guide health care providers in caring for children impacted by disasters (particularly non-pediatricians). This study aimed to establish consensus-based core competencies for pediatric disaster response through international expert agreement across disciplines.
Methods:
A three-round modified Delphi study was conducted following CREDES criteria, using competency statements generated via a comprehensive scoping review of pediatric disaster literature. International disaster medicine experts rated competency statements on a 7-point linear scale (1 = disagree, 7 = agree). Consensus was defined a priori as standard deviation (SD) ≤ 1.0. Data were collected and analyzed using the STAT59 online platform.
Results:
57 competencies met consensus criteria across three Delphi rounds, with mean scores ranging from 5.4 to 6.6. The highest-ranked competencies (mean = 6.6) were pediatric vulnerabilities recognition, pediatric transport management, child identification and tracking, and child-parent reunification. Decontamination initiation was also highly ranked (mean = 6.5).
Conclusions:
The 57 consensus-based core competencies for pediatric disaster medicine response, spanning 16 practice domains, provide a foundation to further develop standardized curricula, guide preparedness and response efforts, and define minimum training expectations for health care providers caring for children impacted by disasters.