Abstract
Introduction
The provision of life-saving medical care in austere environments requires individuals working in teams to rescue patients, yet few studies measure trainee performance in these environments.
Objectives
Our goal was to develop a competency-based curriculum for patient care providers using a chaotic, multi-patient, and environmentally challenging environment.
Methods
A 5-hour wilderness/emergency preparedness training (EPT) curriculum was developed by a statewide panel of experts including 9 learning objectives, 18 competencies and 34 performance objectives. Following brief didactic and small group sessions, inter-professional teams of 5–6 trainees were observed in a large patient simulator designed to recreate environmentally challenging (ie, flood evacuation), multi-patient scenarios using trained patient actors. Successful completion of 16 individual and 18 team performance objectives were assessed by trained observers. Prior to training, team members completed a 24-question knowledge assessment, a demographic survey and a comfort level self-assessment. Following training, trainees repeated the 24 questions, self-assessment, and a course assessment.
Results
One-hundred ninety-five participants completed the course between November 2012 and August 2013, including 90 (46.1%) health professional students, 60 (30.8%) physicians, 32 (16.4%) nurses, 5 (2.6%) health administrators, 3 (1.5%) EMS/fire personnel, 3 (1.5%) environmental engineers, and 2 (1.0%) law enforcement officials. Thirty-eight (19.5%) reported >3 hours of wilderness/EPT each year while 157 (80.5%) reported ≤ 3 hours of yearly EPT. One-hundred ninety-five (73.3%), 139 (52.2%) and 66 (33.8%) participants completed the pretest, posttest, and course assessment. The average percentage of correct answers between the pretest and posttest increased from 47.4 to 77.8. 66 (100%) reported the course relevant to care providers and 61 (92.4%) highly recommended the course.
Conclusions
Our competency-based wilderness/EPT curriculum used a large simulator to measure performance in a chaotic environment. Novice and experienced trainees improved knowledge and highly recommended the course. Further research is needed to assess the impact of the curriculum on individuals and teams.