Wetta-Hall Ruth, Berg-Copas Gina M, Cusick Jost Janet, Jost Gary
Department of Preventive Medicine and Public Health, University of Kansas School of Medicine, Wichita, Kansas 67214, USA.
Prehosp Disaster Med. 2007 Sep-Oct;22(5):448-53. doi: 10.1017/s1049023x00005197.
Prehospital and community hospital healthcare providers in the United States must be prepared to respond to burn disasters. Continuing education is the most frequently utilized method of updating knowledge, skills, and competence among healthcare professionals. Since preparedness training must meet multiple educational demands, it is vital to understand how participants' work and educational experience and the program's content and delivery methods impact knowledge acquisition, and how learning influences confidence and competence to perform new skills.
The purpose of this exploratory, convenience sample study was to identify healthcare provider characteristics and continuing education training content areas that were predictive of self-reported improvement in competence after attending a mass-casualty burn disaster continuing education program.
Logistic regression analysis of data from a post-training evaluation from nine, one-day continuing education conferences on mass burn care was used to identify factors associated with improved self-reported competency to respond to mass burn casualties.
The following factors were associated most closely with increased self-reported competency: (1) prehospital work setting (odds ratio (OR) = 3.06, confidence interval (CI) = 0.83-11.30, p = 0.09); (2) 11 or more years of practice (OR = 0.31, CI = 0.09-1.08, p = 0.07); and (3) practice in an urban setting (OR = 0.01, CI = 0.18-0.82, p < 0.01). Confidence items included: (1) ability to implement appropriate airway management modalities (OR = 2.31, CI = 1.03-5.17, p < 0.04); (2) manage patients with electrical injuries (OR = 4.86, CI = 1.84-12.85, p < 0.001); (3) identify non-survivable injuries (OR = 2.24, CI = 0.93-5.43, p = 0.07); and (4) recognize special problems associated with burns in young children or older adults (OR = 2.14, CI = 0.87-5.23, p = 0.10). The final model explained 89.9% of the variability in self-reported competence.
Interventions used to train healthcare providers for burn disasters must cover a broad range of topics. However, learning needs may vary by practice setting, work experience, and previous exposure to disaster events. This evaluation research provides three-fold information for continuing education research: (1) to identify content areas that should be emphasized in future burn care training; (2) to be used as a model for CE evaluation in other domains; and (3) to provide support that many factors must be considered when designing a CE program. Results may be useful to others who are planning CE training programs.
美国的院前和社区医院医疗保健提供者必须做好应对烧伤灾难的准备。继续教育是医疗保健专业人员更新知识、技能和能力最常用的方法。由于备灾培训必须满足多种教育需求，了解参与者的工作和教育经历以及课程内容和授课方式如何影响知识获取，以及学习如何影响执行新技能的信心和能力至关重要。
本探索性便利样本研究的目的是确定医疗保健提供者的特征以及继续教育培训内容领域，这些特征和领域可预测在参加大规模伤亡烧伤灾难继续教育项目后自我报告的能力提升情况。
对来自九个为期一天的大规模烧伤护理继续教育会议的培训后评估数据进行逻辑回归分析，以确定与自我报告的应对大规模烧伤伤员能力提高相关的因素。
以下因素与自我报告的能力提高最密切相关：（1）院前工作环境（优势比（OR）=3.06，置信区间（CI）=0.83 - 11.30，p = 0.09）；（2）11年或以上的从业经验（OR = 0.31，CI = 0.09 - 1.08，p = 0.07）；（3）在城市环境中工作（OR = 0.01，CI = 0.18 - 0.82，p < 0.01）。信心项目包括：（1）实施适当气道管理方式的能力（OR = 2.31，CI = 1.03 - 5.17，p < 0.04）；（2）处理电损伤患者的能力（OR = 4.86，CI = 1.84 - 12.85，p < 0.001）；（3）识别不可存活损伤的能力（OR = 2.24，CI = 0.93 - 5.43，p = 0.07）；（4）认识与幼儿或老年人烧伤相关的特殊问题的能力（OR = 2.14，CI = 0.87 - 5.23，p = 0.10）。最终模型解释了自我报告能力变异性的89.9%。
用于培训医疗保健提供者应对烧伤灾难的干预措施必须涵盖广泛的主题。然而，学习需求可能因实践环境、工作经验和以前接触灾难事件的情况而异。这项评估研究为继续教育研究提供了三方面的信息：（1）确定未来烧伤护理培训中应强调的内容领域；（2）用作其他领域继续教育评估的模型；（3）为设计继续教育项目时必须考虑许多因素提供支持。研究结果可能对其他正在规划继续教育培训项目的人有用。
