University Department of Anesthesiology and Intensive Care Medicine of Tübingen, Hoppe- Seyler- Straße 3, 72076, Tübingen, Germany.
Psychological Institute, Department of Biological and Personality Psychology, University of Freiburg, Freiburg, Germany.
BMC Med Educ. 2021 Dec 10;21(1):610. doi: 10.1186/s12909-021-03043-6.
Disaster medicine is a component of the German medical education since 2003. Nevertheless, studies have shown some inconsistencies within the implementation of the national curriculum, and limits in the number of students trained over the years. Recently, the SARS-CoV-2 pandemic and other disasters have called attention to the importance of training medical students in disaster medicine on a coordinated basis. The aim of this study is to present and evaluate the disaster medicine and humanitarian assistance course, which was developed in the University of Tübingen, Germany.
The University Clinic for Anesthesiology and Intensive Care Medicine in Tübingen expanded the existing curriculum of undergraduate disaster medicine training with fundamentals of humanitarian medicine, integrating distance learning, interactive teaching and simulation sessions in a 40 h course for third-, fourth- and fifth- year medical students. This prospective and cross-sectional study evaluates the Disaster Medicine and Humanitarian Assistance course carried out over five semesters during the period between 2018 and 2020. Three survey tools were used to assess participants' previous experiences and interest in the field of disaster medicine, to compare the subjective and objective level of knowledge before and after training, and to evaluate the course quality.
The total number of medical students attending the five courses was n = 102 of which n = 60 females (59%) and n = 42 males (41%). One hundred two students entered the mandatory knowledge assessment, with the rate of correct answers passing from 73.27% in the pre-test to 95.23% in the post-test (t [101] = 18.939, p < .001, d = 1.88). To determine the subjective perception of knowledge data were collected from 107 observations. Twenty-five did not complete the both questionnaires. Out of a remaining sample of 82 observations, the subjective perception of knowledge increased after the course (t [81] = 24.426, p < .001, d = 2.69), alongside with the interest in engaging in the field of disaster medicine (t [81] = 7.031, p < .001, d = .78). The 93.46% of the medical students (n = 100) graded the training received with an excellent overall score (1.01 out of 6).
The study indicates a significant increase in students' understanding of disaster medicine using both subjective and objective measurements, as well as an increase interest in the field of disaster medicine and humanitarian assistance. Whereas former studies showed insufficient objective knowledge regarding disaster medical practices as well as subjective insecurities about their skills and knowledge to deal with disaster scenarios, the presented course seems to overcome these deficiencies preparing future physicians with the fundamentals of analysis and response to disasters. The development and successful implementation of this course is a first step towards fulfilling disaster medicine education requirements, appearing to address the deficiencies documented in previous studies. A possible adaptation with virtual reality approaches could expand access to a larger audience. Further effort must be made to develop also international training programs, which should be a mandatory component of medical schools' curricula.
灾难医学自 2003 年以来一直是德国医学教育的一个组成部分。然而,研究表明,在国家课程的实施方面存在一些不一致之处,而且多年来接受培训的学生人数也有限。最近,SARS-CoV-2 大流行和其他灾害引起了人们对协调基础上培训医学生灾难医学的重要性的关注。本研究旨在介绍和评估在德国图宾根大学开发的灾难医学和人道主义援助课程。
图宾根大学麻醉学和重症监护医学系在现有的本科灾难医学培训课程中增加了人道主义医学基础,将远程教育、互动教学和模拟课程整合到 30 至 5 年级医学生的 40 小时课程中。本前瞻性和横断面研究评估了 2018 年至 2020 年间进行的五次灾难医学和人道主义援助课程。使用了三种调查工具来评估参与者在灾难医学领域的先前经验和兴趣,比较培训前后主观和客观知识水平,并评估课程质量。
参加五门课程的医学生总数为 n=102,其中 n=60 名女性(59%)和 n=42 名男性(41%)。102 名学生参加了强制性知识评估,正确答案的比例从预测试的 73.27%提高到后测试的 95.23%(t[101]=18.939,p<0.001,d=1.88)。为了确定主观知识感知的数据来自 107 次观察。其中 25 人没有完成两份问卷。在剩余的 82 次观察样本中,课程结束后主观知识感知增加(t[81]=24.426,p<0.001,d=2.69),同时对参与灾难医学领域的兴趣增加(t[81]=7.031,p<0.001,d=0.78)。93.46%的医学生(n=100)对培训给予了极好的整体评分(6 分制中的 1.01 分)。
该研究表明,学生对灾难医学的理解无论是主观的还是客观的都有显著提高,同时对灾难医学和人道主义援助领域的兴趣也有所增加。虽然以前的研究表明,灾难医学实践的客观知识不足,以及对处理灾难情景的技能和知识的主观不安全感,但所提出的课程似乎克服了这些不足,为未来的医生提供了分析和应对灾害的基础知识。该课程的开发和成功实施是满足灾难医学教育要求的第一步,似乎解决了以前研究中记录的不足。通过虚拟现实方法进行可能的调整,可以扩大受众范围。还必须努力开发国际培训计划,该计划应成为医学院课程的必修组成部分。