Home Articole medicale TitluGENERAL PRINCIPLES OF EDUCATION AND TRAINING IN DISASTER MEDICINE THAT WOULD CONSTITUTE THE STANDARDS IN THE DOMAIN l articolului

TitluGENERAL PRINCIPLES OF EDUCATION AND TRAINING IN DISASTER MEDICINE THAT WOULD CONSTITUTE THE STANDARDS IN THE DOMAIN l articolului

ARTICOL PUBLICAT DE:
Medicina de familie - medic familie Steiner Nicolae Prof. Nicolae Steiner online
Loc de munca: Universitatea Titu Maiorescu
Specializare: Medicina de familie
1 August 2011 10:44

o Multi-disciplinary programs The operational context of Disaster Medicine is more and more multi-disciplinary and most of authors form the specialty literature consider that educational programs from the domain must reflect that operational reality.              o Central focus on vocational trainingThe training and educational programmes for all the levels of Disaster Medicine practitioners must be focused on a central point that is related to the knowledge’s, understanding, competencies and skills integrated in the program. The educational program must fulfill at least the local standards, the educational request and in the same time to reflect the international standards that appears from a large process of international consultation of the specialists from the educational domain.o  The training framework based on scenarios and case studies.In every educational program, the objectives of such an education and different teaching methods must be related with this objective. A common method used in specialists education form the healthcare domain is that the education must be based on case studies and scenarios.  In such models the case studies and selected scenarios would be:• Integrated in bio/medical sciences, medico/social sciences, clinical sciences, public health sciences and the standards of emergency management;• Integrated in knowledge’s, competencies and necessary skills in a holistic approach;• Facilitate the development of a cognitive competency and of management to the participants;• Facilitate the capacity of changing in a modern and dynamic environment of development and integrated of the emergency response system;• Facilitate the use of the concepts/principles in information applying;• Facilitate an approach based on evidences and research practices that would establish the backgrounds of teaching from the evaluations of major events;• Allow to be focused on student requirements and applicable in flexible strategies.o  The themed approach In the structured educational programs some new initiatives are the introduction of themed approach. In such programs the content is arranged in themes that integrates the specific disciplines and tries to introduce the student in a curriculum much integrated in real life.o Base disciplines and the optional onesFor all these events exists some that is designated as "core knowledge’s" that would constitute a educational requirement for all the practitioners form the health care domain and "optional knowledge’s" that would be added and developed together with the competencies according to professional training and personal interest.o Modular approach The general framework facilitates a modular approach. Through such an approach and the international standards and guidelines would be possible to chose different core units and a number of optional units according to the existing risks and threats and with the dimension of the educational facilities and opportunities, and with the individual requests.o The surveyed practice experienceThe very nature of Disaster Medicine necessitates a ready to use approach familiar to all practitioners in the mode of execution of table top and field exercises.  For that according to the complexity in continuous rise of the disastrous events and to the need of concrete competencies demonstration in major events management that would be considered as major threats for the health of a community it is proposed that Disaster Medicine teaching and education on the high level would include mandatory an training time dedicated to surveyed practice before the finalizing of courses.o The competency approachThe education movement based on competencies is not a new approach, being more and more recognized in the last decades. This approach was related to the development of the training in the industrial domain especially in improvement of productivity of a country in the international arena.Some authors stated that this approach is a reducing approach not suitable for a professional educational program.This authors had argued that this approach is not able to develop cognitive processes at a high level, like the adoption of decisions, that is the main attribute requested to practitioners of Disaster Medicine. o The conceptual framework of competenciesThe competencies requested to the persons involved in the events that constitutes a major threat to the health management could be situated in the middle of three major domains (disciplines) namely: clinical care, public health and emergency situations management.  The clinical domain is not reduced only to the competencies belonging to Emergency Medicine but includes and the psycho-social aspects and the contributions of other disciplines of the health sciences.  Training levels for the medical personnel involved response and management of disastersCategory Attribute Target Description Core & optional knowledge’s Training mode Formal evaluation Certificates releasing Instructor levelLevel 1 Community Civilians, base training at the community level and emergency situations knowledge’s Management course of training of local communities for emergency situations Short courses of competencies for seven days No Seven days course certificate YesLevel 2 First medical responders First contact, suppliers and respondents of health care system from all the disciplines. Management course of training of prehospital phase of medical intervention in disaster cases. Course for management of CBRNE consequences of terror attacks Short courses of competencies for seven days Yes Seven days course certificate)) YesLevel 3 First hospital level responders First contact, suppliers and respondents form all the disciplines. Management course of training of hospital phase of medical intervention in disaster cases. Course for management of CBRNE consequences of terror attacks Short courses of competencies for seven days Yes Seven days course certificate YesLevel 4 County level medical authorities  managers  master level courses Managers from all the county level facilities Complementary attested in practice of Disaster Medicine Three months courses Yes Diploma of Master course YesLevel 5 Professional level master level for the medical authorities managers from the county level or regional or county hospitals Formal educational courses like master courses, Subject of an international credentialising. Based on a curriculum approved by the national authorities So it was established by academic organizations Yes Diploma of Master course Academic  and professional personnelLevel 6 Specialized level / Consultants and advisers/ master level course and practical experience Formal educational courses like master courses, Subject of an international credentialising.” Based on a curriculum approved by the national authorities So it was established by academic organizations Yes Diploma of Master course Academic  and professional personnelLevel 7 Leading level researchers and consultants form national level leaders – Doctoral level of training Formal educational courses like doctoral Training, Subject of an international credentialising.. Based on a curriculum approved by the national authorities So it was established by academic organizations Yes Diploma of Doctoral course Academic  and professional personnelWhat will be common base elements in practitioners training in Disaster Medicine.1 On the interface of the disciplines that would be common in Disaster Medicine training of the practitioners of this specialty would exist the absolutely needed disciplines namely the management of prehospital phase, of the hospital phase and of the management of Mass casualties incidents, and the management of CBRNE incidents casualties and the management of general response of the healthcare system in emergency situations created by disasters.2      Regarding the particular elements form limited interest that would be include in the training are the monitoring of exposure level at the radiations of the populations after the radiological incidents, medical specific management of the incidents and other like the management of people gatherings.Conclusions -proposalsOwing in mind that the "Medical response of the health care system" is more and more multi disciplinary, it is mandatory to study with a great attention the educational needs of different specialties that have some involvement in disaster response. On the other hand their appearance is like ann huge procession on the classical training systems to introduce the Disaster Medicine Teaching in all domains of this training because the practical and theoretical knowledge’s could not be achieved through a nonleaded training such is the case of Romania, were exist a confusion induced by the participants that would to lead the system without any knowledge on the functioning.The application of the system presented has the advantage that integrates the training request of Disaster medicine of the all levels of medical specialties that are participating in disaster response, and the applying of the Law 95 denies the responsibility of the Romanian Health Ministry in Medical response to disasters. In conclusion is the time to re-give the responsibility of medical intervention in disaster cases to the Medical authorities without any involvement of any other authorities from outside of the ministry.Bibliography:[1] BRADT D, ABRAHAM K, and  FRANKS R,  A Strategic plan for Disaster Medicine in Australasia. Emergency Medicine (2003) 15, 271-282[2] FISHER (J.) and SEYNAEVE (G.J.R.). A Masters in Disaster Management? Melbourne, WADEM Education Committee, May 9, 2003, 1 pag.[3] Frank ARCHER, MBBS, MEd,MPH, FAFPHM;1 Geert SEYNAEVE,MD2*Dr. Anastasia ZIGOURA (Greece) International Guidelines and Standards for Consequences of Events that May Threaten the Health Status of a  Community, A Report of an Open International WADEM Meeting, Brussels, Belgium, 29–31 October, 2004,  - Prehospital and Disaster Medicine, vol 22,  march-april 2007 nr.2.,p. 120-130.

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