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Professionalization of Anesthesiologists and Critical Care Specialists in Humanitarian Action: A Nationwide Poll Among Italian Residents

Published online by Cambridge University Press:  15 December 2014

Alba Ripoll Gallardo*
Affiliation:
Research Center in Emergency and Disaster Medicine and Computer Science Applied to Medical Practice (CRIMEDIM), Università del Piemonte Orientale, Novara, Italy
Pier Luigi Ingrassia
Affiliation:
Research Center in Emergency and Disaster Medicine and Computer Science Applied to Medical Practice (CRIMEDIM), Università del Piemonte Orientale, Novara, Italy
Luca Ragazzoni
Affiliation:
Research Center in Emergency and Disaster Medicine and Computer Science Applied to Medical Practice (CRIMEDIM), Università del Piemonte Orientale, Novara, Italy
Ahmadreza Djalali
Affiliation:
Research Center in Emergency and Disaster Medicine and Computer Science Applied to Medical Practice (CRIMEDIM), Università del Piemonte Orientale, Novara, Italy
Luca Carenzo
Affiliation:
Research Center in Emergency and Disaster Medicine and Computer Science Applied to Medical Practice (CRIMEDIM), Università del Piemonte Orientale, Novara, Italy
Frederick M. Burkle Jr.
Affiliation:
Harvard Humanitarian Initiative, Harvard School of Public Health, Cambridge, MassachusettsUSA
Francesco Della Corte
Affiliation:
Research Center in Emergency and Disaster Medicine and Computer Science Applied to Medical Practice (CRIMEDIM), Università del Piemonte Orientale, Novara, Italy
*
Correspondence: Alba Ripoll Gallardo, MD CRIMEDIM - Università del Piemonte Orientale Via Lanino 1 Ferrucci 33, 28100 - Novara, Italy E-mail ripoll@med.unipmn.it

Abstract

Background

Over the last decades, humanitarian crises have seen a sharp upward trend. Regrettably, physicians involved in humanitarian action have often demonstrated incomplete preparation for these compelling events which have proved to be quite different from their daily work. Responders to these crises have included an unpredictable mix of beginner-level, mid-level, and expert-level providers. The quality of care has varied considerably. The international humanitarian community, in responding to international calls for improved accountability, transparency, coordination, and a registry of professionalized international responders, has recently launched a call for further professionalization within the humanitarian assistance sector, especially among academic-affiliated education and training programs. As anesthetists have been involved traditionally in medical relief operations, and recent disasters have seen a massive engagement of young physicians, the authors conducted, as a first step, a poll among residents in Anesthesia and Critical Care Medicine in Italy to evaluate their interest in participating in competency-based humanitarian assistance education and in training incorporated early in residencies.

Methods

The Directors of all the 39 accredited anesthesia/critical care training programs in Italy were contacted and asked to submit a questionnaire to their residents regarding the objectives of the poll study. After acceptance to participate, residents were enrolled and asked to complete a web-based poll.

Results

A total of 29 (74%) of the initial training programs participated in the poll. Out of the 1,362 questionnaires mailed to residents, 924 (68%) were fully completed and returned. Only 63(6.8%) of the respondents voiced prior participation in humanitarian missions, but up to 690 (74.7%) stated they were interested in participating in future humanitarian deployments during their residency that carried over into their professional careers. Countrywide, 896 (97%) favored prior preparation for residents before participating in humanitarian missions, while the need for a specific, formal, professionalization process of the entire humanitarian aid sector was supported by 889 (96.2%).

Conclusions

In Italy, the majority of anesthesia/critical care residents, through a formal poll study, affirmed interest in participating in humanitarian assistance missions and believe that further professionalization within the humanitarian aid sector is required. These results have implications for residency training programs worldwide.

Ripoll GallardoA, IngrassiaPL, RagazzoniL, DjalaliA, CarenzoL, BurkleFMJr, Della CorteF. Professionalization of Anesthesiologists and Critical Care Specialists in Humanitarian Action: A Nationwide Poll Among Italian Residents. Prehosp Disaster Med. 2015;30(1):1-6.

Type
Original Research
Copyright
Copyright © World Association for Disaster and Emergency Medicine 2014 

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Footnotes

Conflict of interest: The authors declare that this research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

References

1. Guha-Sapir, D, Hoyois, P, Below, R. Annual Disaster Statistical Review 2012: The Numbers and Trends. 2013. http://reliefweb.int/report/world/annual-disaster-statistical-review-2012-numbers-and-trends. Accessed January 10, 2014.Google Scholar
2. Burkle, FM Jr, Nickerson, JW, von Schreeb, J, et al. Emergency surgery data and documentation reporting forms for sudden-onset humanitarian crises, natural disasters and the existing burden of surgical disease. Prehosp Disaster Med. 2012;27(6):577-582.Google Scholar
3. McQueen, KA, Parmar, P, Kene, M, et al. Burden of surgical disease: strategies to manage an existing public health emergency. Prehosp Disaster Med. 2009;24(Suppl 2):s228-231.Google Scholar
4. Salama, P, Spiegel, P, Talley, L, et al. Lessons learned from complex emergencies over past decade. Lancet. 2004;364(9447):1801-1813.Google Scholar
5. Griinewald, F, Binder, A, Griinewald, F, et al. Inter-agency Real Time Evaluation in Haiti: 3 months after the earthquake. 2010. http://www.unicef.org/evaluation/files/Haiti_IA_RTE_final_Eng.pdf. Accessed January 10, 2014.Google Scholar
6. Walker, P, Russ, C. Fit for purpose: the role of modern professionalism in evolving the humanitarian endeavour. International Review of the Red Cross. 2011. http://www.icrc.org/eng/resources/documents/article/review-2011/irrc-884-walter-russ.htm. Accessed January 10, 2014.Google Scholar
7. Burkle, FM Jr, Lyznicki, JM, James, JJ. “Cross-disciplinary competency and professionalization in disaster medicine and public health.” NATO Science for Peace and Security Series - E: Human and Societal Dynamics. Volume 100. Handbook for Pandemic and Mass-Casualty Planning and Response: 72-78.Google Scholar
8. Zhang, L, Liu, X, Li, Y, et al. Emergency medical rescue efforts after a major earthquake: lessons from the 2008 Wenchuan earthquake. Lancet. 2012;379(9818):853-861.Google Scholar
9. Kreiss, Y, Merin, O, Peleg, K, et al. Early disaster response in Haiti: the Israeli field hospital experience. Ann Intern Med. 2010;153(1):45-48.CrossRefGoogle ScholarPubMed
10. Chu, K, Stokes, C, Trelles, M, et al. Improving effective surgical delivery in humanitarian disasters: lessons from Haiti. PLoS Med. 2011;8(4):e1001025.Google Scholar
11. Brennan, RJ, Nandy, R. Complex humanitarian emergencies: a major global health challenge. Emerg Med (Fremantle). 2001;13(2):147-156.Google Scholar
12. Johnson, K, Idzerda, L, Baras, R, et al. Competency-based standardized training for humanitarian providers: making humanitarian assistance a professional discipline. Disaster Med Public Health Prep. 2013;7(4):369-732.Google Scholar
13. Burkle, FM Jr. The development of multidisciplinary core competencies: the first step in the professionalization of disaster medicine and public health preparedness on a global scale. Disaster Med Public Health Prep. 2012;6(1):10-12.Google Scholar
14. Bradt, DA, Drummond, CM. Professionalization of disaster medicine--an appraisal of criterion-referenced qualifications. Prehosp Disaster Med. 2007;22(5):360-368.CrossRefGoogle ScholarPubMed
15. Schultz, CH, Koenig, KL, Whiteside, M, et al. National Standardized All-Hazard Disaster Core Competencies Task F. Development of national standardized all-hazard disaster core competencies for acute care physicians, nurses, and EMS professionals. Ann Emerg Med. 2012;59(3):196-208e1.CrossRefGoogle Scholar
16. Dey, CC, Grabowski, JG, Gebreyes, K, et al. Influence of international emergency medicine opportunities on residency program selection. Acad Emerg Med. 2002;9(7):679-683.CrossRefGoogle Scholar
17. Powell, AC, Casey, K, Liewehr, DJ, et al. Results of a national survey of surgical resident interest in international experience, electives, and volunteerism. J Am Coll Surg. 2009;208(2):304-312.Google Scholar
18. Anspacher, M, Frintner, MP, Denno, D, et al. Global health education for pediatric residents: a national survey. Pediatrics. 2011;128(4):e959-965.Google Scholar
19. Matar, WY, Trottier, DC, Balaa, F, et al. Surgical residency training and international volunteerism: a national survey of residents from 2 surgical specialties. Can J Surg. 2012;55(4):S191-199.Google Scholar
20. Research Center in Emergency and Disaster Medicine and Computer Science Applied to Medical Practice (CRIMEDIM). https://crimedim.dir.unipmn.it. Accessed January 9, 2014.Google Scholar
21. Raimbow for Africa Onlus. http://www.rainbow4africa.org. Accessed January 9, 2014.Google Scholar
22. Rossler, B, Marhofer, P, Hupfl, M, et al. Preparedness of anesthesiologists working in humanitarian disasters. Disaster Med Public Health Prep. 2013;7(4):408-412.CrossRefGoogle ScholarPubMed
23. Surveymonkey. http://www.surveymonkey.com. Accessed January 9, 2014.Google Scholar
24. Kaplowitz, MD, Hadlock, TD, Levine, R. A comparison of web and mail survey response rates. Public Opin Quart. 2004;68:94-101.CrossRefGoogle Scholar
25. European Master in Disaster Medicine (EMDM). http://www.dismedmaster.com. Accessed January 9, 2014.Google Scholar
26. King, RA, Liu, KY, Talley, BE, et al. Availability and potential impact of international rotations in emergency medicine residency programs. J Emerg Med. 2013;44(2):499-504.Google Scholar
27. Drain, PK, Primack, A, Hunt, DD, et al. Global health in medical education: a call for more training and opportunities. Acad Med. 2007;82(3):226-230.Google Scholar
28. Slepski, LA. Emergency preparedness and professional competency among health care providers during hurricanes Katrina and Rita: pilot study results. Disaster Manag Response. 2007;5(4):99-110.Google Scholar
29. Marchbein, D. Humanitarian surgery: a call to action for anesthesiologists. Anesthesiology. 2013;119(5):1001-1002.CrossRefGoogle Scholar
30. Van Hoving, DJ, Wallis, LA, Docrat, F, et al. Haiti disaster tourism--a medical shame. Prehosp Disaster Med. 2010;25(3):201-202.Google Scholar
31. Redmond, AD, Mardel, S, Taithe, B, et al. A qualitative and quantitative study of the surgical and rehabilitation response to the earthquake in Haiti, January 2010. Prehosp Disaster Med. 2011;26(6):449-456.Google Scholar
32. Welling, DR, Ryan, JM, Burris, DG, et al. Seven sins of humanitarian medicine. World J Surg. 2010;34(3):466-470.Google Scholar
33. Scott, LA, Carson, DS, Greenwell, IB. Disaster 101: a novel approach to disaster medicine training for health professionals. J Emerg Med. 2010;39(2):220-226.Google Scholar
34. Angelini, P, Arora, B, Kurkure, P, et al. Commentary: critical reflections on subspecialty fellowships in low-income countries. Acad Med. 2012;87(2):139-141.Google Scholar