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Using Innovative Simulation Modalities for Civilian-based, Chemical, Biological, Radiological, Nuclear, and Explosive Training in the Acute Management of Terrorist Victims: A Pilot Study

Published online by Cambridge University Press:  28 June 2012

Italo Subbarao ,
William F. Bond ,
Christopher Johnson ,
Edbert B. Hsu  and
Thomas E. Wasser
Italo Subbarao*
Affiliation:
Department of Emergency Medicine, Johns Hopkins University, Baltimore, Maryland, USA
William F. Bond
Affiliation:
Department of Emergency Medicine, Lehigh Valley Hospital and Health Network, Allentown, Pennsylvania, USA
Christopher Johnson
Affiliation:
Department of Emergency Medicine, Orlando, Florida, USA
Edbert B. Hsu
Affiliation:
Department of Emergency Medicine, Johns Hopkins University, Baltimore, Maryland, USA
Thomas E. Wasser
Affiliation:
Department of Health Studies, Lehigh Valley Hospital and Health Network, Allentown, Pennsylvania, USA
*
Italo Subbarao, MD, MBA The Johns Hopkins Center for Critical, Event Preparedness and Response 201 N. Charles St., Suite 1400 Baltimore, MD 21201, USA E-mail: italo_subbarao@yahoo.com
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Abstract

Objectives:

Chemical, biological, radiological, nuclear, and explosive (CBRNE) incidents are low frequency, high impact events that require specialized train-ing outside of usual clinical practice. Educational modalities must recreate these clinical scenarios in order to provide realistic first responder/receiver training.

Methods:

High fidelity, mannequin-based (HFMB) simulation and video clinical vignettes were used to create a simulation-based CBRNE course directed at the recognition, triage, and resuscitation of contaminated victims. The course participants, who consisted of first responders and receivers, were evaluated using a 43-question pre- and post-test that employed 12 video clinical vignettes as scenarios for the test questions. The results of the pre-test were analyzed according to the various medical training backgrounds of the participants to identify differences in baseline performance. A Scheffe posthoc test and an ANOVA were used to determine differences between the medical training backgrounds of the participants. For those participants who completed both the pre-course and post-course test, the results were compared using a paired Student's t-test.

Results:

A total of 54 first responders/receivers including physicians, nurses, and paramedics completed the course. Pre-course and post-course test results are listed by learner category. For all participants who took the pre-course test (n = 67), the mean value of the test scores was 53.5 ±12.7%. For all participants who took the post-course test (n = 54), the mean value of the test scores was 78.3 ±10.9%. The change in score for those who took both the pre- and post-test (n = 54) achieved statistical significance at all levels of learner.

Conclusions:

The results suggest that video clinical vignettes and HFMB simulation are effective methods of CBRNE training and evaluation. Future studies should be conducted to determine the educational and cost-effectiveness of the use of these modalities.

Keywords

algorithmchemicalbiologicalradiologicalnuclearand explosive (CBRNE)CBRNE trainingcontaminationdirty resus-citationsimulationsymptom-basedterror-ismtriage
Type
Brief Report
Information
Prehospital and Disaster Medicine , Volume 21 , Issue 4 , August 2006 , pp. 272 - 275
Copyright
Copyright © World Association for Disaster and Emergency Medicine 2006

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