The development of the [US] National Disaster Life Support (NDLS) programs (Advanced, Basic, and Core Disaster Life Support) began prior to 11 September 2001, but in its aftermath, the NDLS programs have become a leading all-hazards disaster medicine training program in the US. The NDLS programs are taught through a training center model. The curriculum is revised via the National Disaster Life Support Education Consortium (NDLSEC), a multi-disciplinary, multi-specialty consortium.

The National Disaster Life Support Foundation (NDLSF) is a not-for-profit organization developed by the academic medical centers and partners that developed the NDLS programs. The founding institutions are the Medical College of Georgia, die University of Georgia, the University of Texas Southwestern, the University of Texas-Houston, and the American Medical Association. The NDLSF has die responsibility to oversee, certify, and monitor a network of training centers. The NDLSEC consist of individual members and 75 representative stakeholder organizations.

The training center network overseen by the NDLSF consists of 70 training centers in the US and 10 developing international training centers. The NDLSEC has >150 members with representatives from virtually every medical discipline and specialty. More than 70,000 individuals have been trained.

The NDLS programs have employed a training center network model to deploy standardized, all-hazards disaster educational programs. The NDLS programs have been successful in bridging die gap in disaster medicine education programs in the US and may represent a useful model for other countries to provide disaster medicine education.

A recent national assessment of emergency planning in Canada suggests that healthcare professionals are not properly prepared for disasters. In response to this gap, an interprofessional course in disaster management was developed, implemented, and evaluated in Toronto from 2007 to 2008. Undergraduate students in nursing, medicine, paramedicine, police, media, and health administration programs from Centennial College, the Michener Institute for Applied Health Sciences, George Brown College, Ryerson University, and the University of Toronto, took the eight-week online course. Curriculum developers set interprofessional competency as a major course outcome right from the start, and this concept guided content and activity development. The course was highly interactive and included video, a discussion forum, an online board game, and the opportunity to participate in a mock disaster simulation with professional staff.

A research study, funded by Health Canada, was conducted using quantitative and qualitative methods to examine the impact of the course on students' disaster management competencies and interprofessional attitudes.

Results indicate that the online course and simulation exercise provided an excellent opportunity for undergraduate students to learn and practice inter-professional collaboration, develop disaster management skills, and develop empathy for victims.

Results underscore the necessity of extensive inter-institutional collaboration regarding simulation planning, curriculum development, and faculty training. The session should be of interest to emergency and disaster educators, heakhcare professionals, policy-makers, and researchers.

Disaster medicine is an increasingly important part of medicine. Training in the practical aspects of disaster medicine often is impossible, and simulation may offer an educational opportunity superior to traditional didactic methods.

Twenty-two medical students at the Università degli studi del Piemonte Orientale were block-randomized into two groups of 11 students stratified by year of education. All participants received an eight-hour course of lectures and problem-based learning in disaster medicine. The intervention group received additional disaster medicine training on the disastermed.ca patient simulator, while the control group spent equal time on the simulator in a non-disaster setting. The ability of the two groups to manage a simulated disaster was compared.

Students in the intervention group were able to triage their patients more quickly than the control group (mean difference = 43 seconds, 95% CI 0.34–1.09 minutes, p <0.0003). Patients in the intervention group also were assessed more quickly (mean difference = 6.3 minutes, 95% CI = 0.4–12.1 minutes, p <0.04). Scores of performance indicators on a standardized scale was significantly higher in the intervention group (18/18) compared to the control group (8/18; p <0.0004). All students stated that they preferred the simulation-based curriculum to a lecture-based curriculum. When asked to rate the exercise overall, the median score was 8 on a 10-point modified Likert scale with no difference between the control and intervention groups.

Simulation of a mass-casualty incident increased the speed at which medical students were able to triage and assess simulated patients. Exposure to the disaster simulation also increased the scores on a structured command-and-control performance indicator instrument. Overall student satisfaction with the simulation-based curriculum was high, and all students felt that the simulation was a valuable learning experience.

Disaster and emergency personnel must master a variety of medical skills and must be able to perform under various stressful circumstances. In general, medical personnel are highly educated and are expected to be self-critical individuals even under extreme circumstances. However, self-critical abilities seldom are trained or evaluated within these circumstances. The combination of training for critical tasks and coping with stress can be trained in a personalized way by using serious gaming techniques. Immersion in the real-life stressful context, by means of a game, is a strong trigger for the intrinsic motivation to learn. Serious gaming could be useful, but it is unclear in what way games should include self-critical learning and coping with stress.

Several studies on the possibilities of serious gaming for medical personnel were performed: (1) an investigation on self-directed learning in ambulance workers; (2) an adventure based learning experiment with military physician; and (3) a literature review on games and stress.

The more subjects are capable of self-critical learning, the more they benefit from a game. Subjects can actively take control on what, how, and when they want to learn, which has an effect on self-efficacy and coping. Moreover, self-critical learning can be enhanced in a game, using feedback directed at the effects of stress on the critical performance of (medical) tasks.

The ways serious games can enhance self-critical learning and coping with stress will be elaborated upon.

The World Association for Disaster and Emergency Medicine (WADEM) Education Committee recommends that all health professionals be exposed to a core program in disaster health. This paper describes the framework, implementation, and evaluation of a Graduate Certificate in Emergency Preparedness and Disaster Health designed for health professionals.

Based on the WADEM Education Committee's framework for disaster health and the structure of the World Health Organization (WHO) Health Action in Crises Unit, a four-unit Graduate Certificate in Emergency Preparedness and Disaster Heath was developed, implemented and evaluated.

This Graduate Certificate evolved over diree years and includes four units: (1) an introduction to emergency preparedness and disaster health; (2) emergency preparedness; (3) response and major incident management, and (4) disaster recovery. Each unit has national and international perspectives.

Appropriate conceptual models provided the content and process of the course, although these have been difficult to locate. Delivery is largely on-campus with pre-reading and post-course assignments. A faculty of national and international leaders enriches delivery. Assessment largely has been assignment-based, with participation in one “Emergotrain” exercise required. Students may take the full Graduate Certificate or individual units only, either for credit or not-for-credit professional development.

Student feedback has been positive, with the introductory unit being rated as amongst the top 10% of units conducted in the faculty for two years in a row. The content, process, and assessments have been well supported with only few suggestions made for future modifications. An online option will now be offered in 2009, and a Graduate Diploma and Masters also will be available in 2009.

This Graduate Certificate has been evaluated positively by participants. The conceptual modeling has been validated and the model may be of interest to other WADEM members.