The Effectiveness of Disaster Training for Health Care Workers: A Systematic Review
Received 13 September 2006; received in revised form 15 February 2007, 7 May 2007, 22 July 2007 and 24 September 2007; accepted 28 September 2007. published online 07 December 2007.
Study objective
Evidence-based medical literature is lacking about the best methods to train health care providers in disaster response. We systematically review the recent literature to report whether training interventions in disaster preparedness improve knowledge and skills in disaster response.
Methods
We searched MEDLINE through PubMed, ISI Web of Science, BIOSIS, Cumulative Index to Nursing and Allied Health (CINAHL), the Cochrane Library, ClinicalTrials.gov, the Public Affairs Information Service, and Education Full Text. Selected journals, articles, and other comprehensive reports were also reviewed for relevant citations. Subjects of eligible articles were hospital-based and out-of-hospital health care providers. Articles meeting inclusion criteria were published in English between January 2000 and December 2005, described a training exercise undertaken to further knowledge or skills in disaster response, measured a quantitative and objective outcome, and used a control group. Included studies were independently reviewed by 2 researchers, and study quality was assessed with criteria adapted from the US Preventive Services Task Force and the Centre for Reviews and Dissemination.
Results
We identified 258 studies. Nine studies are included in this review. Computer- and lecture-based training interventions may be effective in increasing disaster-related knowledge for out-of-hospital providers, though questions about study design and quality may cast doubt on the results. Evidence about effectiveness of training for inhospital providers is inconclusive. Comparison across studies is difficult because of diversity in study subjects, designs, and interventions. Results are likely biased by contamination from outside events.
Conclusion
The available evidence is insufficient to determine whether training interventions for health care providers are effective in improving knowledge and skills in disaster response.
aBeth Israel Deaconess Medical Center, Harvard Affiliated Emergency Medicine Residency, Department of Emergency Medicine, Boston, MA
bDepartment of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC
cInjury Prevention Research Center, University of North Carolina at Chapel Hill, Chapel Hill, NC
Address for correspondence: Jefferson Williams, MD, MPH, Beth Israel Deaconess Medical Center, Harvard Affiliated Emergency Medicine Residency, Department of Emergency Medicine, One Deaconess Road, West Clinical Center 2, Boston, MA 02215; 617-754-2339, fax 617-754-2350
Supervising editor: Peter C. Wyer, MD
Funding and support: By Annals policy, all authors are required to disclose any and all commercial, financial, and other relationships in any way related to the subject of this article, that might create any potential conflict of interest. See the Manuscript Submission Agreement in this issue for examples of specific conflicts covered by this statement. This systematic review was conducted with the support of the University of North Carolina at Chapel Hill Injury Prevention Research Center and the North Carolina Department of Health and Human Services Injury and Violence Prevention Branch. The project was supported in part by the North Carolina Department of Health and Human Services, Division of Public Health grant number 01596-05.
Publication dates: Available online December 11, 2007.
ABSTRACT