129 Disaster Education: A Survey Study to Analyze Disaster Medicine Training in Emergency Medicine Residency Programs in the United States

Abstract

The increase in natural and man-made disasters occurring worldwide and the associated widespread destruction places emergency medicine (EM) physicians at the forefront of responding to these crises. Despite the growing political and educational interest in disaster medicine, it is unclear if resident training has been able to include these educational goals. While there has been data published on the status of Emergency Medical Services (EMS) education in residencies in the United States (US), no data specifically addresses education in disaster medicine. Recent data indicates disaster-preparedness is the most frequently listed component program directors want to add to their curricula. Additionally, there are no clear standardized recommendations or requirements for training programs. This study surveys residencies in the US to clarify the level of education in disaster medicine in EM residencies specifically, identify areas least and most addressed and highlight effective educational models already in place. The authors distributed an online survey tool of multiple-choice and free-response questions to accredited EM residency Program Directors and Chief Residents in the US between February 7, 2014 and April 24, 2014. Questions assessed residency background and details on disaster medicine competencies addressed during training. Out of 183 programs, 64 (35%) responded to the survey and completed all required questions. Of the completed surveys, 68.75% of the respondents are program directors and 31.25% are chief residents. Of the respondents, 76.56% represent 3-year training programs and 20.31% are from 4-year programs. 7.41% of the responding programs note they have an associated disaster medicine fellowship. Almost all programs (95.31%) report having some level of disaster medicine training in their residency, but only 26.42% have a specific track or specialty course. The most common disaster medicine educational competencies taught are patient triage and decontamination, both of which are addressed by 78.1% of responding programs. The most commonly identified methods to teach disaster medicine are drills and lectures/seminars. Program directors report the time spent on disaster medicine training is too little as per 53.70% of respondents, just right as per 42.59% of respondents and too much as per 3.70% of respondents. Commonly identified limitations to providing disaster education are limited time (33.8%) and limited resources (15.4%), though many programs (48.4%) indicate they are not limited in the amount of education they provide. There are no statistically significant differences between 3-and 4-year programs in level of disaster education provided. There are a variety of educational tools used to teach disaster medicine in US residencies today, with a larger focus on the use of lectures and hospital drills. However, there is no indication there is a similar educational approach across all residencies. The better training and background emergency medicine-trained physicians have, the higher chance of success of an emergency department, hospital and community when faced with any level of disaster. This survey highlights the opportunity for the creation of a model for resident education in disaster medicine.