Residents working with M\xe9decins Sans Fronti\xe8res: training and pilot evaluation

Alba Ripoll-Gallardo,Francesco della Corte,Jeffrey Michael Franc,Grazia Meneghetti,Alessandro Costa,Ettore Mazzanti,Luca Ragazzoni

doi:10.1186/s13049-020-00778-x

Abstract

BackgroundWell-prepared humanitarian workers are now more necessary than ever. Essential to the preparation process are: clearly defined learning objectives, curricula tailored to the nuances of humanitarian settings, simulation-based training, and evaluation. This manuscript describes a training program designed to prepare medical residents for their first field deployment with Médecins Sans Frontières and presents the results of a pilot assessment of its effectiveness.MethodsThe training was jointly developed by the Research Center in Emergency and Disaster Medicine- CRIMEDIM of the Università del Piemonte Orientale, Novara, Italy, and the humanitarian aid organization Médecins Sans Frontières- Italy (MSF-Italy); the following topics were covered: disaster medicine, public health, safety and security, infectious diseases, psychological support, communication, humanitarian law, leadership, and job-specific skills. It used a blended-learning approach consisting of a 3-month distance learning module; 1-week instructor-led coaching; and a field placement with MSF. We assessed its effectiveness using the first three levels of Kirkpatrick’s training evaluation model.ResultsEight residents took part in the evaluation. Four were residents in emergency medicine, 3 in anesthesia, and 1 in pediatrics; 3 of them were female and the median age was 31 years. Two residents were deployed in Pakistan, 1 in Afghanistan, 1 in the Democratic Republic of Congo, 1 in Iraq, 2 in Haiti and 1 on board of the MSF Mediterranean search & rescue ship. Mean deployment time was 3 months. The average median score for the overall course was 5 (excellent). There was a significant improvement in post-test multiple choice scores (p = 0.001) and in residents’ overall performance scores (P = 0.000001).ConclusionResidents were highly satisfied with the training program and their knowledge and skills improved as a result of participation.Trial registrationThis study was approved by the Institutional Ethics Committee (date 24-02-2016, study code UPO.2015.4.10).

Highlights

Widespread global health inequalities and the resulting shortage of humanitarian health workers have led to an increased presence of young doctors in disaster and humanitarian crises [1]
Training objectives for physicians working with Médecins Sans Frontières (MSF) differ from the set of skills acquired in medical schools and residency programs
Learning There was a significant improvement in post-test multiple-choice scores when compared to pre-test scores (p = .001) [Fig. 2] and a significant improvement in residents’ overall performance scores (P = .000001) [Fig. 3]

Summary

Introduction

Widespread global health inequalities and the resulting shortage of humanitarian health workers have led to an increased presence of young doctors in disaster and humanitarian crises [1]. Training objectives for physicians working with Médecins Sans Frontières (MSF) differ from the set of skills acquired in medical schools and residency programs These professionals are confronted with unique challenges and ethical dilemmas [3] including, but not limited to, different spectra of diseases, limited resources, cultural diversity, and social disruption. Essential to the preparation process are: clearly defined learning objectives, curricula tailored to the nuances of humanitarian settings, simulation-based training, and evaluation This manuscript describes a training program designed to prepare medical residents for their first field deployment with Médecins Sans Frontières and presents the results of a pilot assessment of its effectiveness

Methods

Results

Discussion

Conclusion