Improving Team Performance for Public Health Preparedness.

OBJECTIVE: Between May 2010 and September 2011, the University of Minnesota School of Public Health partnered with the Minnesota Department of Health (MDH) to assess the effect of exercises on team performance during public health emergency response. METHODS: Participants were divided into 3 research teams exposed to various levels of intervention. Groups consisted of a control group that was given standard MDH training exercises, a didactic group exposed to team dynamics and communication training, and a treatment group that received the didactic training in addition to a post-exercise facilitated debriefing. To assess differences in team performance, teams engaged in 15 functional exercises. RESULTS: Differences in team performance across the 3 groups were identified, although there was no trend in team performance over time for any of the groups. Groups demonstrated fluctuation in team performance during the study period. Attitudinal surveys demonstrated an increase in workplace satisfaction and confidence in training among all groups throughout the study period. CONCLUSIONS: Findings from this research support that a critical link exists between training type and team performance during public health emergency response. This research supports that intentional teamwork training for emergency response workers is essential for effective public health emergency response. (Disaster Med Public Health Preparedness. 2017;11:7-10).

Disaster behavioral health capacity: Findings from a multistate preparedness assessment.

PURPOSE: To identify gaps in disaster behavioral health, the Preparedness and Emergency Response Learning Center (PERL) at the University of Minnesota's School of Public Health supported the development and implementation of a multistate disaster behavioral health preparedness assessment. Information was gathered regarding worker knowledge of current disaster behavioral health capacity at the state and local level, and perceived disaster behavioral health training needs and preferences. METHODS: Between May and July 2015, 143 participants completed a 31-item uniform questionnaire over the telephone by a trained interviewer. Trained interviewers were given uniform instructions on administering the questionnaire. Participants included county and city-level public health leaders and directors from Minnesota, Wisconsin, and North Dakota. FINDINGS: Findings demonstrate that across the three states there is a need for improved disaster behavioral health training and response plans for before, during, and after public health emergencies. This study identified perceived gaps in plans and procedures for meeting the disaster behavioral health needs of different atrisk populations, including children, youth, and those with mental illness. There was consistent agreement among participants about the lack of behavioral health coordination between agencies during emergency events. VALUE: Findings can be used to inform policy and the development of trainings for those involved in disaster behavioral health. Effectively attending to interagency coordination and mutual aid agreements, planning for effective response and care for vulnerable populations, and targeted training will contribute to a more successful public health response to emergency events.

Mobile phone use among Medical Reserve Corps coordinators and volunteers: an exploratory study.

OBJECTIVE: To better understand how mobile phones can be used during emergency response, this study identifies a) current mobile phone use among Medical Reserve Corps (MRC) volunteers and coordinators in their daily lives and during response; b) challenges for mobile phone use during response; and c) areas for capacity building. DESIGN: In 2012, 459 MRC volunteers and coordinators responded to a 35-question survey conducted online through SurveyMonkey. Respondents were asked how they use their mobile phones in their daily lives and during response, and how they would like to use them during response. Frequencies were calculated using SurveyMonkey and Excel. MAIN OUTCOME MEASURES: Respondents reported frequent and varied mobile phone use in their daily lives, with 99 percent of respondents owning a phone, 82 percent texting, and 87 percent of smartphone owners using apps. Although 80 percent of respondents who had been deployed used mobile phones during response, use of sophisticated mobile phone features was low; only 10 percent accessed emergency preparedness apps and 23 percent browsed the Internet for emergency response information. Respondents indicated a desire to use more features during response, such as emergency preparedness apps (72 percent) and e-mail to send or receive response instructions (80 percent). CONCLUSION: Results indicate that given access to mobile technology and training, emergency responders would like to increase their mobile phone use during response. Implications of these findings show a need for organizations to improve their support of mobile phone use.

Using gaming simulation to evaluate bioterrorism and emergency readiness training.

INTRODUCTION: The University of Minnesota: Simulations, Exercises and Effective Education: Preparedness and Emergency Response Learning Center uses simulations, which allow trainees to participate in realistic scenarios, to develop and evaluate competency. BACKGROUND/RATIONALE: In a previous study, participants in Disaster in Franklin County: A Public Health Simulation demonstrated that prior bioterrorism and emergency readiness training (BT/ER) is significantly associated with better performance in a simulated emergency. We conducted a second analysis with a larger data set, remapping simulation questions to the Public Health Preparedness and Response Core Competency Model, Version 1.0. METHODS/ACTIVITY: We performed an outcome evaluation of the impact of public health preparedness training. In particular, we compared individuals with significant BT/ER training to individuals without training on the basis of performance in a simulated emergency. We grouped participants as group 1 (≥45 hours of BT/ER training) and group 2 (<45 hours). Dependent variables included effectiveness of chosen responses within the gaming simulation, which was measured as the proportion of questions answered correctly for each participant. The relationship of effectiveness with significant BT/ER training was estimated using either multiple linear or logistic regression. RESULTS/OUTCOMES: For overall effectiveness, group 1 had 2% more correct decisions, on average, than group 2 (P < .001). Group 1 performed significantly better, on average, than group 2 for competency 1.1 (P = .001) and competency 2.3 (P < .001). However, group 1 was significantly worse on competency 1.2 than group 2. DISCUSSION: Results indicate that prior training is significantly associated with better performance in a simulated emergency using gaming technology. Effectiveness differed by competency, indicating that more training may be needed in certain competency areas. NEXT STEPS: Next steps to enhancing the usefulness of simulations in training should go beyond questioning if the learner learned and included questions related to the organizational factors that contributed to simulation effectiveness, and attributes of the simulation that encouraged competency and capacity building.

Games, simulations, and learning in emergency preparedness: a review of the literature.

Between 2007 and 2011, a comprehensive review of the literature was conducted to identify the usefulness of educational games and simulations in developing and evaluating the competency of public health professionals to prepare for, respond to, and recover from emergencies. This article presents an overview of the literature related to the use of games and simulations in education and training, summarizes key findings, identifies key features of gaming simulation design for educational effectiveness, and suggests that use of these emerging teaching and learning strategies be considered in the development of a comprehensive approach for creating and evaluating competency.

The evidence base for effectiveness of preparedness training: a retrospective analysis.

OBJECTIVES: In 2007, the Centers for Disease Control and Prevention (CDC) commissioned an Evidence-Based Gaps Collaboration Group to consider whether past experience could help guide future efforts to educate and train public health workers in responding to emergencies and disasters. METHODS: The Group searched the peer-reviewed literature for preparedness training articles meeting three criteria: publication during the period when CDC's Centers for Public Health Preparedness were fully operational, content relevant to emergency response operations, and content particular to the emergency response roles of public health professionals. Articles underwent both quantitative and qualitative analyses. RESULTS: The search identified 163 articles covering the topics of leadership and command structure (18.4%), information and communications (14.1%), organizational systems (78.5%), and others (23.9%). The number of reports was substantial, but their usefulness for trainers and educators was rated only "fair" to "good." Thematic analysis of 137 articles found that organizational topics far outnumbered leadership, command structure, and communications topics. Disconnects among critical participants--including trainers, policy makers, and public health agencies--were noted. Generalizable evaluations were rare. CONCLUSIONS: Reviews of progress in preparedness training for the public health workforce should be repeated in the future. Governmental investment in training for preparedness should continue. Future training programs should be grounded in policy and practice needs, and evaluations should be based on performance improvement.

A longitudinal study of the impact of an emergency preparedness curriculum.

OBJECTIVE: We conducted a longitudinal study to evaluate the impact of a curriculum designed to develop competency in emergency preparedness among public health professionals. METHODS: At six and 12 months following completion of one or more courses in the areas of emergency preparedness, response, and recovery, or in food protection, course participants were contacted and asked to identify if their participation allowed them to develop targeted competencies, identify important knowledge or skills they had acquired, provide examples of application of learning, and describe the impact of changes. Over five years, 36 sets of data were collected. RESULTS: The response rate of those who responded at either six or 12 months, or for both time periods, was 63%. At both six and 12 months,those who responded agreed that the learning activity helped them develop the competency associated with it in the curriculum plan. Respondents described multiple applications of learning and reported the development of reflective and systems-thinking abilities. CONCLUSIONS: The results provide compelling evidence that learners do develop competencies that impact their work activities as a result of competency-based educational programming and are able to apply these competencies in their work and organizational activities.

Using gaming simulation to evaluate bioterrorism and emergency readiness education.

OBJECTIVE: We performed an outcome evaluation of the impact of public health preparedness training as a group comparison posttest design to determine the differences in the way individuals who had participated in training performed in a simulated emergency. METHODS: The Experimental Group 1 included students who had graduated from or were currently enrolled in the bioterrorism and emergency readiness (BT/ER) curriculum at the University of Minnesota School of Public Health. The comparison groups included individuals who had access to the Internet and were aware of the 2006 online simulation Disaster in Franklin County: A Public Health Simulation. The evaluation process employed surveys and the gaming simulation as sources for primary data. RESULTS: Participants in the BT/ER curriculum (p=0.0001) and other participants completing at least 45 hours of training in the past year (p=0.0001) demonstrated higher effectiveness scores (accuracy of chosen responses within the simulation) than participants who did not report significant amounts of training. CONCLUSIONS: This evaluation research demonstrated that training is significantly associated with better performance in a simulated emergency using gaming technology.

A flexible approach to training veterinarians in public health: an overview and early assessment of the DVM/MPH dual-degree program at the University of Minnesota.

As a result of the growing need for public-health veterinarians, novel educational programs are essential to train future public-health professionals. The University of Minnesota School of Public Health, in collaboration with the College of Veterinary Medicine, initiated a dual DVM/MPH program in 2002. This program provides flexibility by combining distance learning and on-campus courses offered through a summer public-health institute. MPH requirements are completed through core courses, elective courses in a focus area, and an MPH project and field experience. Currently, more than 100 students representing 13 veterinary schools are enrolled in the program. The majority of initial program graduates have pursued public-practice careers upon completion of the program. Strengths of the Minnesota program design include accessibility and an environment to support multidisciplinary training. Continued assessment of program graduates will allow for evaluation and adjustment of the program in the coming years.

Competencies most valued by employers--Implications for master's-prepared occupational health nurses.

Educational institutions seek to prepare students to compete for positions in the workplace with a competency-based education. Employers are important stakeholders in the preparation of occupational health nurses. Competencies considered most valuable by employers will affect their hiring decisions. This study identifies competencies valued by employers in the workplace.

Crosscutting competencies for occupational health and safety professionals.

A change from a quarter system to a semester system presented a convenient opportunity for faculty at the Midwest Center for Occupational Health and Safety (a 27-year-old National Institute for Occupational Safety and Health-sponsored education and research center) to evaluate the current curriculum. As part of this process faculty identified both individual and crosscutting competencies for four programs: Occupational Medicine, Occupational Health Nursing, Industrial Hygiene, and Occupational Injury Epidemiology and Control. Faculty identified potential competency sets using published literature, course objectives, and content summaries. Common themes, termed crosscutting competencies, were identified. Seventy program graduates (58%) responded to a survey designed to assess the value of, and proficiency in, these competencies based on their postgraduation job experience. All 29 crosscutting competencies were rated as valuable or very valuable by respondents in each of the four programs. There was less agreement between respondents in proficiency ratings, with 24 of 29 competencies rated either proficient or very proficient. Comparing value and proficiency provided an opportunity to further refine the curriculum and a model for enhancing the skills, knowledge, and attitudes of future environmental and occupational health professionals. With further testing, we propose this set of crosscutting competencies be considered for adoption as a set of interdisciplinary core competencies for Occupational Health and Safety professionals.