Exploring medical first responders' perceptions of mass casualty incident scenario training: a qualitative study on learning conditions and recommendations for improvement.

OBJECTIVE: Despite participating in scenario training, many medical first responders (MFRs) perceive themselves as inadequately prepared to respond to mass casualty incidents (MCIs). The objective of this study was to conduct a comprehensive examination of traditional MCI scenario training methods, focusing on their inherent strengths and limitations. An investigation into the perceptions of MFRs who had participated in MCI scenario training was carried out to identify potential areas for improvement and provide recommendations for refining MCI training protocols. DESIGN: Qualitative inductive approach using semistructured interviews that took place between October 2021 and February 2022. Data were analysed with qualitative content analysis. SETTING: MCI scenario training involving four organisations (three emergency medical services and one search-and-rescue organisation) tasked with responding to MCIs, collectively representing four European Union countries. PARTICIPANTS: 27 MFRs (17 emergency medical services personnel and 10 search-and-rescue volunteers) were recruited to participate in the study. RESULTS: Two categories and seven associated subcategories (shown in parentheses) were identified as influencing the learning outcomes for MFRs: Training in a context mirroring real-world incidents (conducting incident scene risk assessment, realistic representation in casualties, incorporating scenario variety into the curriculum, interagency collaboration, role alignment when training incident site management) and use of a pedagogical framework (allowing for mistakes, the importance of post-training evaluation). CONCLUSIONS: This study reaffirms the value of traditional MCI scenario training and identifies areas for enhancement, advocating for realistic scenarios, interagency collaboration, improved incident site management skills and thorough post-training evaluation. It suggests a shift in MCI training conceptualisation and delivery. The potential of virtual reality technologies as a valuable addition to training methods is explored, with a note on the need for further research to ascertain the long-term effectiveness of these technologies. However, the selection of a training method should consider programme goals, target population and resources.

Assessing cultural safety in Aboriginal and Torres Strait Islander Health.

OBJECTIVE: The aim of this study was to explore how nurses and midwives (trained at Flinders University in Adelaide) from rural, remote and urban locations view the impact of cultural safety training on their practice and the extent to which they incorporated cultural safety principles into their practice. DESIGN: qualitative research study. SETTING: rural, remote and urban locations across Australia. PARTICIPANTS: Nurses and midwives who had undertaken cultural safety training at Flinders University as part of their undergraduate degree. METHODS: Participants were recruited for semi-structured interviews. Interviews were recorded and transcribed verbatim. Transcripts were coded independently by members of the research team. MAIN OUTCOME MEASURES: The use of cultural safety principles in participants' practice, and the extent to which they were applied, was determined. Barriers and enablers to enacting cultural safety in the workplace were also identified. RESULTS: 10 individuals participated in an interview (7 nurses and 3 midwives). The Modified Monash Model was used to classify participant location with the following observed: MM1, six; MM2, two; MM5, one; MM6, one. 3 participants were from the Northern Territory and 7 from South Australia. Participants were at varying stages in their journey of cultural safety, ranging from early stages to those able to embody the Cultural Safety Principles and negotiate barriers to provide culturally safe care. Educational strategies for participants to progress their cultural safety journey were also identified. CONCLUSION: The extent to which cultural safety principles are applied in practice is diverse amongst the nurses and midwives that participated in this study, demonstrating that cultural safety is a journey and ongoing support is needed.