Col. (r) Prof. NICOLAE STEINER MD, PhD
Asociation of Reserve Officers Romania
Titu Maiorescu University Master course of Disaster Medicine NATO international expert for Disaster Medicine Former member of Health Security Committee of E.U Member of WADEM Honorary member of NDMS of USA
Work presented at NATO-CIOMR summer congress august 2014 Fulda, Germany(Editeaza, Sterge)
Scenario based training
In any educational program must be specified the educational objectives and various methods of learning, to be in relation to these objectives. A common method used in the education of health care professionals is to educate based on "cases or scenarios."
The models will be selected based on cases or scenarios, teachers must meet the following requirements: synergistically integrate all major science subjects to human health (bio sciences/medical sciences, medical/social sciences, clinical sciences, public health, emergency management standards;
integrate knowledge, skills and attitudes needed in a holistic approach;
facilitate the development of cognitive skills and course management;
to support and promote the development of capacity for change in a modern, dynamic and integrated emergency response system;
to be based on the use of concepts / principles in the application of knowledge, a scientific approach based on research evidence and practice to ensure the fundamentals of learning from evaluations of major events;
allowing their adaptation to the needs of knowledge and training of students and applicable to flexible strategies.
An themed approach
The structure of education programs, including recent initiatives that have proven effective include introducing themes based approach. In such programs the content is structured on specific subjects and themes that integrate the student practitioner attempts to introduce a more integrated curriculum in real life.
Core and optional subjects
For most events that constitute the object of study, there is indeed a common body of knowledge, called "knowledge base" that require a common educational needs of all workers in health care and "optional knowledge" that can be added, deepened with skills based on basic training and personal interests broaden knowledge.
An Modular approach
Need to report to the international standards of the principle of interoperability guideline requires the organization in a way modular way which allows to choose different base units and a number of optional units based on actual risks and dangers, size and possibilities of educational institutions and the requirements or preferences of learners.
A supervised practice experience
The very nature of "Medical Management of Disasters" at hand requires a mode in which the "computer assisted exercises" and practical exercises in the field to be used.
Therefore, given the increasing complexity of forms with potential disaster phenomena and the need to demonstrate specific skills in the context of these major events, such as a threat to the health of a community, it was suggested that education of "Medical Management of Disasters" upper level should include a mandatory period of supervised practical training before completion of the courses, as a basic requirement, with didactic component of the course.
A competence-based approach
Competence-based education is not new, it has gained greater recognition in the last 10 years, when some authors have demonstrated that reality is a component skills reductionist approach and inappropriate in a professional education program, arguing that this approach is incapable to develop high-level cognitive processes such as decision making, which is a basic attribute called practitioners of "Medical Management of Disasters."
However other authors argue that these skills may develop these at a higher level in an environment where the focus is on competence-based approach. Of particular interest is the fact that if such a competency based approach is general enough to be applicable internationally or is useful only locally.
A conceptual competency
Competencies required of persons involved in the management of events that constitute a major threat to health may be located at the intersection of three major areas (disciplines), namely:
• Clinical care
• Public Health
• Emergency management.
Clinical areas not only reduce the powers belonging to emergency medicine, but also includes aspects of the psychology of, and contributions from other health disciplines such as clinical care of wounded, clinical care of compound wounds and so on.
To prepare medical personnel for intervention in disasters, we are proposing five levels of training:
LEVEL I: short courses themed area for medical management of disaster-response volunteers and staff locally (reserve officers and NCOs). These courses will have lasting 5-7 days, and ends with a certificate of graduation
LEVEL II: short courses with topics on medical response to disasters, mid-level staff who will be in charge of disaster victims receive (reserve officers locally) in disaster response unit of Municipalities higher. These courses will have duration of 5-7 days and ends with a certificate of graduation
LEVEL III: short courses themed area hospital disaster response (for reserve officers and NCOs working in the hospital). These courses will have duration of 5-7 days and ends with a certificate of graduation.
O noua tehnica chirurgicala in tratarea scoliozei a fost aplicata la Spitalul „Marie Curie”
Un sistem nou-descoperit in tratamentul scoliozei la copii a fost efectuat cu succes la Spitalul Marie Curie.