Noncompressible torso hemorrhage (NCTH) is a major challenge in prehospital bleeding control and is associated with high mortality. This study was performed to estimate medical knowledge and the perceived barriers to information acquisition among health-care workers (HCWs) regarding NCTH in China.

A self-administered and validated questionnaire was distributed among 11 WeChat groups consisting of HCWs engaged in trauma, emergency, and disaster rescue.

A total of 575 HCWs participated in this study. In the knowledge section, the majority (87.1%) denied that successful hemostasis could be obtained by external compression. Regarding attitudes, the vast majority of HCWs exhibited positive attitudes toward the important role of NCTH in reducing prehospital preventable death (90.4%) and enthusiasm for continuous learning (99.7%). For practice, fewer than half of HCWs (45.7%) had heard of NCTH beforehand, only a minority (14.3%) confirmed they had attended relevant continuing education, and 16.3% HCWs had no access to updated medical information. The most predominant barrier to information acquisition was the lack of continuing training (79.8%).

Knowledge and practice deficiencies do exist among HCWs. Obstacles to update medical information warrant further attention. Furthermore, education program redesign is also needed.

The aim of this study was to evaluate district nurses’ (DN) perceived nutritional care and actual level of knowledge about nutritional care before and after a continuing educational intervention.

Nutritional treatment is an important part of nursing care, and health professionals responsible for nutritional care for older adults must therefore have sufficient understanding of nutritional problems to provide appropriate support. Previous research has shown that nutritional problems frequently go unrecognized and that health care personnel often lacks knowledge about nutritional care and relevant methods of assessing nutritional status. However, little is known about DNs’ knowledge about nutritional care.

An evaluative study with a study-specific questionnaire administered before and after a 2.5-day continuing educational course for DNs in primary health care in Stockholm County, Sweden. The course was given over a period of two to three months. The questionnaire measured DNs’ perceived nutritional care and actual level of knowledge about nutritional care.

A total of 456 DNs completed the questionnaire both before and after the intervention. Participants’ mean age was 50 years. They had worked a mean of 26 years in health care and 10 years as DNs. Before the intervention, many DNs reported that they did not work with nutritional care in an optimal way. After the intervention, significant improvements were found in perceived nutritional care and actual level of knowledge about the topic. However, not all DNs achieved the learning objectives of the course, so work remains to be done to ensure that DNs have sufficient knowledge of nutritional care to provide appropriate support and correctly prescribe oral nutritional supplements.

The study provides new information on DNs’ perceived nutritional care and actual level of knowledge. The result of the intervention helps lay the foundation for good nutritional care for older patients in primary care.

A major barrier to the adoption of an approach that integrates spirituality into palliative care is the lack of preparation/education of healthcare professionals on the topic. This study aimed to evaluate the effectiveness of a continuing education activity for healthcare professionals addressing spirituality and spiritual care provision to patients and families within palliative care.

We conducted an intervention study using a quantitative pre- and posttest design in a convenience sample of 52 healthcare professionals. Participants completed the Brazilian version of the Spiritual Care Competence Scale before and after attending a four-hour continuing education activity.

Significant differences were observed between pre- and postintervention scores in the following dimensions: assessment and implementation of spiritual care, professionalization and improving the quality of spiritual care, personal support, and patient counseling (p < 0.001), and referral (p = 0.003).

The results of this study provide preliminary evidence of a positive effect of this educational intervention on the development of the competences needed by healthcare professionals to deliver a comprehensive approach centered on the patient/family, which includes attention to spirituality and spiritual care in the decision-making process.

Foreign animal disease (FAD) outbreaks can have devastating impacts, but they occur infrequently in any specific sector anywhere in the United States (US). Training to proactively discuss implementation of control and prevention strategies are beneficial in that they provide stakeholders with the practical information and educational experience they will need to respond effectively to an FAD. Such proactive approaches are the mission of the Secure Food System (SFS; University of Minnesota; St. Paul, Minnesota USA).

The SFS exercises were designed as educational activities based on avian influenza (AI) outbreaks in commercial poultry scenarios. These scenarios were created by subject matter experts and were based on epidemiology reports, risk pathway analyses, local industry practices, and site-specific circumstances. Target audiences of an exercise were the groups involved in FAD control: animal agriculture industry members; animal health regulators; and diagnosticians. Groups of industry participants seated together at tables represented fictional poultry premises and were guided by a moderator to respond to an on-farm situation within a simulated outbreak. The impact of SFS exercises was evaluated through interviews with randomized industry participants and selected table moderators. Descriptive statistics and qualitative analyses were performed on interview feedback.

Eleven SFS exercises occurred from December 2016 through October 2017 in multiple regions of the US. Exercises were conducted as company-wide, state-wide, or regional trainings. Nine were based on highly pathogenic avian influenza (HPAI) outbreaks and two focused on outbreaks of co-circulating HPAI and low pathogenicity avian influenza (LPAI). Poultry industry participants interviewed generally found attending an SFS exercise to be useful. The most commonly identified benefits of participation were its value to people without prior outbreak experience and knowledge gained about Continuity of Business (COB)-permitted movement. After completing an exercise, most participants evaluated their preparedness to respond to an outbreak as somewhat to very ready, and more than one-half reported their respective company or farms had discussions or changed actions due to participation.

Evaluation feedback suggests the SFS exercises were an effective training method to supplement preparedness efforts for an AI outbreak. The concept of using multi-faceted scenarios and multiple education strategies during a tabletop exercise may be translatable to other emergency preparedness needs.

LinskensEJ, NeuAE, WalzEJ, St. CharlesKM, CulhaneMR, SsematimbaA, GoldsmithTJ, HalvorsonDA, CardonaCJ. Preparing for a Foreign Animal Disease Outbreak Using a Novel Tabletop Exercise. Prehosp Disaster Med. 2018;33(6):640–646.

Previous studies have illustrated pediatric knowledge deficits among Emergency Medical Services (EMS) providers. The purpose of this study was to identify perspectives of a diverse group of EMS providers regarding pediatric prehospital care educational deficits and proposed methods of training improvements.

Purposive sampling was used to recruit EMS providers in diverse settings for study participation. Two separate focus groups of EMS providers (administrative and non-administrative personnel) were held in three locations (urban, suburban, and rural). A professional moderator facilitated focus group discussion using a guide developed by the study team. A grounded theory approach was used to analyze data.

Forty-two participants provided data. Four major themes were identified: (1) suboptimal previous pediatric training and training gaps in continuing pediatric education; (2) opportunities for improved interactions with emergency department (ED) staff, including case-based feedback on patient care; (3) barriers to optimal pediatric prehospital care; and (4) proposed pediatric training improvements.

Focus groups identified four themes surrounding preparation of EMS personnel for providing care to pediatric patients. These themes can guide future educational interventions for EMS to improve pediatric prehospital care.

BrownSA , HaydenTC , RandellKA , RappaportL , StevensonMD , KimIK . Improving Pediatric Education for Emergency Medical Services Providers: A Qualitative Study. Prehosp Disaster Med. 2017;32(1):20–26.

Prehospital and community hospital healthcare providers in the United States must be prepared to respond to burn disasters. Continuing education is the most frequently utilized method of updating knowledge, skills, and competence among healthcare professionals. Since preparedness training must meet multiple educational demands, it is vital to understand how participants'work and educational experience and the program's content and delivery methods impact knowledge acquisition, and how learning influences confidence and competence to perform new skills.

The purpose of this exploratory, convenience sample study was to identify healthcare provider characteristics and continuing education training content areas that were predictive of self-reported improvement in competence after attending a mass-casualty burn disaster continuing education program.

Logistic regression analysis of data from a post-training evaluation from nine, one-day continuing education conferences on mass burn care was used to identify factors associated with improved self-reported competency to respond to mass burn casualties.

The following factors were associated most closely with increased self-reported competency: (1) prehospital work setting (odds ratio (OR) = 3.06, confidence interval (CI) = 0.83–11.30, p = 0.09); (2) 11 or more years of practice (OR = 0.31, CI = 0.09–1.08, p = 0.07); and (3) practice in an urban setting (OR = 0.01, CI = 0.18–0.82, p >0.01). Confidence items included: (1) ability to implement appropriate airway management modalities (OR = 2.31, CI = 1.03–5.17, p >0.04); (2) manage patients with electrical injuries (OR = 4.86, CI = 1.84–12.85, p >0.001); (3) identify non-survivable injuries (OR = 2.24, CI = 0.93–5.43, p = 0.07); and (4) recognize special problems associated with burns in young children or older adults (OR = 2.14, CI = 0.87–5.23, p = 0.10). The final model explained 89.9% of the variability in self-reported competence.

Interventions used to train healthcare providers for burn disasters must cover a broad range of topics. However, learning needs may vary by practice setting, work experience, and previous exposure to disaster events. This evaluation research provides three-fold information for continuing education research: (1) to identify content areas that should be emphasized in future burn care training; (2) to be used as a model for CE evaluation in other domains; and (3) to provide support that many factors must be considered when designing a CE program. Results may be useful to others who are planning CE training programs.

Procedural sedation guidelines were established for a tertiary care pediatric emergency department (ED). We developed a pediatric procedural sedation course to disseminate these guidelines.

Our objective was to evaluate the effectiveness of a sedation course in improving physicians' knowledge of pediatric procedural sedation practices and guidelines, relative to individual self-directed learning.

We recruited emergency staff physicians and fellows as well as fourth-year pediatric residents in a tertiary care pediatric ED to participate in a randomized, controlled, educational intervention. All consenting physicians received pediatric sedation educational material for individual study 2 weeks before a learning assessment. Participants were randomly assigned to one of 2 groups. The self-directed learning group (n = 24) completed a multiple-choice examination without receiving any formal teaching. The study group (n = 24) participated in a 4-hour formal multi-faceted sedation course before writing the multiple-choice examination.

The groups did not differ significantly in demographic characteristics or self-perceived knowledge of pediatric sedation. The formal teaching group's median examination score (83.3%; range 75.8%–96.5%) was significantly higher (p < 0.0001) than the median examination score of participants in the self-directed study group (73.3%, range 43.5%–86.6%).

The multifaceted sedation course was more effective in improving physician knowledge and understanding of sedation guidelines and practices than unstructured, self-directed learning.

Physicians and nurses are integral components of the public health bioterrorism surveillance system. However, most published bioterrorism preparedness surveys focus on gathering information related to selfassessed knowledge or perceived needs and abilities.

A survey of physicians and nurses in Hawaii was conducted to assess objective knowledge regarding bioterrorism agents and diseases and perceived response readiness for a bioterrorism event.

During June and July 2004, an anonymous survey was mailed up to three times to a random sample of all licensed physicians and nurses residing in Hawaii.

The response rate was 45% (115 of 255) for physicians and 53% (146 of 278) for nurses. Previous bioterrorism preparedness training associated significantly with knowledge-based test performance in both groups. Only 20% of physicians or nurses had had previous training in bioterrorism preparedness, and <15% felt able to respond effectively to a bioterrorism event. But, >70% expressed willingness to assist the state in the event of a bioterrorist attack.

Additional bioterrorism preparedness training should be made available through continuing education and also should become a component of both medical and nursing school curricula. It is important to provide the knowledge necessary for physicians and nurses to improve their ability to perform in the event of a bioterrorist attack.

In Ontario, Canada, Emergency Medical Care Assistants (EMCAs) have many opportunities for continuing education. However, little is known about how EMCAs learn.

The intent of this study was to explore the distribution of learning styles, preferences for major learning environment characteristics, and the associations between these two factors among the EMCA population in Ontario, Canada.

Following review of the literature, a 32-item survey of learning environment characteristics was constructed to measure the respondents' preferences. Using a random number generator, 386 EMCAs were selected for participation. Each received: a) an explanatory cover letter; b) a copy of the Kolb Learning Style Inventory (LSI) questionnaire; c) a second questionnaire consisting of learning environment characteristics; and d) a stamped, return addressed envelope. Completed surveys were scored to determine the respondent's Learning Style. The LSI and Learning Environment survey results were entered into a data base and subjected to Dual Scaling analysis in order to 1) Identify the distribution of learning styles; and 2) Explore associations between styles and environmental characteristics.

A total of 75 completed surveys were returned, each of the four styles of learning (Converger; Diverger; Assimilator; and Accommodator) were identified in the sample. Dual Scaling analysis indicated a noteworthy association (R(jt) correlation >0.300) between learning style and 10 of the 32 environmental characteristics. The data describe the usefulness of each of the learning styles.

Accommodators believed courses with a strong emphasis on practical applications and working in groups to be very useful, but were less interested in courses with a strong emphasis on theory. Assimilators felt lectures and courses with a strong emphasis on theory very useful, but were less interested in providing input into course objectives. Divergers found that a lot of verbal explanation is useful, but were less interested in working with teachers who act as coaches. Convergers believed that working with teachers who act as coaches is useful. They also preferred courses with a strong emphasis on practical applications, but were less interested in courses with a strong emphasis on theory.

The findings in this study, provide some additional insight into the connections between learning style and elements of the learning environment, and their application may contribute to operationalizing learning theory.