Hospitals continue to be the primary patient collection point for medical casualties in disasters, regardless of the event. The hospital closest to the event typically receives the majority of patients without consideration of the institution’s level of preparedness, trauma designation, or current bed availability. Therefore, Emergency Department personnel must be trained in the various nuances of disaster management (e.g., triage, incident command, decontamination, and agent monitoring) that may be required during the initial presentation of victims. Staff throughout the hospital need to understand their roles in an emergency, how they fit into their hospital’s incident command system, how they should protect themselves and their patients, and what response actions are expected of them. Finally, hospital leaders must be well versed in all phases of emergency management (mitigation, preparedness, response, and recovery) and be prepared to direct their staff accordingly.
Hospitals recognize the importance of emergency preparedness training, but tight budgets, multiple shifts, time constraints, lack of in-house expertise, and high turnover make it challenging to retain a well trained staff. Increasingly busy clinical, managerial, and support staff commonly lack the time and/or schedule flexibility to depend purely on traditional room training methods to become familiar with the broad scope of emergency-management duties and responsibilities. In addition, the nation’s current economic crisis and skyrocketing travel costs are forcing hospitals to explore the use of technology to accomplish required training.
With minimal technological investment, some eLearning offerings enable hospitals to provide critical training for employees across various disciplines and job categories, and in different locations. eLearning also can address information-retention issues. According to some research, nearly 70 percent of the information learned in a training course is forgotten by the time the student needs it.1 Theoretically, by making the training materials available anytime, anywhere, students can instantly refresh their knowledge. eLearning also allows learners to work at their own pace and to have greater control of their learning environment by being able to choose the style of learning that is most appealing to them.
eLearning is now a multi-billion dollar industry with projections of a 33 percent growth rate expected over the next several years.2 Because of the ever-growing popularity of both portable and hand-held devices, the opportunity to distribute learning materials to support initial training, refresher training, and just-in-time training will inevitably follow technology’s lead. Effectively training members of the nation’s emergency-response and healthcare communities is essential, and eLearning technology allows this information to be disseminated in a more consistent, more easily accessible, and more economical manner. To accomplish certain efficiencies, however, eLearning must be integrated with other learning (including instructor led training), knowledge transfer, and performance-improvement approaches.
While eLearning is becoming mainstream in many medical facilities, it has yet to be proven if it will actually improve a hospital’s state of emergency preparedness or depth of learning – i.e., the actual internal process by which the learner takes in information, applies experience, and translates it into knowledge or skills. Although it may be appropriate to use eLearning to replace basic didactic presentations, it remains unknown whether or not this technology can be effectively applied to tabletop exercises, leadership decision-making instruction, and/or skill-based training. In addition, it is important to keep in mind that not all eLearning is created equally. Current eLearning offerings for hospital emergency preparedness vary from PowerPoint® presentations (which require the learner to read segments of script embedded on each slide), to streaming videos, to commercially available programs that incorporate various learning modalities such as sound, visuals, video, and animation. The most effective means of providing training and the appropriate balance between traditional and eLearning approaches still needs to be determined. Formal guidance, standardization, or outcome metrics also must be determined to ensure that this approach reaps the benefits being sought.
Footnotes: 1Keller, D: Distance learning works when gas and airfares skyrocket. MLO Med Lab Obs, 2009 Mar 41 (3): 32-3, 37. PMID: 19374185 [PubMed - indexed for MEDLINE]
2Howell, SL, Williams, PB, Lindsay, NK: Thirty-two Trends Affecting Distance Education: An Informed Foundation for Strategic Planning. www.westga.edu/~distance/ojdla/fall63/howell63.html (accessed 12/9/2009)
Dr. Howard Levitin, president of DQE Inc., is both an Emergency Physician and Clinical Assistant Professor at the Indiana University School of Medicine. He has published and lectured widely in the areas of healthcare emergency preparedness.