title: Integrated decision-making in response to weapons of mass destruction incidents: development and initial evaluation of a course for healthcare professionals.
abstract: BACKGROUND
  Standardized, validated training programs for teaching administrative decision-making to healthcare professionals responding to weapons of mass destruction (WMD) incidents have not been available. Therefore, a multidisciplinary team designed, developed, and offered a four-day, functional exercise, competency-based course at a national training center.
  
  
  OBJECTIVE
  This report provides a description of the development and initial evaluation of the course in changing participants' perceptions of their capabilities to respond to WMD events.
  
  
  METHODS
  Course participants were healthcare professionals, including physicians, nurses, emergency medical services administrators, hospital administrators, and public health officials. Each course included three modified tabletop and/or real-time functional exercises. A total of 441 participants attended one of the eight course offerings between March and August 2003. An intervention group only, pre-post design was used to evaluate change in perceived capabilities related to administrative decision-making for WMD incidents. Paired evaluation data were available on 339 participants (81.9%). Self-ratings for each of 21 capability statements were compared before and after the course. A 19-item total scale score for each participant was calculated from the pre-course and post-course evaluations. Paired t-tests on pre- and post-course total scores were conducted separately for each course.
  
  
  RESULTS
  There was consistent improvement in self-rated capabilities after course completion for all 21 capability statements. Paired t-tests of pre- and post-course total scale scores indicated a significant increase in mean ratings for each course (all p < 0.001).
  
  
  CONCLUSIONS
  The tabletop/real-time-exercise format was effective in increasing healthcare administrators' self-rated capabilities related to WMD disaster management and response. Integrating the competencies into training interventions designed for a specific target audience and deploying them into an interactive learning environment allowed the competency-based training objectives to be accomplished.
authors.affiliation: University of Alabama at Birmingham, School of Nursing Building, Room 235 1701 University Boulevard, Birmingham, AL 35294-1210, USA. erpphd@uab.edu
authors.forename: Erica
authors.initials: E
authors.lastname: Pryor
authors.forename: Emily
authors.initials: E
authors.lastname: Heck
authors.forename: Linda
authors.initials: L
authors.lastname: Norman
authors.forename: Betsy
authors.initials: B
authors.lastname: Weiner
authors.forename: Rick
authors.initials: R
authors.lastname: Mathews
authors.forename: James
authors.initials: J
authors.lastname: Black
authors.forename: Thomas
authors.initials: T
authors.lastname: Terndrup
mesh_terms: D023482:Bioterrorism; D003162:Competency-Based Education; D003657:Decision Making; D004189:Disaster Planning; D004493:Education / Q000458:organization & administration*; D004521:Educational Measurement; D006282:Health Personnel / Q000193:education*; D006801:Humans; D033183:Interdisciplinary Communication; D011361:Professional Competence; D015397:Program Evaluation / Q000379:methods*; D014481:United States