The effectiveness of disaster training for health care workers: a systematic review.
OBJECTIVE
Evidence-based medical literature is lacking about the best methods to train health care providers in disaster response. We systematically review the recent literature to report whether training interventions in disaster preparedness improve knowledge and skills in disaster response.


METHODS
We searched MEDLINE through PubMed, ISI Web of Science, BIOSIS, Cumulative Index to Nursing and Allied Health (CINAHL), the Cochrane Library, ClinicalTrials.gov, the Public Affairs Information Service, and Education Full Text. Selected journals, articles, and other comprehensive reports were also reviewed for relevant citations. Subjects of eligible articles were hospital-based and out-of-hospital health care providers. Articles meeting inclusion criteria were published in English between January 2000 and December 2005, described a training exercise undertaken to further knowledge or skills in disaster response, measured a quantitative and objective outcome, and used a control group. Included studies were independently reviewed by 2 researchers, and study quality was assessed with criteria adapted from the US Preventive Services Task Force and the Centre for Reviews and Dissemination.


RESULTS
We identified 258 studies. Nine studies are included in this review. Computer- and lecture-based training interventions may be effective in increasing disaster-related knowledge for out-of-hospital providers, though questions about study design and quality may cast doubt on the results. Evidence about effectiveness of training for inhospital providers is inconclusive. Comparison across studies is difficult because of diversity in study subjects, designs, and interventions. Results are likely biased by contamination from outside events.


CONCLUSIONS
The available evidence is insufficient to determine whether training interventions for health care providers are effective in improving knowledge and skills in disaster response.
Williams
Jefferson
J
Beth Israel Deaconess Medical Center, Harvard Affiliated Emergency Medicine Residency, Department of Emergency Medicine, Boston, MA 02215, USA. jgwillia@bidmc.harvard.edu
Nocera
Maryalice
M
Casteel
Carri
C
D000488:Allied Health Personnel / Q000193:education*; D003194:Computer-Assisted Instruction / Q000379:methods*; D004189:Disaster Planning / Q000379:methods*; D004636:Emergency Service, Hospital / Q000458:organization & administration*; D006801:Humans; D010564:Personnel, Hospital / Q000193:education*; D014741:Video Recording