title: Ebola Virus Disease Simulation Case Series: Patient With Ebola Virus Disease in the Prodromal Phase of Illness (Scenario 1), the "Wet" Gastrointestinal Phase of Illness (Scenario 2), and the Late, Critically Ill Phase of Disease (Scenario 3).
abstract: BACKGROUND
  As part of an international response to the Ebola virus disease (EVD) outbreak, the US Department of Defense has deployed thousands of personnel to help train and augment international health care workers. The transmission risk of this deadly virus to health care workers has been extreme, demonstrating the importance of safe practices while caring for these patients. Medical simulation training is well recognized as an integral component for disease outbreak preparedness. Therefore, the US Government created a program of instruction that outlines a formalized EVD training program, using high-fidelity simulation, which projects both an understanding of the disease and its transmission risks.
  
  
  METHODS
  Two 5-day training courses were established to provide training to the 65-member Department of Defense Ebola Response Team, which would be activated during a stateside Ebola outbreak. This training consisted of Ebola-specific protocols, personal protective equipment familiarization, and scenario-based certification for physicians, nurses, and public health trainers. Simulation was used to replicate the work environment inside an Ebola treatment unit.
  
  
  RESULTS
  Three comprehensive clinical scenarios covering a wide spectrum of EVD presentations were designed around details of published cases to provide the most realistic and relevant EVD training available. The authors conducted 10 iterations of the 3 EVD clinical scenarios totaling more than 1100 hours of simulation training.
  
  
  CONCLUSIONS
  Quality practical exercises to include specialized task performance and collective teamwork training relied heavily on dedicated facilities and realistic medical simulation resulting in valuable lessons learned. In future iterations, these characteristics would be imperative to a successful training course.
authors.affiliation: From the Uniformed Services University of the Health Sciences, Bethesda, MD (H.M.D., P.F.L., R.C.M., J.V.L.); Brooke Army Medical Center, San Antonio, TX (H.M.D., P.F.L., J.K.M., K.A.B., S.G.W., R.V.C., C.K.M.); Naval Medical Center San Diego, San Diego, CA (R.C.M.); and Clinical Research Department (J.V.L.), Naval Medical Research Center, Frederick, MD.
authors.forename: Heather M
authors.initials: HM
authors.lastname: Delaney
authors.forename: Pedro F
authors.initials: PF
authors.lastname: Lucero
authors.forename: Ryan C
authors.initials: RC
authors.lastname: Maves
authors.forename: James V
authors.initials: JV
authors.lastname: Lawler
authors.forename: Joseph K
authors.initials: JK
authors.lastname: Maddry
authors.forename: Kimberlie A
authors.initials: KA
authors.lastname: Biever
authors.forename: Shannon G
authors.initials: SG
authors.lastname: Womble
authors.forename: Robert V
authors.initials: RV
authors.lastname: Coffman
authors.forename: Clinton K
authors.initials: CK
authors.lastname: Murray
mesh_terms: D002985:Clinical Protocols; D003140:Communicable Disease Control / Q000458:organization & administration*; D016638:Critical Illness / Q000628:therapy*; D004196:Disease Outbreaks; D006282:Health Personnel / Q000193:education*; D019142:Hemorrhagic Fever, Ebola / Q000453:epidemiology / Q000628:therapy* / Q000635:transmission; D006801:Humans; D017053:Infection Control / Q000458:organization & administration; D000067393:Personal Protective Equipment / Q000706:statistics & numerical data*; D000066908:Simulation Training / Q000458:organization & administration*; D014481:United States