Integrated decision-making in response to weapons of mass destruction incidents: Development and initial evaluation of a course for healthcare professionals

Introduction: Standardized, validated training programs for teaching administrative decision-making to healthcare professionals responding to weapons of mass destruction (weapons of mass destruction) 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 weapons of mass destruction 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 weapons of mass destruction 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 postcourse 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 postcourse total scale scores indicated a significant increase in mean ratings for each course (all p <0.001). Conclusion: The tabletop/real-time-exercise format was effective in increasing healthcare administrators' self-rated capabilities related to weapons of mass destruction 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.