Organizing a CME and Workshop on Disaster Management: A Process Documentation

Introduction

Natural and man-made disasters have been increasing in frequency and severity, affecting millions of people worldwide.¹ Disasters can be broadly classified as natural or man-made, including earthquakes, landslides, floods, wildfires, tsunamis, pandemics, terrorism, wars, and industrial accidents. These events demand well-coordinated emergency responses to minimize casualties and infrastructure damage. Healthcare professionals are key stakeholders in disaster response, and their prompt, informed actions can significantly reduce morbidity and mortality. Disaster medicine is a broad and dynamic field; hence, Continuing Medical Education (CME) with hands-on workshops on disaster management is crucial to ensuring that healthcare professionals remain updated on planning, preparedness, and best practices in disaster response.² The importance of disaster management education for healthcare professionals cannot be overstated. Disasters disrupt health systems, leading to a spike in casualties, overwhelming the public health systems, and create resource constraints, particularly in low- and middle-income countries. Such circumstances call for trained medical personnel to make rapid decisions, allocate limited resources effectively, and work collaboratively across disciplines.³

A Continuing Medical Education (CME) program on disaster management ensures that healthcare providers are equipped with the knowledge and skills to manage mass casualties, triage patients efficiently, prevent disease outbreaks, and contribute effectively to affected populations. Globally, efforts are underway to incorporate disaster medicine into healthcare curricula and training programs.^4-7 In addition to theoretical knowledge, there is a need for hands-on training in first aid techniques, which constitutes an integral component of disaster management education. The practical application of these skills prepares healthcare professionals for the unpredictable, high-pressure environments typical of disaster scenarios. Engaging participants in real-life drills, simulation exercises, and scenario-based training allows responders to practice critical first-aid procedures in controlled yet realistic settings. This experiential learning builds confidence, enhances reaction times, and bridges the gap between theory and practice, ensuring that participants are not only knowledgeable but also capable of executing life-saving interventions under stressful conditions.^8-11 Although several educational frameworks such as Advanced Disaster Life Support (ADLS) and the Hospital Emergency Incident Command System (HEICS) offer valuable instruction, they are not universally accessible or consistently integrated into the broader healthcare education system. As a result, varying levels of preparedness are observed among healthcare professionals across institutions.¹²

CME programs on disaster management need to be tailored to align with the region’s specific risk epidemiology, and using a time-tested framework for planning and execution plays a crucial role in the success of a program. Moore’s framework is a well-recognized, structured, step-by-step approach for planning and evaluating CME activities.¹³ It utilizes the adult learning principles, centered around real-world impact, and encourages continuous improvement.¹⁴ Therefore, a one-day CME with hands-on first-aid training was organized for interested healthcare professionals in our region using Moore’s framework.

Objectives

To document the planning and implementation of the CME on disaster management and to assess participant satisfaction with the event.

Materials and Methods

The study was conducted with institutional ethics committee approval. All participants and resource faculty provided written informed consent for publication and sharing of photography. Data confidentiality was maintained throughout the study. Participation was entirely voluntary, and participants were assured that their performance would be used solely for educational assessment and program improvement purposes.

The theoretical framework applied was Moore’s instructional design approach, comprising participation, satisfaction, knowledge, competence, performance, patient health, and community health. This model offers a series of iterative steps to create effective educational and training programs. Moore’s Needs Assessment within the outcomes framework was employed to evaluate the training requirements.¹⁵

The first responders during hospital-based disasters are healthcare teams that typically include emergency medicine consultants, residents, emergency technicians, and nurses. These teams handle a variety of emergencies that present unique challenges not fully addressed by traditional training methods. Additionally, mock disaster drills revealed shortcomings in triage, rapid assessment, and treatment protocols. Given these observations, a targeted educational intervention was necessary to engage all members of the healthcare team in disaster scenarios, ensuring broad participation and capacity-building. By incorporating scenario-based training and hands-on exercises, the intervention aimed to bridge the gap between theoretical knowledge and practical application, empowering participants to perform critical tasks with confidence during a disaster.

Consequently, emergency medicine consultants, in collaboration with simulation instructors, decided to organize a one-day CME session focused on hands-on training in the fundamentals of disaster management. Enhancing healthcare professionals’ skills in this area is expected to contribute to a more resilient healthcare system, capable of effectively managing disaster scenarios and ultimately benefiting the broader community.

For the Design

Brainstorming for CME content was conducted by the emergency medicine faculty and simulation instructors. A consensus was reached that the morning session would include five interactive lectures, as shown in Table 1, followed by a mock field disaster drill. After lunch, seven hands-on skills sessions were planned, as outlined in Table 2. Each interactive session was designed to incorporate specific learning objectives. A field mock drill simulating a multistoried building collapse involving ten victims was conducted. Participants were briefed on the START triage and filled out the START triage checklists for all victims. At the end of the mock drill, all participants participated in a debriefing session.

Development Phase of Preparation

The schedule was finalized, and in-house and regional experts were identified to deliver the interactive lectures in the forenoon sessions. For the mock drills, a group of student volunteers was assembled to perform the roles of victims. The entire mock drill was orchestrated by an emergency medicine physician with special training in disaster medicine. For the mock drill, the physician selected five physician volunteers and four junior residents to perform triage and assist with initial management, along with ten student volunteers who acted as victims. All participants involved in this drill followed a predefined script outlining the sequence of events. Moulage for simulated injuries was prepared by simulation instructors trained in moulage techniques. This entire team for mock drill comprised of 19 resource faculty.

For the afternoon hands-on skills stations, two in-house faculty experts were assigned to each station as facilitators. All stations were arranged and prepared the day before the event, and all facilitators conducted a dry run with their part-task trainers and related equipment. Preparation for the event began two months prior. Once the topic and resource faculty were finalized, regular zoom meetings were held to discuss concerns and review proceedings of the CME. The first flyer was released 45 days prior to the event; however, the initial response was very poor, with only four registrants. The brochure was subsequently circulated to all healthcare professional groups, after which 84 healthcare professionals registered for the CME.

Implementation Day

The CME commenced with participant registration and breakfast at the Decennial Hall at 8.15 am. The interactive sessions began punctually at 9 am, and most participants arrived on time. Session experts had submitted their presentations to the organizers the previous day, enabling smooth transitions between sessions. The first lecture introduced disasters and standard types, laying the foundation for understanding the broad concepts of disaster medicine. A session on the role of government agencies in disaster response followed. A brief inauguration ceremony was held at 10 am, during which the organizing chair welcomed the gathering and highlighted the need for such a CME. The institution’s Director delivered a message emphasizing the need for such training programs and reinforced institutional support for capacity-building events aimed at community strengthening. The organizing secretary then proposed the vote of thanks, acknowledging the hard work and meticulous planning by the resource faculty, and expressing appreciation to the participants for their engagement.

Following a short tea break, the interactive sessions resumed, covering topics such as field and hospital disaster responses and medico-legal issues during disaster. All participants then assembled on the ground floor to witness the disaster drill. They were required to complete a checklist while witnessing the mock drill. The drill was conducted in slow motion, with each victim assessed, triaged, and treated sequentially. The treating teams remained frozen until their turn. This enabled participants to complete the checklist aligned with the START triage format and to appreciate the sequence of disaster management. A debriefing followed, during which participants posed questions that the mock-drill team effectively addressed.

After a short lunch break, participants proceeded to the skills and simulation center for the afternoon hands-on sessions. Seven rooms were designated for skills training, with a larger room allotted for the triage and decontamination session. Participants were divided into teams of twelve and rotated through the stations every 20 minutes. Student volunteers assisted with timekeeping and provided a warning signal to the facilitator five minutes before the end of session. Each station had two facilitators who alternated roles to avoid fatigue. At 4.30 pm, all participants completed a general feedback form and received their certificates of participation.

Following Moore’s Evaluation Framework for CME, participant engagement and satisfaction with the course were documented. As this was a sensitization program on disaster management, assessments of knowledge, competence, performance, patient health, or community health were not included. However, all participants received feedback on their performance during the skills stations. A survey questionnaire regarding basic demographics and satisfaction scores was collected at the end of the program.

Results

All data are presented in frequency tables. A total of 84 participants were included in the study. Demographic details are summarized in Table 3, and satisfaction scores are summarized in Table 4.

Discussion

All healthcare professionals must continuously update their knowledge and skills through continuing medical education programs to provide best care for their patients. CMEs should focus on reflective practice, providing opportunities for hands-on training, and address issues related to patient safety and public health needs.¹⁶ Accordingly, a CME was planned for all healthcare professionals who are directly or indirectly involved in disaster management.

Moore and colleagues proposed an educational framework specifically for CME that aims to create effective learning aligned with public health needs. In our research, we applied Moore’s framework to identify the CME needs, and to guide the planning and execution of the program, including assessment of participant engagement and satisfaction. Harris and Lucero also employed Moore’s framework in their research and found it effective in changing the participant behavior in ways that positively impact patient outcomes.^14,17

We observed that more females than males were enrolled in the program, which contrasts with the findings of Wiotowitch NC.¹⁸ The higher proportion of female participants may be attributed to their greater emphasis on skill enhancement, professional networking, and maintaining competitiveness in their profession. Most participants were from medical backgrounds, although we had a smaller number from nursing, homeopathy (complementary medicine), and quality management. Considering the multidisciplinary management required during disasters, it is ideal for healthcare professionals from diverse fields to learn and collaborate. Prihaltiningsih T and Eisenmann D, in their research on interprofessional training in disaster and emergency medicine, reported that structured training enhances communication, collaboration, and disaster management skills among healthcare students, thereby improving preparedness and teamwork in disaster situations.^19,20

Most participants agreed that the overall conduct of the CME was good. They expressed satisfaction with the experts’ interactive discussions in the morning and the mock drill. The session topics and the mock drill were meticulously planned based on a comprehensive needs assessment. Selecting appropriate experts helps share unique information, supports deliberations, and enhances the quality and depth of discussions.^21,22 Mock disaster drills using simulation exercises play a crucial role in sensitizing and preparing healthcare professionals to deal with real-world situations. Similar exercises have been shown to be effective by Bhattacharya S and Kimura R.^23,24 The effectiveness of such drills depends on several factors, such as organization, clearly defined roles, frequent practice, effective communication, teamwork, leadership, and overall training quality.^25,26 Our observations showed mixed responses from participants regarding their confidence in performing first-aid skills after the afternoon skills stations. This may be attributed to the limited time allotted, as each station was assigned only twenty minutes, with twelve participants practicing in each round. Some participants reported that they were unable to perform the skills due to the time constraints. The main reasons for participant dissatisfaction during skills training include inadequate feedback, unmet expectations, inequitable access to training resources, and reduced participant engagement.^27,28 Venue and refreshments during training programs also significantly influence participant engagement and overall satisfaction with CME activities.²⁹

Limitations

A major limitation of this study was the absence of pre-course evaluation of participants’ baseline knowledge and skills. Such assessment would have helped us quantify the gain in knowledge and skills. Additionally, the responses were collected from participants who willingly registered for the CME, indicating a highly motivated group. This may have contributed to higher satisfaction scores.

Conclusion

A one-day CME on disaster management comprising expert interactive sessions, followed by a disaster mock drill, and hands-on training in basic first-aid methods designed for healthcare professionals was appreciated by all participants. They expressed high levels of satisfaction with conduct of the program.

Conflict of Interest

Nil