Development And Evaluation Of Training Program For Infectious Disease Emergencies Response Competence Of Healthcare Workers

AimsIn recent years,there have been frequent infectious disease emergencies that threaten human health and have caused serious damage in China and in the world.Healthcare workers need to have certain competence to successfully respond to infectious disease emergencies.However,healthcare workers in our country lack corresponding competence and targeted training.In order to address this issue,this study aims to construct a core emergency response competence system for healthcare workers to respond to infectious disease emergencies;to transform the system to be a questionnaire;then to develop a core emergency response capacity training program for infectious disease emergencies for healthcare workers;to conduct an experimental study to test the effectiveness of training and improve the training program to provide resources for training emergency personnel.Methods1.Construct the content framework of the training programA preliminary formulation of a three-level structure of the Competence system for infectious diseases emergencies for healthcare workers was conducted,basing on the "emergency life cycle" theory and the "action framework" proposed by the WHO in responding to infectious disease emergencies,combining with the results of literature analysis.The final draft of the competence system was revised through the Delphi expert consultation method.The analytic hierarchy process and the average distribution method were adopted to calculate the weight and combination weight of each competence index.2.Transform to form the assessment tool of the training programReferring to the Emergency Preparedness Information Questionnaire,the emergency competence system was transformed into a 5-point Likert questionnaire that was rated by self-evaluating familiarity.The convenience sampling method was used to select 336 healthcare workers from 5 tertiary hospitals and 2 secondary hospitals in Shanghai to conduct pre-surveys.The reliability and validity of the questionnaire were evaluated by item analysis,content validity,internal consistency reliability,and test-retest reliability.3.Develop Infectious disease emergencies training program for healthcare workersThe Infectious disease emergencies training program for healthcare workers was developed by taking the emergency competence system as the content framework,Curriculum Development for Medical Education – A Six-Step Approach as the guide,and integrating the concept of Adult Education concept.The draft of the program includes training booklets,division of training modules,training purposes of each module,training methods,training time,standard of trainers,training facilities,and training materials.Then the expert group meeting was conducted to revise the program.4.Conduct experimental study to verify the contents and the effectiveness of the training programThe implementation plan for the experimental study was developed according to the implementation requirements of the training program.Self-comparative study design was adopted,and the convenience sampling method was used to select 51 healthcare workers who come to participate in the continuing training.Six were excluded due to lack of data or absence from some training modules,and 45 were finally included.The measurement tools include theoretical examination papers,skill assessment sheets,the emergency response competence questionnaire,and satisfaction questionnaire.Results1.Result of the content frameworkThrough two rounds of expert consultations,the final draft of the emergency competence system included 3 first-level indexes,such as the “emergency prevention competence”,“emergency preparedness competence”,and “emergency response competence” of infectious disease emergencies;11 second-level indexes;and 38 third-level indexes.The weight calculation results showed that the first-level index of the highest weight was “emergency rescue competence”,the second-level index of the highest weight was “public health response”,and the third-level indexes of the highest weight were “put on and take off of personal protective equipment correctly”."Memorize the isolation requirements for all types of transmission" and "implement hand hygiene correctly."2.Assessment tool of the training program and its reliability and validityThe questionnaire consisted of 51 items and 3 parts,such as response competence for infectious disease emergencies,rescue experience and training needs for emergencies,and demographic information.The effective response rate of the pre-survey was 93.2%,and finally 312 healthcare workers were included in the data analysis.Critical Ratios of each item were higher than 3.00,and all the p values were less than 0.001;the scale content validity of the questionnaire was 0.87,the content validity of four items was lower than 0.78,and the others were 0.79~1.00;the internal consistency reliability coefficients of each sub-questionnaire and each dimension were 0.757~0.957;and the test-retest reliability coefficients were 0.448~0.772,and all were statistically significant.3.Result of the training programThe final training program adopted group training format and modular design.It consisted of Test and 8 training modules,such as the Overview of emergency response of infectious disease emergencies,Theoretical knowledge related to infectious disease emergencies,Information acquisition of emerging infections diseases,Skills related to infectious disease emergencies,Situational case analysis,Situational case deduction,Design of health education plans,and Experience sharing lecture.The training program database included training knowledge booklet,skills booklet,skills demonstration videos,lecture slides,scenario scripts and discussion questions,health education plan design guide and assessment sheet,and theoretical test papers,skills assessment sheets,training program satisfaction questionnaire.These materials were uploaded and shared using network disk.4.Results of the quasi-experiment studyAfter the training,the scores of the trainees' theoretical test increased by 44.2±17.77 points(p < 0.001),and the accuracy rates of all parts of the knowledge test were increased by more than 30%.The skills assessment scores were all qualified.All of the self-evaluation familiarity scores of the emergency response capabilities after training were higher than 3 points,and were higher than the scores before training with statistical significance.All trainees were generally satisfied or very satisfied with the training;73.3%(n=33)thought that the training contents were easy or very easy to grasp;97.8%(n= 44)thought the focus of the training was clear or very clear;64.4%(n=29)believed that the timelines of the training modules were appropriate;97.8%(n=44)believed that the training atmosphere was active or very active;84.1%(n=37)often or consistently used the knowledge booklet throughout the training;95.5%(n=42)considered the knowledge booklet was user-friendly;84.4%(n=38)often or consistently used the skills booklet throughout the training;93.3%(n=42)believed that the skills booklet was user-friendly.ConclusionsThe Infectious disease emergencies training program for healthcare workers can effectively improve the theoretical knowledge regarding emergency response of infectious disease emergencies among trainees,enable them to grasp relevant skills for emergency response of infectious disease emergencies,and enhance their self-evaluation familiarity of core emergency response competence.The training contents were targeted,training booklets were logical,the training modules were theme-clear,step-by-step,and set up reasonably;the training methods were various,vivid,and in line with the needs of healthcare workers.The program provides new training resources to train emergency personnel and contribute to expand emergency response teams.Besides,the Core emergency response competence system for infectious disease emergencies for healthcare workers constructed in this study has broken through the existing boundaries of the field of emergency capacity research.The questionnaire formed by transformation has high reliability,validity and operability,which worth wide application.