Hostname: page-component-586b7cd67f-g8jcs Total loading time: 0 Render date: 2024-11-24T20:51:31.010Z Has data issue: false hasContentIssue false
  • English
  • Français

Attributes of Effective Disaster Responders: Focus Group Discussions With Key Emergency Response Leaders

Published online by Cambridge University Press:  08 April 2013

Richard V. King ,
Carol S. North ,
Gregory L. Larkin ,
Dana L. Downs ,
Kelly R. Klein ,
Raymond L. Fowler ,
Raymond E. Swienton  and
Paul E. Pepe
Get access Rights & Permissions [Opens in a new window]

Abstract

Methods: An effective disaster response requires competent responders and leaders. The purpose of this study was to ask experts to identify attributes that distinguish effective from ineffective responders and leaders in a disaster. In this qualitative study, focus groups were held with jurisdictional medical directors for the 9-1-1 emergency medical services systems of the majority of the nation's largest cities. These sessions were recorded with audio equipment and later transcribed.

Results: The researchers identified themes within the transcriptions, created categories, and coded passages into these categories. Overall interrater reliability was excellent (κ = .8). The focus group transcripts yielded 138 codable passages. Ten categories were developed from analysis of the content: Incident Command System/Disaster Training/Experience, General Training/Experience, Teamwork/Interpersonal, Communication, Cognition, Problem Solving/Decision Making, Adaptable/Flexible, Calm/Cool, Character, and Performs Role. The contents of these categories included knowledge, skills, attitudes, behaviors, and personal characteristics.

Conclusions: Experts in focus groups identified a variety of competencies for disaster responders and leaders. These competencies will require validation through further research that involves input from the disaster response community at large.

(Disaster Med Public Health Preparedness. 2010;4:332-338)

Keywords

competency-based educationdisaster medicinepublic health/emergency preparednesshealth personnel education/trainingconsensusdisaster responsecompetency-based educationemergencies
Type
Concepts in Disaster Medicine
Information
Disaster Medicine and Public Health Preparedness , Volume 4 , Issue 4 , December 2010 , pp. 332 - 338
Copyright
Copyright © Society for Disaster Medicine and Public Health, Inc. 2010

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Stopford, BM.The National Disaster Medical System—America's medical readiness force. Disaster Manag Response. 2005;3:53–56.CrossRefGoogle ScholarPubMed
2.Breaking down territorial boundaries: a call to all professions and disciplines. Disaster Med Public Health Preparedness. 2007;1:3–6.CrossRefGoogle Scholar
3.Rinnert, KJ, Wiggington, JG, Pepe, PE.Outdated concepts in management of disasters. China J Emerg Resuscitation Disaster Med. 2006;1:14–16.Google Scholar
4.Hodge, JG Jr, Pepe, RP, Henning, WH.Voluntarism in the wake of Hurricane Katrina: the uniform Emergency Volunteer Health Practitioners Act. Disaster Med Public Health Preparedness. 2007;1:44–50.CrossRefGoogle ScholarPubMed
5.Carpenter, D.When disaster strikes. Crises test leaders' nerve and range of skills. Hosp Health Netw. 2000;74:48–50, 52, 54.Google ScholarPubMed
6.North, CS, Tivis, L, McMillen, JC, et alCoping, functioning, and adjustment of rescue workers after the Oklahoma City bombing. J Trauma Stress. 2002;15:171–175.CrossRefGoogle ScholarPubMed
7.North, CS.Trauma anonymous. Fire Chief. 2002;June:50–52.Google Scholar
8.Curiel, TJ.Murder or mercy? Hurricane Katrina and the need for disaster training. N Engl J Med. 2006;355:2067–2069.CrossRefGoogle ScholarPubMed
9.Klein, KR, Nagel, NE.Mass medical evacuation: hurricane Katrina and nursing experiences at the New Orleans airport. Disaster Manag Response. 2007;5:56–61.CrossRefGoogle ScholarPubMed
10.Coyle, G, Sapnas, KG, Ward-Presson, K.Dealing with disaster. NursManag. 2007;38:24–30.Google Scholar
11.Advanced, Basic, and Core Disaster Life Support Courses. Chicago: American Medical Association.; 2003-2004.Google Scholar
12.Archer, F, Seynaeve, G.International guidelines and standards for education and training to reduce the consequences of events that may threaten the health status of a community. A report of an Open International WADEM Meeting, Brussels, Belgium, 29-31 October, 2004. Prehosp Disaster Med. 2007;22:120–130.CrossRefGoogle ScholarPubMed
13.Uddin, SG, Barnett, DJ, Parker, CL, Links, JM, Alexander, M.Emergency preparedness: addressing a residency training gap. Acad Med. 2008;83:298–304.CrossRefGoogle ScholarPubMed
14.Alexander, AJ, Bandiera, GW, Mazurik, L.A multiphase disaster training exercise for emergency medicine residents: opportunity knocks. Acad Emerg Med. 2005;12:404–409.CrossRefGoogle ScholarPubMed
15.Garfield, R, Al, WN.Where are we and where shall we go in nursing and emergencies? Prehosp Disaster Med. 2008;23:s9–s10.Google Scholar
16.Weiner, E, Irwin, M, Trangenstein, P, Gordon, J.Emergency preparedness curriculum in nursing schools in the United States. Nurs Educ Perspect. 2005;26:334–339.Google Scholar
17.Veenema, TG.Expanding educational opportunities in disaster response and emergency preparedness for nurses. Nurs Educ Perspect. 2006;27:93–99.Google Scholar
18.Silenas, R, Akins, R, Parrish, AR, Edwards, JC.Developing disaster preparedness competence: an experiential learning exercise for multiprofessional education. Teach Learn Med. 2008;20:62–68.Google Scholar
19.Swienton, RE.The National Disaster Life Support Foundation: local preparedness, global response. J Trauma. 2007;62(6 Suppl))S94–S95.Google Scholar
20.North, CS, Hong, BA, Pfefferbaum, B.P-FLASH: development of an empirically-based post-9/11 disaster mental health training program. Mo Med. 2008;105:62–66.Google ScholarPubMed
21.Cummings, GE, Della Corte, F, Cummings, GG.Disaster medicine education for physicians: a systematic review. Int J Disaster Med. 2006;4:125–136.CrossRefGoogle Scholar
22.Cherry, RA, Davis, T.The road to developing an advanced degree program in public health preparedness. Acad Med. 2007;82:773–780.Google Scholar
23.Macfarlane, C, Joffe, AL, Naidoo, S.Training of disaster managers at a master's degree level: from emergency care to managerial control. Emerg Med Australas. 2006;18:451–456.Google Scholar
24.Training Future Physicians About Weapons of Mass Destruction. Washington, DC: American Association of Medical Colleges.; 2003.Google Scholar
25.Debacker, M, Delooz, H, Corte, FD.The European master program in disaster medicine. Int J Disaster Med. 2003;1:35–41.CrossRefGoogle Scholar
26.Subbarao, I, Lyznicki, JM, Hsu, EB, et alA consensus-based educational framework and competency set for the discipline of disaster medicine and public health preparedness. Disaster Med Public Health Preparedness. 2008;2:57–68.CrossRefGoogle ScholarPubMed
27.Hsu, EB, Thomas, TL, Bass, EB, Whyne, D, Kelen, GD, Green, GB.Healthcare worker competencies for disaster training. BMC Med Educ. 2006;6:19.Google Scholar
28.Gebbie, K, Merrill, J.Public health worker competencies for emergency response. J Public Health Manag Pract. 2002;8:73–81.Google Scholar
29.Markenson, D, DiMaggio, C, Redlener, I.Preparing health professions students for terrorism, disaster, and public health emergencies: core competencies. Acad Med. 2005;80:517–526.Google Scholar
30.Parker, CL, Barnett, DJ, Fews, AL, Blodgett, D, Links, JM.The road map to preparedness: a competency-based approach to all-hazards emergency readiness training for the public health workforce. Public Health Rep. 2005;120:504–514.CrossRefGoogle ScholarPubMed
31.Hites, LS, Lafreniere, AV, Wingate, MS, et alExpanding the public health emergency preparedness competency set to meet specialized local and evolving national needs: a needs assessment and training approach. J Public Health Manag Pract. 2007;13:497–505.Google Scholar
32.Gebbie, KM, Qureshi, K.Emergency and disaster preparedness: core competencies for nurses. Am J Nurs. 2002;102:46–51.Google Scholar
33.Larkin, GL, Arnold, J.Ethical considerations in emergency planning, preparedness, and response to acts of terrorism. Prehosp Disaster Med. 2003;18:170–178.Google Scholar
34.Larkin, GL, Iserson, K, Kassutto, Z, et alVirtue in emergency medicine. Acad Emerg Med. 2009;16:51–55.CrossRefGoogle ScholarPubMed
35.AAMC. Medical school objectives project. American Association of Medical Colleges Web site. 2007. http://www.aamc.org/msop. Accessed March 13, 2007.Google Scholar
36.Common Program Requirements: General Competencies. Accreditation Council for Graduate Medical Education. February 13, 2007. http://www.acgme.org/outcome/comp/GeneralCompetenciesStandards21307.pdf. Accessed November 30, 2008.Google Scholar
37.ABMS Maintenance of Certification. American Board of Medical Specialties Web site. http://www.abms.org/Maintenance_of_Certification/ABMS_MOC.aspx. Accessed November 07, 2007.Google Scholar
38.Kitzinger, J.Qualitative research. Introducing focus groups. BMJ. 1995;311:299–302.Google Scholar
39.Basch, CE.Focus group interview: an underutilized research technique for improving theory and practice in health education. Health Educ Q. 1987;14:411–448.Google Scholar
40.North, CS, Pollio, DE, Pfefferbaum, B.Concerns of Capitol Hill staff workers after bioterrorism: focus group discussions of authorities' response. J Nerv Ment Dis. 2005;193:523–527.Google Scholar
41.Eisenman, DP, Glik, D, Maranon, R, Gonzales, L, Asch, S.Developing a disaster preparedness campaign targeting low-income Latino immigrants: focus group results for project PREP. J Health Care Poor Underserved. 2009;20:330–345.Google Scholar
42.Cone, KJ, Murray, R.Characteristics, insights, decision making, and preparation of ED triage nurses. J Emerg Nurs. 2002;28:401–406.Google Scholar
43.Boendermaker, PM, Schuling, J, Meyboom-deJong, B, Zwierstra, RP, Metz, JCM.What are the characteristics of the competent general practitioner trainer? Family Practice. 2000;17:547–553.Google Scholar
44.Rydon, SE.The attitudes, knowledge and skills needed in mental health nurses: the perspective of users of mental health services. Int J Ment Health Nurs. 2005;14:78–87.Google Scholar
45.Spencer, LM, Spencer, SMCompetence at Work: Models for Superior Performance.New York: John Wiley & Sons; 1993.Google Scholar
46. McClelland, DC.Identifying competencies with behavioral-event interviews. Psychol Sci. 1998;9:331–339.Google Scholar
47. McClelland, DC.Testing for competence rather than for “intelligence.” Am Psychol. 1973;28:1–14.Google Scholar
48.Barrick, MR, Mount, MK.The big five personality dimensions and job performance: a meta-analysis. Personnel Psychol. 1991;44:1–26.Google Scholar
49.Clayton, BL, Lypek, DJ, Connelly, LM.Faculty perceptions of characteristics needed for clinical success at military nurse anesthesia programs. AANA J. 2000;68:515–523.Google Scholar
50.Retzlaff, PD, Gibertini, M.Air Force pilot personality: hard data on the “right stuff.” Multivariate Behav Res. 1987;22:383–399.Google Scholar
51.Chidester, TR, Helmreich, RL, Gregorich, SE, Geis, CE.Pilot personality and crew coordination: implications for training and selection. Int J Aviation Psychol. 1991;1:25.Google Scholar
52.Rose, RM, Fogg, LF, Helmreich, RL, McFadden, TJ.Psychological predictors of astronaut effectiveness. Aviation Space Environ Med. 1994;65 (Sect 1):910–915.Google Scholar
53.Helmreich, RL, Foushee, H, Benson, R, Russini, W.Cockpit resource management: exploring the attitude-performance linkage. Aviation Space Environ Med. 1986;57 (Sect I):1198–1200.Google Scholar
54.Wolfe, TThe Right Stuff.New York: Farrar, Straus and Giroux; 1979.Google Scholar
55.The EMS State of the Sciences Conference: A Gathering of Eagles VIII. http://gatheringofeagles.us. Accessed November 15, 2008.Google Scholar
56.Fleiss, JStatistics for Rates of Proportions.2nd ed. New York: John Wiley & Sons; 1981.Google Scholar
57.Murden, R, Galloway, GM, Reid, JC, Colwill, JM.Academic and personal predictors of clinical success in medical school. J Med Educ. 1978;53:711–719.Google Scholar
58.Shen, H, Comrey, AL.Predicting medical students' academic performances by their cognitive abilities and personality characteristics. Acad Med. 1997;72:781–786.Google Scholar
59. McGaghie, WC.Perspectives on medical school admission. Acad Med. 1990;65:136–139.Google Scholar
60. McGaghie, WC.Qualitative variables in medical school admission. Acad Med. 1990;65:145–149.CrossRefGoogle ScholarPubMed
61.Peskun, C, Detsky, A, Shandling, M.Effectiveness of medical school admissions criteria in predicting residency ranking four years later. Med Educ. 2007;41:57–64.Google Scholar
62.Crosby, FE, Dunn, JD, Fallacaro, MD, Jozwiak-Shields, C, Maclsaac, AM.Preadmission characteristics of advanced practice nursing students. J Am Acad Nurse Pract. 2003;15:424–431.Google Scholar
63.Schneider-Kolsky, M, Wright, C, Baird, M.Evaluation of selection criteria for graduate students in radiation therapy. Med Teach. 2006;28:e214–e219.Google Scholar
64.Greganti, MA, McGaghie, WC, Finn, WF.Personal characteristics of house staff candidates: a quantitative analysis of relative weights. Ann Intern Med. 1982;97:108–111.Google Scholar
65.Feldman, E, Crook, J.Personal characteristics of health professionals: can they be changed by an educational program? J Allied Health. 1984;13:163–168.Google ScholarPubMed
66.Hannigan, TP.Traits, attitudes, and skills that are related to intercultural effectiveness and their implications for cross-cultural training: a review of the literature. Int J Intercultural Relat. 1990;14:89–111.Google Scholar
67.Helmreich, RL.Theory Underlying CRM Training: Psychological Issues in Flight Crew Performance and Crew Coordination. In Orlady HW, Foushee HC (eds.), Cockpit Resource Management Training: Proceedings of the NASA/MAC Workshop. NASA. Tech report No. CP 2455; pages 15-22. Moffett Field, California: NASA Ames Research Center.Google Scholar
68.Nullmeyer, RT, Spiker, VA.The Importance of Crew Resource Management Behaviors in Mission Performance: Implications for Training Evaluation. Military Psychology. 2003;15:77–96.Google Scholar
69.Borrelli, B, Lee, C, Novak, S.Is provider training effective? Changes in attitudes towards smoking cessation counseling and counseling behaviors of home health care nurses. Prev Med. 2008;46:358–363.Google Scholar