Abstract：
BACKGROUND: Disaster medicine is a component of the German medical education since 2003. Nevertheless, studies have shown some inconsistencies within the implementation of the national curriculum, and limits in the number of students trained over the years. Recently, the SARS-CoV-2 pandemic and other disasters have called attention to the importance of training medical students in disaster medicine on a coordinated basis. The aim of this study is to present and evaluate the disaster medicine and humanitarian assistance course, which was developed in the University of Tübingen, Germany.
METHODS: The University Clinic for Anesthesiology and Intensive Care Medicine in Tübingen expanded the existing curriculum of undergraduate disaster medicine training with fundamentals of humanitarian medicine, integrating distance learning, interactive teaching and simulation sessions in a 40 h course for third-, fourth- and fifth- year medical students. This prospective and cross-sectional study evaluates the Disaster Medicine and Humanitarian Assistance course carried out over five semesters during the period between 2018 and 2020. Three survey tools were used to assess participants\' previous experiences and interest in the field of disaster medicine, to compare the subjective and objective level of knowledge before and after training, and to evaluate the course quality.
RESULTS: The total number of medical students attending the five courses was n = 102 of which n = 60 females (59%) and n = 42 males (41%). One hundred two students entered the mandatory knowledge assessment, with the rate of correct answers passing from 73.27% in the pre-test to 95.23% in the post-test (t [101] = 18.939, p < .001, d = 1.88). To determine the subjective perception of knowledge data were collected from 107 observations. Twenty-five did not complete the both questionnaires. Out of a remaining sample of 82 observations, the subjective perception of knowledge increased after the course (t [81] = 24.426, p < .001, d = 2.69), alongside with the interest in engaging in the field of disaster medicine (t [81] = 7.031, p < .001, d = .78). The 93.46% of the medical students (n = 100) graded the training received with an excellent overall score (1.01 out of 6).
CONCLUSIONS: The study indicates a significant increase in students\' understanding of disaster medicine using both subjective and objective measurements, as well as an increase interest in the field of disaster medicine and humanitarian assistance. Whereas former studies showed insufficient objective knowledge regarding disaster medical practices as well as subjective insecurities about their skills and knowledge to deal with disaster scenarios, the presented course seems to overcome these deficiencies preparing future physicians with the fundamentals of analysis and response to disasters. The development and successful implementation of this course is a first step towards fulfilling disaster medicine education requirements, appearing to address the deficiencies documented in previous studies. A possible adaptation with virtual reality approaches could expand access to a larger audience. Further effort must be made to develop also international training programs, which should be a mandatory component of medical schools\' curricula.
METHODS: The University Clinic for Anesthesiology and Intensive Care Medicine in Tübingen expanded the existing curriculum of undergraduate disaster medicine training with fundamentals of humanitarian medicine, integrating distance learning, interactive teaching and simulation sessions in a 40 h course for third-, fourth- and fifth- year medical students. This prospective and cross-sectional study evaluates the Disaster Medicine and Humanitarian Assistance course carried out over five semesters during the period between 2018 and 2020. Three survey tools were used to assess participants\' previous experiences and interest in the field of disaster medicine, to compare the subjective and objective level of knowledge before and after training, and to evaluate the course quality.
RESULTS: The total number of medical students attending the five courses was n = 102 of which n = 60 females (59%) and n = 42 males (41%). One hundred two students entered the mandatory knowledge assessment, with the rate of correct answers passing from 73.27% in the pre-test to 95.23% in the post-test (t [101] = 18.939, p < .001, d = 1.88). To determine the subjective perception of knowledge data were collected from 107 observations. Twenty-five did not complete the both questionnaires. Out of a remaining sample of 82 observations, the subjective perception of knowledge increased after the course (t [81] = 24.426, p < .001, d = 2.69), alongside with the interest in engaging in the field of disaster medicine (t [81] = 7.031, p < .001, d = .78). The 93.46% of the medical students (n = 100) graded the training received with an excellent overall score (1.01 out of 6).
CONCLUSIONS: The study indicates a significant increase in students\' understanding of disaster medicine using both subjective and objective measurements, as well as an increase interest in the field of disaster medicine and humanitarian assistance. Whereas former studies showed insufficient objective knowledge regarding disaster medical practices as well as subjective insecurities about their skills and knowledge to deal with disaster scenarios, the presented course seems to overcome these deficiencies preparing future physicians with the fundamentals of analysis and response to disasters. The development and successful implementation of this course is a first step towards fulfilling disaster medicine education requirements, appearing to address the deficiencies documented in previous studies. A possible adaptation with virtual reality approaches could expand access to a larger audience. Further effort must be made to develop also international training programs, which should be a mandatory component of medical schools\' curricula.
摘要：
背景：灾难医学自2003年以来一直是德国医学教育的组成部分。然而，研究表明，国家课程的实施存在一些不一致之处，以及多年来培训的学生数量的限制。最近,SARS-CoV-2大流行和其他灾难引起了人们对协调培训医学生灾难医学的重要性的关注。这项研究的目的是介绍和评估灾难医学和人道主义援助课程，它是在蒂宾根大学开发的，德国。
方法：蒂宾根大学麻醉学和重症监护医学诊所扩大了现有的本科灾难医学培训课程，包括人道主义医学基础课程，整合远程学习，在第三个40小时课程中的交互式教学和模拟课程，四年级和五年级的医学生。这项前瞻性和横断面研究评估了2018年至2020年期间五个学期进行的灾难医学和人道主义援助课程。三个调查工具被用来评估参与者以前在灾难医学领域的经验和兴趣。比较培训前后的主观和客观知识水平，并对课程质量进行评价。
结果：参加五门课程的医学生总数为n=102，其中n=60女性（59％），n=42男性（41％）。一百零二名学生进入强制性知识评估，正确答案率从前测的73.27％提高到后测的95.23％（t[101]=18.939，p<.001，d=1.88）。为了确定知识的主观感知，从107个观察中收集了数据。25人没有完成这两份问卷。在剩下的82个观测样本中，课程结束后，对知识的主观感知增加(t[81]=24.426，p<.001，d=2.69)，除了对从事灾难医学领域的兴趣（t[81]=7.031，p<.001，d=.78）。93.46％的医学生（n=100）对接受的培训进行了评分，并获得了优异的总分（6分中的1.01分）。
结论：该研究表明，使用主观和客观测量，学生对灾难医学的理解显着增加，以及对灾难医学和人道主义援助领域的兴趣增加。鉴于以前的研究表明，关于灾难医疗实践的客观知识不足，以及他们应对灾难情景的技能和知识的主观不安全感，所提出的课程似乎克服了这些缺陷，为未来的医生准备了分析和应对灾难的基础知识。本课程的开发和成功实施是实现灾难医学教育要求的第一步，似乎解决了以前研究中记录的缺陷。与虚拟现实方法的可能适应可以扩大对更多受众的访问。还必须进一步努力发展国际培训计划，这应该是医学院课程的强制性组成部分。
方法：蒂宾根大学麻醉学和重症监护医学诊所扩大了现有的本科灾难医学培训课程，包括人道主义医学基础课程，整合远程学习，在第三个40小时课程中的交互式教学和模拟课程，四年级和五年级的医学生。这项前瞻性和横断面研究评估了2018年至2020年期间五个学期进行的灾难医学和人道主义援助课程。三个调查工具被用来评估参与者以前在灾难医学领域的经验和兴趣。比较培训前后的主观和客观知识水平，并对课程质量进行评价。
结果：参加五门课程的医学生总数为n=102，其中n=60女性（59％），n=42男性（41％）。一百零二名学生进入强制性知识评估，正确答案率从前测的73.27％提高到后测的95.23％（t[101]=18.939，p<.001，d=1.88）。为了确定知识的主观感知，从107个观察中收集了数据。25人没有完成这两份问卷。在剩下的82个观测样本中，课程结束后，对知识的主观感知增加(t[81]=24.426，p<.001，d=2.69)，除了对从事灾难医学领域的兴趣（t[81]=7.031，p<.001，d=.78）。93.46％的医学生（n=100）对接受的培训进行了评分，并获得了优异的总分（6分中的1.01分）。
结论：该研究表明，使用主观和客观测量，学生对灾难医学的理解显着增加，以及对灾难医学和人道主义援助领域的兴趣增加。鉴于以前的研究表明，关于灾难医疗实践的客观知识不足，以及他们应对灾难情景的技能和知识的主观不安全感，所提出的课程似乎克服了这些缺陷，为未来的医生准备了分析和应对灾难的基础知识。本课程的开发和成功实施是实现灾难医学教育要求的第一步，似乎解决了以前研究中记录的缺陷。与虚拟现实方法的可能适应可以扩大对更多受众的访问。还必须进一步努力发展国际培训计划，这应该是医学院课程的强制性组成部分。
