高等医学院校医学生灾难医学教育课程的设计开发

The design and development of disaster medical education for medical students in curriculum Medical student disaster medicine education

为了提供结构化的灾难医学教育课程，本研究采用医学教育课程开发六步法作为组织流程，以灾难医学专家的专业知识、文献检索灾害医师培训计划、科学证据作为内容开发的基础。最终课程设计由14个模块组成，每个模块教学时间为2h。分别介绍灾难医学概念，包括灾难的响应、医疗救助、法律条款、指挥、协调、沟通和大规模灾难的管理；综述全球灾难援助的医院预案和经验；讨论灾难发生条件下挽救生命的急诊治疗与有限的个人治疗；介绍爆炸、战争、辐射，核事件、化学和生物事件尤其是传染病和恐怖袭击初始处理的特殊性：灾难疏散的演习，大规模灾难分诊分流与当地救灾机构合作的模拟；当地消防部门合作演练个人去污与净化；人体模型复苏练习，个人防护设备应用练习；职业道德、应激疾病、社会心理干预措施和质量改进的培训等。该课程设计提供了合理的时间框架、多学科、多实践的灾难医学教育模式，具有全面灵活的组织结构，可作为医学生灾难医学教育的基本模板。

We aim to develop and implement a disaster medicine curriculum for medical student education,so the six-step approach to curriculum development for medical education has been used as a formal process instrument. Recognized experts in disaster health caxe.have provided input using disaster- related physician training programs, scientific evidence if available, proposals for education by international disaster medicine organizations and their expertise as the basis for content development. The final course consists of 14 modules composed of 2-h units. The concepts of disaster medicine, including response, medical assistance, law, command, coordination, communication, and mass casualty management, are introduced. Hospital preparedness plans and experiences from worldwide disaster assistance are reviewed. Life- saving emergency and limited individual treatment under disaster conditions axe discussed. Specifics of initial management of explosive, war-related, radiological/nuclear, chemical, and biological incidents empha- sizing infectious diseases and terrorist attacks are presented. An evacuation exercise is completed, and a mass casualty triage is simulated in collaboration with local disaster response agencies. Decontamination procedures are demonstrated at the local fire department, and personal decontamination practices are exer- cised. Mannequin resuscitation is practiced while personal protective equipment is utilized. An interactive review of professional ethics, stress disorders, psychosocial interventions, and quality improvement efforts complete the training. The curriculum offers medical disaster education in a reasonable time frame, interdisciplinary format, multi-experiential course and flexible structure. It can serve as a template for basic medical student disaster education.