Based on these startling findings, the University Clinic for Anaesthesiology and Intensive Care Medicine in Tübingen, Germany, developed a course based upon the existing curriculum adding the experiences of other international courses for undergraduate medical students (4, 8-14). The forty hours course is designed for medical students in their third to fifth years of medical school. Each of the 14 key modules from the 2006 curriculum are integrated. In addition, the theory and practice required by international disaster medicine in humanitarian emergencies is taught. Students are taught how to maximise the number of casualties saved within limited resource settings through a variety of interactive teaching and learning methods. Students must initially pass a 10 units e-learning course based on the international standards for humanitarian assistance lined out in The Sphere Handbook in Action (15), before progressing to the residential part of the course. The residential part consists of 30 units and a week of training. This is comprised of a written pre-test, a written post-test, a feedback session and 14 theoretical and 13 practical teaching units. Modern teaching methods include computer-based simulations, table top exercises, skills training, role-play and full-scale live simulations. A meet-up on day one includes topical disaster medicine and humanitarian assistance films. A schedule of the residential part is provided in table 1.
The course is conducted by three experienced medical doctors from the University Clinic for Anaesthesiology and Intensive Care Medicine Tübingen and supported by the Tübingen centre for patient safety and simulation (TÜPASS), the local emergency services and fire department. The aim of this study is to present and evaluate a modern course for the German disaster medicine curriculum, and to assess its impact on undergraduate medical students.
Study design and population
This prospective and cross-sectional study evaluates the pilot course Disaster Medicine and Humanitarian Assistance carried out for a sample of volunteering third, fourth and fifth year medical students over five semesters during the period between 2018 and 2020. The course topics, times and concept as well as the lecturers remained the same over all the five courses.
Three survey tools were used. The first tool used a web-based, purpose-designed pre-course and post-course questionnaire in order to obtain information about the participants’ subjective judgment of their increase in knowledge. The questionnaire consisted of five questions relating to previous experiences in the field of disaster medicine and a further 14 items, which were used to measure the self-reported degree of knowledge before and after the course according to the topics relevant in the curriculum. Additionally, four questions assessed the students’ future interest in engaging in the field of disaster medicine using a 5-point Likert-Scale. Data was collected with the questionnaire software SurveyMonkey®, Version 2.0 (SurveyMonkey Europe; Dublin, Ireland). Participation was voluntary, anonymous and confidential. The participants signed an informed consent form for participation and publication of the assessed data during the course. Additionally the completion of the questionnaires implied participants’ consent giving authors the right of use of the information provided.
The second tool was a compulsory pre- and post-test of knowledge at the beginning and end of the residential part of the course. Both were designed as multiple-choice tests with a single correct answer to each question. The test was used to obtain an objective measure of knowledge increase and course efficacy. It consisted of twenty questions out of the field of disaster medicine and another ten questions relating to Patient Triage. After matching pre- and post-test data, the students’ names were removed for statistical analysis and an overall score was calculated for the pre- and post-test separately through addition of correct answers. Overall percentage scores of correct answers were determined and used for further analysis.
The third tool consisted of the anonymous evaluation system of the University of Tübingen, tuevalon, which is used to evaluate medical students’ courses. The system is completely anonymous and used for all medical school courses in Tübingen. The survey contains ten items evaluating the content of the course, as well as six questions regarding contentedness with the lecturer’s performance. For the present study, the content-related items were of greater interest and therefore reported qualitatively. The aim of integrating this measure was to include information about the medical students’ satisfaction with the course, while the previously named tools were performance-based and focused on learning outcomes.
The collected data was exported from SurveyMonkey® to Microsoft Excel®, Version 2019 (Microsoft Corporation; Redmond, Washington USA). All analysis was performed with the dedicated statistics program IBM SPSS, Version 22 (IBM Deutschland GmbH; Ehningen, Germany). For the subjective judgement of knowledge questionnaire, overall pre- and post-test scores were obtained by calculating the mean values of the 14 knowledge-related items. Likewise, overall scores were obtained for the four future interest related items. Paired sample t-tests were conducted for analysis of differences between the overall scores before and after the course regarding medical students’ knowledge and interest, including information regarding objective increases in knowledge. The paired sample t-test was used as first choice statistical test considering its robustness, despite slight violation of the normality assumption within the given data. All data generated or analysed during this study are included in this published article [and its supplementary information files].