Authors' objectives:

Recent terrorist attacks have increased concerns about the Nation's vulnerability to terrorism, including the potential use of biological weapons. The purpose of this evidence report is to identify and review data on the most effective ways to train clinicians to respond to a bioterrorist attack or other public health events that may pose similar threats to the health care system, including infectious disease outbreaks, toxidromes or mass poisonings, catastrophic events that incite public fear, and events that call for use of hospital disaster plans.

Authors' results and conclusions: The search identified 1,942 unique citations, of which 60 were eligible for complete review. Of these, 53 evaluated the training of clinicians for detection and management of an infectious disease outbreak, 1 evaluated training of clinicians in how to detect and manage toxidromes or mass poisonings, 5 addressed training in how to respond to events that call for the use of hospital disaster plans, and 1 evaluated training of clinicians to report infectious diseases to a central agency. None of the studies evaluated the training of clinicians in how to use Web- or telephone-based central information resources or to communicate with other health professionals during a public health event. Many of the studies had low study quality scores. However, several pertinent findings emerged from some of the studies: 1) use of standardized patients was an acceptable and effective way to train physicians in detection and management of infectious disease outbreaks; 2) satellite broadcasting was an effective way to train large numbers of clinicians and to standardize training across geographically separated groups; 3) a tabletop exercise may be useful for training health care professionals about management of a bioterrorist attack; 4) disaster drill training improved clinicians' knowledge of hospital disaster plans and allowed identification of problems; and 5) a didactic program can help train infection control nurses to report certain infectious disease symptom complexes to a central agency.

Authors' recommendations: Modest evidence exists about effective ways to train clinicians to detect and manage an infectious disease outbreak. Very little evidence exists about how to effectively train clinicians to respond to other types of public health events deemed relevant to bioterrorism preparedness. Almost no evidence exists on training clinicians in aspects of response such as using central information resources, communicating with other professionals, and reporting events to a central agency. This gap in evidence warrants an increased commitment to developing and evaluating educational programs relevant to bioterrorism preparedness, infectious disease outbreaks, and other public health events.

Authors' methods: Systematic review

Project Status: Completed

URL for project: http://www.ahrq.gov/clinic/epcsums/biotrsum.htm

Year Published: 2002

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: United States

Organisation Name: Agency for Healthcare Research and Quality

Contact Address: Center for Outcomes and Evidence Technology Assessment Program, 540 Gaither Road, Rockville, MD 20850, USA. Tel: +1 301 427 1610; Fax: +1 301 427 1639;

Contact Name: martin.erlichman@ahrq.hhs.gov

Contact Email: martin.erlichman@ahrq.hhs.gov

Copyright: Agency for Healthcare Research and Quality (AHRQ)