Preparing for burn disasters: predictors of improved perceptions of competency after mass burn care training.

INTRODUCTION Prehospital and community hospital healthcare providers in the United States must be prepared to respond to burn disasters. Continuing education is the most frequently utilized method of updating knowledge, skills, and competence among healthcare professionals. Since preparedness training must meet multiple educational demands, it is vital to understand how participants' work and educational experience and the program's content and delivery methods impact knowledge acquisition, and how learning influences confidence and competence to perform new skills. PURPOSE The purpose of this exploratory, convenience sample study was to identify healthcare provider characteristics and continuing education training content areas that were predictive of self-reported improvement in competence after attending a mass-casualty burn disaster continuing education program. METHODS Logistic regression analysis of data from a post-training evaluation from nine, one-day continuing education conferences on mass burn care was used to identify factors associated with improved self-reported competency to respond to mass burn casualties. RESULTS The following factors were associated most closely with increased self-reported competency: (1) prehospital work setting (odds ratio (OR) = 3.06, confidence interval (CI) = 0.83-11.30, p = 0.09); (2) 11 or more years of practice (OR = 0.31, CI = 0.09-1.08, p = 0.07); and (3) practice in an urban setting (OR = 0.01, CI = 0.18-0.82, p < 0.01). Confidence items included: (1) ability to implement appropriate airway management modalities (OR = 2.31, CI = 1.03-5.17, p < 0.04); (2) manage patients with electrical injuries (OR = 4.86, CI = 1.84-12.85, p < 0.001); (3) identify non-survivable injuries (OR = 2.24, CI = 0.93-5.43, p = 0.07); and (4) recognize special problems associated with burns in young children or older adults (OR = 2.14, CI = 0.87-5.23, p = 0.10). The final model explained 89.9% of the variability in self-reported competence. CONCLUSIONS Interventions used to train healthcare providers for burn disasters must cover a broad range of topics. However, learning needs may vary by practice setting, work experience, and previous exposure to disaster events. This evaluation research provides three-fold information for continuing education research: (1) to identify content areas that should be emphasized in future burn care training; (2) to be used as a model for CE evaluation in other domains; and (3) to provide support that many factors must be considered when designing a CE program. Results may be useful to others who are planning CE training programs.