上海地区灾难医学知识水平和培训需求调查分析及培训方案探索
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摘要
目的：过去的十几年中，我国自然和人为灾难的强度和频率日益增加，造成了巨大的经济损失，严重的环境破坏，并给受灾群众带来了持久的精神创伤。然而灾难医学并未包含在我国高等医学教育或继续医学教育中。卫生专业人员和社区居民是灾难应急反应的主要群体，医学生是灾难救援的后备力量，但他们的灾难医学知识水平尚不清楚。本研究旨在通过大规模流行病学调查明确灾难救援相关人员的灾难医学知识水平和培训需求，并在此基础上探索针对不同人群的合理培训方案。
方法：采用自填式问卷在上海地区进行灾难医学知识水平和培训需求调查。随机选择600名卫生行业人员（包括医务人员、医学院校教师和卫生管理人员），500名医学生和1600名社区居民进行调查。采用卡方检验、方差分析、Student-Newman-Keuls(SNK)检验、线性回归等方法进行统计学分析。
结果：调查总体应答率为93.7%。共有2529名参与者（包括547名卫生行业人员，456名医学生和1526名社区居民）提供了完整的问卷信息。只有33名（1.3%）曾经接受过系统的灾难医学培训。大多数参与者（87.1%）对灾难医学知识的自我评价较低，新闻媒体(报纸、杂志、互联网、电视、广播)是获得灾难医学知识的最常见途径。
1.卫生行业人员对“偏远地区与城市救援区别”、“人群脆弱性评价”和“PTSD的诊断”这三个问题的回答正确率普遍较低，表示他们普遍在灾难心理学和灾难管理方面存在知识欠缺。医务人员、医学院教师和卫生管理人员的灾难医学知识测试平均分数分别为10.97(95%CI=10.73-11.21)，11.89(95%CI=11.33-12.45)和10.57(95%CI=10.10-11.04)(p=0.002)。医学院校教师的灾难医学知识水平显著高于比医务人员和卫生管理人员，他们的灾难医学知识主要在四个方面存在差异：灾难基本知识、基本急救技术、灾难伤员检伤分类后送、灾难管理及灾后心理援助。卫生管理人员并没有显示出在灾难管理和灾难救援组织方面的优势，甚至对几个相关问题的回答正确率在三类人员中处于最低。医务人员中4种专业（临床医生、公共卫生医生、护士和医疗技术人员）之间也存在灾难医学知识水平的差异。临床医生的知识测试平均得分显著高于公共卫生医生和护士(p <0.001)，即使是在灾后传染病的预防和处理方面也比公共卫生医生有优势。这些结果表明我国医学教育长期以来都是以临床为导向的，却忽视了公共卫生预防，尤其是灾难准备的内容。线性回归分析表明年龄、教育水平、职称水平与卫生行业人员的灾难医学知识测试得分相关。其中，教育程度(β-coefficient=0.204，p <0.001)和职称水平(β-coefficient=0.142，p=0.008)和得分呈正相关，而年龄和得分呈负相关(β-coefficient=-0.193, p <0.001)。
2.医学生在灾难心理学和灾难管理方面也存在知识欠缺。预防医学专业学生和临床医学专业学生的灾难医学知识测试平均分数分别为11.54(95%CI=11.28-11.80)和10.79(95%CI=10.51-11.07)(p<0.001)。他们的知识水平差异体现在对8个问题的回答上，这些问题涉及灾难基本知识、灾难伤员检伤分类、后送及灾后传染病的预防和处理等方面(p<0.05)。线性回归分析表明专业与灾难医学知识测试得分相关(β-coefficient=0.661，p=0.002)，预防医学专业学生的得分更高。虽然卫生行业人员和医学生的知识测试平均得分差异并不明显(p=0.661)，但是仍有5个问题的回答存在显著差别。
3.社区居民对“心肺复苏操作”和“偏远地区与城市救援区别”这两个问题的正确回答率普遍较低，说明他们在急救技术和灾难管理知识方面的欠缺。教育程度高（本科或以上学历）的社区居民和教育程度低（专科或以下学历）的社区居民的灾难医学知识测试平均分数分别为7.42(95%CI=7.20-7.65)和6.91(95%CI=6.80-7.03)(p <0.001)。教育程度与灾难医学知识测试得分相关(β-coefficient=0.214，p=0.001)，教育程度高（本科或以上学历）的社区居民得分更高。卫生行业人员和社区居民对8个相同问题的回答情况表明社区居民的灾难医学知识水平低于卫生行业人员。
4.卫生行业人员与医学生对灾难医学授课方法、课程设置和教材的选择基本一致。大部分都认为专题讲座、现场实习和观看灾难影片是合适的授课方式，应将灾难医学纳入预防专业必修课，并采用国家统编教材作为授课教材。社区居民一致认为灾难医学培训非常必要并应在青少年儿童中推广，专题讲座和现场实习的授课方式较好，同时对定期组织社区灾难模拟演练和成立“社区灾难应急救援志愿队”的意愿也很高。
5.超过一半的卫生行业人员和医学生选择“各项医学急救的基本技术”、“灾区传染病的预防和处理”、“灾难心理障碍”和“各种灾难（核化生灾难）处理原则”作为重点内容，而大部分社区居民选择“各项医学急救的基本技术”和“灾难医学的基本原理”为重点内容。卫生行业人员最感兴趣的是“灾害救援的基本原则”(74.0%)、“灾害伤员的救治原则和急救技术”(69.8%)和“灾难后心理救援”(64.4%)，而社区居民最感兴趣的是“灾害救援的基本原则”(47.9%)和一些具体灾难如“地震”(40.9%)和“火灾”(40.8%)。
结论：总体来看调查结果反映出我国人群面对灾难的高脆弱性。虽然大多数卫生行业人员接受过高等医学教育，但是曾经接受过系统灾难医学培训的很少。传统医学教育是以临床为导向的，可能会导致灾难准备方面的欠缺。中国社会对灾难医学的培训需求非常高，灾难医学培训对卫生行业人员、医学生和社区居民都是必不可少的课程。这三类人群对灾难的不同认知导致了他们对灾难医学培训的不同需求，如对重点内容和感兴趣内容的选择差异。基于调查结果，我们对上海地区的灾难医学培训模式进行了初步探索。从健康教育的角度来看，灾难医学培训项目的开展迫在眉睫。在培训中要注意突出目前人群的薄弱知识环节，如心理救援和灾难管理能力。针对灾难医学的继续医学教育和公众普及教育应充分考虑现有的灾难医学知识水平和培训需求，善于利用新闻媒体渠道，发展实践为导向的适合不同人群的培训项目。
Objective: Over the past decade, the intensity and frequency of natural and man-madedisasters have been noticeably increasing in our country, which have caused hugeeconomic losses, serious environmental disruption and lasting psychological impairment tothe survivors. However, disaster medicine has not been included either in theundergraduate curriculum of medical schools or in the continuing medical education inChina. Health professionals and community residents are main players in disasterresponses but their knowledge levels of disaster medicine are not readily available. Thisstudy aimed to evaluate knowledge levels and training needs of disaster medicine amongpotential disaster responders via a large-scale epidemiological survey and explore thereasonable training programs suitable for different populations.
Methods: A self-reporting questionnaire survey on knowledge level and training needsof disaster medicine was conducted in Shanghai, China.600health professionals includingmedical practitioners, medical teachers and health administrators,500medical students,and1,600local residents were randomly selected to survey. Chi-square test, analysis ofvariance, Student-Newman-Keuls (SNK) test, and linear regression were used forstatistical analysis.
Results: The total response rate was93.7%. A total of2,529participants including547health professionals,456medical students, and1,526community residents providedcomplete information. Only33(1.3%) had ever received systematic training of disastermedicine. For all2,529participants, most of them (87.1%) had low or moderateself-estimated knowledge concerning disaster medicine, and media (newspaper, magazine,internet, and TV/radio) was the most common channel to acquire knowledge on disastermedicine.
1. For health professionals, less accurate responses to ‘diagnosis of post-traumatic stressdisorder (PTSD)’,‘difference between remote and urban rescue’, and ‘populationvulnerability assessment’ indicate the low levels of knowledge on disaster psychology anddisaster administration. In health professionals, the score was10.97(95%CI=10.73-11.21),11.89(95%CI=11.33-12.45), and10.57(95%CI=10.10-11.04) for medical practitioners,medical teachers, and health administrators, respectively (p=0.002). Medical teachers didbetter than medical practitioners and health administrators. The significant differences among different professions were mainly presented in the answers to the9questionscovering4aspects: self-help and first-aid skills, triage and evacuation, psychological relief,and population vulnerability assessment. Health administrators did not show theirproficiency in disaster administration and disaster rescue organization, for they poorlyanswered the related questions. Moreover, there were significant differences in knowledgelevels among4specialties (clinicians, public health physicians, nurses, and medicaltechnicians) of medical practitioners. Clinicians showed higher knowledge level than otherspecialties, even on the aspect of epidemic prevention and control (p<0.001). Thedifferences in the knowledge level indicate that the medical education in China had beenlargely clinically oriented; and little attention has been paid to public health preparedness,especially disaster preparedness. Multivariate linear regression analysis indicated thateducational level (β=0.204, p<0.001) and professional title (β=0.142, p=0.008) weresignificantly associated with an increased knowledge score, whereas age was inverselyrelated to the score (β=-0.193, p<0.001), in health professionals.
2. Medical students also had low levels of knowledge on disaster psychology anddisaster administration. In medical students, the score in public health students (11.54,95%CI=11.28-11.80) was higher than that in clinical medicine students (10.79,95%CI=10.51-11.07)(p<0.001). The rates of correctly answering8questions about basic concepts,triage and evacuation and epidemic prevention and control were significantly differentbetween the students of2majors (p<0.05). Public health major was the factor significantlyassociated with an increased score in medical students (β=0.661, p=0.002). Although thescore of health professionals and medical students was not significantly different (p=0.661), there were significant differences in correctly answering5questions.
3. For community residents, less accurate responses to ‘cardiopulmonary resuscitationprocedure’ and ‘difference between remote and urban rescue’ indicate the low levels ofknowledge on first-aid skills and disaster administration. After stratified by educationallevel, the score of well-educated (bachelor or higher) group (7.42,95%CI=7.20-7.65) wassignificantly higher than that of poor-educated (junior college or lower) group (6.91,95%CI=6.80-7.03)(p<0.001). Educational level was the unique factor significantlyassociated with an increased score in community residents (β=0.214, p=0.001). Wecompared the rates of correctly answering the8common questions in both questionnairesbetween health professionals and community residents. The rates were generally lower in community residents than in health professionals except one question.
4. The overall opinions on teaching method, course arrangement, and teaching materialwere consistent among health professionals and medical students. More than half of healthprofessionals and medical students selected ‘lecture’,‘practical training’, and ‘disastermovies or videos’ as preferred teaching methods, chose ‘required course for public healthprofessional’ as the major training course, and preferred using ‘national unified textbook’as standard teaching material. The majority of community residents selected ‘need to learndisaster medicine’ and ‘need of disaster medicine course for children’. About half ofcommunity residents selected ‘lecture’ and ‘practical training’ as preferred teachingmethods. More than70%of community residents selected ‘willing to participate indisaster simulation drill regularly’ and believed that ‘community volunteer team fordisaster relief should be set up and willing to participate volunteer team’.
5. More than50%of health professionals and medical students selected the contents of‘first aid skills’,‘epidemic prevention and control’,‘psychological problems inpost-disaster relief’, and ‘principles of disaster disposal’ as important contents; while themost community residents chose ‘first aid skills’ and ‘basic concepts of disaster medicine’as important contents. Significant differences existed among subgroups within each groupof participants. Health professionals selected ‘basic principles of disaster rescue’(74.0%),‘treatment principles and first-aid skills’(69.8%), and ‘psychological relief’(64.4%) as themost interested contents, while community residents selected ‘basic principles of disasterrescue’(47.9%) and specific disaster events such as ‘earthquakes’(40.9%) and ‘firedisaster’(40.8%).
Conclusions: In general, our results reflected a high vulnerability of our populationswhen facing disaster. Although the majority of the health professionals received formalmedical education, few of them have ever received systematic training of disaster medicine.Traditional clinical-oriented medical education might lead to a huge gap between theknowledge level on disaster medicine and the current needs of disaster preparedness. Theseresults indicate that the training needs of disaster medicine is very high in Chinese societyand disaster medicine trainings should be executed as indispensable courses for healthprofessionals, medical students, and community residents. Meanwhile, the three groups ofparticipants selected some different key and interested contents for disaster medicinetraining. This reflects that distinct perception of disaster determines the different needs of disaster medicine training in different populations. Based on these data, we suggest adiagram flow of disaster medicine training as Shanghai model. From a health educationperspective, disaster training programs are immediately needed, with specific emphasis oncertain contents, such as psychological relief and administrative skills. Continuing medicaleducation and public education plans on disaster medicine via media should bepractice-oriented, and selectively applied to different populations and take the knowledgelevels and training needs into consideration.
方法：采用自填式问卷在上海地区进行灾难医学知识水平和培训需求调查。随机选择600名卫生行业人员（包括医务人员、医学院校教师和卫生管理人员），500名医学生和1600名社区居民进行调查。采用卡方检验、方差分析、Student-Newman-Keuls(SNK)检验、线性回归等方法进行统计学分析。
结果：调查总体应答率为93.7%。共有2529名参与者（包括547名卫生行业人员，456名医学生和1526名社区居民）提供了完整的问卷信息。只有33名（1.3%）曾经接受过系统的灾难医学培训。大多数参与者（87.1%）对灾难医学知识的自我评价较低，新闻媒体(报纸、杂志、互联网、电视、广播)是获得灾难医学知识的最常见途径。
1.卫生行业人员对“偏远地区与城市救援区别”、“人群脆弱性评价”和“PTSD的诊断”这三个问题的回答正确率普遍较低，表示他们普遍在灾难心理学和灾难管理方面存在知识欠缺。医务人员、医学院教师和卫生管理人员的灾难医学知识测试平均分数分别为10.97(95%CI=10.73-11.21)，11.89(95%CI=11.33-12.45)和10.57(95%CI=10.10-11.04)(p=0.002)。医学院校教师的灾难医学知识水平显著高于比医务人员和卫生管理人员，他们的灾难医学知识主要在四个方面存在差异：灾难基本知识、基本急救技术、灾难伤员检伤分类后送、灾难管理及灾后心理援助。卫生管理人员并没有显示出在灾难管理和灾难救援组织方面的优势，甚至对几个相关问题的回答正确率在三类人员中处于最低。医务人员中4种专业（临床医生、公共卫生医生、护士和医疗技术人员）之间也存在灾难医学知识水平的差异。临床医生的知识测试平均得分显著高于公共卫生医生和护士(p <0.001)，即使是在灾后传染病的预防和处理方面也比公共卫生医生有优势。这些结果表明我国医学教育长期以来都是以临床为导向的，却忽视了公共卫生预防，尤其是灾难准备的内容。线性回归分析表明年龄、教育水平、职称水平与卫生行业人员的灾难医学知识测试得分相关。其中，教育程度(β-coefficient=0.204，p <0.001)和职称水平(β-coefficient=0.142，p=0.008)和得分呈正相关，而年龄和得分呈负相关(β-coefficient=-0.193, p <0.001)。
2.医学生在灾难心理学和灾难管理方面也存在知识欠缺。预防医学专业学生和临床医学专业学生的灾难医学知识测试平均分数分别为11.54(95%CI=11.28-11.80)和10.79(95%CI=10.51-11.07)(p<0.001)。他们的知识水平差异体现在对8个问题的回答上，这些问题涉及灾难基本知识、灾难伤员检伤分类、后送及灾后传染病的预防和处理等方面(p<0.05)。线性回归分析表明专业与灾难医学知识测试得分相关(β-coefficient=0.661，p=0.002)，预防医学专业学生的得分更高。虽然卫生行业人员和医学生的知识测试平均得分差异并不明显(p=0.661)，但是仍有5个问题的回答存在显著差别。
3.社区居民对“心肺复苏操作”和“偏远地区与城市救援区别”这两个问题的正确回答率普遍较低，说明他们在急救技术和灾难管理知识方面的欠缺。教育程度高（本科或以上学历）的社区居民和教育程度低（专科或以下学历）的社区居民的灾难医学知识测试平均分数分别为7.42(95%CI=7.20-7.65)和6.91(95%CI=6.80-7.03)(p <0.001)。教育程度与灾难医学知识测试得分相关(β-coefficient=0.214，p=0.001)，教育程度高（本科或以上学历）的社区居民得分更高。卫生行业人员和社区居民对8个相同问题的回答情况表明社区居民的灾难医学知识水平低于卫生行业人员。
4.卫生行业人员与医学生对灾难医学授课方法、课程设置和教材的选择基本一致。大部分都认为专题讲座、现场实习和观看灾难影片是合适的授课方式，应将灾难医学纳入预防专业必修课，并采用国家统编教材作为授课教材。社区居民一致认为灾难医学培训非常必要并应在青少年儿童中推广，专题讲座和现场实习的授课方式较好，同时对定期组织社区灾难模拟演练和成立“社区灾难应急救援志愿队”的意愿也很高。
5.超过一半的卫生行业人员和医学生选择“各项医学急救的基本技术”、“灾区传染病的预防和处理”、“灾难心理障碍”和“各种灾难（核化生灾难）处理原则”作为重点内容，而大部分社区居民选择“各项医学急救的基本技术”和“灾难医学的基本原理”为重点内容。卫生行业人员最感兴趣的是“灾害救援的基本原则”(74.0%)、“灾害伤员的救治原则和急救技术”(69.8%)和“灾难后心理救援”(64.4%)，而社区居民最感兴趣的是“灾害救援的基本原则”(47.9%)和一些具体灾难如“地震”(40.9%)和“火灾”(40.8%)。
结论：总体来看调查结果反映出我国人群面对灾难的高脆弱性。虽然大多数卫生行业人员接受过高等医学教育，但是曾经接受过系统灾难医学培训的很少。传统医学教育是以临床为导向的，可能会导致灾难准备方面的欠缺。中国社会对灾难医学的培训需求非常高，灾难医学培训对卫生行业人员、医学生和社区居民都是必不可少的课程。这三类人群对灾难的不同认知导致了他们对灾难医学培训的不同需求，如对重点内容和感兴趣内容的选择差异。基于调查结果，我们对上海地区的灾难医学培训模式进行了初步探索。从健康教育的角度来看，灾难医学培训项目的开展迫在眉睫。在培训中要注意突出目前人群的薄弱知识环节，如心理救援和灾难管理能力。针对灾难医学的继续医学教育和公众普及教育应充分考虑现有的灾难医学知识水平和培训需求，善于利用新闻媒体渠道，发展实践为导向的适合不同人群的培训项目。
Objective: Over the past decade, the intensity and frequency of natural and man-madedisasters have been noticeably increasing in our country, which have caused hugeeconomic losses, serious environmental disruption and lasting psychological impairment tothe survivors. However, disaster medicine has not been included either in theundergraduate curriculum of medical schools or in the continuing medical education inChina. Health professionals and community residents are main players in disasterresponses but their knowledge levels of disaster medicine are not readily available. Thisstudy aimed to evaluate knowledge levels and training needs of disaster medicine amongpotential disaster responders via a large-scale epidemiological survey and explore thereasonable training programs suitable for different populations.
Methods: A self-reporting questionnaire survey on knowledge level and training needsof disaster medicine was conducted in Shanghai, China.600health professionals includingmedical practitioners, medical teachers and health administrators,500medical students,and1,600local residents were randomly selected to survey. Chi-square test, analysis ofvariance, Student-Newman-Keuls (SNK) test, and linear regression were used forstatistical analysis.
Results: The total response rate was93.7%. A total of2,529participants including547health professionals,456medical students, and1,526community residents providedcomplete information. Only33(1.3%) had ever received systematic training of disastermedicine. For all2,529participants, most of them (87.1%) had low or moderateself-estimated knowledge concerning disaster medicine, and media (newspaper, magazine,internet, and TV/radio) was the most common channel to acquire knowledge on disastermedicine.
1. For health professionals, less accurate responses to ‘diagnosis of post-traumatic stressdisorder (PTSD)’,‘difference between remote and urban rescue’, and ‘populationvulnerability assessment’ indicate the low levels of knowledge on disaster psychology anddisaster administration. In health professionals, the score was10.97(95%CI=10.73-11.21),11.89(95%CI=11.33-12.45), and10.57(95%CI=10.10-11.04) for medical practitioners,medical teachers, and health administrators, respectively (p=0.002). Medical teachers didbetter than medical practitioners and health administrators. The significant differences among different professions were mainly presented in the answers to the9questionscovering4aspects: self-help and first-aid skills, triage and evacuation, psychological relief,and population vulnerability assessment. Health administrators did not show theirproficiency in disaster administration and disaster rescue organization, for they poorlyanswered the related questions. Moreover, there were significant differences in knowledgelevels among4specialties (clinicians, public health physicians, nurses, and medicaltechnicians) of medical practitioners. Clinicians showed higher knowledge level than otherspecialties, even on the aspect of epidemic prevention and control (p<0.001). Thedifferences in the knowledge level indicate that the medical education in China had beenlargely clinically oriented; and little attention has been paid to public health preparedness,especially disaster preparedness. Multivariate linear regression analysis indicated thateducational level (β=0.204, p<0.001) and professional title (β=0.142, p=0.008) weresignificantly associated with an increased knowledge score, whereas age was inverselyrelated to the score (β=-0.193, p<0.001), in health professionals.
2. Medical students also had low levels of knowledge on disaster psychology anddisaster administration. In medical students, the score in public health students (11.54,95%CI=11.28-11.80) was higher than that in clinical medicine students (10.79,95%CI=10.51-11.07)(p<0.001). The rates of correctly answering8questions about basic concepts,triage and evacuation and epidemic prevention and control were significantly differentbetween the students of2majors (p<0.05). Public health major was the factor significantlyassociated with an increased score in medical students (β=0.661, p=0.002). Although thescore of health professionals and medical students was not significantly different (p=0.661), there were significant differences in correctly answering5questions.
3. For community residents, less accurate responses to ‘cardiopulmonary resuscitationprocedure’ and ‘difference between remote and urban rescue’ indicate the low levels ofknowledge on first-aid skills and disaster administration. After stratified by educationallevel, the score of well-educated (bachelor or higher) group (7.42,95%CI=7.20-7.65) wassignificantly higher than that of poor-educated (junior college or lower) group (6.91,95%CI=6.80-7.03)(p<0.001). Educational level was the unique factor significantlyassociated with an increased score in community residents (β=0.214, p=0.001). Wecompared the rates of correctly answering the8common questions in both questionnairesbetween health professionals and community residents. The rates were generally lower in community residents than in health professionals except one question.
4. The overall opinions on teaching method, course arrangement, and teaching materialwere consistent among health professionals and medical students. More than half of healthprofessionals and medical students selected ‘lecture’,‘practical training’, and ‘disastermovies or videos’ as preferred teaching methods, chose ‘required course for public healthprofessional’ as the major training course, and preferred using ‘national unified textbook’as standard teaching material. The majority of community residents selected ‘need to learndisaster medicine’ and ‘need of disaster medicine course for children’. About half ofcommunity residents selected ‘lecture’ and ‘practical training’ as preferred teachingmethods. More than70%of community residents selected ‘willing to participate indisaster simulation drill regularly’ and believed that ‘community volunteer team fordisaster relief should be set up and willing to participate volunteer team’.
5. More than50%of health professionals and medical students selected the contents of‘first aid skills’,‘epidemic prevention and control’,‘psychological problems inpost-disaster relief’, and ‘principles of disaster disposal’ as important contents; while themost community residents chose ‘first aid skills’ and ‘basic concepts of disaster medicine’as important contents. Significant differences existed among subgroups within each groupof participants. Health professionals selected ‘basic principles of disaster rescue’(74.0%),‘treatment principles and first-aid skills’(69.8%), and ‘psychological relief’(64.4%) as themost interested contents, while community residents selected ‘basic principles of disasterrescue’(47.9%) and specific disaster events such as ‘earthquakes’(40.9%) and ‘firedisaster’(40.8%).
Conclusions: In general, our results reflected a high vulnerability of our populationswhen facing disaster. Although the majority of the health professionals received formalmedical education, few of them have ever received systematic training of disaster medicine.Traditional clinical-oriented medical education might lead to a huge gap between theknowledge level on disaster medicine and the current needs of disaster preparedness. Theseresults indicate that the training needs of disaster medicine is very high in Chinese societyand disaster medicine trainings should be executed as indispensable courses for healthprofessionals, medical students, and community residents. Meanwhile, the three groups ofparticipants selected some different key and interested contents for disaster medicinetraining. This reflects that distinct perception of disaster determines the different needs of disaster medicine training in different populations. Based on these data, we suggest adiagram flow of disaster medicine training as Shanghai model. From a health educationperspective, disaster training programs are immediately needed, with specific emphasis oncertain contents, such as psychological relief and administrative skills. Continuing medicaleducation and public education plans on disaster medicine via media should bepractice-oriented, and selectively applied to different populations and take the knowledgelevels and training needs into consideration.
引文
[1] Zhang Z, Wang W, Shi Z, Wang L, Zhang J. Mental health problems among thesurvivors in the hard-hit areas of the Yushu earthquake. PLoS One.2012;7: e46449.
[2] Pietrzak RH, Tracy M, Galea S, Kilpatrick DG, Ruggiero KJ, et al. Resilience in theface of disaster: prevalence and longitudinal course of mental disorders followinghurricane Ike. PLoS One.2012;7: e38964.
[3] Usami M, Iwadare Y, Kodaira M, Watanabe K, Aoki M, et al. Relationships betweentraumatic symptoms and environmental damage conditions among children8months afterthe2011Japan earthquake and tsunami. PLoS One.2012;7: e50721.
[4] White HK, Hsing PY, Cho W, Shank TM, Cordes EE, et al. Impact of the deepwaterhorizon oil spill on a deep-water coral community in the Gulf of Mexico. Proc Natl AcadSci U S A.2012;109:20303-20308.
[5] Xu G, Ying Y, Liu Y, Chang W, Ni H, et al. Incidences, types, and influencing factors ofsnow disaster-associated injuries in Ningbo, China,2008. Disaster Med Public Health Prep.2012;6:363-369.
[6] Delooz H, Debacker M, Moens G, Johannik K. European survey on training objectivesin disaster medicine. Eur J Emerg Med.2007;14:25-31.
[7]唐黎标.美国社区救灾反应队.现代职业安全.2004;9:61.
[8]赵萍.日本的灾害管理.防灾博览.2011;2:36-41.
[9] Huntington MK, Gavagan TF. Disaster medicine training in family medicine: a reviewof the evidence. Fam Med.2011;43:13-20.
[10] Cummings GE, Della Corte F, Cummings GG. Disaster medicine education inCanadian medical schools before and after September11,2001. CJEM.2005;7:399-405.
[11] Colvard MD, Naiman MI, Mata D, Cordell GA, Lampiris L. Disaster medicinetraining survey results for dental health care providers in Illinois. J Am Dent Assoc.2007;138:519-524; quiz36-7.
[12] Kaiser HE, Barnett DJ, Hsu EB, Kirsch TD, James JJ, Subbarao I. Perspectives offuture physicians on disaster medicine and public health preparedness: challenges ofbuilding a capable and sustainable auxiliary medical workforce. Disaster Med PublicHealth Prep.2009;3:210-216.
[13] Scott LA, Carson DS, Greenwell IB. Disaster101: a novel approach to disastermedicine training for health professionals. J Emerg Med.2010;39:220-226.
[14] Pfenninger EG, Domres BD, Stahl W, Bauer A, Houser CM, Himmelseher S. Medicalstudent disaster medicine education: the development of an educational resource. Int JEmerg Med2010;3:9-20.
[15] Kaji AH, Coates W, Fung CC. A disaster medicine curriculum for medical students.Teach Learn Med.2010;22:116-122.
[16] Summerhill EM, Mathew MC, Stipho S, Artenstein AW, Jagminas L, Russo-MagnoPM, Potter S, Shapiro MJ. A simulation-based biodefense and disaster preparednesscurriculum for internal medicine residents. Med Teach.2008;30:e145-151.
[17] Alexander AJ, Bandiera GW, Mazurik L. A multiphase disaster training exercise foremergency medicine residents: opportunity knocks. Acad Emerg Med.2005;12:404-409.
[18] Subbarao I, Lyznicki JM, Hsu EB, Gebbie KM, Markenson D, et al. Aconsensus-based educational framework and competency set for the discipline of disastermedicine and public health preparedness. Disaster Med Public Health Prep.2008;2:57-68.
[19] Wakasugi M, Nilsson H, Hornwall J, Vikstrom T, Ruter A. Can performanceindicators be used for pedagogic purposes in disaster medicine training? Scand J TraumaResusc Emerg Med.2009;17:15.
[20] Ruter A, Ortenwall P, Vikstrom T. Staff procedure skills in management groups duringexercises in disaster medicine. Prehosp Disaster Med.2007;22:318-321.
[21] Feng D, de Vlas SJ, Fang LQ, Han XN, Zhao WJ, et al. The SARS epidemic inmainland China: bringing together all epidemiological data. Trop Med Int Health.2009;14Suppl1:4-13.
[22] Qiu J, Liu GD, Wang SX, Zhang XZ, Zhang L, et al. Analysis of injuries andtreatment of3,401inpatients in2008Wenchuan earthquake--based on Chinese TraumaDatabank. Chin J Traumatol.2010;13:297-303.
[23] Lin CY, Huang TY, Shih HC, Yuan CH, Chen LJ, et al. The strategies to DVIchallenges in Typhoon Morakot. Int J Legal Med.2011;125:637-41.
[24] Yang P, Yen CF, Tang TC, Chen CS, Yang RC, et al. Posttraumatic stress disorder inadolescents after Typhoon Morakot-associated mudslides. J Anxiety Disord.2011;25:362-8.
[25]姚卫光，徐建军，王冬.关于构建灾难医学教育体系的思考.西北医学教育.2005;13(5):468-469.
[26]王莹莹.还有什么比活下来更重要—减灾从社区做起.中国减灾.2010;6:7-9.
[27] Chan SS, Chan WS, Cheng Y, Fung OW, Lai TK, et al. Development and evaluationof an undergraduate training course for developing International Council of Nurses disasternursing competencies in China. J Nurs Scholarsh.2010;42:405-413.
[28] Pang SM, Chan SS, Cheng Y. Pilot training program for developing disaster nursingcompetencies among undergraduate students in China. Nurs Health Sci.2009;11:367-373.
[29] Ng C, Ma H, Raphael B, Yu X, Fraser J, et al. China-Australia training onpsychosocial crisis intervention: response to the earthquake disaster in Sichuan. AustralasPsychiatry.2009;17:51-55.
[30] Wang C, Wei S, Xiang H, Xu Y, Han S, et al. Evaluating the effectiveness of anemergency preparedness training programme for public health staff in China. Public Health.2008;122:471-477.
[31] Huang B, Li J, Li Y, Zhang W, Pan F, et al. Need for continual education aboutdisaster medicine for health professionals in China-a pilot study. BMC Public Health.2011;11:89.
[1] Kaiser HE, Barnett DJ, Hsu EB, Kirsch TD, James JJ, Subbarao I. Perspectives offuture physicians on disaster medicine and public health preparedness: challenges ofbuilding a capable and sustainable auxiliary medical workforce. Disaster Med PublicHealth Prep.2009Dec;3(4):210-216.
[2] Huang B, Li J, Li Y, Zhang W, Pan F, Miao S. Need for continual education aboutdisaster medicine for health professionals in China-a pilot study. BMC Public Health.2011;11:89.
[3] Cicero MX, Blake E, Gallant N, Chen L, Esposito L, Guerrero M, et al. Impact of aneducational intervention on residents' knowledge of pediatric disaster medicine. PediatrEmerg Care.2009Jul;25(7):447-451.
[4] Khankeh HR, Khorasani-Zavareh D, Johanson E, Mohammadi R, Ahmadi F. Disasterhealth-related challenges and requirements: a grounded theory study in Iran. PrehospDisaster Med.2011Jun;26(3):151-158.
[5] Wang C, Wei S, Xiang H, Wu J, Xu Y, Liu L, et al. Development and evaluation of aleadership training program for public health emergency response: results from a Chinesestudy. BMC Public Health.2008;8:377.
[6] Woltring C, Constantine W, Schwarte L. Does leadership training make a difference?The CDC/UC Public Health Leadership Institute:1991-1999. J Public Health Manag Pract.2003Mar-Apr;9(2):103-122.
[7] Russell ML, McIntyre L. An estimation of Canada's public health physician workforce.Can J Public Health.2009May-Jun;100(3):199-203.
[8] Scott LA, Carson DS, Greenwell IB. Disaster101: a novel approach to disastermedicine training for health professionals. J Emerg Med.2010Aug;39(2):220-226.
[9] Summerhill EM, Mathew MC, Stipho S, Artenstein AW, Jagminas L, Russo-Magno PM,et al. A simulation-based biodefense and disaster preparedness curriculum for internalmedicine residents. Med Teach.2008;30(6):e145-151.
[10] Bartley BH, Stella JB, Walsh LD. What a disaster?! Assessing utility of simulateddisaster exercise and educational process for improving hospital preparedness. PrehospDisaster Med.2006Jul-Aug;21(4):249-255.
[11] Jafari ME. Radiological incident preparedness for community hospitals: ademonstration project. Health Phys.2010Aug;99Suppl2:S123-135.
[12] Eason MP. Sarin exposure: a simulation case scenario. South Med J.2013Jan;106(1):55-62.
[13] Franc-Law JM, Ingrassia PL, Ragazzoni L, Della Corte F. The effectiveness oftraining with an emergency department simulator on medical student performance in asimulated disaster. CJEM.2010Jan;12(1):27-32.
[14] Pelaccia T, Delplancq H, Triby E, Bartier JC, Leman C, Hadef H, et al. Can teachingmethods based on pattern recognition skill development optimise triage in mass-casualtyincidents? Emerg Med J.2009Dec;26(12):899-902.
[15] Prause G, Kroll W, Metzler H, Fuchs G, Kaloud H, Kaltenbock F, et al.[Education ofthe medical student in first aid, emergency and disaster medicine--the Graz model].Anasthesiol Intensivmed Notfallmed Schmerzther.1995Jun;30(4):236-239.
[16] Della Corte F, La Mura F, Petrino R. E-learning as educational tool in emergency anddisaster medicine teaching. Minerva Anestesiol.2005May;71(5):181-195.
[17] Rega P, Bork C, Chen Y, Woodson D, Hogue P, Batten S. Using an H1N1vaccinationdrive-through to introduce healthcare students and their faculty to disaster medicine. Am JDisaster Med.2010Mar-Apr;5(2):129-136.
[18] Archer F, Seynaeve G. International guidelines and standards for education andtraining to reduce the consequences of events that may threaten the health status of acommunity. A report of an Open International WADEM Meeting, Brussels, Belgium,29-31October,2004. Prehosp Disaster Med.2007Mar-Apr;22(2):120-130.
[19] Balch D, Taylor C, Rosenthal D, Bausch C, Warner D, Morris R. Shadow Bowl2003:a collaborative exercise in community readiness, agency cooperation, and medicalresponse. Telemed J E Health.2004Fall;10(3):330-342.
[20] Silvagni AJ, Levy LA, McFee RB. Educating health professionals, first responders,and the community about bioterrorism and weapons of mass destruction. J Am OsteopathAssoc.2002Sep;102(9):491-499.
[21] Wyche KF, Pfefferbaum RL, Pfefferbaum B, Norris FH, Wisnieski D, Younger H.Exploring community resilience in workforce communities of first responders servingKatrina survivors. Am J Orthopsychiatry.2011Jan;81(1):18-30.
[22] Tharp AT, Vasterling JJ, Sullivan G, Han X, Davis T, Deitch EA, et al. Effects of pre-and post-Katrina nonviolent and violent experiences on male veterans' psychologicalfunctioning. Disaster Med Public Health Prep.2011Sep;5Suppl2:S227-234.
[23] Dodgen D, Norwood AE, Becker SM, Perez JT, Hansen CK. Social, psychological,and behavioral responses to a nuclear detonation in a US city: implications for health careplanning and delivery. Disaster Med Public Health Prep.2011Mar;5Suppl1:S54-64.
[24] Lau JT, Kim JH, Tsui H, Griffiths S. Perceptions related to human avian influenza andtheir associations with anticipated psychological and behavioral responses at the onset ofoutbreak in the Hong Kong Chinese general population. Am J Infect Control.2007Feb;35(1):38-49.
[25] Everly GS, Jr., Flynn BW. Principles and practical procedures for acute psychologicalfirst aid training for personnel without mental health experience. Int J Emerg Ment Health.2006Spring;8(2):93-100.
[26] Huntington MK, Gavagan TF. Disaster medicine training in family medicine: a reviewof the evidence. Fam Med.2011Jan;43(1):13-20.
[27] Nilsson H, Vikstrom T, Ruter A. Quality control in disaster medicine training--initialregional medical command and control as an example. Am J Disaster Med.2010Jan-Feb;5(1):35-40.
[28] Colvard MD, Naiman MI, Mata D, Cordell GA, Lampiris L. Disaster medicinetraining survey results for dental health care providers in Illinois. J Am Dent Assoc.2007Apr;138(4):519-524; quiz536-517.
[29] Cefalu CA, Schwartz RS. Salvaging a geriatric medicine academic program in disastermode-the LSU training program post-Katrina. J Natl Med Assoc.2007May;99(5):590-596.
[30] Cummings GE, Della Corte F, Cummings GG. Disaster medicine education inCanadian medical schools before and after September11,2001. CJEM.2005Nov;7(6):399-405.
[31] Pfenninger EG, Domres BD, Stahl W, Bauer A, Houser CM, Himmelseher S. Medicalstudent disaster medicine education: the development of an educational resource. Int JEmerg Med.2010;3(1):9-20.
[32] Merlin MA, Moon J, Krimmel J, Liu J, Marques-Baptista A. Improving medicalstudents' understanding of prehospital care through a fourth year emergency medicineclerkship. Emerg Med J.2010Feb;27(2):147-150.
[33] Coule PL, Schwartz RB. The national disaster life support programs: a model forcompetency-based standardized and locally relevant training. J Public Health Manag Pract.2009Mar;15(2Suppl):S25-30.
[34] Alexander AJ, Bandiera GW, Mazurik L. A multiphase disaster training exercise foremergency medicine residents: opportunity knocks. Acad Emerg Med.2005May;12(5):404-409.
[35] Delooz H, Debacker M, Moens G, Johannik K. European survey on training objectivesin disaster medicine. Eur J Emerg Med.2007Feb;14(1):25-31.
[36] Oztek Z. Public health specialists: occupational description in Turkey. Cah SociolDemogr Med.2010Oct-Dec;50(4):433-444.
[1] Col.Karl H.Houghton.“Hard role for Doctor Seen in Atomic War.”Reno Evening Gazette.1995.
[2] David E.Hogan Jonathna L.Burstein.Disaster medicine.LIPPINCOTT WILLIAMS ANDWILKINS.2007.
[3] International Federation of Red Cross and Red Crescent Societies.World DisastersReport.Geneva,Switzerland: International Federation of Red Cross and Red Crescent Societies.2000.
[4] Noji EK.Advances in disaster medicine[J].Eur J Emerg Med.2002.9(2):185-191.
[5] Auold JL. Disaster Medicine in the21stcentury:future hazards,vulnerabilities and risk[J]. PrehospitalDisaster Med.2002.17(1):3-11.
[6]姚卫光,徐建军,王东.关于构建灾难医学教育体系的思考[J].西北医生教育.2005,13(5):468-469.
[7]灾害医学[N].人民政协报健康周刊,第316期,2009年5月13日.
[8]印国兵,邓博引等.医学生对灾难医学的认识状况及应对方法[J].现代医药卫生.2012,28(7):1092-1093.
[9]马晓光,马岳峰,朱善宽.中国灾难医学现状及发展策略[J].中华急诊医学杂志.2009.18(9):1005-1008.
[10]张新国,辛阔林,姬伟凤.灾难医学救援的难点及行动对策[J].使用医学杂志.2008,25(1):115-116.
[11]刘振立.关于我国灾难医学教育的思考[J].中国危重病急救医学.2003.15(11):643-645.
[12] Paul JA,George SK,Yi P,et a1.Fransient modeling in simulation of hospital operations foremergency response.Prehospital Disaster Med,2006,21(4):223-236.
[13] Macfarlane C,Joffe AL,Naidoo S.Training of disaster managers at a masters degree level:Fromemergency care to managerial contro1.Emerg Med Australas.2006,18(5-6):451-456.
[2] Pietrzak RH, Tracy M, Galea S, Kilpatrick DG, Ruggiero KJ, et al. Resilience in theface of disaster: prevalence and longitudinal course of mental disorders followinghurricane Ike. PLoS One.2012;7: e38964.
[3] Usami M, Iwadare Y, Kodaira M, Watanabe K, Aoki M, et al. Relationships betweentraumatic symptoms and environmental damage conditions among children8months afterthe2011Japan earthquake and tsunami. PLoS One.2012;7: e50721.
[4] White HK, Hsing PY, Cho W, Shank TM, Cordes EE, et al. Impact of the deepwaterhorizon oil spill on a deep-water coral community in the Gulf of Mexico. Proc Natl AcadSci U S A.2012;109:20303-20308.
[5] Xu G, Ying Y, Liu Y, Chang W, Ni H, et al. Incidences, types, and influencing factors ofsnow disaster-associated injuries in Ningbo, China,2008. Disaster Med Public Health Prep.2012;6:363-369.
[6] Delooz H, Debacker M, Moens G, Johannik K. European survey on training objectivesin disaster medicine. Eur J Emerg Med.2007;14:25-31.
[7]唐黎标.美国社区救灾反应队.现代职业安全.2004;9:61.
[8]赵萍.日本的灾害管理.防灾博览.2011;2:36-41.
[9] Huntington MK, Gavagan TF. Disaster medicine training in family medicine: a reviewof the evidence. Fam Med.2011;43:13-20.
[10] Cummings GE, Della Corte F, Cummings GG. Disaster medicine education inCanadian medical schools before and after September11,2001. CJEM.2005;7:399-405.
[11] Colvard MD, Naiman MI, Mata D, Cordell GA, Lampiris L. Disaster medicinetraining survey results for dental health care providers in Illinois. J Am Dent Assoc.2007;138:519-524; quiz36-7.
[12] Kaiser HE, Barnett DJ, Hsu EB, Kirsch TD, James JJ, Subbarao I. Perspectives offuture physicians on disaster medicine and public health preparedness: challenges ofbuilding a capable and sustainable auxiliary medical workforce. Disaster Med PublicHealth Prep.2009;3:210-216.
[13] Scott LA, Carson DS, Greenwell IB. Disaster101: a novel approach to disastermedicine training for health professionals. J Emerg Med.2010;39:220-226.
[14] Pfenninger EG, Domres BD, Stahl W, Bauer A, Houser CM, Himmelseher S. Medicalstudent disaster medicine education: the development of an educational resource. Int JEmerg Med2010;3:9-20.
[15] Kaji AH, Coates W, Fung CC. A disaster medicine curriculum for medical students.Teach Learn Med.2010;22:116-122.
[16] Summerhill EM, Mathew MC, Stipho S, Artenstein AW, Jagminas L, Russo-MagnoPM, Potter S, Shapiro MJ. A simulation-based biodefense and disaster preparednesscurriculum for internal medicine residents. Med Teach.2008;30:e145-151.
[17] Alexander AJ, Bandiera GW, Mazurik L. A multiphase disaster training exercise foremergency medicine residents: opportunity knocks. Acad Emerg Med.2005;12:404-409.
[18] Subbarao I, Lyznicki JM, Hsu EB, Gebbie KM, Markenson D, et al. Aconsensus-based educational framework and competency set for the discipline of disastermedicine and public health preparedness. Disaster Med Public Health Prep.2008;2:57-68.
[19] Wakasugi M, Nilsson H, Hornwall J, Vikstrom T, Ruter A. Can performanceindicators be used for pedagogic purposes in disaster medicine training? Scand J TraumaResusc Emerg Med.2009;17:15.
[20] Ruter A, Ortenwall P, Vikstrom T. Staff procedure skills in management groups duringexercises in disaster medicine. Prehosp Disaster Med.2007;22:318-321.
[21] Feng D, de Vlas SJ, Fang LQ, Han XN, Zhao WJ, et al. The SARS epidemic inmainland China: bringing together all epidemiological data. Trop Med Int Health.2009;14Suppl1:4-13.
[22] Qiu J, Liu GD, Wang SX, Zhang XZ, Zhang L, et al. Analysis of injuries andtreatment of3,401inpatients in2008Wenchuan earthquake--based on Chinese TraumaDatabank. Chin J Traumatol.2010;13:297-303.
[23] Lin CY, Huang TY, Shih HC, Yuan CH, Chen LJ, et al. The strategies to DVIchallenges in Typhoon Morakot. Int J Legal Med.2011;125:637-41.
[24] Yang P, Yen CF, Tang TC, Chen CS, Yang RC, et al. Posttraumatic stress disorder inadolescents after Typhoon Morakot-associated mudslides. J Anxiety Disord.2011;25:362-8.
[25]姚卫光，徐建军，王冬.关于构建灾难医学教育体系的思考.西北医学教育.2005;13(5):468-469.
[26]王莹莹.还有什么比活下来更重要—减灾从社区做起.中国减灾.2010;6:7-9.
[27] Chan SS, Chan WS, Cheng Y, Fung OW, Lai TK, et al. Development and evaluationof an undergraduate training course for developing International Council of Nurses disasternursing competencies in China. J Nurs Scholarsh.2010;42:405-413.
[28] Pang SM, Chan SS, Cheng Y. Pilot training program for developing disaster nursingcompetencies among undergraduate students in China. Nurs Health Sci.2009;11:367-373.
[29] Ng C, Ma H, Raphael B, Yu X, Fraser J, et al. China-Australia training onpsychosocial crisis intervention: response to the earthquake disaster in Sichuan. AustralasPsychiatry.2009;17:51-55.
[30] Wang C, Wei S, Xiang H, Xu Y, Han S, et al. Evaluating the effectiveness of anemergency preparedness training programme for public health staff in China. Public Health.2008;122:471-477.
[31] Huang B, Li J, Li Y, Zhang W, Pan F, et al. Need for continual education aboutdisaster medicine for health professionals in China-a pilot study. BMC Public Health.2011;11:89.
[1] Kaiser HE, Barnett DJ, Hsu EB, Kirsch TD, James JJ, Subbarao I. Perspectives offuture physicians on disaster medicine and public health preparedness: challenges ofbuilding a capable and sustainable auxiliary medical workforce. Disaster Med PublicHealth Prep.2009Dec;3(4):210-216.
[2] Huang B, Li J, Li Y, Zhang W, Pan F, Miao S. Need for continual education aboutdisaster medicine for health professionals in China-a pilot study. BMC Public Health.2011;11:89.
[3] Cicero MX, Blake E, Gallant N, Chen L, Esposito L, Guerrero M, et al. Impact of aneducational intervention on residents' knowledge of pediatric disaster medicine. PediatrEmerg Care.2009Jul;25(7):447-451.
[4] Khankeh HR, Khorasani-Zavareh D, Johanson E, Mohammadi R, Ahmadi F. Disasterhealth-related challenges and requirements: a grounded theory study in Iran. PrehospDisaster Med.2011Jun;26(3):151-158.
[5] Wang C, Wei S, Xiang H, Wu J, Xu Y, Liu L, et al. Development and evaluation of aleadership training program for public health emergency response: results from a Chinesestudy. BMC Public Health.2008;8:377.
[6] Woltring C, Constantine W, Schwarte L. Does leadership training make a difference?The CDC/UC Public Health Leadership Institute:1991-1999. J Public Health Manag Pract.2003Mar-Apr;9(2):103-122.
[7] Russell ML, McIntyre L. An estimation of Canada's public health physician workforce.Can J Public Health.2009May-Jun;100(3):199-203.
[8] Scott LA, Carson DS, Greenwell IB. Disaster101: a novel approach to disastermedicine training for health professionals. J Emerg Med.2010Aug;39(2):220-226.
[9] Summerhill EM, Mathew MC, Stipho S, Artenstein AW, Jagminas L, Russo-Magno PM,et al. A simulation-based biodefense and disaster preparedness curriculum for internalmedicine residents. Med Teach.2008;30(6):e145-151.
[10] Bartley BH, Stella JB, Walsh LD. What a disaster?! Assessing utility of simulateddisaster exercise and educational process for improving hospital preparedness. PrehospDisaster Med.2006Jul-Aug;21(4):249-255.
[11] Jafari ME. Radiological incident preparedness for community hospitals: ademonstration project. Health Phys.2010Aug;99Suppl2:S123-135.
[12] Eason MP. Sarin exposure: a simulation case scenario. South Med J.2013Jan;106(1):55-62.
[13] Franc-Law JM, Ingrassia PL, Ragazzoni L, Della Corte F. The effectiveness oftraining with an emergency department simulator on medical student performance in asimulated disaster. CJEM.2010Jan;12(1):27-32.
[14] Pelaccia T, Delplancq H, Triby E, Bartier JC, Leman C, Hadef H, et al. Can teachingmethods based on pattern recognition skill development optimise triage in mass-casualtyincidents? Emerg Med J.2009Dec;26(12):899-902.
[15] Prause G, Kroll W, Metzler H, Fuchs G, Kaloud H, Kaltenbock F, et al.[Education ofthe medical student in first aid, emergency and disaster medicine--the Graz model].Anasthesiol Intensivmed Notfallmed Schmerzther.1995Jun;30(4):236-239.
[16] Della Corte F, La Mura F, Petrino R. E-learning as educational tool in emergency anddisaster medicine teaching. Minerva Anestesiol.2005May;71(5):181-195.
[17] Rega P, Bork C, Chen Y, Woodson D, Hogue P, Batten S. Using an H1N1vaccinationdrive-through to introduce healthcare students and their faculty to disaster medicine. Am JDisaster Med.2010Mar-Apr;5(2):129-136.
[18] Archer F, Seynaeve G. International guidelines and standards for education andtraining to reduce the consequences of events that may threaten the health status of acommunity. A report of an Open International WADEM Meeting, Brussels, Belgium,29-31October,2004. Prehosp Disaster Med.2007Mar-Apr;22(2):120-130.
[19] Balch D, Taylor C, Rosenthal D, Bausch C, Warner D, Morris R. Shadow Bowl2003:a collaborative exercise in community readiness, agency cooperation, and medicalresponse. Telemed J E Health.2004Fall;10(3):330-342.
[20] Silvagni AJ, Levy LA, McFee RB. Educating health professionals, first responders,and the community about bioterrorism and weapons of mass destruction. J Am OsteopathAssoc.2002Sep;102(9):491-499.
[21] Wyche KF, Pfefferbaum RL, Pfefferbaum B, Norris FH, Wisnieski D, Younger H.Exploring community resilience in workforce communities of first responders servingKatrina survivors. Am J Orthopsychiatry.2011Jan;81(1):18-30.
[22] Tharp AT, Vasterling JJ, Sullivan G, Han X, Davis T, Deitch EA, et al. Effects of pre-and post-Katrina nonviolent and violent experiences on male veterans' psychologicalfunctioning. Disaster Med Public Health Prep.2011Sep;5Suppl2:S227-234.
[23] Dodgen D, Norwood AE, Becker SM, Perez JT, Hansen CK. Social, psychological,and behavioral responses to a nuclear detonation in a US city: implications for health careplanning and delivery. Disaster Med Public Health Prep.2011Mar;5Suppl1:S54-64.
[24] Lau JT, Kim JH, Tsui H, Griffiths S. Perceptions related to human avian influenza andtheir associations with anticipated psychological and behavioral responses at the onset ofoutbreak in the Hong Kong Chinese general population. Am J Infect Control.2007Feb;35(1):38-49.
[25] Everly GS, Jr., Flynn BW. Principles and practical procedures for acute psychologicalfirst aid training for personnel without mental health experience. Int J Emerg Ment Health.2006Spring;8(2):93-100.
[26] Huntington MK, Gavagan TF. Disaster medicine training in family medicine: a reviewof the evidence. Fam Med.2011Jan;43(1):13-20.
[27] Nilsson H, Vikstrom T, Ruter A. Quality control in disaster medicine training--initialregional medical command and control as an example. Am J Disaster Med.2010Jan-Feb;5(1):35-40.
[28] Colvard MD, Naiman MI, Mata D, Cordell GA, Lampiris L. Disaster medicinetraining survey results for dental health care providers in Illinois. J Am Dent Assoc.2007Apr;138(4):519-524; quiz536-517.
[29] Cefalu CA, Schwartz RS. Salvaging a geriatric medicine academic program in disastermode-the LSU training program post-Katrina. J Natl Med Assoc.2007May;99(5):590-596.
[30] Cummings GE, Della Corte F, Cummings GG. Disaster medicine education inCanadian medical schools before and after September11,2001. CJEM.2005Nov;7(6):399-405.
[31] Pfenninger EG, Domres BD, Stahl W, Bauer A, Houser CM, Himmelseher S. Medicalstudent disaster medicine education: the development of an educational resource. Int JEmerg Med.2010;3(1):9-20.
[32] Merlin MA, Moon J, Krimmel J, Liu J, Marques-Baptista A. Improving medicalstudents' understanding of prehospital care through a fourth year emergency medicineclerkship. Emerg Med J.2010Feb;27(2):147-150.
[33] Coule PL, Schwartz RB. The national disaster life support programs: a model forcompetency-based standardized and locally relevant training. J Public Health Manag Pract.2009Mar;15(2Suppl):S25-30.
[34] Alexander AJ, Bandiera GW, Mazurik L. A multiphase disaster training exercise foremergency medicine residents: opportunity knocks. Acad Emerg Med.2005May;12(5):404-409.
[35] Delooz H, Debacker M, Moens G, Johannik K. European survey on training objectivesin disaster medicine. Eur J Emerg Med.2007Feb;14(1):25-31.
[36] Oztek Z. Public health specialists: occupational description in Turkey. Cah SociolDemogr Med.2010Oct-Dec;50(4):433-444.
[1] Col.Karl H.Houghton.“Hard role for Doctor Seen in Atomic War.”Reno Evening Gazette.1995.
[2] David E.Hogan Jonathna L.Burstein.Disaster medicine.LIPPINCOTT WILLIAMS ANDWILKINS.2007.
[3] International Federation of Red Cross and Red Crescent Societies.World DisastersReport.Geneva,Switzerland: International Federation of Red Cross and Red Crescent Societies.2000.
[4] Noji EK.Advances in disaster medicine[J].Eur J Emerg Med.2002.9(2):185-191.
[5] Auold JL. Disaster Medicine in the21stcentury:future hazards,vulnerabilities and risk[J]. PrehospitalDisaster Med.2002.17(1):3-11.
[6]姚卫光,徐建军,王东.关于构建灾难医学教育体系的思考[J].西北医生教育.2005,13(5):468-469.
[7]灾害医学[N].人民政协报健康周刊,第316期,2009年5月13日.
[8]印国兵,邓博引等.医学生对灾难医学的认识状况及应对方法[J].现代医药卫生.2012,28(7):1092-1093.
[9]马晓光,马岳峰,朱善宽.中国灾难医学现状及发展策略[J].中华急诊医学杂志.2009.18(9):1005-1008.
[10]张新国,辛阔林,姬伟凤.灾难医学救援的难点及行动对策[J].使用医学杂志.2008,25(1):115-116.
[11]刘振立.关于我国灾难医学教育的思考[J].中国危重病急救医学.2003.15(11):643-645.
[12] Paul JA,George SK,Yi P,et a1.Fransient modeling in simulation of hospital operations foremergency response.Prehospital Disaster Med,2006,21(4):223-236.
[13] Macfarlane C,Joffe AL,Naidoo S.Training of disaster managers at a masters degree level:Fromemergency care to managerial contro1.Emerg Med Australas.2006,18(5-6):451-456.
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