STUDENTS’ PREFERENCES FOR DISASTER MEDICINE EDUCATION

: Introduction: Disaster medicine training is in constant development. The effort to improve education could be facilitated by the students. They could actively participate in the process by providing useful feedback as well as preferences. Purpose: The aim of this study was to survey and analyze the students’ preferences for disaster medicine education. Materials and methods: A cross-sectional survey was conducted among students of the Medical University of Plovdiv.166 students were surveyed ontheir attitude towards disaster medicine as well as preferences for the training course. Results: Disaster medicine training was considered a necessary part of the education. The most approved form of education was practical training, followed by elective course. The most desired topics are those regarding direct casualty management like first aid, first medical aid, triage and evacuation. Conclusions: To better respond to the expectations and educational needs of the students, modification of the training course could be considered.


INTRODUCTION
Disaster medicine is in constant development related to changing or emerging natural and man-made hazards and improvement of the capabilities for prompt and efficient response. Technological development and complex political and economic processes create entirely new problems for both society and healthcare. Examples are refugee waves, the pandemic spread of coronavirus infection, the effects of global warming and more. These problems will develop and deepen, and the students will face them in their professional life.
[1] University education should aim to prepare them as best as possible. Disaster medicine education has to correspond by implementing the novelties in the specialty as well as the advances in technology and social sciences in the teaching process.
The effort to improve education could be facilitated by the students. They are not just passive recipients; they could and have to actively participate in the educational process providing useful feedback as well as preferences.

PURPOSE
The aim of this study is to survey and analyze the students' preferences for disaster medicine education.

MATERIALS AND METHODS
A cross-sectional study was conducted in 2020 through an anonymous inquiry among students from Medical University -Plovdiv. The questionnaire for the survey aimed to investigate attitudes towards disaster medicine course and perceived benefits from it as well as preferences regarding disaster medicine training.
Analysis, processing and systematization of initial data as quantitative and qualitative variables were performed on the statistics software package IBM SPSS Statistics v.21. For all tests, the level of significance was set at α=0.05.
Descriptive analysis was used to describe the structure of the analyzed variables. Analysis of variance was used for quantitative variables and frequency distributions for qualitative data. Testing of the statistical hypothesis was made with a Two Samples T-Test and Chi-squared analysis (χ 2).
All of the surveyed have taken disaster medicine course as part of their university education. Almost half of them gave a positive assessment of the volume and the content of the subject. (table 1) A thorough analysis has to be performed for the purpose of establishing whether standard disaster medicine topics reflect the contemporary challenges in front of healthcare professionals. https://doi.org/10.5272/jimab.2022283.4578 The medical graduates should have not only comprehensive theoretical knowledge, but they have to successfully apply it in practice by solving therapeutic and organizational problems, making various decisions and assuming responsibility. Passive transmission of theoretical information as a method of teaching no longer suffices. Standard didactic teaching was not very well appreciated by 42.6% (n=69) of the students. It does not correspond to the contemporary tendencies in education.
[2] The students gave a dissatisfactory evaluation of the teaching methods and their usefulness in acquiring skills. 1/3rd of the interviewees find them insufficient. Examples from other researchers show that disaster medicine training that incorporates field exercises, practical skill training, simulations, role games and case scenarios receive better feedback from the participants. [3, 4, 5, 6] These findings highlight the need for balance between lectured and "processed" knowledge and stimulation of independent critical thinking and problem-solving. The latter is highly praised in modern education, but in the field of medicine, it is impossible without a firm knowledge base.
The knowledge and skills that the discipline teaches are specific and do not overlap with other subjects. 70.9% (n=118) state that the discipline should be studied. Similar surveys show even higher results. According to a study from China, 92.2% of the students believed that it should be studied. [7]Even higher results were obtained in the Netherlands -99%. [8] In the light of the still ongoing Covid-19 pandemic, it became evident that dealing with disaster's consequences affects the entire health care system and mandates extraordinary measures. Having the knowledge and skill to prevent harm and provide support for the affectedis essential for medical professionals. It is a promising finding that medical students recognized this. The majority believed that disaster medicine knowledge is necessary for medical practice. More than half of the respondents were convinced that there should be refresher courses and joint training with other first responders. (table 1) A large number of possible devastating events and their relatively rare occurrence makes learning from experience impractical. Maintaining the knowledge is also challenging since it is not solidified in practice. Continuous education incorporating disaster medicine courses could solve this problem. Joint training with other first responder teams will improve one of the most critical features of disaster relief -communication, collaboration and coordination.
The most effective method for obtaining knowledge and skills, according to the students, is practical training (45.4%, n=69), followed by elective course (41.4%, n=63) and traditional lectures and classes (38.2%. n=58). Online

CONCLUSIONS
The survey proves that medical students recognize the need to be prepared for a prompt medical response when a disaster occurs. They expect university education to provide them withtheoretical and practical training that corresponds to the contemporary and foreseeable threats and the novelties in scientific and technological developments. Technology drives medical practice forward, and it is only logical to drive the optimization of education by modifying the volume and complexity of the subject as well as the teaching methods.