Effect of Simulations on First Responders

Effects of Simulation Training in the Preparedness of a Disaster Management System:

For the Training of First Responders

By Cameron Crowson

Jacksonville State University

EM 530: Research Methods of Emergency Management

Dr. Jeff Ryan

July 7, 2015

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Abstract

The purpose of the paper is to propose a research study that examines the effects of

simulations on the preparedness of First Responders in the field of disaster management. Many

different designs have been implemented in several research papers. These dynamic designs help

in the preparation of real world disaster scenes and uses a full spectrum of communication

framework to deliberate over a wide-range of technologies. I believe that these systems will

show an exceptional aspiration and determination to develop disaster mitigation strategies and

preparedness for the future of Emergency Management. I also predict improved participation in

training courses and satisfaction from First Responders.

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Table of ContentsAbstract............................................................................................................................................2

Effects of Physical Simulations in the Preparedness of a Disaster Management System...............4

Literature Review............................................................................................................................5

First Responders..........................................................................................................................5

Integrated Field Experience and Training...................................................................................6

Aims, Goals, and Objective.............................................................................................................7

Hypothesis.......................................................................................................................................7

Experimental Design.......................................................................................................................7

Data Collection................................................................................................................................8

Data Analysis...................................................................................................................................8

Logistical and Financial Considerations..........................................................................................9

Ethical Considerations.....................................................................................................................9

Expected Outcome(s).....................................................................................................................12

Appendixes

Appendix A: Sample Proposal to the Saint Petersburg, FL City District.........................14

Appendix B: Questionnaire to First Responders..............................................................15

Appendix C: Itemized Budget for the Proposed Study......................................................18

Appendix D: Subject Information and Consent Form.......................................................19

Bibliography..................................................................................................................................20

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Effects of Physical Simulations in the Preparedness of a Disaster Management System

Simulation studies have proven to be a great success in helping with Disaster Research as

well as Emergency Management. In many courses, like Emergency Medicine Crisis Resource

Management (EMCRM), “the study subjects [who rated from a 1-5 rating] found EMCRM to be

enjoyable (4.9± 0.3¿… and reported that knowledge gained from the course would be helpful in

their practices (4.5± 0.6¿” (Reznek, et al., 2002). Simulation studies have effectively helped

prepare individuals for field training in areas such as Emergency Medicine, Disaster

Management, Emergency Response, and other Emergency Management fields. Simulation

studies have grown since it first began in the 1940s and 1950s, with the entertainment field, and

blossomed into a field used for a wide-range of possibilities.

Disaster Management systems have been successfully used by first responders to

“provide [a] low cost, effective training platform that enables teams to practice response

scenarios and execute commands on a multitude of incidents in a time-sensitive, safe, and

organized manner” (Nastar, 2015). The National Aerospace Training and Research (NASTAR),

trains using realistic simulations in areas like piloting, medical training, biomedicine, high

performance composites, and information systems.

In the field of Emergency Medicine, technology has increased survival rates because the

“simulation environment prompted realistic responses” (Reznek, et al., 2002). One example of

this is the EMCRM pilot study, which simulated real time responses in crisis simulations like in

using Anesthesia to sedate the patients through surgical procedures.

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I feel that this type of research could benefit city-wide as well as state-wide emergency

management. First Responders are considered to be the most important people in the line of

emergencies, therefore, it would be important to train them.

This paper will concern itself with detail that covers a wide-range topics in simulation

studies, which could and have had an impact on the training of First Responders and Emergency

Managers, in the field of Disaster/Emergency Management; which takes into account the ethics,

logistical and financial considerations, sources of funding, cost analysis/data analysis, and then

explain the expected outcomes.

Literature Review

The goal of the literature review is to evaluate the incentive for the proposed study. The

technologies in Disaster and Emergency Management in comparison with that of the old ways of

designing, selecting, collecting, and analyzing research in the field of Emergency Management

will be the main focus. Therefore, with the modern technology in today’s society, and the

training available for most First Responders, there is satisfactory training accessible to First

Responders; Using technology, like simulation tools, will allow the First Responder to maximize

their learning and have fun with their education.

First Responders

First Responders have used a variety of technology to assist them in their everyday

career. They help with mundane disasters and protect citizens from disasters and emergencies all

around the world, but rarely people take the time to analyze the situation through the eyes of the

First Responder: “The psychological and behavioral consequences for individuals and

communities of public health workers affected by [disasters] are needed in any plan for

interventions before, during, and after a disaster” (Benedek, Fullerton, & Ursano, 2007). The

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First Responder’s psychological, mental, and physiological health is just as important, if not

more important, then the people they are saving during natural disasters.

In the article by Benedict; Fullerton; and Ursano, called First Responders: Mental Health

Consequences of Natural and Human-Made Disasters for Public Health and Public Safety

Workers, the main focus was to introduce the concept of the health consequences of the First

Responders during and after natural and human-made disasters. Mental health disorders like

post-traumatic stress disorder (PTSD) and acute stress disorder (ASD) are major concerns that

affect the outcome of First Responders on the job. It is vital that they are prepared and

understand the situation before they begin their work.

Integrated Field Experience and Training

Simulation studies have had a profound effect on the training and responsiveness of First

Responder on the job: “Benefits of simulation training include standardization and repetition of

content, interactive learning in a clinical setting without patient risk, and the ability to design

goal-oriented clinical experiences” (Coates, et al., 2006). In which, Simulation studies has had a

serious effect on the medical industry and emergency management teams.

From many different articles, it has been concluded that simulation training is much more

preferable over others: “The use of classroom and hands-on training by expert physicians has

been the training mechanism of choice for most medical training [programs]” (Kunkler, 2006).

As stated by Kunkler, in his article, The Role of Medical Simulations, “as the health care

industry becomes more familiar and comfortable with medical simulators and robotic surgery,

additional benefits will be gained” (Kunkler, 2006). The effects of medical technology and

simulation studies have and will have future impacts on society. In which the impacts have been

immense in comparison to regular training.

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Aims, Goals, and Objective

The research provided aims to compile information on a specific study of the importance

of simulation studies on the training of First Responders. The goal is to have a selected group of

First Responders complete a simulation course and compare their response to crisis management

with another group who has not taken simulation training. The objective is to analyze how

effective simulation training is in preparing First Responders for disasters.

Hypothesis

If simulation training is incorporated into Florida first responder training courses, then

Florida first responders will be better prepared to do their jobs.

Null: If simulation training is incorporated into Florida first responder training courses, then

Florida first responders will not be better prepared to do their jobs.

Experimental Design

In order to examine the effectiveness of simulation training on First Responders, I plan to

apply a survey design. Two selected groups of First Responders will form the variance, in which

one group will take simulation training while the other, with no simulation training, will be

elected to serve as the standard for the experiment. A measurable test of skill will be given to

both groups and then graded by a group of Emergency Managers. This will also serve as a

performance assessment, which will ask questions regarding the effectiveness of simulation

training and the willingness to participate in another training course. This will allow a complete

analysis of the First Responder’s involvement in the study and prove my hypothesis.

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Data Collection

The sample form consists of individual selected responders in the state of Florida, who

have and have not participated in simulation-based training. Let’s figure that we need a

proportional and representable sample that will serve as a meaningful count for this study. In the

state of Florida there are approximately 75,800 First Responders. Of the 40 districts of Florida

we need a considerable amount, but not an amount that would cost the State of Florida millions

of dollars for simulation training. For this to stay proportional we could measure the effects of

simulation training in one county in the state of Florida and project that measurement to reflect a

statistically significant amount of individuals.

So, taking a sample from a district of Florida, let’s say the Saint Petersburg, FL district

for example. Then we can take data from the Bureau of Labor Statistics, in which there are

approximately 2,830 employed firefighters; 410 First-Line Supervisors of Police and Detectives;

and 1,810 Emergency Medical Technicians and Paramedics. Altogether, there are at least 5,050

qualified First Responders in just the district of Tampa-Saint Petersburg-Clearwater, FL district.

Considering the cost of each training, cost-break follows in Appendix C, It would cost each

person or the state, about $50.00 per person.

Data Analysis

The goal of the data analysis is to analyze the given statistical inferences through other

research and hypothesis. The computations are based on the data given to us by the individual

First Responders on their survey. The questions are about the influence of training and the

preparedness of the First Responder after the training. In comparison, the questions they are

asked before the simulation training will be taken into account as well. The second group, will be

given a separate option to respond on how well prepared they are in their everyday training.

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For each of the two groups’ statements, in which they will be given the same survey

(Appendix B), I will add the selected responses from their form to a group tally: to compare the

number of prepared responses with that of unprepared as well as the unsatisfied. I will convert

the responses into percentages; the expected number of surveys is the same number of people

that participated in this study. To make sure that these surveys are turned in, we will give them

an option to fill out a survey at the end of the course, and another chance to take the survey at

home, in which it will be mailed out.

From the survey information, questions asked regard specific demographic information,

satisfaction with the training course, satisfaction with the time, and a response question about

whether or not this session prepared the First Responder for their line of duty. Asking these

questions allows me to gain a better understanding of the quality and care of the training as well

as the effectiveness afterword. I intend to apply statistical calculations to the survey samples and

compare the results to the standard group to show that the simulation training has an effect in

preparing First Responders for their line of work.

Logistical and Financial Considerations

Since financial logs are widely available to the public through the Bureau of Labor and

Statistics website, it is not impossible to gain access to addresses and lists of records of each

individual first responder. If we were to consider each Florida district as a candidate for this

survey, then we would need to contemplate state vs. city costs of each individual responder, but

the subject of the study is going to be concentrated around a smaller group of individuals.

Ethical Considerations

Although the psychological, emotional, and physical risks of this training could be

detrimental to the individual, it is up to the first responder to take on the task of bettering their

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education and training for their own career. The survey, however, will be kept short and to the

point, as we do not want this to take up much of their time needed in the field of emergencies.

The research is not completely ethically sound, but the benefits from this type of training could

save people’s lives and perhaps one day open doors for further studies in emergency

management.

Participation in this study is voluntary. Additionally, when the forms are completed the

names of each individual person that participated will be anonymous; because of reasons that

individuals may not do as well in this training.

The following is a clip of the consent form (Appendix D), which reveals the principle of

the study:

“The individual respondent will be responsible for ensuring the completion of the survey as it

pertains to the wellness and education of the Emergency Management program and First

Respondent training. Your Participation is highly needed for ensuring a better response to

disasters and emergencies all across the United States. Anonymity is assured and promised as

the laws in the United States disclose the importance of secrecy of individual information. This

Survey is conducted through the Emergency Management program at Jacksonville State

University, with gaining approval from the cities and districts of the state of Florida.”

Sources of Funding

The review of the literature serves an importance to explain how integrated simulation

studies would have a profound effect on First Responders, by way of including data

methodology and logistical and financial considerations. Keeping in mind the ethical

considerations, of how much money this would cost the city and state governments, there are

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potential sources of funding to alleviate the stress of how much this will cost the tax payer. The

need for better training of First Responders is a recognizable problem. Therefore, based on my

research and data analysis the following organizations have way of providing funds:

Federal Emergency Management Agency

500 C Street SW

Washington, DC 20472

Telephone:  202.646.2500

Florida Division of Emergency Management

2555 Shumard Oak Boulevard

Tallahassee, FL 32399-2100

Telephone: 850.413.9969

The Florida Division of Emergency Management (FDEM) is continually providing

individual and public assistance; in 2011, FDEM provided hazard mitigation assistance in way of

over $5 billion in grants and public assistance programs. I intend to make a proposal to the

Florida Division of Emergency Management to stress the importance of simulation training and

how it can incorporate a well-defined first-aid and medical training program for First

Responders. In comparison, FEMA may also incorporate some funds for the training and

research. By making both of these corporations stakeholders in the research, there may be a way

to alleviate the burden of funding. FEMA and FDEM are the first agencies that I will consider.

Alternative funding sources and sources of support may include:

Tallahassee City Government

300 South Adams Street

Tallahassee FL 32301

Telephone: 850.891.8214

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City of Saint Petersburg

P.O. Box 2842

St. Petersburg, FL 33731

Telephone: 727.893.7111

Jacksonville City Hall

117 W Duval St #425

Jacksonville, FL 32202

Telephone: 904.630.1377

City of Tampa

306 East Jackson Street

Tampa, FL 33602

Telephone: 813.274.8211

Occupational Safety & Health Administration

200 Constitution Ave., NW,

Washington, DC 20210

Telephone: 800.321.OSHA (6742)

Expected Outcome(s)

The proposed research should show that, even though training is expensive, that the

effect of simulation training has a positive effect on the community and the individual First

Responders. In evaluating the data, logistical and financial consideration, ethical considerations,

and sources of funding, there should be very little doubt in allowing this research to pursue. The

reader will learn, from the data and surveys, that simulation studies are the most preferred of the

learning and classroom tools in the 21st century. I believe the responses from the surveys will

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also prove that the impact of simulations will cause better aptitude in the field of disaster

management and provide a more careful analysis of field work. Consequently, there will be more

lives saved, less mental and physiological anguish from the individual First Responder, and

better responsiveness. In return for the training and surveying this will prove my hypothesis on

how positive the effects of simulations can be on the First Responders and individual people all

around the world. This will build trust in the field of Emergency Management and raise

awareness for disaster recovery from individuals and First Responders.

Thank-you for reading the research proposal. The research promises to incorporate new

technologies in the 21st century and apply them to different fields of emergency training. The

research proves my hypothesis and objective of the study. Furthermore, this type of research will

provide and identify effective intermediaries between emergency management and simulation

training; it may aspire others to further research in simulation studies and more productive

research and design similar projects. In acknowledgment of Emergency management and

planning, there may be more desirable and predictable results proven from this research.

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Appendix A:

Sample Proposal to the Saint Petersburg, FL District

7/3/2015

Cameron CrowsonJacksonville State University700 Pelham Rd. North,Jacksonville, AL 36265

Saint Petersburg, FL City Hall175 5th St. NSt Petersburg, FL 33731

To Saint Petersburg, FL City Hall:

We are writing to explain a recent plan of action, which has come up in several of our

council meetings, to train First Responders by way of medical and disaster simulations.

Simulation studies have had a profound impact on 21st and have constantly been the subject by

most disaster response and medical operations teams.

The research promises to incorporate new technologies in the 21st century and apply

them to different fields of emergency training. From the data and surveys, the different

technologies incorporated in the field of Emergency Management have had several key impacts.

This type of training will ultimately save many lives and save the city quite a bit of money in

hospital bills, lawsuits, worker’s compensation, unemployment, and disability claims.

In acknowledgment of Emergency management and planning, there may be more

desirable and predictable results proven from this type of research. This type of research will

provide and identify effective intermediaries between emergency management and simulation

training; it may aspire others to further research in simulation studies and more productive

research and design similar projects.

Cameron CrowsonJacksonville State University

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Appendix B:

Simulation Training SurveyEM 530: Research Methods in Emergency Management 

1. Are you male or female?

Are you male or female?  Female

Male

2. What is your age?

What is your age?  17 or younger

18-20

21-29

30-39

40-49

50-59

60 or older

3. Which of the following categories best describes your employment status?

Which of the following categories best describes your employment status?  Employed, working full-time

Employed, working part-time

Not employed, looking for work

Not employed, NOT looking for work

Retired

Disabled, not able to work

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4. In what language do you speak most often?

Arabic

Armenian

Chinese

English

French

French Creole

German

Greek

Gujarati

Hindi

Italian

Japanese

Korean

Persian

Polish

Portuguese

Russian

Spanish

Tagalo

Vietnamese

Other (please specify)

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5. Overall, were you satisfied with your training experience?

Overall, were you satisfied with your training experience  Extremely satisfied

Very satisfied

Somewhat satisfied

Neither satisfied nor dissatisfied

Somewhat dissatisfied

Very dissatisfied

Extremely dissatisfied

6. How convenient was this training session?

How convenient was this training session?  Extremely convenient

Very convenient

Moderately convenient

Slightly convenient

Not at all convenient

7. In comparison, to your normal training experience, did this prepare you more or less to be a better First Responder?

8. Would you participate in this research study again?

9. Do you have any additional comments?

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Appendix C:

Itemized Budget for the Proposed Study

See separate Excel spreadsheet “EM 530 Budget Crowson”

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Appendix D:

Subject- Information and Consent Form:

A subject-based research study on the preparedness of individuals in a disaster scenario. This study

concerns the information provided in the survey and the consent of the individual to partake in this

research.

What is the Purpose of the Study?

The purpose of the study is to study the effects of simulation training on the individual First

Responder with that of those with regular training, but the main reason for the study is to answer

these questions

Are you, as a responder, better prepared for a disaster scenario, after you participated in the

simulation training?

Would you partake in this study again?

Principle of the Study

The individual respondent will be responsible for ensuring the completion of the survey as it pertains

to the wellness and education of the Emergency Management program and First Respondent training.

Your Participation is highly needed for ensuring a better response to disasters and emergencies all

across the United States. Anonymity is assured and promised as the laws in the United States disclose

the importance of secrecy of individual information. This Survey is conducted through the

Emergency Management program at Jacksonville State University, with gaining approval from the

cities and districts of the state of Florida.

Study Procedures

Individualized data will be taken from assistants in the study to inform us on the effects of the

training on the First Responder; the data will then be recorded in a file and noted as a possible fit or

denial for participation in this study.

Henceforth, if you are presented with a file that you fit the criteria for the study, you will be filled in

on all of the information about the simulation course. Therefore, it is in your best interest to give out

accurate and descriptive information about yourself and training when told to do so.

I consent to give accurate and relevant information in this study and if not I understand that I may be

banned from this and future studies:

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Signature: __________________________ Date: _______________________

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Coates, W. C., Huang, Y. M., Steadman, R. H., Matevosian, R., Larmon, B. R., McCullough, L., & Ariel, D. (2006). Simulation-based training is superior to problem-based learning for the acquisition of critical assessment and management skills. Critical Care Medicine, 34(1), 151-157.

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