Topic 1: Target Groups

To design a program in DM, it is important to know the target group. Globally, 3 different categories—social groups, economic groups, and political groups—are identified as stakeholders involved in DM. These groups are described and their activities are well discussed in an earlier publication.Reference Khorram-Manesh, Ashkenazi and Djalali ¹ All of these groups have different managerial levels; strategic, tactical, and operationalReference Khorram-Manesh, Ashkenazi and Djalali ^{1 ,} Reference Lennquist ² ;

1. 1. Operational managers have some training in being a liaison with and having awareness of other agencies, mainly for individuals preparing for promotion to team leader level. They have a focused knowledge on their tasks but often lack interorganizational skills and knowledge of collaborative parties’ agendas and legislation. Operational managers will already be trained in discipline-specific technical and operational skills required within their fields. A new program will be complementary to their individual skills and facilitate their performance within and among units. This will potentially address basic aspects of ethical, cultural, and legal issues to enhance their capabilities within the international sphere.

2. 2. Tactical managers are trained to a higher level by their parent organizations to lead specialist teams responding to a disaster. Although they are supposed to have some training that would enable them to be aware and liaise with other agencies to varying competency levels across organizations, they often appear to be predominantly focused on their own organization. These are, however, the very staff that will be required to understand and integrate their response/capabilities into the overall DM. To accomplish such a broad competence, they have to be trained in operational capability and capacity as well as have a full understanding of the disaster response system internationally and receiving assistance (host nation support). These are typically the people who will be responsible for overseeing frontline managers and must be able to liaise with national and/or international authorities.

3. 3. Strategic managers are supposed to be trained to develop effective strategies that set out the purpose, rationale, and parameters in which others within the disaster command structure will operate. Personnel at the strategic or gold response level are seemingly involved with the legal, financial, and policy levels within the national authority/organization. They are not normally supposed to be tactical responders and subsequently do not have operational or tactical responsibilities. Although this strategic group requires further knowledge of disaster response, they are not the group with the greatest educational needs; instead, they are supposed to provide tactical managers with information and support in decision-making.

Topic 2: Curriculum, Didactic and Educational Theory; Content of the Competency-Based Program, the Topics

The review of major publications on core competencies needed for DM indicates that key overarching elements/themes common to all of them can be used as references to build competencies and ensures that such competencies are in line with and applicable in such concepts. A set of 7 domains and 34 related core competencies may be developed as shown in Table 1 and presented in earlier publications.Reference Khorram-Manesh, Ashkenazi and Djalali ^{1 ,} Reference Ripoll Gallardo, Djalali and Foletti ^{6 ,} Reference Ingrassia, Foletti and Djalali ^{7 ,} Reference Subbarao, Lyznicki and Hsu ^{9 - 13}

Table 1 Domains and Core Competencies in Disaster Management

Core competencies in Table 1 were matched by the expert group with results obtained from a recent publication in which shortcomings in disaster preparedness in the health system of 27 EU member states were described as 88 items categorized in 8 groups (leadership and governance, logistics and operational support functions in emergencies, medical products and technology, health information, subnational/regional plans for crisis/mass casualty incidents, management of prehospital medical operation, hospital emergency preparedness program, and education and training).Reference Djalali, Della Corte and Foletti ¹⁴ This review, together with an earlier review/survey on the deficiencies in the response chain,Reference Djalali, Ingrassia and Della Corte ³ resulted in the inclusion of the following major area of interests/topics in the curriculum (Table 2): (1) definition and general principles about disasters; (2) disaster cycle and management; (3) functions needed in disaster management (including financing and funding); (4) European organization model; (5) planning, management, leadership, and decision-making (command and control); (6) risk and vulnerability analysis; (7) communication issues (internal and external); (8) cultural aspects of disasters; (9) political considerations; (10) information collecting and sharing; (11) legal aspects of disasters; (12) ethical aspects of disasters; (13) public health issues, including sanitation and hygiene; (14) medical issues (emergencies, trauma); (15) chemical, biological, radiological, nuclear, and high-yield explosives; (16) search and rescue; (17) nongovernmental organizations and voluntary organizations; (18) geospatial support; (19) safety and security; (20) logistics, including evacuation of disaster victims; (21) recovery and reconstruction; (22) mental health care and psychosocial support; and (23) special consideration.

Table 2 Rationale for Each Topic’s Inclusion Based on the Earlier Data

Competencies can be mapped to learning objectives, and each learning objective can be mapped to activities (Table 3), by which both teacher and learner can evaluate the process of learning and acquiring a competency.Reference Bloom ^{15 ,} Reference Fink ¹⁶ Topics will be presented in a handbook, which can be divided into conceptual and practical parts and taught accordingly. Scenarios give flexibility to the program/training as a scenario, and its outcome can be adapted to the participants’ background and desired objectives. Additionally, the direction of training can also be changed if necessitated by the participants’ background; for example, medical professionals and firefighters may need a scenario such as a disco fire with multiple injuries and burns, whereas firefighters, police, and military may use an explosion scenario without human injuries but with an imminent threat to life. Scenarios are very important in involving 2 organizations and can highlight the benefit of the interagency integrated response best able to handle a given event. The EP will provide the platform and basis to train all levels of staff with a common core set of requisite skills and knowledge to enable team building, coordination, integration, and cooperation.

Table 3 Topics, Learning Objectives and Related Activities Based on the Expert Groups Opinion Based on the Extracted and Suggested Topics in Table 2 ^a

^aAbbreviations: CAP, computer-assisted publishing; EAS, Exchange ActiveSync; GI, geographic information; GIS, Geographic Information System; GNSS, Global Navigation Satellite System; GSM, Global System for Mobile Communication; INSARAG, International Search And Rescue Advisory Group; IR, incident response; MI, major incidents; OSOCC, On-Site Operation Coordination Center; PDA, personal digital assistant; SOP, standard operating procedures; VSA, very small array; WFP, World Food Program.

Topic 3: Teaching Methods

The pros and cons of different teaching methods is widely discussed in the literature.Reference Khorram-Manesh ¹⁷

In short the most common type of teaching is face to face teaching, which offers an interaction between teacher and learner. Using this method it is easier to make social contact, establish trust between learner and teacher, and generate new ideas and discoveries during the interaction. However, limited space, low numbers of participants, and insufficient time for feedback are some of its disadvantages.

Skill station is another way of teaching, in which learners pass through a sequence of face-to-face interactions with defined achievement requirements. It represents a slightly more active form of learning in which the focus is on the individual achievements of the learner, and it provides an environment to learn at the learner’s own pace. However, the number of participants is limited while there is a need for large number of teachers and a huge time investment.

Practical exercises with little or no technical input allow learners to simulate the experience of reality, to make controlled errors, and to develop an understanding of the doable and the undoable. They offer learners an opportunity to develop know-how and not only know-what; they develop skills and not just knowledge. This approach enhances team spirit and communication skills. However, it requires careful and lengthy development and testing as well as a great deal of preparation. Other cons with the method are its high costs and limited numbers of learners.

Video lectures have a major advantage in terms of student time management. Video lectures allow teachers to present the major message before a face-to-face meeting that will focus on discussion. This approach, however, lacks interaction between students and teachers or students and their colleagues unless supplemented by discussion.

A computer-mediated environment may offer no interaction between teacher and learner, but it can be improved if each student or small groups of students have their own instructor. Course trajectory (including ancillary material), simulation exercises, and programmed learning are presented to the student without the presence of a human teacher or trainer and can easily be updated. Every student has the opportunity to learn at her or his own pace and time and can be evaluated and guided. There is no limit to the number of participants, and it gives enough time for individual feedback. On the other hand, it requires huge resources and lengthy time to develop an initial course, it isolates students without human contact, and the lack of interaction may result in lower learner satisfaction.

Simulation represents another form of learning in which the student engages deeply in skills training by attempting to solve problems in an environment that is similar to the ones to be encountered in real life. The planning of simulations is a complex topic and depends on the designer’s understanding and knowledge. The students can be more passive or highly hands-on and interactive. They can make mistakes without endangering anyone, and training effectiveness can be measured. Disadvantages of this method are the need for careful selection and matching of trainees to roles necessary as well as the need for highly skilled trainers. This approach can also be expensive and time consuming to set up.

Tabletop simulation offers an intellectual and communicative environment and allows a mix of face-to-face teaching with the addition of some practical exercises that provide the learners with the possibility of putting their gained knowledge into practice. These simulations are largely scenario based, and the degree of reality can be varied to elucidate real-time issues such as lack of communication. Studies on the effects of tabletop simulations on student perception of disaster preparedness and management has shown that compared with field operation exercises, this method provides better possibilities to link the results of disaster exercises to appropriate changes in terms of training, equipment, supplies, and plans as well as to the ability of others to fill in during the absence of key officials. Participants can take a position from their professional function and be active. A large number of functions can be trained simultaneously, and this is flexible enough to provide training for all levels of managerial need as well as multidisciplinary training. It is easier to time and control the workflow and give feedback. It is independent of external environment, and the setup costs are low. However, evaluation of the work on an operative level is hard, and the physical environment cannot be replicated (in contrast to the intellectual and communicative environment, which can be replicated). It also requires strong facilitation and back-office personnel.

Real-time simulations allow the utilization of the whole chain of actions from the pre-hospital setting to command-and-control groups at all levels; consequently, it involves a large number of participants. These play out in certain sequences in real time. Thus, real-time simulations can be an essential component in any form of simulation for disaster relief. It provides possibilities for real-time actions (variation in time and accurate input data in terms of resources, type of injuries, outcome data in terms of mortality and morbidity). It can be adjusted with regard to course length, number of participants, and instructors. The result is reproducible and evaluable, and the cost is acceptable. The importance of information flow and collaboration/cooperation are emphasized, and the time for individual and group feedback is available.Reference Khorram-Manesh, Ashkenazi and Djalali ^{1 ,} Reference Lennquist ^{2 ,} Reference Khorram-Manesh ^{17 ,} Reference Lennquist Montán, Khorram-Manesh, Örtenwall and Lennquist ¹⁸

Blended learning, in which various means of teaching methods are be used, is probably the most cost-effective and suitable type of teaching for disaster and emergency management.Reference Khorram-Manesh, Ashkenazi and Djalali ¹ A blended teaching method offers the flexibility and adaptability needed for managing a continuously changing disaster environment with various severities. By using simulation training in this program, we may not only train individuals but also establish their role in and contribution to the teamwork. It also reveals the possibilities and limitations in each organization/nation and creates conceptual and functional solutions needed for a successful outcome. Both participants and the program can also easily be evaluated using scientific and evaluated methods.Reference Khorram-Manesh, Ashkenazi and Djalali ^{1 ,} Reference Lennquist ^{2 ,} Reference Lennquist Montán, Khorram-Manesh, Örtenwall and Lennquist ¹⁸ Although there will be a proposal in this article about teaching methods used in some parts of this program, teaching methods should be selected based on the capacity and availability of resources at the training center, keeping in mind that different teaching modalities may be associated with different learning outcomes. Teaching centers will be strongly encouraged to integrate different methods of teaching ranging from didactic lecture to computer-based learning to simulation and practical training.

Topic 4: Program Evaluation

Many methods, such as questioning, simulation, skill demonstration, direct observation, and evidence of prior learning/pretest, can be used to evaluate a learner’s gained competency by looking at the learning outcomes.Reference Ahearn and Nalley ¹⁹ However, a good assessment method should also be simple and flexible. It is also important to ensure that the assessment instruments collect evidence that is representative, authentic, and sufficient to allow competence to be inferred. In a blended learning environment with different units and teaching methods, various measures may be used to not only ensure a thorough evaluation of participants but also the program itself. Many of aforementioned methods can be used in the theoretical or semitheoretical parts of a program; however there are other approaches to evaluate training.

Training evaluation is a complex process and none of the existing models alone cover all aspects of the training evaluation. Thus, there is a need for a combined approach. Goal-based and system-based approaches are predominantly used in the evaluation of training. The former evaluation method, proposed by Kirkpatrick,Reference Eseryel ^{20 -} Reference Kirkpatrick ²⁴ has been identified as the most used model in the literature. However, it may not be able to fully define the necessary process and steps needed to improve training by using the outcomes. The latter, on the other hand, can better cover the overall context and situation but may not present the dynamic interaction between the design and the evaluation of training. Thus, an evaluation framework (EF) should be used to properly assess the whole program, and consequently, by using the results, further improvements are guaranteed. Our main goal in designing EF is to establish a complete set of criteria involving 2 main approaches; thus, a twofold evaluation approach should be chosen—the NickolsReference Nickols ²⁵ approach (different points, different moments) as a horizontal axis and the KirkpatrickReference Eseryel ^{20 -} Reference Kirkpatrick ²⁴ levels as a vertical axis—in order to include all the coordinates that need to be evaluated before, during, and after training or before entry, in the workplace and upon exiting the workplace (Figure 2).

Figure 2 The Nickols Approach to Training Evaluation

The Kirkpatrick Model Reference Kirkpatrick ^{21 -} Reference Kirkpatrick ²⁴ consists of 4 levels and describes the way any training initiative is evaluated with regard to the impact on the trainee. Level 1 evaluates the thoughts and feelings of a/the trainee by using feedback forms, training surveys, or questionnaires (reaction of student). Level 2 describes the resulting increase in knowledge or capability (compared with before the training) by using pre- and postcourse professional tests, as well as interview or observation (learning). Level 3 reflects and quantifies the changes in behavior and capability as a result of improvement and implementation/application of the outcomes of the training program (behavior). This requires long-term follow-up, interviews, and cooperation with the trainees, which may be problematic. Finally, level 4 (results) describes how training affects a trainee’s performance, translated into business or environmental changes. These may be difficult to assess as changes in the business and work environment imply managerial measures and a group activity and needs long-term evaluation.

The Nickols approach Reference Nickols ²⁵ defines a very important characteristic of training evaluation—the necessity of a multifactorial approach when measuring the consequences of training—because many different factors, such as the purpose of the evaluation, the target audiences—affect the evaluation process. The evaluation is a tool, which cannot exist independently of the object of evaluation. It is part of the management process as the result of evaluation will be used for designing future training initiatives and efficient use of the resources. It is a continuous process as it takes place parallel to the evaluated process itself, in multiple points of the training, which allows a flexibility that helps remodel the training while it is still ongoing. Besides these, Nickols used the term “strategic view" of training to describe the importance of a thorough and realistic evaluation for the future development of the process/organization by evaluating participants based on 5 horizontal coordinates for training (Figure 2).

These 2 approaches results in a pre- and postcourse assessments and 4 vertical levels of evaluation to describe the importance of the program for the knowledge and skills of the trainees, to find out how to improve future programs, and to determine whether a program should be continued or dropped.

Topic 5: Standard in Disaster Management; Program Design and Standardization

In topic 5 (Figure 3), the participants are professionals working in various phases of DM and at different levels (strategic, tactical, and operational). They also have different educational backgrounds and diverse amounts of experience. However, they all enter an intercultural, interdisciplinary, and competency-based education with the goal of enhancing their overall performance in vertical and horizontal activities. Earlier publications, including this review, have indicated a lack in realistic training and mutual education along with shortcomings in the four Cs (command, control, communication, and collaboration) and standardization. A common set of competencies can be used to standardize the DM program across different training centers.Reference Khorram-Manesh, Ashkenazi and Djalali ^{1 ,} Reference Alexander ^{4 .} Reference Alexander ⁵ Such a program for disaster managers supports the education/training and preparation of attendees to better understand relevant issues for DM. Individual topics are incorporated into knowledge to be further converted into skills and competencies by using different teaching methods. To achieve the overall learning objective and its specific components for such an EP, an appropriate didactic concept should serve as a framework for teaching and learning processes.Reference Khorram-Manesh, Ashkenazi and Djalali ¹ The program may be further standardized by a set of prerequisite conditions (admission criteria), a standardized exam at the end of program, or both.

Figure 3 Final Schematic Program Design

The academic level is first cycle (undergraduate) and second cycle (advanced/master’s level). The first- and second-cycle students participate in parallel lectures and seminars during the first semester. Second-cycle students continue their studies for another semester and receive additional education, such as the ability to read, understand, and integrate research studies and write an academic study on a master’s level. One important part of the examination during the last 3 weeks of the first semester is to write a literature review about an important topic to present the current knowledge and shortcomings within that field. This review is later used in the second cycle as a deeper study to write a master’s thesis based on the existing empirical data. A total sum of 60 European Credit Transfer and Accumulation System (ECTS) credits is given for the whole program.