Methodological Lessons Learned

Designs could be adopted in future climate impact and adaptation studies to explore the implications and identify the responses and their implementation in both gradually evolving impacts as well as extreme climate change.

“It’s quite difficult to describe the development of most parameters quantitatively. We can not establish a precise mathematical model, and can only get the qualitative knowledge of the changes of the system.” Pp. 243

Due to the increase of process complexities and loss of major plant experts, it is important to provide solution to construct fault knowledge structures with respect to process knowledge.

Training interventions appear to be successful but references to gaining information via training and education did not include sharing or developing others either from a lack of means or motivation.Performance improvement was hard to assess.Greater attention should be paid to the front-end of training, not just computing the economic value or benefit of training, but ensuring true value-added by developing a shared understanding and identification with the organisational goals and working out a strategy to manage their achievement through appropriate boundary objects (e.g. benefits realisation maps and balanced scorecards).

Although much attention was given to making the scenario as realistic as possible, the scenario was still a simulation.The degree to which human performance during the simulation mimics behavior in a true disaster is unknown. The present evaluation system is also limited to markers of individual human performance, and does not evaluate equipment, information systems, or even patient management protocols.A three-part tool (triage, medical maneuvers, and radio usage) can provide a method to evaluate functional mass casualty incident exercises, and is easily implemented. For the best results, it should be used in conjunction with direct observation. The evaluation tool has great potential as a reproducible and internationally recognized tool for evaluating disaster management exercises.

According to the authors, further work is required to validate some of the assessment tools so that they can be used to document proficiency.

Involvement of a diverse range of potential end users, the involvement of representatives of all target groups should be sought in the in the development of a simulated ward. Simulations should include the formation of multicentre working and research groups to guide the development and use of simulated wards as well as a centralized database of validated scenarios and assessment tools.

Compared with fuzzy DEMATEL and evidential DEMATEL, D-DEMATEL is well addressed the fuzziness and subjectivity in linguistic assessment and more applicable to identify the CSFs in emergency management, which inherently has a linguistic assessment process.

Incorporate knowledge on the risk factors contributing to incidents in onshore wind farms is necessary between policy makers and regulators.The tool is the work of experts with a specific knowledge of the issue, it should not be a limit to possible configurations of risk that can be found in operating a wind farm and it can be implemented.

Assessment of OR nurses’ technical skill is becoming a training priority. The present evidence suggests that the ICATS-N_ could be considered for use as an assessment/training tool for junior OR nurses.In future empirical work, it is essential to replicate the present findings with larger samples that should ideally be drawn from different institutions.