Experiment planning and deviations

In Germany no legal requirements exist that are valid all over Germany and that define in detail how to organize big events with respect to task forces in order to guarantee safety and help. Many decision makerssimply use experience instead of systematic procedures. Local authority districts may or may not have guidelines for such cases. The city of Dresden, for instance, which is the location of the practical case described in this article, has one (see Landeshauptstadt Dresden, 2004). It is based on a handbook for task forces where a non-scientific method to calculate the size of the task force is presented. Often, the task forces themselves have defined a set of rules which are applied.

For the experimental study an area of Vasilievsky Island in St.Petersburg (Russia) was chosen. The population of the island is approximately 200 thousands of people. The island has four bridges on the eastern part) and one large road, the Western High-Speed Diameter (WHSD), will be constructed in several years to the western part of the island.

The preparation of tabletop exercises as simulation for contexts differing in levels of maturity will look different at each step of the simulation process (please see the data collection plan)

Stage 1: the occupants evacuate the rooms and arrive at the exit of the floor. The  evacuation time is obtained by dividing the distance between the floor exit and the nearest room exit by the walking speed.Stage 2: the exit flow enters the stairwell and the stagnation occurs at the floor exit when the summed flow rates of all room exits in a single floor exceed the flow rate of that floor exit. The evacuation time is not measured until the occupants descended to the next floor.Stage 3: when the stair entry flow arrives at the lower floor and meets with the sources of exiting occupants, it is called ‘‘merge flow’’ (i.e. merge stage). This stage is assumed that the summed merge flow capacity of the n + 1th floor’s stair flow and the nth floor’s exit flow islarger than the maximum stair capacity. Stage 4: the simulation entered stage 4 when the number of the occupants of a single floor approaches the floor capacity. The maximum number of the occupants a floor can be obtained by two components: stair landing area (m2) multiplied by maximum crowd density of the stair landing (people/m2), and stairwell area (m2) multiplied by maximum crowd density of the stairwell (people/m2). The descending flow is consisted of both stair entry flow and the outflow of the floor. When the occupants fully load the stairwell, the stair entry flow between ground floor and second floor will keep the maximum stair flow.Stage 5: Formula 5 and 6 demonstrate that the higher the floor the smaller the flow rate of the floor when the value of the merge flow ratio is lower than a certain constant and the number of the stagnating occupants in the stairwell reaches the maximum. As a result, the occupants on the second floor take the lead in arriving at the ground floor and yet finish the escape behind others. On the contrary, when the value of the merge flow ratio exceeds a certain constant, the occupants of the roof floor take the lead in entering the stairwell.

The semistructured key informant guide created and used to guide the interviews was based on constructs of social cognitive theory, social cohesion, health belief model, social capital, and community resilience.

The exercise was designed for use with multi-professional students: medical, public health, nursing, and veterinary students. The primary target audience was 2nd-year medical students who did not yet have extensive clinical experience.The

Förplanerat manus för en övning, samt även den stimulation som används för att uppnå övningens prestationsmål.

DRIVER+ kommentar 1: I samband med scenarier med DRIVER+ används begreppet för försök och inte för övningar.

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consisted of one confirmed HPAI fatality of a poultry science student and two other possible, non-confirmed student cases, with n.a. given about disease in birds. The scenario was deliberately ambiguous about whether the disease was natural or deliberately introduced. In addition to the clinical response, which is the usual focus of training for health professionals, this created the need for involvement of human and animal disease surveillance and disease containment measures, law enforcement investigation, and public information. The scenario was also tailored to the specific characteristics of the Texas A&M University community, which is the “patient” in this outbreak, including its rural setting and correspondingly limited local medical resources.Study questions and “injects” (the technical term for simulated events in an exercise) were developed to guide the students in problem solving and role playing in small groups. Role playing was the means chosen to encourage development of working relationships among health care students. It is one of the educational approaches that has proven effective in multidisciplinary health profession settings and has emerged as a preferred experiential method of learning. The list of recommended pre-readings was developed from written and electronic sources to provide an orientation to emergency management and incident command principles and background information on HPAI. Where possible, these were taken from the Web sites of lead agencies, such as the Centers for Disease Control (CDC) and Federal Emergency Management Agency (FEMA) to promote familiarity with the sites themselves and with other links from these sitesThe deviation: Because of an administrative misstep, the students did not receive the electronic reading list with embedded hyperlinks, and many of these links were lengthy and hard to enter manually. Thus, they had a much harder task to find the online  readings than was intended.

There are three scenarios conducted. More information related with this section can be found in section “data analysis”.Case 1: earthquake and international aidCase 2: flood and personal rescueCase 3: rail accident

Seventy-eight trainees from the Centers for Disease Control and Prevention (CDC) in 18 cities in Hubei participated in the emergency preparedness training programme in 2005. Two participants did not complete their training and were not part of the evaluation (n ¼ 76). Trainers were selected based on their expertise in the field of public health emergency response, related training programmes and their involvement in continuous consultations on health service programmes, both  educational and promotional. Trainers came from the MOH, WHO, Chinese CDC, Health Department of Hubei Province, Fudan University, Wuhan University and Huazhong University of Science and Technology.

A simulation tool is developed that is able to support the negotiation of both people and automated agents. Pg 8.A realistic

Förplanerat manus för en övning, samt även den stimulation som används för att uppnå övningens prestationsmål.

DRIVER+ kommentar 1: I samband med scenarier med DRIVER+ används begreppet för försök och inte för övningar.

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about a conflict between Canada and spain ( a fishing dispute) was used to evaluate the tool. pg 11

The study included 13 Iranian Registered Nurses (IRNs) with a bachelor’s degree in nursing who had at least 2 weeks’ experience as RNs during the Bam disaster in the earthquake location. None had any personal experiences in disaster conditions and most of them were male nurses. All of them had more than 12 years’ clinical nursing experiences in different hospitals’ wards. The mean ages of participants were 36 years (ranging from 34 to 56 years). They went to the earthquake location voluntarily following the call for help by the nursing office of the Iranian Ministry of Health and Medical Education during the early moments following the disaster.