Exercises in Emergency Preparedness for Health Professionals in Community Clinics
JOURNAL OF COMMUNITY HEALTH
2010; 35 (5): 512-518
EMERGENCY PREPAREDNESS EDUCATION AND TRAINING FOR HEALTH PROFESSIONALS: A BLUEPRINT FOR FUTURE ACTION
BIOSECURITY AND BIOTERRORISM-BIODEFENSE STRATEGY PRACTICE AND SCIENCE
2010; 8 (1): 79-83
Evaluating the potential of international medical graduates as physician assistants in primary care
1996; 71 (8): 886-892
Health professionals in community settings are generally unprepared for disasters. From 2006 to 2008 the California Statewide Area Health Education Center (AHEC) program conducted 90 table top exercises in community practice sites in 18 counties. The exercises arranged and facilitated by AHEC trained local coordinators and trainers were designed to assist health professionals in developing and applying their practice site emergency plans using simulated events about pandemic influenza or other emergencies. Of the 1,496 multidisciplinary health professionals and staff participating in the exercises, 1,176 (79%) completed learner evaluation forms with 92-98% of participants rating the training experiences as good to excellent. A few reported helpful effects when applying their training to a real time local disaster. Assessments of the status of clinic emergency plans using 15 criteria were conducted at three intervals: when the exercises were scheduled, immediately before the exercises, and for one-third of sites, three months after the exercise. All sites made improvements in their emergency plans with some or all of the plan criteria. Of the sites having follow up, most (N = 23) were community health centers that made statistically significant changes in two-thirds of the plan criteria (P = .001-.046). Following the exercises, after action reports were completed for 88 sites and noted strengths, weaknesses, and plans for improvements in their emergency plans Most sites (72-90%) showed improvements in how to activate their plans, the roles of their staff, and how to participate in a coordinated response. Challenges in scheduling exercises included time constraints and lack of resources among busy health professionals. Technical assistance and considerations of clinic schedules mitigated these issues. The multidisciplinary table top exercises proved to be an effective means to develop or improve clinic emergency plans and enhance the dialogue and coordination among health professionals before an emergency happens.
View details for DOI 10.1007/s10900-010-9221-1
View details for Web of Science ID 000282703000009
View details for PubMedID 20146093
THE EVOLUTION AND IMPACT OF THE NATIONAL AHEC PROGRAM OVER 2 DECADES
1991; 66 (4): 211-220
The need to increase the nation's primary care workforce, and the presence of large numbers of international medical graduates (IMGs) who encounter barriers to licensure as physicians, have led to consideration of ways that IMGs might practice as physician assistants (PAs). Several states have explored regulatory changes that would allow IMGs to obtain PA certification through equivalency mechanisms or accelerated educational programs. In California, surveys in 1980, 1993, and 1994 collected information about the interest and preparedness among IMGs seeking PA certification. These surveys revealed that few of the IMGs were interested in becoming PAs as a permanent career, and few could show a commitment to primary care of the underserved. Of the 50 IMGs accepted into California's PA programs in recent years, 62% had academic or personal difficulties. Only 34 IMGs became certified, and all accepted jobs in primary care specialties. Two preparatory programs in California have assessed the readiness of unlicensed IMGs to enter PA programs, and they have shown that the participants did not demonstrate knowledge or clinical skills equivalent to those expected of licensed PAs. Therefore, policymakers should not consider that IMGs are or can easily become the equivalent of PAs without additional professional training in accredited PA programs. Preparatory programs appear to lessen the barriers to PA training for a few IMGs. In times of scarce resources for training, however, these programs may not be the best use of public funds to increase the primary care workforce.
View details for Web of Science ID A1996VC54200018
View details for PubMedID 9125965
FACTORS INFLUENCING THE DEVELOPMENT OF AREA HEALTH-EDUCATION CENTERS WITH TEXAS-MEXICO BORDER POPULATIONS
1990; 65 (12): 762-768
The national Area Health Education Center (AHEC) program began in 1972 with the purpose of addressing problems of the shortage of physicians and the maldistribution of health professionals. The 40 projects of the program have involved 37 states, 55 medical schools, numerous other health professions schools, and 117 local community AHECs. This 19-month study (1988-1990) was undertaken to systematically assess and clarify the organization, functions, activities, and effects of the national AHEC program over two decades. Data sources were mainly 263 interviews of persons representing the full spectrum of those associated with and participating in AHECs. The findings describe a national network of school and community partnerships that were engaged in planning and implementing educational activities and were responsive to changing needs of health care. The individual AHECs differ in structure and activities as a function of the era in which each began, legislative requirements, and the specific community's needs for health professionals. As organizations, AHECs have unique functions that appear to have benefited the target communities or regions, participating schools, students, and medical school residents. Viability of AHECs in the future will depend on their ability to maintain a focus on health professions education in spite of state or community pressure to provide direct services--both clinical services and public education. At the same time, success will depend on the AHECs' capacity to respond effectively to changing needs of the community and the health care delivery system.
View details for Web of Science ID A1991FG78300011
View details for PubMedID 2012653
Area Health Education Centers (AHECs) have been viewed as an appropriate vehicle for implementing new initiatives for training health professionals who will work along the U.S.-Mexico border. Perceptions about this program in Texas were evaluated from July 1988 to June 1989 to identify problems and formulate suggestions that might be of use to academic health science centers (HSCs)--and in particular medical schools--working with Hispanic populations. Interviews were conducted with 116 people: the presidents and/or deans of all eight Texas HSCs and/or medical schools, other deans and faculty, community leaders in five border counties, and state officials. The school and community perspectives about past and present AHEC activities were compared. Some of the barriers were: insufficient components of the health care delivery system to support medical education in severely underserved areas; differing school and community priorities; cultural differences between the school faculty and the community; and feeling among community physicians and dentists that AHECs were a source of competition. The school and community respondents agreed that the AHEC program needs more cooperative planning and training that emphasizes public health education for future AHEC-like activities with border populations.
View details for Web of Science ID A1990EN32800013
View details for PubMedID 2252495