Disaster Medicine and Public Health Preparedness

Research Article

A Consensus-based Educational Framework and Competency Set for the Discipline of Disaster Medicine and Public Health Preparedness

Italo Subbarao, James M. Lyznicki, Edbert B. Hsu, Kristine M. Gebbie, David Markenson, Barbara Barzansky, John H. Armstrong, Emmanuel G. Cassimatis, Philip L. Coule, Cham E. Dallas, Richard V. King, Lewis Rubinson, Richard Sattin, Raymond E. Swienton, Scott Lillibridge, Frederick M. Burkle, Richard B. Schwartz and James J. James


Background: Various organizations and universities have developed competencies for health professionals and other emergency responders. Little effort has been devoted to the integration of these competencies across health specialties and professions. The American Medical Association Center for Public Health Preparedness and Disaster Response convened an expert working group (EWG) to review extant competencies and achieve consensus on an educational framework and competency set from which educators could devise learning objectives and curricula tailored to fit the needs of all health professionals in a disaster.

Methods: The EWG conducted a systematic review of peer-reviewed and non–peer reviewed published literature. In addition, after-action reports from Hurricane Katrina and relevant publications recommended by EWG members and other subject matter experts were reviewed for congruencies and gaps. Consensus was ensured through a 3-stage Delphi process.

Results: The EWG process developed a new educational framework for disaster medicine and public health preparedness based on consensus identification of 7 core learning domains, 19 core competencies, and 73 specific competencies targeted at 3 broad health personnel categories.

Conclusions: The competencies can be applied to a wide range of health professionals who are expected to perform at different levels (informed worker/student, practitioner, leader) according to experience, professional role, level of education, or job function. Although these competencies strongly reflect lessons learned following the health system response to Hurricane Katrina, it must be understood that preparedness is a process, and that these competencies must be reviewed continually and refined over time. (Disaster Med Public Health Preparedness. 2008;2:57–68)

(Received December 13 2007)

(Accepted December 17 2007)

Dr Subbarao is Director, Public Health Readiness Office, American Medical Association; Mr Lyznicki is Senior Scientist, Center for Public Health Preparedness and Disaster Response, American Medical Association; Dr Hsu is Director of Training, Johns Hopkins Office of Critical Event Preparedness and Response; Dr Gebbie is Director, Center for Health Policy, Columbia University School of Nursing; Dr Markenson is Director, Center for Disaster Medicine, New York Medical College; Dr Barzansky is Director, Division of Undergraduate Medical Education, American Medical Association; Dr Armstrong is with the Division of Acute Care Surgery, University of Florida Health Science Center; Dr Cassimatis is Vice President, Affiliations and International Affairs and Associate Dean for Clinical Affairs, Uniformed Services University of the Health Sciences; Dr Coule is Director, Center for Operational Medicine, Medical College of Georgia; Dr Dallas is Director, Institute for Health Management in Mass Destruction Defense, University of Georgia and Medical College of Georgia; Dr King is Director, Education and Research, University of Texas Southwestern Medical Center; Dr Rubinson is Senior Medical Advisor for Healthcare Preparedness and Response, Interagency Policy Agreement, Division of Healthcare Quality and Promotion, Centers for Disease Control and Prevention; Dr Sattin is Professor, Emergency Medicine and Internal Medicine, Medical College of Georgia; Dr Swienton is Co-Director of Emergency Medical Services, Disaster Medicine and Homeland Security Section, University of Texas Southwestern Medical Center; Dr Lillibridge is Assistant Dean and Director, Global Health and Security Program, Center for Biosecurity and Public Health Preparedness, Texas A&M Health Science Center; Dr Burkle is Senior Fellow, Harvard Humanitarian Initiative, Harvard School of Public Health; Dr Schwartz is Chair, Department of Emergency Medicine, Medical College of Georgia; and Dr James is Director, Center for Public Health Preparedness and Disaster Response, American Medical Association.

Supported by Medical College of Georgia subaward 07-20312-7 under Health Resources and Services Administration (HRSA) grant T01 HP06415.

The findings and conclusions in this article are those of the authors and do not necessarily represent the views of HRSA, the Centers for Disease Control and Prevention, or the Agency for Toxic Substances and Disease Registry.