Course Report
International Medical Education and Harmonization Program for
Nuclear Accident Preparedness
Report on Budapest Course
_____________________________________________________________________
Course Dates:ÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿ September 27-October 1, 1999
General Summary:ÿÿÿ The objectives of the trip to the “Frederic Joliot-Curie” National Research Institute for Radiobiology and Radiohygiene were twofold:
To conduct a course entitled “Medical Preparedness and Emergency Medical Assistance for Nuclear and Radiological Accidents;”
To provide a teaching venue for new faculty trained during the trainer program held three months earlier at the Charles University 3rd Faculty of Medicine, Prague, Czech Republic.
The course was jointly organized by Boston University School of Medicine (BUSM) and International Atomic Energy Agency (IAEA) under the auspices of the regional project RER/9/049 and was based upon a core curriculum previously developed and updated for this project. This was a well-organized course with a number of additional activities which were greatly appreciated by all. Future courses may require making additional refinements to the visual aids and a more detailed briefing prior to the assessment decontamination drill.
Background: The design of the “International Medical Education and Harmonization Program for Nuclear Accident Preparedness” adheres to a training model consisting of train-the-trainer course followed by “Echo” courses held at participating sites. One cycle of six courses has concluded, making up the initial training phase – Phase I – of the project. In Phase I the project was targeted to a group of 15 former Soviet Union and Eastern Europe nations. In order to expand the program to additional sites in Europe, a second training cycle was undertaken, consisting of aÿ trainer program at Charles University and an implementation course in Budapest, involving an additional 22 East European nations.
The Budapest course represents the eighth overall teaching of the training program and the second time in Central Europe. By repeating the same course in different sites, the project aims to carry out integration among sites and personnel, as well as be a conduit for inter-regional harmonization. As the course is continuously improved based on feedback received from its previous administrations it is an example of sustained administration of a standardized curriculum. Such are the project’s Phase II aims.
Course Organization: The course was hosted by the “Frederic Joliot-Curie” National Research Institute for Radiobiology and Radiohygiene, directed by Dr. Gyorgy Koteles, with Dr. Gyozo Horvath, Head, Dept. of Radiopathology, as course organizer. BUSM provided course manuals, some members of the course faculty, and overall program organization. Dr. Istvan Turai, the IAEA technical officer for the project, directed the curriculum updates and supplemental materials that were used in the course.
Course Schedule: The course covered the content in five days of lectures, demonstrations, videotapes, a practical drill, and one visit on the last day to the Paks Nuclear Power Plant. See appendix for course schedule and participants.
Practical Exercises: The practical program consisted of the use of radiological survey instruments and the assessment decontamination exercise. As in other courses the participants actively participated in the hands-on instrument use. A substantial number of instruments allowed all to spend an adequate amount of time practicing. The assessment decontamination exercise was carried out Thursday afternoon. While the drill was logistically well organized and the “casualties” played their roles well, further emphasis needs to be given to the purpose and prescribed outcomes in order to make the effort relevant.
Faculty: The group of faculty-instructors were:
Dr. Raimundas Aleknavicius,ÿ Lithuania
Dr. Stanko Tezak, Croatia
Dr. Miklos Kiss, Hungary
Dr. Jure Fettich, Slovenia
Dr. Felicia Popescu, Romania (alternate)
Following the Prague course these new faculty-instructors had received a letter outlining recommendations to improve the quality of presentations. A copy of such a letter was submitted earlier. The faculty-instructors stepped up to the challenge with quality visual aids and an engaging attitude towards the participants. The timing was perfect, allowing for adherence to the schedule. The overuse of crowded, printed overheads continues to be a problem; such material is mostly illegible and should be removed.
Drs. Erwin F. Hirsch, Istvan Turai (IAEA), and Robert Ricks (US Department of Energy’s training facility, REAC/TS) were additional faculty as well as course monitors.
Participants:35 participants from 17 Eastern European countries participated throughout the course. The reports of the Japanese accident on Thursday morning further involved faculty and participants in discussions. As customary, a pre- and post-test were administered. Certificates of attendance were delivered to each participant at the conclusion of the course.
Pre/Post-Tests: Data from the preliminary educational effectiveness evaluation demonstrated an average score of 68% correct answers (pre-test) compared to 87% correct answers (post-test). This group of participants presented one of the highest entry-level scores, reminiscent of the Moldova and Prague courses. The learning gain, adjusted for the level at which the participants started, was a respectable 59%, the highest of the group of courses that took place in the aftermath of the initial training cycle.
Visit to the Paks Nuclear Power Plant: On the last day, a visit to the only Hungarian nuclear power plant, a two-hour bus ride, was organized.ÿ The visit included presentations by Dr. Turai and briefings by the plant’s medical director and health physicist, followed by a visit to the plant’s Emergency Response Center.
Recommendations:ÿ Some overlap in the course material leads us to believe that the material can be condensed and the course shortened, particularly for an audience at a high entry-level of knowledge. Or, repetitive material could be replaced by additional varied practical exercises in an effort to depart from an overly lecture format. The decontamination drill should be reviewed in order to have it result in a better outcome: at present, participants seem to spend too much time on the decontamination issues and they forget the patient. The practical aspects of the course are of value and should continue to be part of each course.
The faculty trainees should be asked to carry more of the course load so that there is less involvement in actual teaching by BUSM, REAC/TS, and IAEA. The contribution of these three groups should really be in direction, monitoring, and expert resources, not teaching. Otherwise the training program’s intent is not served and there is not enough local investment nor involvement.
