摘要：All graduating physicians should be competent with the basic principles of contagious disease outbreak detection and management. In order to educate our students and residents on this important topic, we created a three-hour workshop that included a case-based simulation exercise, and we offered a two-week medical student course in Emerging Infections and Bioterrorism. Twenty-two emergency medicine residents and sixty-four senior medical students rotating in the emergency department of an urban university tertiary referral center participated in a three-hour workshop between July 2005 and April 2006. Pre- and post- workshop surveys given immediately before and immediately following each session were used to determine participant satisfaction and self-reported knowledge and confidence in outbreak response. In March 2006 we offered a medical student elective course in Emerging Infections and Bioterrorism. Thirteen fourth-year medical students from a variety of specialties attended the two-week course. The course focused on selected topics in emerging and re-emerging infections and addressed general principles of infection control and biological disaster planning for healthcare facilities. A survey was given to all graduating fourth-year medical students in 2005 and 2006, before and after creation of the didactic course, to evaluate their comfort and perceived knowledge of outbreak detection and containment. Overall, both students who participated in the workshop and those who participated in the didactic course (with or without the workshop) showed improvement in self-reported knowledge of outbreak detection and management, although the effect was statistically significant only for those participating in the didactic course. Due to the small numbers of emergency medicine residents who completed the surveys, we cannot comment on the effectiveness of the resident workshop, although there was a trend toward improved self-reported knowledge after the workshop. Students pursuing internal medicine, pediatrics, emergency medicine, and ENT were most likely to report that outbreak education was very important. Nearly all participants felt outbreak preparedness was not covered in existing curricula, and 92% thought the workshop was beneficial. Most participants felt that outbreak preparedness was not adequately addressed in their curricula and almost all wanted more instruction. In addition, the didactic course and workshop improved self-reported student knowledge of the basic principles of contagious disease outbreak detection and management. Based on the results of our study, we propose integration of a three-hour simulation-based workshop with other instructional endeavors in emerging infections and biopreparedness into medical education curricula. We recommend the offering of a more comprehensive course for those pursuing emergency medicine and the primary care specialties, as they will be the most likely to encounter an outbreak. A web-based course may be a desirable alternative for institutions that could not otherwise add this training to their curriculum due to logistical reasons or time constraints. Further research is needed to determine the feasibility and effectiveness of these educational strategies.
