NLM Webinar series: “Insider’s Guide to Accessing NLM Data: EDirect for PubMed”

Beginning February 21, 2017, the National Library of Medicine (NLM) will present the three-part webinar series “Insider’s Guide to Accessing NLM Data: EDirect for PubMed.” This series of workshops will introduce new users to the basics of using EDirect to … Continue reading

Ready or Not: Communicating During an Emergency in the Country of Georgia

Tbilisi-Flood-blog

Emergencies don’t wait for you to be ready.

In 2015, the country of Georgia invited CDC to conduct a training on the principles of Crisis and Emergency Risk Communication (CERC). But before we could get there, the capital city of Tblisi was struck by a major flood.

The flash flood and ensuing mudslide killed 20 people and covered much of the city in water and mud. There were news reports about the massive damage, human casualties, and even escaped zoo animals.  Ready or not, responders had to jump in and communicate clearly about the emergency.

This is exactly the type of situation CERC training is intended to prepare for. When a crisis hits, people need understandable, trustworthy, and accurate information they can act on. And they need it fast.  CERC helps communicators ensure that the right messenger is delivering the right message at the right time.

CERC saves lives

When we arrived in Georgia, my co-worker Kellee Waters and I discovered that the news reports hadn’t captured the intensity of the flood the way firsthand accounts could. We heard sobering stories from our colleagues about the impact of the disaster: a stream that turned into a raging river; a landslide that caught everyone off guard.

In the aftermath of the flood, many of our Georgian colleagues found themselves needing to use CERC principles — with or without training. They had to quickly and clearly inform people about threats in different parts of the city and communicate what actions the government was taking to rescue people and animals.

Lessons from the flood

When we began our training, we found that participants’ experiences from the flood gave them valuable insight. Those who had been involved in communicating about the flood stressed the importance of consistent messaging. They recalled that messages about safety had been quickly reported and repeated in the news and on social media; making information readily available to reporters allowed important safety messages to be disseminated faster and wider and increased their credibility. The government had helped by being the first to report accurate, credible messages that offered action steps for citizens to stay safe – before, during and after the crisis.

Class participants also talked about identifying and connecting with groups of people who did not speak Georgian as their first language. This was crucial so all Georgians could return to a more familiar and normal life as quickly as possible after the flood.

While not everyone in our class had a role in communicating during the flood, they all recognized the value of effective communication in an emergency response. They also noted that good communication takes experience, knowledge, and expertise.

None of the participants would have wished this tragedy on their country, but they all had a strong resolve to use the experience to prepare for future events.

Shaking things up!

Participants with trainers after receiving their CERC certificates.
Participants with trainers after receiving their CERC certificates.

During class, participants learned about the different agencies where they worked and considered how each agency might play a role in future responses. They practiced developing messages and explored strategies for making sure those messages reached the right people.

As part of the training, we used an earthquake scenario to identify the types of information different audiences need in a response, and we looked at how those needs evolved over time.

For example, class participants recognized that a large earthquake would likely receive global news coverage, but that the first priority would be getting safety information to the affected people. They had to make decisions about how to get life-saving information to first responders and those affected while providing enough information for all audiences so that rumors and misinformation would not spread.

Armed with new knowledge, our colleagues in Georgia are now prepared to act more swiftly and effectively to make sure everyone receives the information they need, no matter when or where disaster might strike.

CDC Ebola Training in Anniston

Banner_EPR_Feature

 

Making the decision to volunteer in an Ebola Treatment Unit (ETU) in West Africa shows a lot of courage and takes support from friends, loved ones, and other healthcare workers. It also requires the knowledge and skills to safely treat very sick patients in a challenging environment. CDC understands that healthcare workers preparing to deploy to West Africa need to know the infection prevention and control principles necessary for working in an ETU. To help meet this need, CDC offers an introductory training course at the Federal Emergency Management Agency’s (FEMA) Center for Domestic Preparedness in Anniston, Alabama.

CDC’s Preparing Healthcare Workers to Work in Ebola Treatment Units (ETUs) in Africa training course allows students to work in a mock ETU, where they practice putting on and taking off (donning and doffing) personal protective equipment (PPE). They also practice triaging patients, drawing blood, and safely cleaning up body fluid spills. In addition to this hands-on training, participants attend lectures to better understand the disease and how to protect themselves physically and mentally when working in an ETU. For most of the trainees, working in an ETU will be a new experience. This course gives them an opportunity to practice the required skills and prepare themselves psychologically.

People at a hand washing stationA recent graduate of the training, Kwan Kew Lai, is back in the United States after serving as a doctor with the International Medical Corps (IMC) in an ETU in Liberia. Kwan Kew volunteered for the Ebola outbreak response because she understood the critical need for healthcare personnel on the ground to help combat the epidemic. Kwan Kew knew the work was going to be dangerous, but she knew her skills were desperately needed, especially since so many local healthcare workers in West Africa had already lost their lives to Ebola while providing care. Kwan Kew has spent the last nine years volunteering during public health emergencies and natural disasters; however, she described the Ebola outbreak as one of the most difficult and heart-wrenching experiences she has ever faced.

Her journey began with CDC’s 3-day training course, which she completed along with 35 other healthcare workers. Kwan Kew traveled to West Africa in mid-October. When she arrived in Bong, Liberia, she was greeted by a huge sign announcing “Ebola is real and it is here in Liberia.” At a roadblock performing temperature checks, another banner read, “Fight the Ebola virus. Protect yourself. Protect your family. Protect your community.”  These signs were a striking reminder of the reality Liberia faces as a country plagued by the largest Ebola outbreak in history.

Her first day at the 52-bed ETU began at 6:45 a.m. with caring for 33 patients, 15 confirmed and 18 suspected to have Ebola. Each day, Kwan Kew had to use her training, meticulously donning and doffing her PPE, a process which took 15 to 20 minutes each time. Even with temperatures reaching 89 degrees Fahrenheit during training in Alabama, those conditions were nothing like the humid weather the trainees would face in West Africa.

Kew in front of an Ebola treatment unit sign.Kwan Kew, an avid runner, compared wearing layers of PPE and treating patients in the sweltering heat of Liberia to running a marathon on a very hot day.

“At mile 17, I began to hit the wall, but somehow pushed myself to mile 20, at which point I invariably asked myself why I was running this marathon or any marathon at all. But at the stretch to the finish line and at the end, the emotional boost to have finished running 26.2 miles was just indescribable.”

The physical demands, weather, and hot gear worn in the ETU were not the only challenge Kwan Kew faced. She also wrote about how hard it was to care for patients and encourage them to be hopeful while being encumbered by PPE.

“What makes it even more poignant is that when the patients need close human contact the most, in times of extreme suffering, pain, and fear, there is none to offer except with a barrier of protective covering. In the beginning, it hit home to me that there was a real possibility of a true exposure; however, as time went on, inspired by the persistence, dedication, and selfless caring of my colleagues, that fear was pushed to the back of my mind and the goal of getting the patients better overwhelmingly became my main concern.”

Now back in the United States, Kwan Kew’s 21-days of self-monitoring are over. While she is ready to return to her normal job as an infectious disease doctor in Boston, Massachusetts, she can’t help thinking about the uncertainty facing people in West Africa as Ebola continues to spread.

The Second Offering of “A Librarian’s Guide to NCBI” at NIH

NCBI, in collaboration with NLM and the National Network of Libraries of Medicine NLM Training Center (NTC) at the University of Utah, recently presented the second offering of A Librarian’s Guide to NCBI. Health Sciences Librarians from 17 universities and … Continue reading

A Librarian’s Guide to NCBI — an intensive training course for medical librarians to be offered April 2014

The NCBI in partnership with the National Library of Medicine Training Center (NTC) will offer the Librarian’s Guide to NCBI course on the NIH campus in April 2014. This will be the second presentation of the course; it was previously … Continue reading

A Librarian’s Guide to NCBI: Course Follow-up

NCBI, in collaboration with NLM and the National Network of Libraries of Medicine NLM Training Center (NTC) at the University of Utah, recently presented A Librarian’s Guide to NCBI. This new course was designed to prepare health science librarians for … Continue reading

A Librarian’s Guide to NCBI – A New Education Initiative

Next week NCBI will premiere A Librarian’s Guide to NCBI, a new course aimed at teaching health science librarians about NCBI resources. The course is sponsored by the NCBI, the National Library of Medicine (NLM), and the National Network of Libraries of Medicine’s NLM Training Center … Continue reading

Do as we say, not as we did

In the recent Federation of American Societies for Experimental Biology (FASEB) Washington Update, there is a letter to NIH director Francis Collins that supports recommendations from the Biomedical work force working group’s recent report. The report recommends, among other things, shortening the average Ph.D. training time to five years, while increasing training in skills targeting scientific careers outside of academia. How practical would it be to implement these recommendations?

Graduate school takes far too long. Ph.D.s are, generally, ill-equipped to do much more than academic bench work. But, I’m not convinced that the current system can be changed easily.

One reason Ph.D. takes so long is that a first author publication from your research is often a de facto requirement for graduation. These days, papers require increasingly complex experiments and reams of data, not to mention drawn out review processes. Unless publication requirements change, I don’t think a significant dent can be made in the average time to graduate number.

Increased training in the skills needed for pursuits outside of academic science may be moe daunting. Improving these skills will require time outside the lab and the support of PIs, who were indoctrinated with the traditional values of academic research. Time for this training must either come at the expense of less training in research skills or increased time in graduate school.

The recommendations do not really address the major role that PIs will play in making these changes happen. While I think that many investigators will support these recommendations, PIs are only familiar with the academic track may not equipped to mentor students through a shorter training period,while also facilitating career development. These and their previous experiences. Without training for mentors to match the increased training of students, this plan will be doomed to fail.

It is a multi-layered problem, but I’m glad that the NIH seems to be taking a look at the situation they fund. I’ve personally struggled with a lack of training in areas outside of academic benchwork and I hope that the system will be improved. To see what fellow blogger Mike thinks of this issue,  check out his post on the topic.