Emergency and Disaster Preparedness amongst

Emergency Medicine Residents in Singapore

Tan Yeong Quah EMJ ,

1 YQ ,
1 JLJ1
1Department of Emergency Medicine, Singapore General Hospital

Domain (number of Overall Junior Senior Difference of means

Introduction: Disasters are increasingly prevalent in today’s world, questions) response, Residents, Residents, (95% CI), p
from natural disasters such as Hurricane Katrina, to mass shootings, Mean (± SD) Mean (± SD) Mean (± SD)
to the worldwide COVID-19 pandemic. Locally in Singapore, this (N=37) (N=28) (N=9)
1. Detection and 2.81 (±0.82) 2.74 (±0.83) 3 (±0.81) -0.26 (-0.90,0.38)
included the collapse of Hotel New World in 1986, the Nicoll
Response to an Event p = 0.423
Highway Collapse in 2004, and the Shell Refinery fires in 2011 and (6)
2015. Emergency Medicine (EM) physicians are often first 2. The incident 2.53 (±0.93) 2.43 (±0.94) 2.85 (±0.88) -0.41 (-1.14,0.31)
responders and leaders of the disaster medical response. Therefore, command system (ICS) p= 0.253
and your role within it
it is important for EM Residents to have the requisite knowledge. (8)
This study aims to assess the level of preparedness and attitudes 3. Ethical issues in 2.84 (±0.79) 2.71 (±0.82) 3.22 (±0.57) -0.51 (-1.11,0.09)
towards disaster medicine amongst EM Residents in Singapore. triage (4) p=0.093
4. Epidemics and 2.49 (±0.99) 2.43 (±0.99) 2.67 (±1.05) -0.24 (-1.02,0.54)
Surveillance (4) p= 0.54
Methods: A cross-sectional study was performed with residents 5. Isolation/ Quarantine 2.91 (±1.05) 2.82 (±1.10) 3.17 (±0.90) -0.35 (-1.17,0.48)
enrolled in EM Residency Programmes in Singapore (Academic Year (2) p = 0.4
6. Decontamination (3) 2.88 (±0.93) 2.83 (±0.98) 3.03 (±0.79) -0.20 (-0.93,0.53)
2020/2021). A self-administered, 44-item online questionnaire p = 0.575
based on the Emergency Preparedness Information Questionnaire 7. Communication/ 2.54 (±0.90) 2.42 (±0.89) 2.90 (±0.86) -0.48 (-1.17,0.21)
(EPIQ) was delivered via the online GoogleFormsTM platform. This Connectivity (7) p = 0.164
assessed familiarity through 10 dimensions as well as attitudes 8. Psychological Issues 2.34 (±0.95) 2.37 (±0.97) 2.25 (±0.95) 0.12 (-0.63,0.87)
(4) p = 0.755
towards emergency preparedness and preferred learning methods. 9. Special Populations 2.53 (±0.95) 2.41 (±0.97) 2.89 (±0.82) -0.48 (-1.21,0.26)
Data was collected from May 2020 to November 2020. The (2) p = 0.193
Emergency Preparedness Information Questionnaire was initially 10. Accessing Critical 2.28 (±0.93) 2.19 (±0.89) 2.56 (±0.82) -0.37 (-1.09,0.36)
Resources (3) p = 0.311
developed by the Wisconsin Health Alert Network, to assess nurses’
Overall familiarity with 2.60 (±0.82) 2.52 (±0.83) 2.85 (±0.76) -0.33 (-0.96, 0.01),
self-reported familiarity with emergency preparedness, in 2004. It disaster preparedness p = 0.302
has since been externally validated and is widely used to survey (calculated)
healthcare professionals. Overall familiarity with 2.43 (±0.90) 2.36 (±0.95) 2.67 (±0.71) -0.31 (-1.01,0.39)
disaster preparedness p = 0.376
(reported)
Results
Discussion: Limitations included small sample size due to the response rate
• 37/90 (41%) residents responded; 28 (75%) were Junior of 37 residents (41%). Questionnaires had been planned to be distributed
Residents (JR) and the remainder Senior Residents (SR). at face-to-face combined teachings which might have increased the
• For overall familiarity with disaster preparedness, the overall response rate; however due to COVID restrictions, this pivoted to online
calculated mean knowledge score was 2.60 (±0.82), and the platforms. Additionally, as anonymity was ensured, it was not possible to
mean self-reported knowledge score was 2.43 (±0.90). compare which cluster the participants came from; this may have led to
unequal distribution across Residency clusters. Hence, the study was held
• There was no statistically significant difference in overall
over a few months, in order to increase the response rate and obtain more
calculated or self-reported familiarity with disaster preparedness accurate representation. The COVID pandemic was also ongoing during the
between JRs and SRs. study, hence the residents’ attitudes as well as knowledge of emergency
• There was no significant difference in overall familiarity between preparedness may have been affected by the evolution of the pandemic.
the 17% (45) participants who participated in ≥1 course
compared to those who attended none; mean difference 0.288 (- Conclusion: Currently, EM Residents have a poor overall (mean 2.60 ±0.82)
0.314, 0.891), p=0.338. and self-reported (mean 2.43 ±0.90) familiarity with regards to emergency
• Residents felt that disaster medicine was relevant to their preparedness, however they recognized its importance and relevance. Of
the 10 competency dimensions, lower scoring areas included how to access
practice and that it was necessary to learn more about it; mean
critical resources and psychological issues. More focus could be put into
of 4.22 (±0.98) and 4.16 (±0.90) respectively.
teaching these areas. The most preferred learning format was
• The highest ranked learning method was workshop/simulation simulation/workshop training. The challenge of conducting face-to-face
training (45.5%), followed by lectures (23.4%). training during the pandemic necessitated virtual workshops and training,
and more research is needed in this area.

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