Children are not small adults. Nowhere is this understanding more critical than in the aftermath of a disaster event, when the strained resources of healthcare providers must be directed where they can do the most good in the least time. Frontline responders are unfortunately rarely trained in the principles and practice of pediatric disaster triage and often do not understand the special pediatric needs and considerations they must take into account when acting decisively and quickly to direct actions in a stressful situation that is often chaotic and always taxing. Researchers at Yale University School of Medicine (YSM) have developed a live simulation training protocol on pediatric disaster triage that has been shown to be effective but also relatively expensive, resource-intensive and therefore difficult to disseminate widely. The Yale New Haven Health System Center for Healthcare Solutions (YNHHS-CHS) has taken up this challenge, proposing to use YNHHS-CHS expertise with online training solutions and web development to create and implement a computer-based simulation that will build on the live simulation model and carry the research into a new medium that will be more cost-effective and able to more broadly engage and educate greater numbers of emergency medical service providers (EMSPs). YNHHS-CHS specialists with design and training skills will use the expertise of YSM pediatric emergency medicine specialists Mark Cicero, MD, who developed the live simulation training, and Marc Auerbach, MD, and the YNHHS-CHS network of emergency management contacts to engage EMSPs in this learning process. The computer- based simulation training will be delivered to 600 EMSPs in southern New England (Connecticut, Rhode Island and Massachusetts) and evaluated for future broader dissemination. Multiple retention evaluations, scenario-based and decision-tree driven, will be conducted: immediately at the end of the online training and at three- and six-month intervals post-training to determine the value of the training in delivering information and fostering the ability to apply it in simulated scenarios. A 10% random sampling of participants will also take an in-person live simulation retention evaluation to further assess and demonstrate the usefulness of the training. The project objective is to achieve a success rate of >80% of learners performing pediatric disaster triage with accuracy that is >/=90%.

Public Health Relevance

Emergency planners often focus on large-scale disaster events, but smaller-scale local events are far more common and together have a much greater impact on the health and well-being of communities - particularly events involving children, such as bus accidents or school-related crises. Children are often present at a disaster site and sorting out their needs and requirements can be a significant challenge to emergency medical service providers. This project brings together Yale School of Medicine pediatric emergency medicine specialists and Yale New Haven Health System Center for Healthcare Solutions instructional design and emergency management experts who are committed to developing a training that delivers the greatest possible efficiency and effectiveness with the greatest possibl accuracy in making choices and directing appropriate healthcare resources to improve disaster event outcomes and mitigate negative consequences for children, disasters'most vulnerable and often least understood victims.

National Institute of Health (NIH)
Agency for Healthcare Research and Quality (AHRQ)
Research Demonstration and Dissemination Projects (R18)
Project #
Application #
Study Section
Special Emphasis Panel (HSQR)
Program Officer
Hogan, Eileen
Project Start
Project End
Budget Start
Budget End
Support Year
Fiscal Year
Total Cost
Indirect Cost
Yale University
Schools of Medicine
New Haven
United States
Zip Code