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Lamkowski, A.* ; Combs, S.E. ; Abend, M.* ; Port, M.*

Training of clinical triage of acute radiation casualties: A performance comparison of on-site versus online training due to the covid-19 pandemic.

J. Radiol. Prot. 41, S540-S560 (2021)
DOI
Open Access Green möglich sobald Postprint bei der ZB eingereicht worden ist.
A collection of powerful diagnostic tools have been developed under the umbrellas of NATO for ionising radiation dose assessment (BAT, WinFRAT) and estimate of acute health effects in humans (WinFRAT, H-Module). We assembled a database of 191 ARS cases using the medical treatment protocols for radiation accident victims (n = 167) and the system for evaluation and archiving of radiation accidents based on case histories (n = 24) for training purposes of medical personnel. From 2016 to 2019, we trained 39 participants comprising MSc level radiobiology students in an on-site teaching class. Enforced by the covid-19 pandemic in 2020 for the first time, an online teaching of nine MSc radiobiology students replaced the on-site teaching. We found that: (a) limitations of correct diagnostic decision-making based on clinical signs and symptoms were experienced unrelated to the teaching format. (b) A significant performance decrease concerning online (first number in parenthesis) versus on-site teaching (reference and second number in parenthesis) was seen regarding the estimate time (31 vs 61 cases per hour, two-fold decrease, p = 0.005). Also, the accurate assessment of response categories (89.9% vs 96.9%, p = 0.001), ARS (92.4% vs 96.7%, p = 0.002) and hospitalisation (93.5% vs 97.0%, p = 0.002) decreased by around 3%-7%. The performances of the online attendees were mainly distributed within the lower quartile performance of on-site participants and the 25%-75% interquartile range increased 3-7-fold. (c) Comparison of dose estimates performed by training participants with hematologic acute radiation syndrome (HARS) severity mirrored the known limitations of dose alone as a surrogate parameter for HARS severity at doses less than 1.5 Gy, but demonstrated correct determination of HARS 2-4 and support for clinical decision making at dose estimates >1.5 Gy, regardless of teaching format. (d) Overall, one-third of the online participants showed substantial misapprehension and insecurities of elementary course content that did not occur after the on-site teaching.
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Publikationstyp Artikel: Journalartikel
Dokumenttyp Wissenschaftlicher Artikel
Korrespondenzautor
Schlagwörter Acute Radiation Syndrome ; Corona ; Covid-19 ; Education ; On-site ; Online ; Prodromal Symptoms; Total-body Irradiation; Early Dose Assessment; Medical-management; In-vivo; Chernobyl Disaster; Epr Dosimetry; Exposure; Prediction; Accidents; Responses
ISSN (print) / ISBN 0952-4746
e-ISSN 1361-6498
Zeitschrift Journal of Radiological Protection
Quellenangaben Band: 41, Heft: 4, Seiten: S540-S560 Artikelnummer: , Supplement: ,
Verlag Institute of Physics Publishing (IOP)
Verlagsort Temple Circus, Temple Way, Bristol Bs1 6be, England
Nichtpatentliteratur Publikationen
Begutachtungsstatus Peer reviewed
Institut(e) Institute of Radiation Medicine (IRM)
Förderungen Technical University of Munich