253 - Building Better Responders: Outcomes from a Military-Wide, Pediatric-Focused Humanitarian Assistance Training Course

Publication Number: 253.4171

Alison M. Helfrich, Uniformed Services University of the Health Sciences F. Edward Hebert School of Medicine, Bethesda, MD, United States; Alyssa MacMahon, Uniformed Services University of the Health Sciences F. Edward Hebert School of Medicine, Bethesda, MD, United States; Natalie Burman, Uniformed Services University of the Health Sciences F. Edward Hebert School of Medicine, San Diego, CA, United States; Sebastian Lara, Uniformed Services University of the Health Sciences F. Edward Hebert School of Medicine, Sigonella Italy, Armed Forces - AE, United States; Lauren Wolf, Uniformed Services University of the Health Sciences F. Edward Hebert School of Medicine, Falls Church, VA, United States; Patrick W. Hickey, Uniformed Services University, Bethesda, MD, United States; Michelle Kiger, University of Colorado School of Medicine, Highlands Ranch, CO, United States

Background: Children are frequently among the most impacted groups in the wake of humanitarian disasters. The U.S. military conducts a 2-day course known as the Military Medical Humanitarian Assistance Course (MMHAC) to prepare medical personnel to respond to the medical, population health, logistical, and ethical challenges inherent in humanitarian and disaster relief missions. It focuses on care of the most vulnerable populations, including children. MMHAC has been taught since 1998 with minor modifications and content updates, but the curriculum has not been comprehensively reviewed and revised since its inception.

Objective: To analyze data from MMHAC pre- and post-tests and course evaluations to inform curricular improvements and humanitarian training.

Design/Methods: Data were collected from MMHAC attendees between June 2020 and May 2024. Participants were asked to complete a 38-item knowledge-based pre- and post-test and a 30-response course evaluation to receive course certification. Pre- and post-test results were compared using Wilcoxon signed rank test. Descriptive statistics were calculated on 5-point rating scale responses on the effectiveness of each module. We performed a content analysis of free-response module feedback.

Results: Data were analyzed from 742 military medical professionals. Participants scored significantly higher on post-tests than pre-tests (mean[SD] 85.1 [11.7] vs. 53.1 [13.0], p< 0.001), with 89.5% passing the post-test on the first attempt. Questions on non-governmental organizations (NGOs) and preventive medicine were frequently answered incorrectly on pre-test but had the largest improvements on post-test (Table 1). Modules on ethics, infections and diarrhea/dehydration rated most highly in course evaluations, with lower ratings for modules on NGOs and calculating surveillance rates. Free-responses suggested improving modules on mission planning and logistics, increasing case discussions, more personal experiences from instructors and interactive content, and the addition of instruction on psychological first aid, women’s health, and caring for chronic conditions.

Conclusion(s): The MMHAC has been highly effective in preparing military medical personnel to care for children and other vulnerable populations affected by humanitarian disasters, but course evaluations highlight the need for enhancing interactive instructional methods and expanding content to additional vulnerable populations. Next steps include focus groups of MMHAC site directors, a follow-up survey on proposed revisions, and ongoing feedback from participants based on changes informed by this program evaluation.

TABLE 1: Breakdown of Pre- and Post-Test Results by Question & Module Topic
* individual pre- and post-test question data for was unavailable for 176 and 299 participants, respectively (only total score available for pre- and/or post-test)