Physicians aren't confident they can recognize infections from anthrax and other bioterrorism disease threats
Potential threats from biological terrorism underscore the need for frontline health care providers to quickly and accurately identify infection with biological agents such as smallpox and anthrax, which may be used in bioterrorism. Yet physicians are not confident in their ability to recognize such bioterrorism threats, according to a recent survey. In 2004, researchers mailed surveys to all physicians who practiced in a three-hospital system in Connecticut that included a major medical center, children's hospital, and community hospital. Those surveyed were asked about their confidence levels in recognizing six Category A bioterrorism agents recognized by the Centers for Disease Control and Prevention. The agents included anthrax, botulism, smallpox, plague, tularemia (a bacterial infection common among wild rodents), and viral hemorrhagic fever (including the Ebola virus). Other questions on the survey were designed to assess physicians' education and training needs in bioterrorism preparedness, as well as their preferred training method.
Out of 820 responding physicians, 71 percent said they were "not confident" about recognizing 5 of the 6 infectious agents. Just under half (48.8 percent) felt comfortable identifying smallpox. Tularemia was the infectious agent with the highest level of uncertainty for physicians. When faced with an unknown infectious disease, most (71 percent) would consult an infectious disease specialist for advice. The majority (72 percent) had a poor understanding of and familiarity with Connecticut's public health reporting requirements and procedures.
In terms of physician specialty, those with the most confidence were infectious disease and emergency medicine physicians. The majority of physicians surveyed (78 percent) preferred lectures and conferences for learning more about bioterrorism. Continuing medical education programs that used interactive workshops were the least preferred method of delivery, despite research documenting this approach as one of the most effective methods for acquiring new skills and knowledge. The study was supported in part by the Agency for Healthcare Research and Quality (HS13693).
See "Critical challenges ahead in bioterrorism preparedness training for clinicians," by Kari A. Hartwig, Dr.P.H., M.A., David Burich, M.S.N., A.P.R.N.-B.C., Christopher Cannon, M.S.N., M.P.H., M.B.A., F.A.C.H.E., and others in the January/February 2009 Prehospital and Disaster Medicine 24(1), pp. 47-53.
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