Transcript Workshop Instructions

Innovations in Medical
Education: Teaching Contagious
Disease Outbreak Awareness to
Medical Students and Residents
Larissa May, M.D.
Department of Emergency Medicine
The George Washington University School of Medicine
Teaching Contagious Disease
Outbreak Preparedness
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Emergency department personnel should
be competent at contagious disease
outbreak detection and management.
Given the emphasis on emerging
infectious diseases and the threat of
biowarfare, there is great need to develop
instructional methods on these topics.
The Educational Methods
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The workshop is held in a hospital conference room,
with the availability of internet, telephone, and other
hospital resources, simulating “real-life”.
A hypothetical case of Ebola presenting to an
emergency department is outlined.
Participants are then divided into small groups
representing the ED physician, the local health
department, the CDC, Hospital Administration, the
Hospital Epidemiologist, and the Laboratory
Director.
Educational Methods
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Each group has 30 minutes to define their roles and
responsibilities in preparation for the hypothetical
outbreak.
A companion manuscript outlining principles of
outbreak detection, surveillance, reporting and
containment is provided.
After the small group sessions, each group presents
and rationalizes their approach to and responsibilities
in responding to the outbreak.
The faculty facilitator then gives a 60 minute lecture.
Educational Methods
Pre and post workshop surveys have
indicated the workshop is considered useful.
 We believe the format of this workshop is
easy to reproduce and can serve as a
foundation for a curriculum in emerging
infections and communicable disease
management, and can easily be applied to
other educational topics.
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The Contagious Disease Outbreak
Workshop: Clinical Case
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28 year old previously healthy female biologist
presents with fever and spreading rash
Two days ago she developed a fever, sore throat,
and vomiting
She has had several very dark bowel movements
Today her boyfriend noted she was drowsy and
disoriented
She returned from Uganda 3 days ago, where she
was collecting samples from wild monkeys for
DNA analysis
Clinical Case
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Vitals: 84/52 HR 132 T 104.4 94% RA diaphoretic
Tachypneic with bilateral bibasilar rales
Centripetal maculopapular rash with hemorrhagic
erythema on the palms and soles
Subconjunctival hemorrhages, palatal petechiae
Diffuse abdominal tenderness with guarding; black
stool
You are the only physician working in
the Emergency Department…
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The nurse notifies you that you have two urgent
incoming calls
EMS is transporting a 44 year-old diplomat with
massive GI and gingival bleeding, febrile to 102,
blood pressure of 60/palp
On the other line a concerned internist is sending
two returned travelers with fever and rash
Objectives
How do we recognize potential sentinel
cases for an outbreak?
 How do we report a suspected outbreak?
 What measures can we take toward
outbreak containment in the emergency
department?
 What resources are available in the event of
an outbreak?
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Workshop
ED physician
 Local health department
 National health office (CDC)
 Hospital administration (Incident command)
 Infection control officer
 Laboratory
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Workshop
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Each small group of 2 or 3 students uses the
companion manuscript, internet, telephone and
hospital resources to define their roles and
responsibilities in preparing for an outbreak
The small group research takes 30 minutes
The groups then convene and a representative
from each focus group discusses their findings
A faculty member facilitates this discussion
Lecture
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The faculty facilitator gives a 60 minute lecture on
the following topics:
– Outbreak Epidemiology and Recognition
– Syndromic Surveillance
– Outbreak Reporting
– Outbreak Containment and Hospital Response
Plans
– Infection Control Guidelines
– Clinical Case Discussion
Clinical Case: Conclusion
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A tentative diagnosis of viral hemorrhagic fever is
made
Patients placed in airborne isolation, cohorted with
staff
You call Infectious Disease on Call and Hospital
Administration for activation of the Contagious
Disease Outbreak Plan
You notify the DC DOH emergency hotline and the
CDC for recommendations and assistance in
containment of the outbreak and contact tracing
Identification and confirmation of Ebola serotype
made by USAMRIID BSL 4 laboratory
Outbreak Preparedness: Goals for Clinicians
Be familiar with epidemiologic criteria for
sentinel cases
 Know your hospital emergency preparedness
plans and how to report a suspected sentinel
case
 Follow basic principles of isolation, infection
control, and cohorting in an outbreak
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Summary: Workshop Materials
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Clinical Case
Companion Manuscript “Emerging and Re-Emerging
Infections: Public Health Preparedness: Introduction
to Infectious Outbreak Reporting and Containment”
Powerpoint Lecture
Pre and Post Workshop Surveys
For more information, contact Larissa May at
[email protected]
Note: this is not a commercial product