Background: Situated in the western Pacific Ocean, Taiwan has faced a diverse array of natural and man-made disasters. Since 2000, disaster medicine education has been progressively integrated into various medical professions, with a focus on training disaster medical assistance teams, managing chemical and radiological emergencies, and enhancing prehospital and hospital emergency management capabilities. Despite the key roles of emergency physicians (EP) as primary responders and crucial managerial personnel during disasters, a comprehensive assessment of the disaster medicine core competencies (DMCC) required for emergency medicine (EM) residency training might serve as a blueprint for Taiwan’s EM residency core curriculum. We sought to survey the most critical DMCCs, prioritize them, and determine their appropriateness for the EM residency training program. We also compare dthe prioritization of DMCCs between Taiwan and the United States.
\nMethods: To accomplish these objectives, we employed a modified Delphi method over three rounds. Initially, three EPs developed a draft of DMCCs for Taiwan. This draft, including 42 DMCCs, was subsequently reviewed by a task force comprising 22 leaders in disaster medicine from EM residency training hospitals across Taiwan. The Delphi method facilitated consensus on the DMCCs through three iterative rounds of polling, with each round evaluating the appropriateness of the proposed competencies. The study also compared the prioritized DMCCs proposed in both Taiwan and the US.
\nResults: The following 15 DMCCs were rated as highly appropriate with high consensus agreement: personal protective equipment (PPE); decontamination; incident command systems; mass casualty incidents; basic concepts and nomenclature of disaster medicine; medical response to chemical emergencies; triage; identification, notification, activation, and information collection; medical response to radiation emergencies; medical response to bioterrorism and biological emergencies; mental health; disaster exercises; prehospital disaster management; communication and information management; and health consequences of different disasters. A comparison with DMCCs in the US revealed shared prioritization for PPE and decontamination competencies. However, Taiwan placed greater emphasis on prehospital disaster operation management, mental health implications, and health consequences across different disasters, while the US focused more extensively on emergency management within hospitals.
\nConclusion: The expert-consensus-driven ranking of DMCCs in the study showed noteworthy agreement with the US. However, the roles of EPs, experience of previous disasters, and government policies may influence specific competencies. This underscores the importance of incorporating local context into disaster medicine training.
","language":"eng","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"Disaster Medicine"},{"word":"Core Competency"},{"word":"emergency medicine resident"},{"word":"Taiwan"},{"word":"United States"}],"section":"Disaster Medicine/ Emergency Medical Services","is_remote":true,"remote_url":"https://escholarship.org/uc/item/3x212619","frozenauthors":[{"first_name":"Joyce","middle_name":"","last_name":"Tay","name_suffix":"","institution":"National Taiwan University Hospital, Department of Emergency Medicine, Taipei, Taiwan","department":""},{"first_name":"Wei-Kuo","middle_name":"","last_name":"Chou","name_suffix":"","institution":"National Taiwan University Hospital, Department of Emergency Medicine, Taipei, Taiwan","department":""},{"first_name":"Ming-Tai","middle_name":"","last_name":"Cheng","name_suffix":"","institution":"National Taiwan University Hospital, Department of Emergency Medicine, Taipei, Taiwan","department":""},{"first_name":"Chih-Wei","middle_name":"","last_name":"Yang","name_suffix":"","institution":"National Taiwan University Hospital, Department of Emergency Medicine, Taipei, Taiwan; National Taiwan University College of Medicine, Department of Medical Education & Bioethics, Taipei, Taiwan National Taiwan; University Hospital, Department of Medical Education, Taipei, Taiwan","department":""},{"first_name":"Shuo-Kuen","middle_name":"","last_name":"Huang","name_suffix":"","institution":"National Taiwan University Hospital, Department of Emergency Medicine, Taipei, Taiwan; National Taiwan University Hospital Hsin-Chu Branch, Department of Emergency Medicine, Hsinchu, Taiwan","department":""},{"first_name":"Chien-Hao","middle_name":"","last_name":"Lin","name_suffix":"","institution":"National Taiwan University Hospital, Department of Emergency Medicine, Taipei, Taiwan","department":""}],"date_submitted":"2024-06-22T15:41:46.158000Z","date_accepted":"2025-03-10T04:17:13.574000Z","date_published":"2025-06-25T08:31:00Z","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/24961/galley/37044/download/"}]}