# Updated Core Competencies for Disaster Medicine and Public Health

## TL;DR

Experts updated one of 11 core competencies for disaster medicine and public health to better reflect modern needs, especially after the COVID-19 pandemic.

## Contribution

A revised competency focusing on hazard identification and risk explanation was agreed upon through expert consensus.

## Key findings

- One core competency was updated with near-perfect agreement among experts.
- The revised competency emphasizes identifying hazards and explaining associated risks in disaster settings.
- Changes reflect lessons learned from the pandemic and evolving disaster response practices.

## Abstract

Based on expert consensus, what changes should be made to the original Core Competencies for Disaster Medicine and Public Health?

In this mixed-methods qualitative study, 2 of the 23 proposed competency changes showed near-perfect interrater agreement, suggesting these competencies require updating. The updates in the competencies focus on the identification of hazards and explaining the associated risks in disaster settings.

Implementing the changes recommended through this study will align diverse educational needs within the disaster medicine and public health sectors and, ultimately, create more effective and well-prepared responses.

This qualitative study reports the results of an expert consensus survey process to update the National Center for Disaster Medicine and Public Health’s list of core competencies for health professionals in disasters and public health emergencies.

In 2012, the National Center for Disaster Medicine and Public Health (NCDMPH) created a set of core competencies for disaster medicine and public health through an expert stakeholder panel. The COVID-19 pandemic and other significant events have reshaped experts’ understanding of which core competencies should be prioritized to ensure that health professionals are prepared for disasters and public health emergencies.

To determine whether the original core competencies should be updated given the many advancements in the field over the last decade.

For this mixed-methods qualitative study, in April 2024, the NCDMPH convened 20 subject matter experts in clinical medicine, emergency management, government, and academia to provide qualitative feedback surrounding the current set of 11 disaster health core competencies.

A Delphi survey incorporating the potential changes or additions to the initial core competencies was distributed to 42 additional stakeholders between April and July 2024 to quantify the level of agreement. Gwet AC2, a measure of interrater agreement, was applied to evaluate the strength of agreement for the need to change each core competency. Competencies with substantial or near-perfect agreement were updated.

Twenty subject matter experts proposed 23 changes to the original core competencies in an initial focus group. Sixteen respondents who completed all items of the Delphi survey reached near-perfect agreement on updating 1 competency and associated subcompetency. The original competency required a demonstration of knowledge of personal safety measures that can be implemented in a disaster or public health emergency. This competency was refined as the identification of physical, psychological, and security hazards associated with the incident. A subcompetency was added that included explaining physical and psychological health, safety, and security risks associated with disasters and public health emergencies.

In this mixed-methods evaluation, subject matter experts agreed that 1 of 11 disaster health core competencies required modification. These changes included refined language on recognizing hazards and explaining safety and security risks, reflecting observations and experiences during the COVID-19 pandemic and recognition of diverse types of health. These changes ensure training and education of disaster health responders remains synchronized with developments in the preparedness and response communities.