# Are you ready? A cross-sectional survey of education, training and learning activities for peacetime crisis and armed conflict preparedness in Swedish emergency departments

## TL;DR

This study examines how well Swedish emergency departments prepare their staff for peacetime crises and armed conflicts through education and training.

## Contribution

The study provides a national assessment of disaster preparedness education and training in Swedish emergency departments.

## Key findings

- Emergency departments provide education on managing care during disasters but lack training for extreme weather and armed conflicts.
- Disaster preparedness training is more common in departments with a designated responsible employee.
- Education and training remain incomplete, potentially leaving staff unprepared for all-hazard disasters.

## Abstract

The evolving security landscape in Europe underscores the crucial importance of disaster preparedness. Emergency Departments’ (EDs) personnel – comprising nurses, nurse assistants and physicians – play a vital role in managing crises during both peacetime and armed conflicts. However, readiness and educational preparation of Emergency Department (ED) personnel are inconsistent; consequently, Sweden’s National Board of Health and Welfare (NBHW) has introduced national recommendations concerning education and training for both peacetime crises and armed conflicts. This study aimed to investigate the extent to which education and training of ED personnel align with NBHW recommendations for peacetime crisis and armed conflict preparedness in Swedish EDs. A descriptive cross-sectional study was conducted among all 70 hospital-based EDs in Sweden. In August 2025, a questionnaire comprising 45 items was distributed, covering topics related to NBHW recommendations, as well as specific aspects of International Humanitarian Law. The findings revealed that EDs provide education and training on how emergency care is organised and managed during disaster situations, as well as how to strengthen their capability to deliver care under such conditions. However, education and training for emergency care during extreme weather events and armed conflicts remain incomplete. The survey also revealed that disaster preparedness education and training were more common among EDs that had a designated employee responsible for overseeing these activities. Finally, this descriptive and exploratory study indicates that EDs are taking steps to enhance ED personnel’s knowledge and skills in organising and managing emergency care during disaster situations, as well as their capacity to deliver care under such conditions. Nevertheless, education and training related to disaster preparedness and patient care during peacetime crises and armed conflicts remain incomplete. Consequently, ED personnel may have inadequate education and training necessary to respond effectively to all-hazard disasters.