Table 1 Competency domains, general learning objectives and some performance objectives at the basis of the training curriculum

1. Disaster medicine

• Understand the definition and different phases of disasters.

• Define the nature of injury or illness in relation to different types of disasters.

• Describe objectives and features of disaster medicine.

• Understand the international disaster response mechanism with involved bodies and organizations.

• List the four phases of disaster management

• Name the office of the United Nations responsible for the international coordination in case of disaster or humanitarian emergency

2. Incident Management System (IMS)

• Describe the general principles and different phases of the IMS.

• Demonstrate ability to work within an IMS.

• Describe the concept and different methods of Mass Casualty Triage.

• Define the concept of surge capacity and its role in unforeseen emergencies and disasters.

• Correctly carry out the initial reporting from a simulated disaster site using the METHANE (Major accident, Exact location, Type of accident, Hazards, Access, Number of victims, Emergency services) method.

• Assign simulated victims with the correct priority code according to the Simple Triage And Rapid Treatment (START) triage.

3. Communication

• Recognize a disaster in progress, assess and report the situation.

• Define and apply the principles of successful communication with local and expatriate staff, within and among organizations and with the media during emergencies.

• Describe the radio communication procedures and protocols.

• Recognize the importance of post-event reports.

• Implement the basic principles of communication in a public release statement with the media regarding the attack of a health facility by one belligerent party.

• Write and present a post-event report after a simulated mass casualty event summarizing the facts occurred and the actions taken.

• Successfully collaborate with a member of local staff with very limited English speaking skills during the clinical management of a simulated critically -ill patient.

4. Resource management

• Manage supplies, drugs and equipment and other resources for an effective response.

• Manage, supervise, and appropriately use local staff and expatriate aid workers during emergencies.

• Consider early blood compatibility testing for relatives of patients in an hemorrhagic shock scenario when whole blood is scarce or not available.

• Demonstrate competence in the use of outdated equipment (e.g ventilators) to provide safe anesthesia in a low-resource-setting.

5. Public health

• Recognize the top priorities for public health interventions during complex emergencies.

• Describe indicators used to assess and monitor public health during complex emergencies.

• Understand key epidemiological principles and terminology.

• Define the minimum levels to be attained in humanitarian interventions regarding the provision of water, sanitation and hygiene.

• Define the minimum levels to be attained in humanitarian interventions regarding the provision of food and nutrition.

• Identify which infectious diseases can constitute a major threat following a disaster according to the geographical location and the type of emergency occurring.

• Describe the information to be gathered during a Initial Rapid Assessment and elaborate an intervention plan according to the identified public health needs.

• Name the minimum quantity of safe drinking water (liters/ person/ day) to be provided in an humanitarian intervention.

• List the main anthropometric indices used to assess malnutrition.

• Demonstrate knowledge about the age groups to be covered by a measles vaccination campaign

6. Safety and security

• Understand the need for a safe and secure approach in humanitarian environments.

• Analyze the security environment on the basis of the seven pillars of security.

• Apply the preventive measures and/or individual or collective responsibilities adapted to each form of stress.

• Identify sources of risk, describe risk scenarios and identify risk mitigation measures.

• Demonstrate successful negotiation skills when approaching a simulated check point.

• Demonstrate ability to prevent incidents during road travels (e.g carrying ID card, being able to clearly explane the mission of his/her organization etc).

• Identify landmine markings during outdoors exercises

7. Ethics and international humanitarian law

• Apply basic principles of medical ethics to disaster situations.

• Recognize and react accordingly to the difficulties entailed by humanitarian scenarios where different cultural backgrounds are represented.

• Define the concept and understand the origins of International Humanitarian Law

• List the main International Human Rights

• Describe the role of International Humanitarian Law in in protecting the dignity and rights of the most vulnerable populations during armed conflicts

• Demonstrate tolerance when dealing with local staff and patients with different cultural background (e.g covered with burqa).

• Describe the origin of the Geneva Convention

8. Situational awareness

• Respond appropriately to an ever-changing environment and stress-induced situations.

• Adapt to pressure and change to operate effectively within humanitarian contexts.

• Demonstrate avoiding fixation errors during the management of critically-ll patients in simulated low-resource scenarios.

• Demonstrate ability to anticipate likely events in crisis situations (e.g a huge number of victims to come after a single patient presents with acute organophosphorus pesticide poisoning in a war context).

9. Psychological support

• Describe the main psychological needs in emergency contexts.

• Describe the essential criteria to organize actions in psychological support.

• Apply the principles of psychological first aid in emergency situations

• Identify and list the basic principles of Disaster Mental Health. Demonstrate ability to provide the principles of Psychological First Aid

• Demonstrate ability to develop good practices to manage personal stress in order to mitigate potential adverse effects of stress

10. Leadership

• Understand the definition of leadership and recognize the importance in an emergency context.

• Describe the different management styles.

• Understand conflict management and modify one’s own management style.

• Apply the principles of Non-Violent communication.

• Demonstrate ability to implement a Non-Violent communication when giving a member of the local staff a negative feedback regarding his performance during a recent emergency.

• Demonstrate ability to make firm decisions during a critical event: e.g. priority of transport for severely injured patients in an hostile environment.

11. Clinical considerations in the specific field of Anesthesia, Pediatrics and Emergency Medicine in Low Resource Settings

• Understand and apply the principles of safe anesthesia, emergency medicine or pediatrics in low-resource settings according to the needs and resource available.

• Demonstrate good knowledge in the use of Halothane, ketamine, suxamethonium and pancuronium

• Demonstrate ability to perform a newborn resuscitation in a resource-constrained environment

• Promptly recognize and treat signs and symptoms of malaria in high risk areas