To Örebro University

Objective: Disaster response requires a diverse set of skills, yet there is no universally agreed definition of the specific competences needed. Therefore, this study aimed to explore how disaster responders acquire competence.

Methods: A qualitative study using inductive thematic analysis. Individual interviews with disaster responders who had worked in a leading position.

Results: The study included 14 participants from 7 nationalities, all of whom were experienced disaster responders from different professions. From the analysis, four themes arose describing different ways of acquiring the competences and skills required to function as a disaster responder. Previous background, formal training, mental preparedness, and personal traits all had a role in how competences and skills were acquired among disaster responders.

Conclusion: Formal training alone cannot fully prepare disaster responders for the reality of a disaster but needs to be combined with personal experiences from both disasters and other contexts as well as mental preparation. Personal traits also play a role for acquisition of competence. When designing training programs, technical disaster-specific skills should serve as the core, but equal emphasis should be placed on non-technical skills, especially teamwork, leadership, mentoring, and gender awareness within response teams. These elements contribute to developing capable and well-prepared responders.

Disasters strike worldwide and cause large-scale suffering. However, there is only limited knowledge on how to best prepare disaster responders, and no universal consensus on the core competences that disaster responders need or should be required to have. The aim of this thesis was to understand the competences used and needed by disaster responders.

This thesis is based on four studies: two using a qualitative design with content analysis (Study I) and reflexive thematic analysis (Study IV), one scoping review (Study II) and one cross-sectional study (Study III). The results showed that although disaster responders are a diverse group, the competences they require are based on a combination of technical skills, non-technical skills, previous experience and personal traits. Leadership skills, teamwork skills and communication seem to be the most important skills for disaster responders’ ability to act during a disaster response mission. Another important aspect of disaster response is mental preparedness. Although disaster specific technical skills should form the foundation of disaster training programs, there is a need for a greater focus on non-technical skills. When technical and non-technical skills are combined with desirable personal traits, mental preparedness, and previous experience as well as training tailored for the disaster responders and adequate for the task, this seems to provide the best context for creating competence among disaster responders.

Background: There is no universal agreement on what competence in disaster medicine is, nor what competences and personal attributes add value for disaster responders. Some studies suggest that disaster responders need not only technical skills but also non-technical skills. Consensus of which non-technical skills are needed and how training for these can be provided is lacking, and little is known about how to apply knowledge of non-technical skills in the recruitment of disaster responders. Therefore, this scoping review aimed to identify the non-technical skills required for the disaster medicine response.

Method: A scooping review using the Arksey & O´Malley framework was performed. Structured searches in the databases PuBMed, CINAHL Full Plus, Web of Science, PsycInfo and Scopus was conducted. Thereafter, data were structured and analyzed.

Results: From an initial search result of 6447 articles, 34 articles were included in the study. These covered both quantitative and qualitative studies and different contexts, including real events and training. The most often studied real event were responses following earthquakes. Four non-technical skills stood out as most frequently mentioned: communication skills; situational awareness; knowledge of human resources and organization and coordination skills; decision-making, critical-thinking and problem-solving skills. The review also showed a significant lack of uniform use of terms like skills or competence in the reviewed articles.

Conclusion: Non-technical skills are skills that disaster responders need. Which non-technical skills are most needed, how to train and measure non-technical skills, and how to implement non-technical skills in disaster medicine need further studies.

INTRODUCTION: Disaster responders are an important part of disaster response. However, despite large efforts to train disaster responders, there is a limited scientific knowledge regarding which competences and skills such responders value and lack during a real mission. The aim of this study was to investigate used and needed skills among disaster responders responding to the earthquake in Türkiye and Syria 202.

METHODS: A cross-sectional study using a non-randomized sample was conducted, collected between March and July, 2023. The participants were recruited through invitations distributed to international organizations, and the data were gathered through a web-based survey. The data were analyzed using descriptive and comparative statistics.

RESULTS: A total of 525 participants involved in the disaster response in Türkiye or Syria in February 2023 were included. The most common valued skills were teamwork skills (n = 252, 59%), technical knowledge (n = 204, 48%), leadership skills (n = 105, 24%) and communication skills (n = 114, 17%). Women valued stress management (n = 33, 26%) more than leadership (n = 24, 19%) Technical knowledges were more valued among first-time responders (n = 168, 82%) compared to experienced responders (n = 108, 54%, p-value < 0.001). The most reported lacked skills were mental preparedness (n = 237, 53%), knowledge of the management system of international response (n = 132, 30%), stress management (n = 105, 24%) and leadership (n = 102, 23%).

CONCLUSION: The results showed slightly different needs in the various phases of a response, as well as some differences between men and women. Improving mental preparedness was not one of the most highly valued skills, but it was one of the skills that was most lacking; this discrepancy is an interesting finding. More in-depth analysis and additional studies are needed to further understand how best to prepare disaster responders and how their training can include the desirable skills. Further studies should be focused on the experience and knowledge of qualified disaster responders. This knowledge could also be of use when recruiting since several of the non-technical skills are not only gained solely through specific training.

Objectives: The coronavirus disease (COVID-19) crisis response in Sweden was managed foremost by a collaboration of several national agencies. Normally, their strategical and operational collaboration is limited, but the pandemic required new and unfamiliar collaborations. This study aimed to clarify the facilitators and barriers of perceived effective staff work within and between 4 national agencies.

Methods: A qualitative study of 10 participants with leading roles within the 4 national agencies' crisis organization was conducted via snowball sampling. The participant interviews were conducted between August and November 2020 and analyzed using content analysis.

Results: Four categories emerged from the analysis: individual characteristics, intra-agency organization, interorganizational collaboration, and governmental directives. Subcategories crystallized from the data were analyzed and divided into factors for facilitating or to function as barriers for effective staff work.

Conclusion: Individual factors such as attitude and approach were important for perceived effective staff work as well as clear mandates and structure of the organization. Barriers for perceived effective staff work include lack of network, the complexity of the mission and organizational structures, as well as lack of preparations and unclear mandates. Although flexibility and adaptability are necessary, they cannot always be planned, but can be incorporated indirectly by selecting suitable individuals and optimizing organizational planning.