With the continuing threat of terrorist attacks, education on bioterrorism remains a top priority for CME providers. But the focus has changed — from the “disease of the day” to an underlying new awareness of how to deal with the spectrum of potential terrorist strikes. “We will always have the immediate broadcast, the just-in-time learning,” says Maureen Lichtveld, MD, MPH, and associate director for workforce policy and planning at the Centers for Disease Control. “But what you really want is that sustainable learning so you can get sustained performance. This is not passing a test and moving on and then forgetting all you've learned. This is about making sure you can function consistently and effectively in a terrorism event.” CDC is involved in changing professional school curricula, and updating such continuing learning tools as specialty board exams, to cover terrorism response.

Since you can't anticipate exactly where or how the next emergency will come, Lichtveld stresses a “diversity of content areas.” Terrorism preparedness now means not only learning to diagnose and treat the likely biological, chemical, and radiological agents, as well as mass trauma, it also means learning to navigate a public health and law enforcement system that may be alien to most medical practitioners.

The American College of Emergency Physicians' October 2002 meeting featured nine terrorism-preparedness topics, according to Debbie Smithey, CMP, director of educational meetings and CME. The offerings included Rapid Deployment of Real-Time Surveillance for Chemical and Biological Terrorism, and Who's in Charge: Bioterrorism Meets Bureaucracy. “That session identified the state, federal, military, public health, and private institutions involved in the American bioterrorism response and discussed what resources different agencies had available for emergency physicians and emergency departments in responding to chemical and biological attacks,” she says.

Wanted: Hands-on Experience

Another change is that clinicians are starting to want more than information — they want hands-on experience. “What we're finding is that people are interested in more of a live exercise,” says Kristina Sinclair, program manager with the Center for Disaster Preparedness at the University of Alabama at Birmingham. UAB has developed a smallpox outbreak training session, staged at the Noble Training Center, in Anniston, Ala., which was once the hospital of a now-closed Army base at Fort McClellan. “They walk through the emergency department, the upstairs unit, the hospital administrators room, and a control room where everything can be seen,” explains Emily Hack, program coordinator. “They're putting on the protective gear,” adds Sinclair, “so they can really feel what it's like.” The center has applied for funding to take the program on the road, and is also developing modules for other agents, such as pneumonic plague.

One thing that hasn't changed is the chief source of funding — it's still the government. Although there has been some industry support for events like Biosecurity 2002, by and large educators are able to take advantage of the government's interest in terror preparedness.

“Although the focus is on terrorism preparedness, the yield will be far beyond terrorism preparedness,” says Lichtveld. “It will also strengthen the public health infrastructure and the everyday response on the healthcare front lines.”