Leigh Elton is a registered nurse and works as part of the NCCTRC education team focussing on enhancing public health capacity for AUSMAT and with regional neighbours.
Current capacity building and education models in the Pacific
The National Critical Care and Trauma Response Centre (NCCTRC) delivers internationally recognised courses licenced by the Advanced Life Support Group (ALSG) across the Pacific.
The products delivered include Major Incident Medical Management and Support (MIMMS) in a three day and one day version along with Hospital Major Incident Medical Management and Support (HMIMMS) which is a two day course.
The two and two day iterations of H/MIMMS have an instructor pathway embedded into the course structure. Formative and summative assessment are carried out by ALSG recognised instructors. Participants that satisfy the assessment components of the course are also considered on a number of soft skills (communication, inclusivity, credibility etc.) that are highly sought after in the MIMMS and wider teaching community.
The strength of course delivery is amplified by partnering with local faculty and content experts delivering contextualised content. Additional benefits by partnering with our Indo-Pacific colleagues reduces communication barriers and assists in participant engagement.
Once identified the ‘potential instructor’ is to undertake a Generic Instructor Course (GIC) or have completed a recognised course which focuses on adult learning theory and educational strategies. Upon successful completion the ‘potential instructor’ becomes an Instructor Candidate.
The Instructor Candidate model allows for the junior instructor to be mentored by senior faculty, ensuring that guidance and support is provided while consolidating content along with exploring teaching strategies.
Capacity building in the Pacific is evident in the development of 33 faculty across MIMMS, HMIMMS, and GIC products since its inception in 2014. Along with the development of faculty, Fiji has successfully trained two MIMMS Course Directors resulting in independent delivery of MIMMS courses. A third Regional Engagement specific GIC is due to run toward the end of 2022 with the hope to see 24 new H/MIMMS Instructors added to the Indo-Pacific roster across eight countries.
Gaining global attention – key areas of success when looking at global emergency care
I was honoured to recently attend the International Conference of Emergency Medicine in Melbourne, Australia. With a strong Pacific representation, it was wonderful to reconnect with many of our colleagues and hear about the exceptional work that they have been doing, especially within the disaster space and most notably their experience with COVID-19.
A number of speakers introduced key areas of success when responding to and assessing global emergency care, and interestingly highlighted non-traditional concepts which occur around acute care and disaster management.
Deepak Sharma, Emergency Consultant, CMW Hospital, Suva Fiji, discussed how Major Incident Medical Management and Support (MIMMS) has recently become fully self-sufficient in Fiji and how that has helped MIMMS become context specific, run by an all Fijian faculty. This has strengthened their response in an appropriate, timely manner while building their disaster capacity.
Dr Mangu Kendio, Emergency Consultant, Port Moresby General Hospital in Papua New Guinea, spoke about partnership in action, as part of the Decolonising Global Health panel. Working together with AUSMAT and their experience in Papua New Guinea during their COVID-19 outbreaks, how they felt listened to and supported. Her experience around the nuances of language, cultural context and access being ongoing challenges within the Papua New Guinean health system and acknowledging how COVID-19 has tested that further. The need for strong supportive partnerships was found in AUSMAT during this trying time for the emergency staff in Port Moresby General Hospital.
Additionally, there was noted appreciation from Tonga as New Zealand Dr Adrian Kerner, Emergency Consultant and Global Emergency Care from Waitemata District Health Board, Auckland New Zealand, presented his ‘Interview with a colleague’ speaking to Senior Dr Kalo, Emergency physician from Samoa, who explored the important role in her experience of the Tsunami in 2021 and how to systematically respond with the tools that she had learnt during MIMMS in 2018, despite it being a number of years ago.
Other key areas of emergency care gaining global attention focused on environmental health, equity, inclusion and decolonisation. Decolonisation and working to create equity in health care and within the global health context. Working together, sharing information and strength based health care, all vital to include in our approach and systems. Finally, examining what tools we may need for reflexivity within international partnership and reviewing how colonial patterns persist and reinforce power within the global health context.
These health concepts are not traditionally part of emergency care or disaster, but now are being recognised as key themes which influence the nature of health that we are now responding to globally.
Training ahead – new education methods on the horizon with support of NCCTRC Regional Engagement
Something that we have all experienced over the last few years is the COVID-19 pandemic as a protracted disaster, and the way in which disaster management is used resulting in a new perspective required to ensure effective management in the long term.
With this in mind, together with the global health trends in emergency care becoming more public health focused, this brings exciting new opportunities for the NCCTRC.
Already, there is work being progressed with the introduction of two new courses under the Regional Engagement Program, specifically the Essentials of Critical Care and Rehabilitation in Disasters and Emergencies (RIDE) courses. Pleasingly the global health trends in emergency care and disaster management grow out of public health concepts and new training is on the horizon for both AUSMAT team members and potentially regional engagement, helping to support public health capacity across the Indo-Pacific.