Setting With a Focus on One Specific

¶ … setting with a focus on one specific EMS unit that will participate in the CDP training program. This setting was selected because it offered a snapshot collection of data that could be valuable based on the outcome of the training provided by the CDP program. The researcher will conduct pre and post-interviews with the members of the EMS unit as they start and complete the program. One of the benefits of this style of approach is that it allows for the gathering of qualitative and quantitative data.

A mixed research study design provides the researcher with hard, numerical data on feelings, thoughts, beliefs and perceptions. The organization benefits from this type of study because the organization can analyze through numerical data how its members actually perceive the training they receive. The data can help discover whether the training is effective or needs to be improved upon.

Research Topic

This thesis focuses on effectiveness of a specific form of training for frist responders that was developed, tested, and implemented after 9/11. Despite the fact that this program had its origins in real field conditions, this does not mean that it does not require continual testing and re-evaluating to determine if the philosophy and pragmatics of the program are the best that they can be.

This form of training has been praised for its ability to enable hospital staff and other first responders to effectively deal with crisis situations. "I feel the course was very helpful in helping to formulate my response to the current [H1N1] situation. Having the P3 course helped to put everything in focus as it happened. I think Pandemic training is very important; I believe that by having this training, it helped us to keep our organization functioning calmly, with focus and with the knowledge that Infection Control and Safety Services had the situation under control" said one graduate of the program (News, 2012, CDP website). The program is designed so that skills can be learned a single time and then applied in a number of different circumstances. It will be assessed in both objective and subjective terms.

The ability to cope with emergencies through preparation and genuinely effective drills was enabled by CDP training, according to many graduates. The CDP model of training, while it is tailored to the needs of the specific personnel under consideration is not only grounded in a healthcare model, but also in the needs of other emergency responders. This can be seen as a strength of the program, given that coordination with government officials, police and fire-fighters are essential during a disaster (Waugh 2003: 393). Training through an agency that embraces the perspective of many emergency-related services requires EMS staff to better learn how to cooperate with other agencies involved in dealing with security threats, and studying the CDP model could help unite the worldview of different response agencies.

Part of what this thesis examines is the extent to which this form of training has the ability to serve as a form of translation service between and among different agencies and the ways in which they work.

Research Problem and Research Questions

The research problem is focused on the efficacy of a certain type of EMT training and the ways in which first responders will be able to react under a range of circumstances. Given that different EMTs have received different types of training, this population provides an excellent opportunity to examine the effectiveness of training as well as -- and this is just as important -- the ways in which first responders themselves understand the effectiveness of how they are being trained and how it affects their sense of community. Only half of all EMS providers have received training in dealing with WMD weapons of mass destruction) response procedures.

And only 18.1 in a recent survey said that their agencies possessed the required equipment to adequately respond to a WMD emergency. EMS providers that received WMD training reported a higher comfort level dealing with emergencies than those who had received no training at all (Reilly, Markenson & DiMaggio 2007: 298-300). This seems contradictory at first, and so requires further study.

This thesis will attempt to determine why this should be the case. The ways in which first responders are trained are of utmost importance, of course, but too often studies of them focus only on objective criteria such as injury rates. While such objective standards are necessarily useful, they cannot be the only criteria to be used when making such assessments. Interviewing those involved in such trainings and who must transfer these trainings into daily work must also be interviewed to get the fullest possible picture of what types of training are the most effective.

The best way to provide such training can be controversial. How to provide it, what type of training is most effective, and what type of training is most cost-effective are all concerns that must be answered and are issues that will be taken up in the course of this research. In response to the need for additional training, in June 1998, the Center for Domestic Preparedness (CDP) created a training center for EMS responders.

"The CDP's mission is to operate a federal training center for delivery of high-quality, comprehensive preparedness training programs for the nation's emergency responders," including EMS personnel (About the CDP, 2012, CDP website). "Responders from across the country train at the Center for Domestic Preparedness and return to their hometowns with specialized skills and experience" (Why train with the CDP, 2012, CDP website). Part of the focus of this research is the extent to which the term "comprehensive" is shared across agencies.

This study will conduct a case study of a facility that has made use of the CDP training program. The participants will be surveyed to see if their level of perceived comfort in dealing with a WMD response has increased, as a result of the program. The construction of the program and its perceived deficits and strengths will also be assessed. The suggestions that participants themselves have to offer will be incorporated and assessed in turn.

Research Study Design

The population for this study will include the entire EMS unit, even those members of the unit who do not participate in the CDP training. This will help ensure that the opinions of as many different members of the community are included. The different experiences of the group's members can be assessed along the divide of whether or not they participated in the training as a method of gaining further insight into its effectiveness.

The members of this unit are a diverse population; there are not as many women as there are men, the age range is approximately 26 on the young side, and 48 on the old side. The unit's members are (for the most part) highly educated and motivated individuals who are compassionate and passionate about their work and the people they are entrusted with to help. Many of the group are married, and approximately 25% are of minority heritage.

The entire group is differentiated from other careers because they are constantly and consistently faced with life-saving opportunities. Additionally, their quick actions and thinking can oftentimes avert disaster on a very personal level. This group was chosen because of their advanced training, and constant education they receive both through on-the-job experience, and in the professional training courses that they are required to attend.

Because this particular group learns through experience and practice-based standards are often developed through this experience it seems likely that this group will provide a wealth of data on how to improve or enhance the CPD training that is being evaluated. One recent study determined that "Self-evaluation can help schools to detect problems and monitor improvement initiatives" (Schildkamp, Visscher, Luyten, 2009, p. 69).

The same study found that "school self-evaluation instruments may provide schools with information on process variables associated with school effectiveness, which schools can use to improve their performance" (p.69). If this study is successful then perhaps the tools used herein will provide long-tern benefits to both the school(s) that use the tools, and the students that are taught by those school(s).

The study's participants were chosen because they were willing to attend the training and willing to have an observer/interviewer throughout the entire process. Additionally, the group is representative of a large contingent of like-minded individuals and groups throughout the nation. The sample size -- as compared to the overall EMS population -- is rather small, and that could limit the validity of the study. The study is not meant to show that the CPD training will be effective in every case, and throughout the entire land, but is meant to determine the level of effectiveness as portrayed by one EMS group.

The study is meant to add to the level of significant literature, it is not meant to be the comprehensive leader of the available literature. The recruitment methods used to choose this group were relatively simple; the researcher approached a couple of local EMS groups to determine if, and when, they were participating in the CPD program. One EMS group had already completed the program, the other was preparing to do so.

The group that was preparing to do so, was more than willing to be part of a study, especially since the results of the study would help to determine how effective the training was perceived to be. This proved to be a useful coincidence.

After having discussed why certain methods were chosen, it is also to note why others were considered then passed on. Neither phenomenology nor ethnography would be appropriate for this type of research, given that phenomenology takes a relatively descriptive mode, merely describing a phenomenon, and there are undeniable political implications of the decision to embark upon a specific training program, in terms of the opportunity cost of time and resources. A case study method does not have to be judgmental, but it can compare perceived benefits and detriments of using a specific program, versus how the unit was functioning previously. Also, although unlike a research design, there is no control group to compare effectiveness, a case study method can still engage in some speculative and projected planning of how the EMS responders might respond to such an event using its new knowledge. This is the nature of field research.

An ethnography would not be appropriate, given that an ethnography approaches the event from the perspective of an outsider to the culture. As someone with a medical background, I am an 'insider' to a hospital and the perspective of medical professionals. Additionally, the individuals involved in the creation of the training program do not come from a culture outside my own. Although some ethnographers now write about their own cultures, this is not the standard sense of what ethnographic work is.

Data Collection

The mixed research design of this study allows for qualitative data to be gathered and analyzed with quantitative measurements. A case study such as this one, is an excellent candidate for qualitative measurements. The CPD training program attempts to provide information that can be life-saving during a natural, or unnatural (such as an attack with weapons of mass destruction) disasters.

Collecting qualitative data will take a number of different forms throughout this study, and will include a number of different data gathering tools. The different data gathering tools will be overseen by a prepared program. As one study recently discovered, "the focus of assessment of clinical performance has moved from over-reliance on individual tools to constructing a coherent assessment program" (Wilkinson, 2007, p. 631). The proposed study seeks to develop a 'coherent assessment program' not just use tools with no purpose. The Wilkinson study also determined that "the purpose of such an assessment program is to gather high-quality evidence to make well-informed decisions" (p. 631).

It is the objective of this study to also gather high quality evidence in order to make well-informed decisions and to do that will require a variety of tools. A key tool will be the researcher's notes and observations of the participants as they start, participate and complete the CPD training. The researcher will attempt to listen to the participants and write down their responses, thoughts, perceptions and ideas as they go through the course requirements.

The researcher's observations will be recorded both digitally and through the use of a writing instrument.

The data capture method will be what the researcher observes through the actions of the participants as well. Such actions can be facial movements, speech, reactions to course instructors, body language and emotions, among others. Studies show that "pure data such as gate counts, computer uses, and more aren't as satisfying to those who hold the purse strings as are measurements that articulate impact" (Miller, Fialkoff, Kelley, 2012, p. 35). Tools such as observations and interviews allow for the measurements of impact, not just statistics.

Because the researcher is looking to evaluate feelings and perceptions the third tool implemented through the study will be formative and structured interviews conducted by the researcher. Interviews allow the participant a more structured arena for expressing his/her thoughts and ideals. The researcher will record participant responses to open-ended prompts that allow the participant to expand upon their feelings and thoughts.

A key tool implemented will be an informed consent tool. This form is created to inform the participant(s) of the purpose and circumstances of the study. The informed consent tool spells out objectives, what the study is attempting to discern, how long the study will last, any compensation that will be available, who the study will benefit and who is conducting the study. The informed consent form also provides a line for the participant's signature signifying dissemination and consent to participating in the study.

Data Collection Procedures

The proposed study will include a setting with a focus on one specific EMS unit that will participate in the CDP training program. This setting was selected because it offered a snapshot collection of data that could be valuable based on the outcome of the training provided by the CDP program. The researcher will conduct pre and post-interviews with the members of the EMS unit as they start and complete the program.

One of the benefits of this style of approach is that it allows for the gathering of qualitative and quantitative data. A mixed research study design provides the researcher with hard, numerical data on feelings, thoughts, beliefs and perceptions. The organization benefits from this type of study because the organization can analyze through numerical data how its members actually perceive the training they receive. The data can help discover whether the training is effective or needs to be improved upon.

Data Analysis Plan

The case study data analysis will be facilitated by the use of data analysis software. The software employed for qualitative data analysis (QDA) in this study will function as a data-reduction mechanism. The researcher's part in the study remains interpretive regardless of the fact that the coding is generated by the computer program and some data is highlighted with respect to thematic relationships that emerge. The researcher will generate personally important, rich, and salient accounts from the data provided by the study respondents.

The data analysis will proceed in a bottom-up fashion, such that the codes are derived from the data rather than from any pre-existing theory. The researcher will work intensively with the data, creating annotations as the process unfolds. These annotations are intended to focus on insights about the perspective and insights of the participants in the study with regard to their experiences in the CDP training. Patterns that emerge from data inspection and analysis are called themes. The researcher will explore the recurring themes in order to identify what is meaningful to the participants.

Qualitative data analysis (QDA) will be accomplished through the use of a computer software application designed for analysis of qualitative information. The computer software application will be used for the researcher's narrative accounts and observational data, and it will be used for recording and analyzing the transcripts of participant interviews.