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Institutional Review Board (IRB) approval was required prior to
the start of the project. The student team developed the research
protocol and prepared the necessary documentation for IRB
The study was designed to evaluate WTW in the face of out-
breaks of infectious diseases with contact transmission--Ebola
virus disease (EVD)--versus respiratory transmission--Middle
East Respiratory Syndrome (MERS).
Students' WTW was evaluated by a questionnaire distributed
to 671 students at the three schools. Students were given ade-
quate time to complete the inventory at the beginning of class,
producing an outstanding 92 percent response rate.
WTW was measured as the highest hypothetical mortality
rate of an infectious disease transmitted by contact or respira-
tory routes for which the student would still be willing to
adhere to work roles and responsibilities. In addition, the
questionnaire elicited the reasons behind the reported WTW,
such as personal safety and risk to family, assessed the respon-
dents' knowledge of EVD and MERS, and identified their
prior experience as a first responder.
Analyzing the Data and
Characterizing the Findings
he student research team analyzed the sample as a whole
and by individual health care field--medicine, nursing,
and pharmacy. Overall, students were less fearful for their
health and more willing to work during infectious disease out-
breaks with contact transmission than during disease out-
breaks transmitted via the respiratory route.
Medical students expressed the greatest WTW, followed by
nursing students and then pharmacy students. Medical stu-
dents were the most fearful for their health and also the most
knowledgeable about infectious diseases. Prior disaster train-
ing was associated with greater WTW across the entire group
of questionnaire respondents.
Willingness increased with relevant disease-related knowl-
edge and prior training, along with the assurance that there
would be appropriate personal protective equipment to keep
them safe from infection. It is important to note that, of the
three schools, only the medical school provided curriculum
content, albeit minimal, in disaster preparedness and response.
Important Conclusions
his study was the first published in the scientific literature to
directly compare WTW among students of medicine, nurs-
ing, and pharmacy. The results suggest that, if an infectious dis-
ease outbreak--contact- or respiratory-transmitted--were to
occur, medical, nursing, and pharmacy students would be willing
to work in situations of highly lethal illness. This willingness is
dependent on the extent of their knowledge of the disease and
the availability of personal protective equipment.
A small minority of health care schools incorporate disaster
preparedness and response into their curricula. The authors
hope that publication of the results of this study will serve as
motivation nationally to incorporate more disaster education
into health care curricula. "Rima and Kapil and their student
research team colleagues are to be congratulated for taking
this project from concept to completion," says Dr. Lacy, "and
for finding and disseminating results that may influence health
care education across the country and, ultimately, our nation's
preparedness to respond to disasters."
Two of the students will graduate in May, while the others
are now immersed in their postgraduate training. Meanwhile,
new teams of health care students are already working with
Dr. Lacy on novel projects to advance disaster preparedness
and response.
unique feature of this
research was that, unlike many
projects in which students are given a
subsidiary role, in this project, with
appropriate faculty supervision, the
student team developed the concept,
performed the project, analyzed the
results, and wrote and submitted
the paper," says Clifton R. Lacy, MD '79 (facing page).
"From start to finish, this was their project."
Robert Wood Johnson
Jaya Kanduri, MD '17
Megan Nahass, MD '16
Justin Oh '18
Rima Patel, MD '17
Jennifer Yoon '18
Parth Shukla, MD '17
Kapil Wattamwar, MD '17