Effectiveness of Indoor and Outdoor Preparedness Simulation in
Improving First Aid Competency in Emergency Response Phase
Among Trained Lay People in Surakarta Municipality
Addi Mardi Harnanto and Sunarto
School of Nursing, Surakarta Health Polytechnic, Surakarta, Indonesia
Keywords: Simulation, First aid competence, Emergency response phase, Trained lay person.
Abstract: The capacity of national emergency preparedness and response requires the support of all elements of the
community. Trained lay people are ordinary people who have received first aid training and disaster
preparedness individually or in groups. Trained lay people have an interest in getting involved in first aid
and preparedness. The aim of this study is to analyse the differences in the effectiveness of indoor and
outdoor disaster preparedness simulations to improve the competence of first aid in emergency response
phase among trained lay people in Surakarta Municipality. This study used a quasi-experimental study with
pre-posttest with control group design with real treatment of respondents who get action in the form of
simulation. Sampling technique in this study is the total sampling of all trained lay people assisted Surakarta
Health Polytechnic with number of 120 people. The t test results showed that the value t = 10.393> t table
(0.05, df 39) = 8.750 with a confidence level of 95% indicates α = 0.00 <0.05. It can be concluded that
there is a significant difference in effectiveness between the simulation of indoor and outdoor disaster
preparedness in improving the competence of first aid in the emergency response among trained lay people
in Surakarta Municipality. Outdoor simulation is more effective than indoor simulation in improving the
competence of first aid in the emergency response among trained lay people in Surakarta Municipality.
1 BACKGROUND
Law of the Republic of Indonesia Number 24 Year
of 2007 explains that the territory of the Republic of
Indonesia has geographical, geological, hydrological
and demographic conditions which enable the
occurrence of disasters, whether caused by natural
factors, non-natural factors or human factors causing
human casualties, environmental damage, objects,
and psychological impacts that in certain
circumstances can inhibit national development.
Disaster preparedness is a series of activities
undertaken to anticipate disasters through organizing
as well as through appropriate and efficient
measures. Disaster emergency response is a series of
immediate activities in the event of a disaster to deal
with adverse impacts, including rescue and
evacuation of victims, property, basic needs,
protection, refugee management, rescue, and
recovery of facilities and infrastructure (Law of the
Republic of Indonesia Number 24 Year of 2007).
Trained lay people are ordinary people who
have received first aid training and disaster
preparedness individually or in groups. Trained lay
people have an interest in getting involved in first
aid and preparedness. One of the capabilities
possessed by trained lay people in the emergency
response phase is the ability to carry out first aid.
With a good first aid ability is expected to improve
services with indicators of decreased mortality and
morbidity. Based on the results of interviews with
Scout members and Surakarta Voluntary Corps
trained by of Surakarta Health Polytechnic, they
informed that they have understood and have the
ability in the first aid field in emergency conditions.
They also stated that they often perform first-aid
simulations in the emergency response phase of both
indoor simulation with props of cards containing
case images and outdoor simulations with victim and
survivor models. Indoor simulations have already
begun to be developed on the basis of more effective
use of time and cost.
472
Harnanto, A. and Sunarto, .
Effectiveness of Indoor and Outdoor Preparedness Simulation in Improving First Aid Competency in Emergency Response Phase Among Trained Lay People in Surakarta Municipality.
DOI: 10.5220/0008327004720476
In Proceedings of the 9th International Nursing Conference (INC 2018), pages 472-476
ISBN: 978-989-758-336-0
Copyright
c
2018 by SCITEPRESS – Science and Technology Publications, Lda. All rights reserved
The aim of this study is to analyse the
differences in the effectiveness of indoor and
outdoor disaster preparedness simulations to
improve the competence of first aid in emergency
response phase among trained lay people in
Surakarta Municipality.
2 METHODS
This study was conducted in August 2016 located at
Surakarta. This type of study is comparative
experimental study with pretest-post test with
control group design with real treatment to
respondents who get action in the form of
simulation. The population in this study were all
members of trained lay people coordinated by
Health Polytechnic of Surakarta with total of 120
people. Sampling technique in this study was total
sampling.
The research instrument consisted of a
questionnaire on first aids for assessing knowledge,
a skill assessment form for assessing skills, and a
Group Discussion Forum Guideline for more in-
depth review of data. These research instruments
were developed based on emergency nursing
department and disaster preparedness of Nursing
Department of Surakarta Health Polytechnic and
conducted expert validity test. The questions in this
study were consulted in advance to two of
emergency nursing practitioners and nursing
academics.
Respondents were invited to attend the
Surakarta Health Polytechnic campus for data
collection. Respondents were divided into 2 groups
at random by the even and odd numbering method of
drawing at the time of filling the attendance list.
Data collection starts from pre-test. Then a disaster
preparedness simulation was conducted. The first
group performs the simulation with indoor method
and the second group is guided to carry out the
outdoor method simulation. After completion of the
simulation, post-test was directly conducted. At the
end of the session, focus group discussions were
conducted to obtain more in-depth data with the
question of "whether the advantages and
disadvantages of simulating using indoor or outdoor
methods."
Data analysis using computer tool program
SPSS for windows version 16. The test of bivariate
statistic used is t test to test the difference of
effectiveness of two treatment groups and
descriptive analysis used to examine the FGD
results.
3 RESULTS
All of 120 respondents invited in this study atended
the data assessment activity. As shown in Table 1,
in the indoor simulation group, the average pre-test
score was 54.56 and the post-test score was 63.31.
There was an increase between pre-test and post-
test with an average increase of 8.75. In the outdoor
simulation group, the average pretest score was
54.56 and the postest score was 63.31. There was an
increase between pretest and postest with an average
increase of 8.75.
Based on table 2, outdoor groups showed an
increase in value of 25.33 higher than the indoor
group showing an increase of 8.75. Table 3 shows
the results of t test that the value of t = 10,393> t
table (0,05, df 39) = 8,750 with 95% confidence
level with α = 0,00 <0,05. Based on this result, it can
be concluded that there is a significant difference of
effectiveness between the simulation of disaster
preparedness indoors and outdoors in improving the
capability of first aids phase of emergency. Outdoor
simulation is more effective than indoor simulation.
After the respondents completed the pretest,
simulation and postest, Focus Group Discussion
(FGD) was conducted. Respondents were grouped
into 12 groups with an average member of 10 people
in each group. Group members were not mixed
between indoor simulation and outdoor simulation
groups. The discussion was guided by FGD Guide
that have been prepared by researchers such as
"whether the advantages and disadvantages of
simulation implementation by indoor or outdoor
method".
Tabel 1: Frequency Distribution of Pretest and
Postest Value.
Group
Pre-test
Post-test
Difference
Indoor
54.56
63.31
8.75
Outdoor
51.75
77.08333
25.33333
Tabel 2: Average Difference in Increment of Pre-test
And Post-test Value.
Indoor
8.75
<
Tabel 3: t-test.
t
t table
P
Sign
10.393
8.750
0,00
<
0,05
Effectiveness of Indoor and Outdoor Preparedness Simulation in Improving First Aid Competency in Emergency Response Phase Among
Trained Lay People in Surakarta Municipality
473
The conclusion of the FGD results is that 60
respondents (100%) in the indoor simulation group
argue that indoor simulation is very helpful in
achieving knowledge related to the completion of
disaster preparedness case scenario. Respondents are
very helpful because the data in written scenarios in
detail and coherent. According to 50 respondents
(83.3%) in the indoor simulation group stated that
the simulation is not good for improving clinical
skills but very helpful in improving critical thinking
skills. 60 respondents (100%) in the outdoor
simulation group argued that they were greatly
assisted in improving skills or skills in relief.
Respondents in this group also felt that they were
actually helping victims or victims of disaster so as
to touch aspects of affective and critical thinking.
4 DISCUSSION
Based on the results, this study indicates that the
simulation activities performed very effectively
show good results. Learning method is one of the
teaching methods that can be used in group learning.
The learning process that uses the simulation is not
an actual object or activity, an important pretend to
teach activities. Simulation activities can be done by
students in high grade in elementary school. In
learning, students will be fostered their abilities
related to the skills of interacting and
communicating in groups. In addition, in the
simulation method students are invited to play the
role of some behaviors that require according to the
learning objectives (Sa'ud, 2005).
The Tawalbeh, & Tubaishat (2013) study shows
that the current study adds positive evidence that
simulation methods greatly affect students'
knowledge and confidence in applying Advance
Cardiac Life Support (ACLS) knowledge. Other
studies showing similar results were Alinier, Hunt,
& Gordon, (2004), Feingold, Calaluce, & Kallen
(2004), Goldenberg, et al. (2005), Mole &
McLaffery (2004) who stated that the simulation
method has a positive effect in improving
knowledge, confidence and clinical skills. In
addition, the simulation method also enhances
critical thinking skills for nursing students in the
learning of Cardio Pulmonary Resuscitation
(Ackermann, 2009; Bruce et al., 2009; Kim & Jang,
2011; Long, 2005).
Members of trained lay people coordinated by
Health Polytechnic of Surakarta are prepared to be
reliable first responder who are equipped with soft
skills of volunteer activities. Therefore, the
debriefing activity through the simulation method is
very appropriate because it is very effective in
improving knowledge, skills, confidence and critical
thinking ability. In addition, this method can be used
in context-based learning, one example of learning
materials can be lifted from social life, social values
as well as actual and past social problems for the
future. Disaster preparadness is an aspect of social
life that must be familiarized to the community,
especially for the trained lay people including
voluntary corps who must guard the community in
the face of disaster.
Both groups of respondents showed an increase in
the value of first-aid emergency cases in the disaster
response phase. This fact shows that both simulation
method (indoor and outdoor) can stimulate the
improvement of respondent ability. The increase in
the value of the outdoor simulation group is more
significant than the indoor simulation group. This
situation illustrates that outdoor simulations
performed using roleplay techniques by
implementing actual demonstration skills can further
improve the competence of respondents.
Most respondents from all groups argue that it is
advisable that at every disaster preparedness training
program always combine indoor and outdoor
methods. The indoor method is carried out at the
beginning of the exercise while the outdoor method
is carried out at the end of the training.
The results support the previous study which
states that the direct simulation method with a
scenario has a positive impact on the improvement
of its main capability in the psychomotor domain. A
big classroom teaching framed in a natural disaster
simulation method is acceptable and highly effective
for medical students to develop non-technical skills,
cooperation, negotiation and communication that are
important for teamwork. The simulation design can
be an added value in medical schools in disaster
prone areas, including in developing countries and
as a viable intervention to learn non-technical skills
needed for patient safety (Jorm, Roberts, Lim,
Roper, Skinner, Robertson, Gentilcore and
Osomanski, 2016).
The meta analysis conducted by Kim, Park &
Shin (2016) shows that simulation-based nursing
education has a strong effect on education. Very
large effects are seen in the psychomotor domain. In
addition, the effect of simulation-based nursing
education is not proportional to the level of loyalty.
Therefore, it is important to use all the appropriate
simulation levels to meet all educational objectives
and outcomes.
INC 2018 - The 9th International Nursing Conference: Nurses at The Forefront Transforming Care, Science and Research
474
The medical institute reports that simulations
are identified as a method to improve safety in the
medical field, such as flight simulations used to
improve the safety of the aviation industry.
However, while there is evidence that simulations
can improve task performance, there is little
evidence that simulations actually increase output to
patients (Kaji, Bair, Okuda, Kobayashi, Khare, &
Vozenilek, 2008).
Study conducted by Ambarika (2016) shows the
result that education and simulation of disaster
management as one of the best media to prepare
students to be disaster volunteer because through the
learning process by educating and simulating
disaster can increase knowledge and skill and ability
of student to become disaster volunteer so will
increase volunteer preparedness. Disaster education
and training are needed to be implemented at the
institution so that all students have the preparedness
to become disaster volunteers because disaster can
come at any time and it requires disaster volunteers.
Nurudin and Widaryati (2015) conducted a research
with the result that there is an effect of training on
earthquake disaster relief on the readiness of grade
VII students at SMP N 1 Imogiri Bantul Yogyakarta
in 2015. Hence, it is concluded that the simulation is
very effective against the increase of preparedness as
a measure of the affective domain.
Study of Syuaib (2014) concludes that there are
significant differences in the effect of different
learning strategies on preparedness learning
outcomes about natural disasters, with students
learning by strategy role play is more
accommodative than simulated learning.
5 CONCLUSIONS
Based on the results of research on 120 respondents
can be drawn conclusion that outdoor simulation is
more effective than indoor simulation but these two
methods can equally improve the ability of first aid.
It would be better, if a combination of these two
methods of training is done in training of trained lay
people.
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