Recent terrorist attacks, coupled with a high number of natural disasters, have had a destabilizing impact on the general population, causing distress and fear and clearly indicating the need to include disaster preparedness training as part of the curriculum of all educational programs for the health professions [1]. Although medical schools in the United States are encouraged to follow the recommendations of the Association of American Medical Colleges to develop a disaster medicine module for inclusion in the curriculum of medical students, few medical schools explicitly include practical education on disasters and health threats in their curriculum [2]. In addition, 91.4% of medical students stated that they would appreciate the introduction of an optional module that would educate them on disaster medicine and 94.1% indicated that a knowledge of disaster medicine would be helpful in their future career [3]. Although pharmacists can make many contributions in a variety of emergencies and during a disaster response, their specific role is not well defined [4,5]. Indeed, chemical, biological, radiological, and nuclear (CBRN) risks, including nerve agents, vesicants, radionucleotides, anthrax, and ricin poisoning, could require hospital pharmacies to provide antidotes, antibiotics, antitoxins, and other pharmaceuticals in large amounts [5]. Moreover, with the increasing risk of mass casualty events, pharmacists may also function as first-line responders in case of man-made disasters or as second-line responders caring for victims in health-system or community settings [4]. Therefore, it is crucial to equip pharmacists with the skills and knowledge necessary for any of these eventualities. However, while many pharmacy schools may already be involved with disaster preparedness planning at the local level, there are very few articles on the inclusion of mass casualty education within the undergraduate pharmacy curriculum [6,7].

This study describes the experiences of the Faculty of Pharmacy of Marseille with the development of an elective course on the pharmacist’s role in disaster management and presents an evaluation of the effects of this new teaching module on pharmacy students’ knowledge of disaster response. Students’ self-perceived knowledge, perceptions of teaching quality, and degree of satisfaction were assessed using a voluntary survey.

The creation of the final curriculum resulted in a course of 6 modules coupled with 1 visit to a military establishment of medical supplies. The duration of each course was 2 hours (13:30–15:30 and 15:30–17:30), except for the presentation and visit of a military establishment of medical supplies, which comprised 4 hours (Table 1).

The first module (2 hours) focused on the organization and mission of the SSA and introduced the essentials of disaster medicine terminology. Natural and technological disasters, terrorism, man-made disaster, and environmental threats were considered within the framework of the legal environment and regulations for civil protection and disaster preparedness. The functional roles and responsibilities assumed by the SSA and by other authorities involved in crisis management were identified as key competencies.

Module 2 (8 hours) addressed knowledge of CBRN risk management, with descriptions of the recognition and management of incidents involving explosive, chemical, radiological/nuclear, or biological agents, including emergency medical first aid, specific measures, surgical and medical treatment of injuries. Technical equipment, mobile units, protective gear, and contamination detection devices were also presented. The knowledge evaluation was focused on specific dangers of CBRN agents, associated symptoms, self-protection, first-aid medical treatment, and decontamination operations.

The third module (4 hours) discussed the principles of hospital disaster management and preparedness. Mass casualty disposition, the treatment area, transport issues, incident action plans, and information about a functional operations center were presented. As core competencies, notification, deployment, and mobilization actions were taught.

The fourth module (4 hours) taught life-saving and specific emergency medical care for various disaster situations, containing first aid and specific approaches to injuries, burns, explosions, blasts, and illnesses from warfare. Life-saving emergency and limited individual treatment under disaster conditions were discussed. Logistical requirements for the care of burn injuries and high-speed bullet injuries were presented. Presentation of past disasters and reflections on disaster assistance experiences gained from the recent terrorist attacks in Paris and Nice were used to discuss the core competencies.

The fifth module (4 hours) dealt with the pharmacist’s role in drug manufacturing and the military pharmaceutical supply. As key competencies, students were evaluated on their knowledge on factors affecting logistic support in military operations and antidote production.

The sixth module (4 hours) presented the pharmacist’s role from a toxicological perspective. Hazardous chemical accidents, acute poisoning, and toxic syndromes were discussed. This module also dealt with analytical chemistry and toxicology applied to the evaluation of exposure and health risks, as well as practical applications of analytic methods used in toxicology in criminal laboratories. The key competencies for this module were hazard identification, exposure assessment, and management of acute poisoning and intoxication.

The last module consisted of visiting a military establishment of medical supplies and was essentially designed to assess the success of the course.

After the opening of optional course registration, the 60 allotted places in the course were filled in 2 hours, demonstrating significant interest in this course. The average attendance rate at the beginning and the end of each lecture was 97.8%.

To the best of our knowledge, few publications have described the development of educational courses for pharmacy students [6,10]. This course was focused on actual scenarios and was in accordance with quality criteria for improving teaching approaches [11]. Although examiners often perceive multiple-choice quizzes as unfair because they may not be sufficient to fully assess the relevance of the course, some studies have demonstrated that multiple-choice quizzes are a well-established and reliable method of assessing knowledge that has a solid relationship with overall competence and performance [12,13]. Moreover, 5 options are commonly used in summative or formative assessments because doing so improves psychometric quality by limiting the effect of random guessing [14]. Of course, this course only enabled students to become familiar with terms and concepts, and did not provide a sufficient framework to retain competencies, which need to be refreshed and assessed through periodic evaluations of knowledge and skills [9]. However, in our experience, this 30-hour course allowed us to provide students with adequate knowledge in a reasonable period and was fully compatible with the educational program and organization of the Faculty of Pharmacy.

The interest expressed by students demonstrated the appeal of this optional module for third-year pharmacy students. With the emerging role of pharmacists in bioterrorism preparedness and disaster response, their integration in the health system is becoming crucial [15]. Indeed, pharmacists provide an effective means of distributing medications, counselling patients, and assisting other members of the health care system. As pharmacists are becoming more integral in the field of CBRN risk, they must efficiently manage these risks and provide information to mass public or information campaigns, because new media are likely to provide flawed information [15].

This voluntary course resulted in satisfactory knowledge of disaster preparedness among the students, with mean scores of approximately 80% on the multiple-choice quizzes, consistent with a previous study [2].

Students’ satisfaction with the course was extremely positive, confirming that most of them (as was found for medical students) would welcome the introduction of an emergency preparedness module into their curriculum [3].

Some limitations of our teaching methods can be noted. First, some students argued that simulation exercises and formal training were lacking in this course. However, some disadvantages of simulation-based medical learning have been identified; for instance, participants will always approach a simulation differently from real life, and only limited amounts of high-quality evidence on the effect and validity of simulation-based training are available [16]. Nevertheless, we will consider this suggestion, and next year a mass triage simulation will be organized by the BMPM to improve students’ understanding of mass casualty management situations. To give students personal experience of how it feels to work in protective equipment, students will also receive practical training in the use of personal protective equipment [9]. This training session will be conducted in a small-group format (5 students associated with 1 BMPM physician) and volunteers will simulate casualties presenting with various disorders, from superficial injuries to moribund conditions and emotional trauma. Students will conduct triage and assume different functional roles. In addition, to demonstrate students’ performance as practising health professionals, a longitudinal evaluation and individualized continuing education plans would be ideal, but these steps may be beyond the scope of our study.

This course was found to have the potential to increase the number of pharmacists prepared to respond to disasters. It also expanded students’ understanding of the pharmacist’s role and stimulated their interest in emergency preparedness. As pharmacists should play an important role in emergency preparedness and response, the introduction of corresponding courses into the standard pharmacy curriculum would be welcome.