What are the general and specific objectives and relevant literature for a proposal on assessing knowledge, attitude, and confidence in wilderness first aid among healthcare workers in Malaysia?

General and Specific Objectives for Wilderness First Aid Knowledge, Attitude, and Confidence Assessment Among Malaysian Healthcare Workers

The primary objective of this proposal is to develop and validate a comprehensive assessment tool to evaluate knowledge, attitude, and confidence in wilderness first aid among healthcare workers in Malaysia, with the ultimate goal of improving patient outcomes in remote settings.

Background and Rationale

Wilderness first aid (WFA) represents a critical skill set for healthcare workers operating in remote environments where definitive medical care may be delayed or unavailable. The American Heart Association emphasizes the importance of first aid training, with evidence showing that trained providers demonstrate reduced mortality rates compared to untrained individuals (9.8% vs. 15.6%) 1.

Despite this importance, there remains a significant knowledge gap in wilderness medicine education and assessment in Malaysia, highlighting the need for validated assessment tools 1.

General Objectives

1. To develop and validate a comprehensive questionnaire that accurately measures knowledge, attitude, and confidence in wilderness first aid among Malaysian healthcare workers.

2. To establish baseline data on the current level of wilderness first aid preparedness among healthcare workers in Malaysia.

3. To identify gaps in wilderness first aid knowledge and training that can inform future educational interventions.

Specific Objectives

For Knowledge Assessment Domain:

• To evaluate healthcare workers' understanding of:
  • Recognition and management of heat-related illnesses in wilderness settings 1
  • Management of traumatic injuries in remote environments 1
  • Wound care and infection prevention techniques specific to wilderness settings 1
  • Management of environmental emergencies (hypothermia, altitude sickness, etc.) 1
  • Improvisation of medical equipment in resource-limited settings 1
  • Evacuation decision-making criteria 1

For Attitude Assessment Domain:

• To assess healthcare workers':
  • Perceived importance of wilderness first aid training 1
  • Beliefs about the effectiveness of wilderness first aid interventions 1
  • Perceptions about their role in wilderness settings 1
  • Willingness to provide care in remote environments 1
  • Attitudes toward improvisation in resource-limited settings 1

For Confidence Assessment Domain:

• To measure healthcare workers' self-efficacy in:
  • Applying wilderness first aid techniques under pressure
  • Making critical decisions in remote settings without immediate backup
  • Improvising medical equipment when standard supplies are unavailable
  • Leading emergency responses in wilderness environments
  • Teaching basic wilderness first aid skills to others

Methodological Framework

Questionnaire Development Process:

1. Comprehensive Literature Review

   • Review existing wilderness first aid guidelines and assessment tools 1
   • Analyze Malaysian healthcare context and specific wilderness challenges 1

2. Expert Panel Consultation

   • Assemble experts in emergency medicine, wilderness medicine, and questionnaire development 1
   • Define specific domains to be measured (knowledge, attitude, confidence) 1

3. Item Generation and Selection

   • Develop scenario-based questions to assess application of knowledge 1
   • Include items of varying difficulty to differentiate between respondents 1
   • Create culturally appropriate content for Malaysian context 1

4. Validation Process

   • Conduct face validity testing with a small group of healthcare workers 1
   • Perform cognitive interviews to understand question interpretation 1
   • Apply Item Response Theory (IRT) for the knowledge domain 1, 2
   • Conduct Exploratory Factor Analysis (EFA) for attitude and confidence domains 1, 3, 2
   • Verify sampling adequacy using Kaiser-Meyer-Olkin (KMO) test and Bartlett's test of sphericity 1, 3, 2

5. Cultural Adaptation

   • Ensure cultural appropriateness for Malaysian healthcare workers 1
   • Address translation issues through proper translation and back-translation procedures for Malay version 1, 3

Relevant Literature Review

Wilderness First Aid Guidelines and Training

1. American Heart Association and American Red Cross Guidelines (2024)

   • Emphasizes the need for first aid research evaluating care provided by nonprofessional responders in prehospital settings 4
   • Identifies knowledge gaps in immobilization of long-bone fractures, rewarming of frostbite, and cooling of thermal burns 4

2. International Consensus on First Aid Science (2015)

   • Provides evidence that first aid training improves patient outcomes 4
   • Highlights the lack of observational studies in wilderness medicine 4

Questionnaire Development and Validation

1. Wilderness First Aid Questionnaire Development (2025)

   • Outlines comprehensive methodology for developing wilderness first aid assessment tools 1
   • Emphasizes the importance of cultural context and practical application 1

2. COVID-19 Questionnaire Validation Studies in Malaysia (2022-2025)

   • Demonstrates successful validation of health-related questionnaires in Malaysian context 3, 5
   • Provides methodological framework applicable to wilderness first aid assessment 3

3. Knowledge, Attitude and Practice Assessment Among Healthcare Workers

   • Shows moderate knowledge levels among relief workers regarding first aid measures 6
   • Identifies correlation between education level and first aid knowledge 6

4. First Aid Training in Wilderness Settings

   • Reveals knowledge gaps among workers in remote areas despite regular training 7
   • Supports the need for specialized wilderness first aid training 7

Expected Outcomes and Significance

The development and validation of this assessment tool will:

1. Provide a reliable instrument to evaluate wilderness first aid competency among Malaysian healthcare workers
2. Identify specific knowledge gaps to inform targeted educational interventions
3. Establish baseline data for future research and program evaluation
4. Contribute to the limited body of research in wilderness medicine education
5. Ultimately improve patient outcomes in remote settings through enhanced provider preparedness

By addressing these objectives, this proposal aims to fill a critical gap in wilderness medicine education and assessment in Malaysia, with potential applications to other Southeast Asian contexts.