What is the framework for researching wilderness first aid knowledge among healthcare workers in Malaysia?

Research Framework for Wilderness First Aid Knowledge Among Healthcare Workers in Malaysia

A comprehensive research framework for investigating wilderness first aid knowledge among healthcare workers in Malaysia should focus on addressing critical knowledge gaps identified in current guidelines while incorporating cultural and contextual factors specific to Malaysia.

Literature Review

Current State of Wilderness First Aid Research

• The American Heart Association and American Red Cross Guidelines (2024) emphasize a significant lack of research evaluating care provided by nonprofessional responders in prehospital settings, particularly in wilderness contexts 1
• International Consensus on First Aid Science (2015) provides evidence that first aid training improves patient outcomes, with trained providers demonstrating reduced mortality rates (9.8% vs 15.6%) compared to untrained individuals 1
• Despite regular training, knowledge gaps persist among workers in remote areas, highlighting the need for specialized wilderness first aid training 2
• Current research lacks diversity, with most studies focusing on male, White participants from North America and Western Europe 1

Wilderness First Aid in Malaysia

• Malaysia's unique geographical features (tropical forests, remote areas) create specific wilderness medicine challenges that require tailored first aid approaches 3
• Previous community-based health initiatives in Malaysia, such as the Primary Health Care approach in malaria control, demonstrate the importance of community participation in healthcare delivery 4
• The Malaysian healthcare system faces challenges in addressing the needs of diverse populations, including those in remote areas, suggesting potential gaps in wilderness first aid knowledge 5

Research Gap

• There is a critical absence of validated assessment tools to evaluate wilderness first aid knowledge, attitudes, and confidence among healthcare workers in Malaysia 3
• Limited research exists on wilderness first aid education effectiveness in the Malaysian context, particularly regarding knowledge retention and skill application 6
• Current wilderness first aid training often lacks cultural and contextual relevance for Malaysian healthcare workers 3
• Research is needed to understand the unique wilderness first aid needs in low-resource settings and low- and middle-income countries 1

Problem Statement

Healthcare workers in Malaysia lack adequate wilderness first aid knowledge and skills necessary to provide effective emergency care in remote settings, yet no validated assessment tools exist to measure this gap or inform targeted educational interventions.

Significance of Research

• This research will establish baseline data on wilderness first aid preparedness among Malaysian healthcare workers, identifying specific knowledge and training gaps 3
• Findings will inform the development of culturally appropriate wilderness first aid training programs tailored to Malaysia's unique environmental challenges 3, 2
• The study addresses the American Heart Association's call for greater diversity in first aid research and understanding the unique needs of underrepresented populations 1
• Results may improve patient outcomes in remote settings, as evidence shows trained first aid providers reduce mortality rates and hospitalization duration 1

Research Questions

1. What is the current level of wilderness first aid knowledge, attitudes, and confidence among healthcare workers in Malaysia?
2. What are the specific wilderness first aid training needs of Malaysian healthcare workers based on the country's geographical and environmental context?
3. What factors influence the retention and application of wilderness first aid knowledge and skills among Malaysian healthcare workers?
4. How can a culturally appropriate assessment tool be developed and validated to measure wilderness first aid competence in the Malaysian context?

General Objective

To develop and validate a comprehensive assessment framework for measuring wilderness first aid knowledge, attitudes, and confidence among healthcare workers in Malaysia.

Specific Objectives

1. To conduct a comprehensive literature review on wilderness first aid practices, existing assessment tools, and the Malaysian healthcare context
2. To identify key domains of wilderness first aid knowledge relevant to the Malaysian context through expert consensus
3. To develop and validate a culturally appropriate questionnaire measuring wilderness first aid knowledge, attitudes, and confidence
4. To establish baseline data on wilderness first aid preparedness among Malaysian healthcare workers
5. To identify factors influencing wilderness first aid knowledge retention and application in the Malaysian context

Methodology

Study Design

• Mixed-methods sequential exploratory design:
  • Phase 1: Qualitative exploration through expert interviews and focus groups
  • Phase 2: Quantitative assessment using the developed questionnaire

Questionnaire Development Process

1. Literature Review and Expert Panel Formation

   • Assemble experts in emergency medicine, wilderness medicine, and questionnaire development 3
   • Define specific domains to be measured (knowledge, attitudes, confidence)

2. Item Generation

   • Develop scenario-based questions reflecting Malaysian wilderness contexts
   • Include items assessing knowledge of:
     • Heat-related illnesses
     • Traumatic injuries in remote settings
     • Wound care and infection prevention
     • Environmental emergencies
     • Improvisation of medical equipment
     • Evacuation decision-making criteria 3

3. Content Validation

   • Expert review of draft questionnaire
   • Calculate content validity index (CVI)
   • Revise items based on expert feedback

4. Face Validation

   • Conduct cognitive interviews with small group of healthcare workers
   • Evaluate clarity, comprehensibility, time required, and format 3
   • Refine questionnaire based on feedback

5. Pilot Testing

   • Administer questionnaire to sample of 30-50 healthcare workers
   • Analyze psychometric properties:
     • Item Response Theory (IRT) for knowledge domain
     • Exploratory Factor Analysis (EFA) for attitude and confidence domains
     • Verify sampling adequacy using Kaiser-Meyer-Olkin test and Bartlett's test 3

6. Reliability Testing

   • Assess internal consistency using Cronbach's alpha
   • Test-retest reliability with 2-week interval

Main Study Implementation

1. Sampling

   • Stratified random sampling of healthcare workers from different regions of Malaysia
   • Include diverse healthcare professionals (physicians, nurses, paramedics)
   • Calculate sample size based on validation requirements

2. Data Collection

   • Administer finalized questionnaire
   • Collect demographic data and professional experience information
   • Document previous wilderness first aid training

3. Data Analysis

   • Descriptive statistics for knowledge, attitudes, and confidence scores
   • Inferential statistics to identify factors associated with wilderness first aid competence
   • Multivariate analysis to determine predictors of knowledge retention

Ethical Considerations

• Obtain approval from relevant Malaysian ethics committees
• Ensure informed consent from all participants
• Maintain confidentiality and data security

Expected Outcomes

1. A validated, culturally appropriate wilderness first aid assessment tool specific to the Malaysian context
2. Baseline data on wilderness first aid knowledge, attitudes, and confidence among Malaysian healthcare workers
3. Identification of specific knowledge gaps and training needs
4. Evidence-based recommendations for wilderness first aid education in Malaysia

This research will address critical gaps identified in current guidelines while providing valuable insights into wilderness first aid preparedness in Malaysia, ultimately contributing to improved emergency care in remote settings.