History of the efforts
Hirosaki University Graduate School of Health Sciences 2008-2012
Project of Human Resources Development for Radiation Emergency Medicine
Although careful attention is paid to the safe use of radiation in Japan and substantial radiation protection measures are taken, the possibility of accidental exposure to radiation remains. Therefore, as a precautionary measure against such occurrences, systems must be in place to ensure both the provision of radiation emergency medicine and the prevention of radiation exposure incidents.
In Japan, nuclear facilities are located in or near 19 prefectures in either the eastern or the western division. The radiation emergency system in Japan is centered on the National Institute of Radiological Sciences and Hiroshima University, which are designated local tertiary radiation emergency hospitals for the eastern and western divisions, respectively.
Consolidation of advanced medical technologies is indispensable for radiation emergency medicine. In addition, specific countermeasures, such as nursing care for patients exposed to radiation, contamination control and decontamination measures, radiation dosimetry, and specific clinical assays, are required. However, in Japan, radiation-related education is currently part of the general medical curriculum. Therefore, a special educational program that focuses on radiation emergency medicine is required.
Numerous nuclear energy?related institutions are located in Aomori Prefecture, and the prefectural government has designated Hirosaki University Hospital as the local tertiary radiation emergency hospital. The mission of Hirosaki University in terms of radiation emergency medicine is to create a system for the effective treatment of heavily exposed patients and to develop human resources in this field of study. From this perspective, Hirosaki University Graduate School of Health Sciences has been developing human resources for radiation emergency medicine since 2008.
Step 1: Goal-setting and organization-building(2008)
At the start of the project, project goals were clarified and activities were organized and developed. Hirosaki University established a radiation safety system to provide a framework for radiation safety-related cooperation within the university. Decisions were made regarding the five points for consideration indicated in Figure 1. In addition, a project executive committee that consists of four sectors, each with its own role, was set up in the School of Health Sciences. Because the school did not have a specialist, the entire faculty had to re-learn the basics of radiation emergency medicine at the start of the project. Consequently, nearly every staff member participated in a 3-day training session at the National Institute of Radiological Sciences. Finally, we were able to accumulate knowledge, information, and skills through repetitive learning, training, and visits to relevant domestic and overseas organizations.
Step 2: Development of a basic philosophy and curriculum design(2009)
In the second step, we established the foundation for new education in radiation emergency medicine for health professionals. A plan for the development of human resources was designed and the curriculum was systematized. Figure 2 is a conceptual diagram of the basic educational philosophy used to cultivating human resources in this field of study. The education program consists of three domains: undergraduate, postgraduate, and continuing education. In undergraduate education, the goal is to give students basic knowledge in radiation emergency medicine, as well as specialized knowledge in each sub-field of this study area. The goal of graduate education is to provide students with expertise in radiation emergency medicine and to enable them to solve problems and play leadership roles in emergencies such as radiation disasters. An additional goal is for health professionals to be able to promote education and research in radiation emergency medicine. In continuing education, the goal is to prepare medical professionals to respond to radiation emergencies with appropriate knowledge and skill.
Step 3: Start-up of education and research(2010)
In the next step, education programs in each domain were started and academic research on radiation emergency medicine was begun in the field of health sciences. Two radiation-related subjects were allocated to the curriculum for liberal arts undergraduates. Radiation coursework and 15 new subjects related to radiation emergency medicine were added for graduate education. In addition, a program certified by Hirosaki University for specialists was established. For those undertaking continuing education, a 2.5-day course for nursing staff and a 2-day course for radiological technologists were conducted. The objectives for students are to acquire essential radiation emergency medicine knowledge and to undergo training that enables them to perform appropriate responses and safety management in radiation emergencies.
Additionally, research activities were systematically started in the field of health sciences. As a result, over 54 studies have been conducted in the areas of medical life sciences and health care sciences in the past 4 years.
Step 4: Support for the response to the Fukushima Nuclear Power Plant accident(2011)
Just as the project was progressing smoothly and awareness of the importance of radiation emergency medicine training was increasing, the Great East Japan Earthquake and the consequent nuclear disaster at Fukushima Dai-ichi Nuclear Power Plant occurred. Response support was organized at Hirosaki University and, on the basis of decisions made by the university radiation safety organization, 582 faculty members, including nursing staff and radiological technologists in the School of Health Sciences, were sent to Fukushima to survey the disaster evacuees for radiation exposure. This was done from the time of the accident until the end of July 2011.
At the end of May 2011, Hirosaki University was asked to support medical check-ups in a temporary homecoming project for evacuees. Three nurses and three radiological technologists from our school were sent to perform this task over a period of 16 days. They were able to clearly demonstrate the success of our project in developing human resources to provide support. In particular, the nursing staff proactively strived to relieve the anxiety of the evacuees and their children. These points are important features of the support provided by Hirosaki University
Step 5: Generalization of the project toward
The goal in the last phase of the project was to promote cooperation and collaboration with radiation emergency medicine-related organizations both within and outside the university in relation to education and research. On the basis of the 5-year results of the program, measures were discussed for ongoing human resources development programs, and strategies for further program development were devised.
These discussions led to the drafting of basic concepts for the next project. A budget request for the project was subsequently submitted to the Ministry of Education, Culture, Sports, Science, and Technology. The mission of the new project is to cultivate health professionals who can be leaders in the practice of radiation emergency medicine and to develop effective human resources for the purpose of radiation risk communication.
The Radiological Nursing Society of Japan was established on 20 September 2012 in cooperation with Nagasaki University and Kagoshima University, both of which have special graduate school courses in radiation nursing. This Society will continue its work to build on our academic foundation by continuing its efforts to establish a radiation nursing program at Hirosaki University that is able to certify nursing specialists.
The objectives of the 5-year project seem to have been achieved. However, although we are continuing to increase the development of human resources for radiation emergency medicine, we still need to verify and reexamine the effects of the program in areas such as skill improvement for teachers and students. It is also critical that we transmit the education programs to the other nations of Asia, where concern about radiation contamination has been increasing.