Table Of ContentTrain the Trainers Workshop
on Medical Physics Support
for Nuclear or Radiological
Emergencies
Centers for Disease Control and Prevention
Atlanta, Georgia, USA
23-27 May 2016
Contents
1. Introduction ............................................................................................................................ 1
2. Objective and Structure of the Workshop .............................................................................. 2
2.1. Objective of the Workshop ..................................................................................................... 2
2.2. Structure of the Workshop ..................................................................................................... 2
2.3. Target Audience and Participants’ Qualifications ................................................................... 2
2.4. Expected Output ..................................................................................................................... 2
2.5. Workshop Programme ............................................................................................................ 3
2.6. Contributors to Drafting and Review ...................................................................................... 4
2.7. Lecturers at the Train the Trainers Workshop on Medical Physics Support for Nuclear or
Radiological Emergencies ................................................................................................................... 5
3. Training Modules .................................................................................................................... 6
3.1. Module 1: Introduction ........................................................................................................... 6
3.2. Module 2: Nuclear and Radiological Emergencies .................................................................. 7
3.3. Module 3: Radiation Measurements and Instrumentation .................................................... 9
3.4. Module 4: Dose Assessment and Dose Reconstruction ....................................................... 10
3.5. Module 5: Monitoring and Decontamination of People, Waste Management – Scene and
Reception Centre .............................................................................................................................. 12
3.6. Module 6: Monitoring and Decontamination of People, Waste Management – Hospital... 14
3.7. Module 7: Biological Effects of Radiation – Cell and Tissue Effects, Stochastic Effects ....... 15
3.8. Module 8: Protection Strategies for the Public .................................................................... 17
3.9. Module 9: Protection Strategies for Workers ....................................................................... 19
3.10. Module 10: Medical Management ................................................................................... 20
3.11. Module 11: Psychological Effects and Impacts on Mental Health .................................... 21
3.12. Module 12: Effective Risk Communication ....................................................................... 22
3.13. Module 13: Education and Training in NRE (theory and practice, training of others) ..... 24
4. Practical training ................................................................................................................... 25
4.1. Practical training for Module 3: Radiation Measurements and Instrumentation ................ 25
4.2. Practical training for Module 5: Monitoring and Decontamination of People Waste
Management – Scene and Reception Centre ................................................................................... 25
4.3. Practical training for Module 6: Monitoring and Decontamination of People, Waste
Management – Hospital .................................................................................................................... 26
4.4. Practical training for Module 12: Effective Risk Communication ......................................... 27
4.5. Tabletop Exercise .................................................................................................................. 28
5. Reading List ........................................................................................................................... 29
6. Additional Resources ............................................................................................................ 29
1. Introduction
The management of Nuclear or Radiological Emergency (NRE) situations requires specially trained
personnel. Commonly, clinical medical physicists (usually practicing in radiology, radiotherapy, and
nuclear medicine) are part of the team responsible for the proper and safe use of ionizing radiation I
a hospital environment. Although medical physicists, especially clinical medical physicists working in
hospitals, have in-depth knowledge in radiation dosimetry, including dose reconstruction and dose
measurements, they are usually not involved in NRE response. Tapping the reservoir of skills and
expertise of clinical medical physicists (who often are the only local radiation protection experts)
may strengthen the current NRE preparedness and response mechanisms. However, in a few
instances where medical physicists were involved in NREs, it appeared that many lacked specific
knowledge and some skills that are required in such situations. This lack of specific knowledge and
skills is probably due to the fact that most current medical physics curricula do not include a specific
module on this topic. As a response to this finding, the IAEA, in consultation with the World Health
Organization (WHO), the International Organization for Medical Physics (IOMP) and the International
Radiation Protection Association (IRPA), decided to initiate a project to develop a specific training
package to help prepare medical physicists to support NRE situations. Development of the training
package started in 2014 with the support of the Government of Japan and in collaboration with
Fukushima Medical University (FMU) and the National Institute of Radiological Sciences (NIRS). The
package was also endorsed by The Japan Society of Medical Physics (JSMP). The training package
was applied for the first time at the International Workshop that was held in 2015, in Fukushima,
with the support of FMU and NIRS. Using lessons learned and experience acquired during the first
Workshop, the IAEA in collaboration with Argonne National Laboratory (ANL), the Centers for
Disease Control and Prevention (CDC), and the Radiation Emergency Assistance Center/Training Site
(REAC/TS) have organized the second “Train the Trainers Workshop on Medical Physics Support for
Nuclear or Radiological Emergencies”. The effort has been supported in part by the United States of
America National Nuclear Security Agency (NNSA). The Emory University School of Medicine made
the Experiential Center for Learning available for the practical exercise portion of the workshop in
collaboration with the department of Emergency Medicine.
The current workshop has been designed to provide a specific training on NRE preparedness and
response for clinical medical physicists. It also aims to:
Encourage/facilitate the embedding of medical physicists in NRE preparedness teams, in
cooperation with other professions and organizations, at strategic and operational levels,
both within hospitals and in the wider emergency planning structure;
Recognize the essential contributions of medical physics staff (technicians, dosimetrists etc.)
in NRE preparedness programmes and to ensure appropriate training;
Promote the interaction of medical physicists with other professional groups involved in NRE
preparedness, including through participation in regular training and exercises; and
Encourage consideration of the potential of appropriately trained medical physicists to
contribute to multidisciplinary NRE training of other professional groups, both within and
outside the health care settings.
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2. Objective and Structure of the Workshop
2.1. Objective of the Workshop
The objective of this workshop is to provide the participants with a good understanding of their
potential complementary roles in NRE situations, and to prepare them to contribute effectively to
support the response to such situations, as identified in emergency preparedness plans. The
participants are also expected to contribute to the training of other health care professionals in
response to NRE situations. The workshop will also introduce the participants to a multidisciplinary
team approach in dealing with NRE situations.
2.2. Structure of the Workshop
This five day workshop will consist of lectures, demonstrations, simulation, role play, and practical
sessions followed by discussions with the participants. The topics to be covered include the following
Modules:
Module 1: Introduction
Module 2: Nuclear and Radiological Emergencies
Module 3: Radiation Measurements and Instrumentation
Module 4: Dose Assessment and Dose Reconstruction
Module 5: Monitoring and Decontamination of People Waste Management – Scene and
Reception Centre
Module 6: Monitoring and Decontamination of People, Waste Management – Hospital
Module 7: Biological Effects of Radiation – Cell and Tissue Effects, stochastic effects
Module 8: Protection Strategies for the Public
Module 9: Protection Strategies for Workers
Module 10: Medical Management
Module 11: Psychosocial Effects and Impacts on Mental Health
Module 12: Effective Risk Communication
Module 13: Education and Training in NRE (Theory and Practice, Training of Others)
The detailed contents of each module are given in section 3: “Training modules”
2.3. Target Audience and Participants’ Qualifications
The workshop addresses clinical medical radiation physicists working in hospitals, in one of the
following areas: radiation oncology, diagnostic radiology, nuclear medicine and/or radiation
protection. The specific requirements for participation are given below:
Postgraduate degree at the Master degree level or equivalent,
Completion of a specialized clinical training programme in radiation oncology, diagnostic
radiology or nuclear medicine;
Minimum of three years’ experience as a clinical medical radiation physicist, with a radiation
protection function in their employment;
Involvement in education and training in radiation protection;
Previous involvement in regional or national emergency response activities is highly
desirable.
2.4. Expected Output
Participants will gain the skills and knowledge necessary to contribute effectively to the response to
an NRE situation as identified in emergency preparedness plans. They will have a better
understanding of their potential roles in NRE situations and be in a position to contribute to the
training of others in the response to NRE situations.
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Monday, Tuesday, Wednesday, Thursday, Friday,
23 May 2016 24 May 2016 25 May 2016 26 May 2016 27 May 2016
Shuttle bus pickup times (meeting point: in front of the hotel)
08:00 08:00 - 09:00: Registration Monday: 07:00
Tuesday - Friday: 08:00
09:00 - 09:30: Opening Remarks 09:00 - 10:30: Rapid Dose 09:00 - 10:00: Protection
09:00 Magnitude Estimation to Help Strategies for the Public
09:30 - 10:00: Introduction
Guide Medical Management - with (A. Salame- Alfie) 09:00 - 11:00: Tabletop Exercise
09:00 - 11:30: Monitoring and
(A. Meghzifene)
Examples (Z. Kazzi, A. Ansari, A.
Decontamination of People - 10:00 - 10:45: Protection
10:00 - 11:00: Nuclear and
(S. Sugarman) Meghzifene)
Scene and Reception Centres Strategies for Workers
10:00 Radiological Emergencies
10:30 - 10:45: Short break
(A. Ansari, K. Caspary) (J. Anderson)
(A. Ansari)
10:45 - 11:00: Short break
10:45 - 12:15: Rapid Dose
11:00 - 11:15: Short break 11:00 - 11:15: Short break
Magnitude Estimation to Help
11:00 - 12:15: Medical
11:00 11:15 - 12:15: Nuclear Guide Medical Management - with 11:15 - 12:15: Effective Risk
Management - Part 1
Radiological Emergencies (Sources Examples Communication - Principles
11:30 - 12:30: Transportation to
(N. Dainiak)
and Case Studies) (M. Jenkins) (S. Sugarman) (K. Vidoloff, V. Siegel)
Emory Hospital
12:00
12:30 - 13:00: Initial Brief with
12:15 - 13:30: Lunch Break 12:15 - 13:30: Lunch break Lunch 12:15 - 13:30: Lunch break 12:15 - 13:30: Lunch break
13:00
13:30 - 14:30: 12. Medical
13:30 - 15:00: Effective Risk
Management - Part 2
13:30 - 15:30: Radiation Communication - Practical
13:00 - 17:00: Unique Challenges
13:30 - 15:30: Environmental Dose
(N. Dainiak)
Measurements and Training
of Monitoring and
14:00 Assessment - with Examples
Instrumentation (+demo) (K. Vidoloff, V. Siegel)
Decontamination of Patients at 14:30 - 15:30: Our Experience in
(T. Kraus)
(M. Jenkins)
Hospitals (demonstration and Tokai-mura Nuclear Accident
2.5. Workshop Programme
practical exercise) (S. Mineishi) 15:00 - 15:30: Coffee break
15:00
(N. Dainiak, M. Jenkins, C. Iddins,
15:30 - 15:50: Short break 15:30 - 15:50: Short break
15:30 - 16:00: Short break
W. Baxter, Z. Kazzi)
15:30 - 16:30: Knowledge Testing,
15:50 - 16:50: The Psychosocial
Workshop Evaluation Discussion
Impact and What You Can Do To
16:00 16:00 - 17:30: The Biological Help
15:50 - 17:50
Effects of Radiation (J. David)
Visit to the CDC Radiobioassay
16:30 - 17:30: Conclusion,
16:50 - 17:50
(T. Jorgensen)
Laboratory
Evaluation, Plenary
Transformative Learning:
A Reception dinner will be held on Wednesday, May 25, 2016
17:00 Integration of Theory to Practice
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for Adult Learning (C. Piper)
2.6. Contributors to Drafting and Review
Akahane, K. National Institute of Radiological Sciences, Japan
Akashi, M. National Institute of Radiological Sciences, Japan
Ansari, A. Centers for Disease Control and Prevention, United States of America
Berris, T. International Atomic Energy Agency
Carr, Z. World Health Organization
Dainiak, N. Radiation Emergency Assistance Center/Training Site, an asset of
National Nuclear Security Agency/Department of Energy, United
States of America
Dörr, W. Medical University of Vienna, Austria
Engel-Hills, P. Cape Peninsula University of Technology, South Africa
Fukuda, S. National Institute of Radiological Sciences, Japan
Fukumura, A. National Institute of Radiological Sciences, Japan
Gilley, D. International Atomic Energy Agency
Hefner, A. Q. E. International Radiation Protection Association
Henderson-Suite, V. National Radiotherapy Center, Trinidad and Tobago
Herrera-Reyes, E. International Atomic Energy Agency
Holmberg, O. International Atomic Energy Agency
Imai, R. International Atomic Energy Agency
Isaksson, M. University of Gothenburg, Sweden
Ishikawa, T. Fukushima Medical University, Japan
Kanda, R. National Institute of Radiological Sciences, Japan
Kim, E. National Institute of Radiological Sciences, Japan
Kumagai, A. Fukushima Medical University, Japan
Kurihara, O. National Institute of Radiological Sciences, Japan
Lafortune, J. F. International Atomic Energy Agency
Meghzifene, A. International Atomic Energy Agency
Ng, K. H. University of Malaya, Malaysia
Nüsslin, F. Technische Universität München, Germany
Ohtsuru, A. Fukushima Medical University, Japan
Takashi, O. Fukushima Medical University, Japan
Wilkins, H. Royal Devon and Exeter Hospital, United Kingdom
Wolbarst, A. University of Kentucky, United States of America
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2.7. Lecturers at the Train the Trainers Workshop on Medical Physics Support for Nuclear or
Radiological Emergencies
Anderson, J. Centers for Disease Control and Prevention, United States of America
Ansari, A. Centers for Disease Control and Prevention, United States of America
Baxter, W. Radiation Emergency Assistance Center/Training Site, an asset of
National Nuclear Security Agency/Department of Energy, United
States of America
Caspary, K. Oak Ridge Associated Universities, United States of America
Dainiak, N. Radiation Emergency Assistance Center/Training Site, an asset of
National Nuclear Security Agency/Department of Energy, United
States of America
David, J. Georgia Department of Behavioral Health and Developmental
Disabilities, United States of America
Iddins, C. Radiation Emergency Assistance Center/Training Site, an asset of
National Nuclear Security Agency/Department of Energy, United
States of America
Jenkins, M. Radiation Emergency Assistance Ce nter/Training Site, an asset of
National Nuclear Security Agency/Department of Energy, United
States of America
Jorgensen, T. Georgetown University , United States of America
Kazzi, Z. Department of Emergency Medicine, Emory University School of
Medicine, United States of America
Kraus, T. Sandia National Laboratories , United States of America
Meghzifene, A. International Atomic Energy Agency
Mineishi, S. University of Alabama at Birmingham , United States of America
Piper, C. Centers for Disease Control and Prevention, United States of America
Salame-Alfie, A. Centers for Disease Control and Prevention, United States of America
Siegel, V. Centers for Disease Control and Prevention, United States of America
Sugarman, S. Radiation Emergency Assistance Center/Training Site, an asset of
National Nuclear Security Agency/Department of Energy, United
States of America
Vidoloff, K. Centers for Disease Control and Prevention, United States of America
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3. Training Modules
3.1. Module 1: Introduction
Table 1. Contents of Module 1
Objective The aim of this module is to introduce the participants to the role of the
medical physicist in the context of proper response to NRE events, to
orientate them to the topics and prepare them for the course . This
module will also introduce participants to the framework of disaster
medicine
Pre-requisites The participants are expected to meet the pre-requisites for admission to
(Learning in Place) the training workshop and to have the prior learning in place as required
by each Module
Learning Outcomes Participation in Module 1 will enable:
Awareness of the general concept and medical physics related
aspects of preparedness and response to NRE
Understanding of the role of the medical physicist within an
emergency response plan and the requirements to act efficiently
and effectively
Knowledge of the various types and planning categories of NRE
Familiarity with the main, relevant IAEA Safety Standards and
Guidelines [5, 6]
Core knowledge and This module will provide an introduction to the overall objective and
Competencies goals of the workshop. In preparation for other modules, this module will
introduce:
Nuclear and Radiological Emergencies
Radiation Measurement and Instrumentation
Dose Assessment and Reconstruction (including environmental
dose assessment)
Monitoring, Decontamination (People, Area) and waste
management
Biological Effects of Radiation
Protection Strategies for Public and Workers
Medical Management and Psycho-social Effects of NRE
Risk communication
Training in NRE (theory and practice, training of others)
Role of the medical physicist in response teams (may vary
depending on local situations)
Teaching and Learning Lecture
Activities
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