Updated Core Competencies for Disaster Medicine and Public Health.

Importance: In 2012, the National Center for Disaster Medicine and Public Health (NCDMPH) created a set of core competencies for disaster medicine and public health through an expert stakeholder panel. The COVID-19 pandemic and other significant events have reshaped experts' understanding of which core competencies should be prioritized to ensure that health professionals are prepared for disasters and public health emergencies. Objective: To determine whether the original core competencies should be updated given the many advancements in the field over the last decade. Design, Setting, and Participants: For this mixed-methods qualitative study, in April 2024, the NCDMPH convened 20 subject matter experts in clinical medicine, emergency management, government, and academia to provide qualitative feedback surrounding the current set of 11 disaster health core competencies. Main Outcomes and Measures: A Delphi survey incorporating the potential changes or additions to the initial core competencies was distributed to 42 additional stakeholders between April and July 2024 to quantify the level of agreement. Gwet AC2, a measure of interrater agreement, was applied to evaluate the strength of agreement for the need to change each core competency. Competencies with substantial or near-perfect agreement were updated. Results: Twenty subject matter experts proposed 23 changes to the original core competencies in an initial focus group. Sixteen respondents who completed all items of the Delphi survey reached near-perfect agreement on updating 1 competency and associated subcompetency. The original competency required a demonstration of knowledge of personal safety measures that can be implemented in a disaster or public health emergency. This competency was refined as the identification of physical, psychological, and security hazards associated with the incident. A subcompetency was added that included explaining physical and psychological health, safety, and security risks associated with disasters and public health emergencies. Conclusions and Relevance: In this mixed-methods evaluation, subject matter experts agreed that 1 of 11 disaster health core competencies required modification. These changes included refined language on recognizing hazards and explaining safety and security risks, reflecting observations and experiences during the COVID-19 pandemic and recognition of diverse types of health. These changes ensure training and education of disaster health responders remains synchronized with developments in the preparedness and response communities.