Incorporation of Realistic Stress and Stress Management into Crisis Management Training for Acts of Terrorism

The tragedies of September 11th 2001 demonstrated that terror attacks require the combined and coordinated efforts of a vast array of agencies and response units. Enormous demands are placed on situational awareness, command, information assessment and transmission, and logistics. Emergency systems must not only be quick to respond, but should be prepared for sustained integrative and cooperative operations. Decision-making is further complicated by the inherent uncertainty of the threat — the nature, duration and origin. Therefore, crisis preparation and management for acts of terror are not merely reducible to, or extensions of, preparations in place for natural disasters — strategies must anticipate limited knowledge regarding the threat and its origin.

The Army Research Development Engineering Center (ARDEC) is in the process of building a facility for training and research toward emergency responses to terrorism. The Army Cooperative Training for Terrorism (ACTT) will have several unique features: 1) scale; training will be accomplished in a permanent test bed with to-scale buildings, parks, airstrips, railroad cars, etc., 2) breadth; concurrent, integrative training of a number of agencies, and 3) science; involvement of government and academic scientists in all phases of training and evaluation. The centerpiece of the facility is the Emergency Operations Center (EOC). The EOC will be a training and test facility for management and systems for effective command and control.

Ultimately, the effectiveness of training is evaluated in terms of the performance of trainees during actual events. To respond effectively under pressure, one must train under pressure. A three-phase process will be enacted to incorporate realistic stress into “hands on” training for EOC personnel. First, protocols for assessing the degree of stress involved in current EOC training scenarios from physiological and psychological perspectives will be developed and submitted for appropriate approval by the New Jersey Medical School Institutional Review Board (IRB). Concurrently, scenarios will be developed that simulate the uncertainty and ambiguity inherent in acts of terror. Pilot studies will be initiated to evaluate stress reduction techniques and equipment appropriate for EOC personnel in NJMS laboratories. Second, these newly developed scenarios will be evaluated for the degree of stress instilled in trainees and its attendant effects on performance. Under these more realistic stress conditions, the performance of trainees is expected to decline and stressfulness to increase relative to current training scenarios. Third, experiments will then be performed at the EOC comparing the performance of personnel with or without stress-reduction training. Improved performance and a reduction of overall stressfulness are expected in trainees given additional training in stress management. This two-pronged approach — incorporating stressfulness into the training scenarios and teaching trainees effective stress management techniques — will lead to better performance and improved health in EOC personnel in the event of actual terrorist actions.