The notion of competency in pre-hospital emergency medical service (EMS) personnel is mainly focused on the professional proficiency that he/she has to provide intervention outside of hospital setting. Consequently, the effectiveness of pre-hospital EMS performance very much depends upon the capability of the personnel at the scene and as well during transport to the definitive care center. The aim of this study is to appraise and explore the competency of pre-hospital care staff and provide strategies for improvement. Methods: A mixed method approach combining the qualitative and quantitative study design. Of 134 staffs only 111(82.84%) returned the questionnaire. Nine semi-structured interviews and two focus group discussions were performed. The main informants were nurses/assistant medical officers, nurse/assistant medical officer administrators, and emergency physicians. Results: From the quantitative finding on the competency of staff handling pre-hospital EMS, all had the essential knowledge and skills. However, most of them reported not having good knowledge and skills for invasive procedures (31%-61%), include giving medications (61%-66%). The qualitative information provided insight about the issues and strategies for the personnel in regards to competency. All the relevant qualitative data were merged into 5 categories relating issues and 5 categories to strategies that could affect the competency of the personnel. Conclusion: Pre-hospital EMS systems need to consider that the competency of pre-hospital EMS personnel has to come along with the responsible attitude of the staff itself, the support of medical direction, clear protocol for guiding them whenever needed, and continuous professional-development courses require them to maintain their professional proficiency.

Introduction: Flood disaster is a natural disaster that has unexpectedly occurred again. Community cooperation in terms of managing flood and focusing on families’ needs has become more systematic. It is important for a household to be prepared in any disaster. One of the preparations that should be done is the stockpiling of emergency supplies or flood supply kits during evacuation. This study aimed to develop a specific disaster kit for households for evacuation during a flood disaster based on cultural context. Methods: Data were collected from 75 key informants from every level of households that really have a great experience during the flood disaster that helping family packing for a living needs before evacuation. The development of the disaster kit based on cultural needs and all their views, needs, experiences, challenges, frustration and happiness was obtained from the interview sessions. Results: There are five themes that emerged from this research related to developing a disaster kit. The themes are community preparedness in dealing with flood disaster, hygiene issues during the flood, inadequate food supply, how the community responds to insufficient water supply, and coping method with illness. After being finalized, there are seven kits: a general supplies kit, documentation kit, emergency food and water supply kit, prayer kit, hygiene kit, basic first aid kit, and baby kit. Conclusion: The development disaster kit was created to help the communities to be more aware and prepared before disaster strikes.

Learning environment in the universities plays an important role in producing highly competent graduates especially in nursing profession. Thus, the most important as-pects are the teaching activities and as well as student – teacher interaction in daily environment in the university. To investigate the International Islamic University Malay-sia (IIUM) nursing students experience towards their teachers and to identify the rela-tionship between teaching and students learning perception in their learning environ-ment. This study used quantitative method and utilized two out of five subscales in Dundee Ready Educational Environment Measurement (DREEM). The subscales used were students’ perception of learning (SPoL) , students’ perception of teacher (SPoT) and total items in these both subscales are 12 and 11 items, respectively. The ques-tionnaire results revealed that IIUM nursing students scored 28.54/48.00 in (SPoL) and 28.13/44.00 in (SPoT). Both findings showed the IIUM nursing students’ experience their teachers and the learning environment are moving in towards positive directions. The regression finding was 51% of the total variation in students’ perception of teacher score was explained by students’ perception of learning. Although the overall sub-scales (SPoL) score in the current study falls in the category of a more positive per-ception, 2 out of 12 items were poorly scored by the IIUM nursing students. The re-searcher strongly agrees that listening to the expression of students is an important consideration for an educational institution. The overall mean score for (SPoT) showed that the students perceived their teachers as moving in the right direction. In this pre-sent IIUM study, one item showed a mean score of less then 2.00. As a result, these two subscales most probably should reflect the same outcome such as in their aca-demic performance and experience greatly during their student life on campus. The arising issues from this DREEM study at IIUM embrace the need for the creation of supportive environment as well as designing and implementing interventions to remedy unsatisfactorily elements of the learning environment for more effective and successful teaching and learning to be realised.