Introduction

We live in a society that is clearly sensitized to the physical and mental impact that crises, emergencies, and disaster situations have on citizens. The demand for the assistance of emergency psychology professionals in these situations is usually met by the agencies managing them, with the provision of specific units of professionals to respond and meet the needs of a psychological nature and high emotional impact that occur both in the affected population and in the professionals working in the intervention services.

In Spain, the terrorist attacks in Madrid (2004) and Barcelona (2017), the air crashes of Spanair (2008) and Germanwings (2015), the earthquake in Lorca (2011), or the Alvia train accident in Santiago de Compostela (2012), are just some examples of the important work carried out by emergency psychology professionals. To this, we must add the numerous ordinary emergency situations such as traffic accidents, suicides, gender violence, etc., in which the role of this professional is essential to contribute both to minimize the psychological impact caused and to prevent the appearance of future post-traumatic psychopathology.

However, if there has been a situation that has marked a before and after in the impact on the mental health of the population and has driven initiatives to contribute to the care provided, it has been the recent COVID-19 crisis. Numerous psychologist units were set up, not only in Spain but in most countries of the world, to assist both the population and practitioners, mainly health professionals, who were carrying out aid work in the most difficult moments of the pandemic.

As a consequence, the European Union approved Regulation 2021/241 of February 12, 2021 establishing the "Recovery and Resilience Mechanism" (Parlamento Europeo y Consejo de la Unión Europea [European Parliament and Council of the European Union], 2021), by which, among other measures, Member States are urged to strengthen the resilience of the population by supporting measures in the field of healthcare with a view to, among other things, "increasing the response capacity and preparedness for crises, improving the continuity of activities and public services". Following this, on April 29, 2021, Spain approved the Recovery, Transformation, and Resilience Plan (Ministerio de Asuntos Económicos y Transformación Digital [Ministry of Economic Affairs and Digital Transformation], 2021) including in component 18 of its lever policies, the renewal and expansion of the capacities of the Spanish Health System, based on the idea that for a society to be resilient it must have the necessary capacities to face future challenges that may arise. In this sense, reference is made to the need to reinforce the capabilities at the healthcare level in the face of future situations of a different nature that require anticipation, rapid response, and coordination.

These initiatives are a clear example of the importance of the need to promote actions that contribute to guaranteeing adequate mental health care in crisis, emergency, and catastrophe situations and, therefore, actions that guarantee the training regulation and specialization of emergency psychology professionals who will intervene in these situations. In Spain, Law 44/2003, of 21 November, on the regulation of health professions (Jefatura del Estado [Head of State], 2003b), determines the need to carry out a permanent review of teaching methodologies and teaching in the healthcare field, and Royal Decree 589/2022, of 19 July, which regulates the transversal training of specialties in Health Sciences (Ministerio de la Presidencia, Relaciones con las Cortes y Memoria Democrática [Ministry of the Presidency, Relations with the Courts and Democratic Memory], 2022), underscores the importance of adequate training for specialists in Health Sciences as a fundamental principle on which the National Health System must be based and refers to the fact that with regard to this training, "accumulated experience has shown the importance of acquiring a series of competencies, mainly of an attitudinal nature, necessary for the professional practice of specialists". Thus, it is considered essential "to ensure that specialists in Health Sciences acquire and maintain throughout their professional practice these essential competencies for the provision of quality and efficient health care".

There has recently been extensive debate among experts, professional associations, scientific societies, and other organizations (Civil Protection, Military Emergency Unit, etc.) on the importance and need for emergency psychology professionals to have specific training to guarantee their specialization in this field (Losada Fernández, 2004; Valero Álamo, 2001; Soto-Baño & Clemente-Suárez, 2021a). This aspect became even more evident after the crisis caused by COVID-19 and was reflected in point 8.d. of the consensus document signed by some twenty psychological organizations linked to the healthcare field, addressing future lines of development of psychology in our country (Consejo General de la Psicología [Spanish Psychological Association], 2020). In addition, the Spanish Psychological Association has been working in this area and has a National Accreditation of Expert Psychologist in Emergency and Disaster Psychology (Comisión Nacional de Acreditación Profesional [National Commission of Professional Accreditation], 2017), which aims to establish the minimum criteria for training and experience in this field to ensure the professional qualification of these practitioners.

Thus, in this paper, and based on the particularities and specific characteristics of the field of action of the emergency psychologist, we propose a training model based on professional competencies that can serve as an initiative for the training required in the face of the possible regulation of the specialization in this role (Soto-Baño & Clemente-Suárez, 2021a). This will even serve as the basis for creating a possible Diploma of Accreditation in Emergency Psychology (Congreso de los Diputados [Congress of Deputies], 2018; Ministerio de Sanidad, Servicios Sociales e Igualdad [Ministry of Health, Social Services, and Equality], 2015), since, as established in Royal Decree 589/2022, "when a given area of knowledge or competencies does not meet the criteria regulated therein for specialties or areas of specific preparation, its training may be assessed through the continuing education of professionals and, if appropriate, it may be the subject of an Accreditation Diploma or Advanced Accreditation Diploma".

This option already had the favorable report of the National Council of Specialties in Health Sciences in 2018, as indicated in the non-legislative motion presented in the Congress of Deputies that same year (Congreso de los Diputados [Congress of Deputies], 2018). Given this scenario and in view of these regulations, it is clearly essential to promote two very specific actions in this field of action of psychology, firstly, providing continuity to emergency psychology professionals in their work activity by incorporating them into the agencies that respond to these situations, and secondly, clearly defining their professional profile and ensuring the specialization and specific training necessary for the performance of this profession within its framework of competence of action.

Basis of the Competency-Based Training Model

The definition of the concept of competency is complex and there are multiple meanings found in the scientific literature since 1973, when McClelland suggested measuring competency instead of intelligence (McClellland, 1973), defining it as "an underlying characteristic of an individual that is causally related to criteria referring to effective or superior performance in a job or situation". A more recent definition is that of Echeverría (2002), who defines it as "an effective capacity to successfully carry out a fully identified work activity, which can be evaluated through observable results, where knowledge (knowing), skills and abilities (knowing what to do), attitudes and behaviors (knowing how to act), and values and beliefs (knowing how to be) are integrated. In this sense, Kane (1992) defines a professional as competent to the extent that "they use the knowledge, skills, attitudes, and good judgment associated with their profession, in order to be able to carry it out effectively in the situations that correspond to the field of their professional practice". Thus, following Villa (2007), competency-based learning consists of "developing generic and specific competencies with the purpose of training the person in scientific and technical knowledge, as well as applying it in diverse and complex contexts, integrating it with their attitudes and values in their own way of acting personally and professionally".

In the field of Spanish healthcare, Article 42 of Law 16/2003, of 28 May, on Cohesion and Quality of the National Health System (Jefatura del Estado [Head of State], 2003a), establishes a definition of the term competence that is the national reference when establishing and delimiting the training and competency objectives of a professional in this field: "professional competence is the ability of the healthcare practitioner to integrate and apply the knowledge, skills, and attitudes associated with the good practices of their profession to solve the problems that arise". Therefore, it is important for a professional to be able to demonstrate not only that they are competent (they have the knowledge) but also that in a real situation they know how to act and can demonstrate their ability to perform (they have the know-how, they demonstrate it, and they do it).

This model is based on the proposal made by psychologist George Miller (1990) to assess professional competence through a pyramid of four levels of training in order of complexity. The two lower levels refer to cognition, at the base of which is the knowledge that a professional must know in order to perform their professional tasks effectively (knowing), followed by the competence or ability to know how to apply the knowledge to specific cases of analysis and interpretation (knowing how). The next two levels refer to behaviors; thus, the first of the two refers to the demonstration of how this knowledge and competence are used in simulated contexts (showing how). Finally, at the apex and top of the pyramid would be performance (doing), i.e., what the professional actually does in their real professional practice.

Thus, the current training models for healthcare professionals are evolving towards the creation of new options focused on training based on the acquisition of competencies, that is, on the ability to demonstrate competence and capacity (Hernández-Ávila & Casanova-Moreno, 2018). As such, training and professionalization processes are incorporating the use of technology, such as simulations and virtual reality-based experiences, in order to improve the practice and facilitate the acquisition and retention of both knowledge and skills.

This is why, in recent years, the concept of "professional competence" has been introduced in several healthcare professions such as nursing and medicine, seeking formulas that lead to the training of highly competent professionals (Escobar Yéndez, Tamayo Escobar, & García Olivera, 2022; González Caballero, 2020; Mazacón Gómez, Paliz Sánchez, & Caicedo Hinojosa, 2020). In this sense, we believe that psychology should also join this trend and therefore introduce new systems of learning and acquisition of professional profiles based on this concept, since excessively rigid training systems, such as the traditional training models, have serious difficulties in adapting to the speed with which the needs of our society arise and change, and especially in the field of action of these psychology professional roles, namely crisis, emergency, and disaster situations. As Amador-Soriano, Velázquez-Albo, and Alarcón-Pérez (2018) point out, "the competencies-based preparation of the psychologist is an opportunity to position them as a professional with knowledge, skills, attitudes, and values of their own".

Professional Competencies of the Emergency Psychologist

Although there are not many articles aimed at determining the competency profile of the emergency psychologist, we found a few examples (Losada Fernández, 2004; Vera & Puertas, 2001). In this regard, we highlight the study by Fernández-Millán, González-Cánovas, & Fernández-Navas (2018) which performs a research analysis on the work of the emergency psychologist in the different Groups of Psychological Intervention in Emergencies and Catastrophes (GIPECs in Spanish) of the Spanish Psychological Association and concludes that there are seven competencies that explain 95.63% of the skills that a psychologist must possess in order to work efficiently in this field (stress resistance, communication, flexibility, empathy, collaboration, teamwork, and technical knowledge).

In the model we propose here, we start from the premise that it is the social needs and those of psychology professionals that should guide the definition of the competencies to be acquired by the emergency psychologist through certain general learning objectives that delimit both the training programs and the evaluation criteria for these competencies. As such, the general objectives of psychological training in emergencies can be summarized in two basic general lines or principles: firstly, to provide the necessary knowledge for the adequate practice of psychology in crisis, emergency, and catastrophe situations, and secondly, to enable the attainment of the skills and competencies necessary for the comprehensive care of victims, affected individuals, intervention personnel, and managers.

Understanding the emergency psychologist as the "professional who intervenes in all phases of a critical situation (normality, response, and rehabilitation), which in the context of emergencies, disasters, or catastrophes refer to events of high emotional impact, which happen unexpectedly and which, due to the sensation of objective or perceived threat experienced, are capable of paralyzing the usual resources of the affected individuals and community who, under normal circumstances, would be able to cope with them more effectively" (Soto-Baño & Clemente-Suárez, 2021b), competency-based training programs must ensure that this professional is prepared not only in the formative knowledge of this discipline and its field of action for the correct performance of their work, but they must also have the psychological and emotional characteristics necessary to carry out this work. Thus, this training should also be aimed at minimizing the consequences of the direct or indirect psychological and emotional impact that may occur in these situations on the professional’s own mental health.

Table 1 shows the design of the training plan based on the professional competencies that we consider necessary for the emergency psychologist to have. This plan is structured in four main competency blocks, which in turn are subdivided into different competency criteria, including in each of them the different competencies that the emergency psychology professional must accredit having achieved. Based on this approach, we can say that psychology professionals who accredit having these competencies are appropriately qualified for the performance of this profession.

Competency Assessment Tests and Methods

Following the bases of the competency-based training model described above, the set of professional competencies that emergency psychologists must meet should be evaluated both by observable behaviors and by verification criteria that determine the presence of these competencies through measurement and evaluation instruments that establish this fulfilment.

However, we are aware of the complexity of this evaluation process at all levels, so we consider that, in order to evaluate each professional competence, different instruments must be used, since it is difficult for a single evaluation method by itself to provide all the information necessary to objectively assess a given competency. For this reason, we consider it necessary to have a combination of different evaluation and assessment methods for the different cognitive and behavioral skills that make up the concept of professional competence, which may be, in some cases, alternative or even complementary.

Thus, due to the difficulty of quantifying behavior and the diverse nature of the methods aimed at evaluating professional competencies, we present in this work a base of the ones that we consider could be used to build a future consensus evaluative model with the participation of all the agents involved in the determination of the training and specialization process of the emergency psychologist, from the psychology professionals themselves to government agencies and scientific and professional entities.

Following Miller's pyramid model (1990) and some of the evaluation methods followed by various authors (Almuedo et al., 2011; Durante, 2006; Martínez Carretero, 2005; Martínez Pantoja, 2012; Schuwirth et al, 2004), we present and develop some of the tests and evaluation methods of competencies that could be used at each of the different levels (Figure 1).

Methods for Assessing Cognitive Levels: Knowledge (Knowing) and Competence (Knowing how)

Written Tests

These are the most commonly used at these levels in any of the types of exams: short answer, long answer, multiple choice, essay, case resolution, etc. It is recommended that the design of these tests be made mostly with descriptions referring to real situations.

Oral Tests

These tests allow us to evaluate the theoretical capacity to solve specific situations in the context of emergencies and catastrophes. Furthermore, they enable us to accredit the individual’s maturity in the development of the competence skills and application of the acquired knowledge, showing the organization, planning, and oral communication capacity of the evaluated person.

Publications and Scientific Papers

In addition to these methods, the publications that the professional has produced are also a method to be taken into account to accredit the training achieved at this level.

Thus, the following work and documentation provided by the professionals will be taken into account when evaluating these levels:

• Doctoral theses and dissertations of training programs: bachelor’s degree, master's degree, etc. dissertations, which demonstrate an approach to scientific research and to the rigor of a written academic work of quality.

• Publications: scientific publications and research papers published in journals, congresses, etc. in the field of psychology and emergencies.

Methods for Assessing Behavioral Levels: Performance (Showing how) and Practice (Doing)

Simulation-Based Testing

Among the best known and most commonly applied are those based on the technique of role playing, where it is important that the people who participate as extras are well trained to represent a specific crisis situation so that the psychologist's capacity for resolution and intervention can be assessed. However, today, these tests should be complemented with the application and use of new technologies, so that we can simulate situations with virtual reality since, for example in catastrophes, these can be very useful for assessing the response capacity of a professional, mainly in relation to the coordination and management of different teams of professionals and their interaction with other agencies involved. These situations can also be assessed through different simulations in which psychologists participate with other organizations and intervention teams (firefighters, health, police, armed forces, etc.).

Direct Observation Tests

Direct observation of a professional's practice is one of the best methodologies to perceive the level achieved in a competency domain or competency. For this purpose, mirrors or recordings can be used to carry out this observation, if it cannot be done directly.

Professional Practice Reports

This is a good method for evaluating the intervention carried out by the psychologist in a specific real situation, assessing the contextualization, techniques used, and resolution of the situation. In addition, these reports are usually carried out within the framework of an institution or competent authority in emergencies, so it is a good method for understanding the degree of compliance with standards and quality indicators.

360º Feedback

The 360º evaluation is a tool based on the collection of information from multiple sources. It involves the evaluation of various aspects of the professional's activity by multiple people present at work and also usually includes self-evaluation. Although we acknowledge that it is not easy to provide this type of evidence, we should not however exclude this possibility, since this evaluation can include satisfaction surveys from individuals attended, evaluation from other colleagues, the head of the team of psychologists, representatives of other teams, and organizations with which the professional has collaborated, etc. that assess the performance and professional practice of the person being evaluated.

In all cases, the accreditation in the acquisition of these competencies can be provided by presenting different tests and certificates where their attainment within the field of emergency psychology in the public or private sphere has been recorded. Thus, the different ways of accrediting the knowledge and competencies acquired in these tests include certificates of accomplishment of training activities that evaluate this knowledge in masters, postgraduate courses, courses, continuing training (CT) activities, professional practice in different teams and organizations, etc.

Conclusions

We are clearly in a situation in which it is essential to define the professional profile of the emergency psychologist we wish to train, in order to respond to the social needs that inevitably arise in crisis, emergency, and catastrophe situations.

Nowadays it is crucial for the training process to be based on new teaching methodologies that facilitate more active and meaningful learning: case studies, problem-based learning, cooperative learning that promote the development of complex competencies such as critical thinking, communication, collaboration, or problem solving, etc.

This is why we must replace the idea that a competent professional is one who possesses only the knowledge and skills to perform a specific profession, competency-based training being a model that can provide greater adaptation to the training required for professionals in emergency psychology, and the competency-based professional profile being a way to determine objectively and systematically the competencies that this professional must meet for the exercise of their profession. With this work, we intend both to respond to the interests of professionals, to achieve their necessary specialization, and to ensure the quality of psychological assistance provided to citizens in these situations. There is no question that for the services provided to citizens to be of quality, we must ensure the competence of the professionals who perform them.

In view of this situation, and due to the special idiosyncrasy of this professional profile, we consider it necessary to develop a specific training and competency proposal, since we believe that it would be inappropriate and risky for this training to be diluted within other training programs belonging to other areas of psychology such as the Degree in Psychology, the Master's Degree in General Health Psychology or the PIR training program for Specialists in Clinical Psychology.

In our opinion, we consider that, due to their complexity and inadequacy to meet the characteristics and needs of this discipline at the present time, the traditional and professionalization models based on the residency system are unfeasible as an approach for the specialization of professionals in emergency psychology. For this reason, we offer here an approach to a training model of specialization based on competencies that could serve as a basis for a new form of professional accreditation and certification in the field of emergency psychology.

In doing so, we intend to instigate reflection and initiate a future line of action for the creation of new specialties in psychology through the creation of accreditation diplomas, since the essential purpose for obtaining them is that the psychologist can demonstrate they have achieved the required competencies by providing the evidence established for this purpose.

To this end, in Spain, it is unquestionably necessary to coordinate and collaborate with all government agencies involved, professional associations, scientific associations, and psychology professionals, to overcome the rigidities, disagreements, and prejudices that prevent us from moving forward and providing Spanish society with a competent psychology professional capable of responding to mental health needs in situations of crises, emergencies, and disasters.

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Author notes

Correspondence: masoto.psi@gmail.com

Conflict of interest declaration