No CrossRef data available.
Article contents
Use of Simulation in Full-Scale Exercises for Response to Disasters and Mass-Casualty Incidents: A Scoping Review
Published online by Cambridge University Press: 24 November 2023
Abstract
Disasters or mass-casualty incidents are uncommon events. The use of simulation is an ideal training modality in full-scale exercises as it immerses the participants in a replication of the actual environment where they can respond to simulated casualties in accordance with existing protocols.
The objective of this scoping review is to answer the research question: “How effective is simulation, as assessed in full-scale exercises, for response to disasters and mass-casualty incidents world-wide?” Studies on full-scale exercises, as defined in World Health Organization (WHO) simulation exercise toolbox, that were published in peer-reviewed journals using the English language from 2001 through 2021 were included. Twenty studies were included from searching PubMed, Embase, and Web of Science. Simulated casualties were the most common simulation modality. Using Kirkpatrick’s levels of evaluation to synthesize the data, simulation was reported to be generally effective and mostly demonstrated at the levels of learning of individuals and/or systems, as well as reaction of individuals. Evaluations at levels of behavior and results were limited due to the uncommon nature of disasters and mass-casualty incidents. However, evaluation outcomes across the full-scale exercises were varied, leading to the inability to consolidate effectiveness of simulation into a single measure. It is recommended for best evidence-based practices for simulation to be adhered to in full-scale exercises so that the trainings could translate into better outcomes for casualties during an actual disaster or mass-casualty incident. In addition, the reporting of simulation use in full-scale exercises should be standardized using a framework, and the evaluation process should be rigorous so that effectiveness could be determined and compared across full-scale exercises.
Keywords
- Type
- Research Report
- Information
- Copyright
- © The Author(s), 2023. Published by Cambridge University Press on behalf of the World Association for Disaster and Emergency Medicine
References
World Health Organization. Simulation exercises. https://www.who.int/emergencies/operations/simulation-exercises. Accessed October 10, 2022.Google Scholar
Al-Elq, AH. Simulation-based medical teaching and learning. J Family Community Med. 2010;17(1):35–40.CrossRefGoogle ScholarPubMed
Lateef, F. Simulation-based learning: just like the real thing. J Emerg Trauma Shock. 2010;3(4):348–352.CrossRefGoogle ScholarPubMed
Cannon-Bowers, JA. Recent advances in scenario-based training for medical education. Curr Opin Anaesthesiol. 2008;21(6):784–789.CrossRefGoogle ScholarPubMed
Flanagan, B, Nestel, D, Joseph, M. Making patient safety the focus: crisis resource management in the undergraduate curriculum. Med Educ. 2004;38(1):56–66.CrossRefGoogle ScholarPubMed
Sweeney, AL, Lui, YL, Watkins, N, et al. Simulation exercises increase staff confidence, knowledge, and skills in managing mass-casualty incidents: a pre-test-post-test study. Tasman Medical Journal. 2021;3(4):112–119.Google Scholar
Preferred Reporting Items for Systematic Reviews and Meta-Analyses. PRISMA for scoping reviews. https://prisma-statement.org/Extensions/ScopingReviews. Accessed October 10, 2022.Google Scholar
Kirkpatrick, DL. Evaluating Training Programs: The Four Levels. Oakland, California USA: Berrett-Koehler; 1994.Google Scholar
Alexander, AJ, Bandiera, GW, Mazurik, L. A multiphase disaster training exercise for emergency medicine residents: opportunity knocks. Acad Emerg Med. 2005;12(5):404–409.CrossRefGoogle ScholarPubMed
Lenz, M, Richter, T. Disaster response to the release of biohazardous agents: instrument development and evaluation of a firefighter’s exercise. Prehosp Disaster Med. 2009;24(3):197–203.CrossRefGoogle Scholar
Gryth, D, Rådestad, M, Nilsson, H, et al. Evaluation of medical command and control using performance indicators in a full-scale, major aircraft accident exercise. Prehosp Disaster Med. 2010;25(2):118–123.CrossRefGoogle Scholar
Ingrassia, PL, Prato, F, Geddo, A, et al. Evaluation of medical management during a mass-casualty incident exercise: an objective assessment tool to enhance direct observation. J Emerg Med. 2010;39(5):629–636.CrossRefGoogle ScholarPubMed
Rutty, GN, Rutty, JE. Did the participants of the mass fatality exercise Operation Torch learn anything? Forensic Sci Med Pathol. 2012;8(2):88–93.CrossRefGoogle Scholar
Klima, DA, Seiler, SH, Peterson, JB, et al. Full-scale regional exercises: closing the gaps in disaster preparedness. J Trauma Acute Care Surg. 2012;73(3):592–598.CrossRefGoogle ScholarPubMed
Rådestad, M, Nilsson, H, Castrén, M, Svensson, L, Rüter, A, Gryth, D. Combining performance and outcome indicators can be used in a standardized way: a pilot study of two multidisciplinary, full-scale major aircraft exercises. Scand J Trauma Resusc Emerg Med. 2012;20:58.CrossRefGoogle Scholar
Austin, EN, Hannafin, NM, Nelson, HW. Pediatric disaster simulation in graduate and undergraduate nursing education. J Pediatr Nurs. 2013;28(4):393–399.CrossRefGoogle ScholarPubMed
Shah, VS, Pierce, LC, Roblin, P, Walker, S, Sergio, MN, Arquilla, B. Waterworks, a full-scale chemical exposure exercise: interrogating pediatric critical care surge capacity in an inner-city tertiary care medical center. Prehosp Disaster Med. 2014;29(1):100–106.CrossRefGoogle Scholar
Austin, EN, Bastepe-Gray, SE, Nelson, HW, et al. Pediatric mass-casualty education: experiential learning through university-sponsored disaster simulation. J Emerg Nurs. 2014;40(5):428–433.CrossRefGoogle ScholarPubMed
Djalali, A, Carenzo, L, Ragazzoni, L, et al. Does hospital disaster preparedness predict response performance during a full-scale exercise? A pilot study. Prehosp Disaster Med. 2014;29(5):441–447.CrossRefGoogle ScholarPubMed
Daniel, P, Gist, R, Grock, A, Kohlhoff, S, Roblin, P, Arquilla, B. Disaster Olympics: a model for resident education. Prehosp Disaster Med. 2016;31(3):237–241.CrossRefGoogle Scholar
Wenham, J, Bennett, P, Gleeson, W. Crash simulation: an immersive learning model. Clin Teach. 2018;15(6):467–471.CrossRefGoogle ScholarPubMed
Saber, DA, Strout, K, Caruso, LS, Ingwell-Spolan, C, Koplovsky, A. An interprofessional approach to continuing education with mass-casualty simulation: planning and execution. J Contin Educ Nurs. 2017;48(10):447–453.CrossRefGoogle ScholarPubMed
McElroy, JA, Steinberg, S, Keller, J, et al. Operation continued care: a large mass-casualty, full-scale exercise as a test of regional preparedness. Surgery. 2019;166(4):587–592.CrossRefGoogle Scholar
Lenz, A, Shelton, R, Ryznar, R, et al. The next nine minutes: lessons learned from the large-scale active shooter training prior to the STEM school shooting. Am J Disaster Med. 2020;15(4):241–249.CrossRefGoogle Scholar
Carenzo, L, Bazurro, S, Colombo, D, Petrini, F, Ingrassia, PL. An island-wide disaster drill to train the next generation of anesthesiologists: the SIAARTI Academy Experience. Disaster Med Public Health Prep. 2021;15(2):151–154.CrossRefGoogle ScholarPubMed
Sheikhbardsiri, H, Yarmohammadian, MH, Khankeh, H, et al. An operational exercise for disaster assessment and emergency preparedness in South of Iran. J Public Health Manag Pract. 2020;26(5):451–456.CrossRefGoogle ScholarPubMed
Foo, NP, So, EC, Lu, NC, et al. A 36-hour unplugged full-scale exercise: closing the gaps in interagency collaboration between the disaster medical assistance team and urban search and rescue team in disaster preparedness in Taiwan. Emerg Med Int. 2021;2021:5571009.CrossRefGoogle Scholar
Innis, J, Mack, K. Evaluation of nursing students’ experiences in an interprofessional simulated disaster exercise. J Nurs Educ. 2021;60(8):445–448.CrossRefGoogle Scholar
Sittner, BJ, Aebersold, ML, Paige, JB, et al. INACSL standards of best practice for simulation: past, present, and future. Nurs Educ Perspect. 2015;36(5):294–298.CrossRefGoogle ScholarPubMed
Hodgson, L. How Violent Attacks Are Changing The Demands of Mass-casualty Incidents: A Review of The Challenges Associated with Intentional Mass-casualty Incidents. www.hsaj.org/articles/16880. Accessed November 1, 2022.Google Scholar
Herrera-Aliaga, E, Estrada, LD. Trends and innovations of simulation for twenty first century medical education. Front Public Health. 2022;10:619769.CrossRefGoogle ScholarPubMed
Cheng, A, Kessler, D, Mackinnon, R, et al; International Network for Simulation-based Pediatric Innovation, Research, and Education (INSPIRE) Reporting Guidelines Investigators. Reporting Guidelines for Health Care Simulation Research: Extensions to the CONSORT and STROBE Statements. Simul Healthc. 2016;11(4):238–248.CrossRefGoogle Scholar
Toosi, M, Modarres, M, Amini, M, Geranmayeh, M. Context, input, process, and product evaluation model in medical education: a systematic review. J Educ Health Promot. 2021;10(1):199.Google ScholarPubMed
Kaufman, R, Keller, JM. Levels of evaluation: beyond Kirkpatrick. Hum Resour Dev Q. 1994;5(4):371–380.CrossRefGoogle Scholar
Johnston, S, Coyer, FM, Nash, R. Kirkpatrick’s evaluation of simulation and debriefing in health care education: a systematic review. J Nurs Educ. 2018;57(7):393–398.CrossRefGoogle ScholarPubMed
Pek et al. supplementary material
Pek et al. supplementary material 1
File
85.9 KB
Pek et al. supplementary material
Pek et al. supplementary material 2
File
21.4 KB