Disaster Preparedness Training for Emergency Medicine Residents Using a Tabletop Exercise

Abstract

Introduction Emergency medicine (EM) physicians serve at the frontline of disasters in our communities. The 2016 Model of Clinical Practice according to the American Board of EM identifies disaster management as an integral task of EM physicians. We described a low-cost and feasible tabletop exercise to implement such training for EM residents. Methods The exercise took place during 2 hours of resident didactic time. A lecture introduced the incident command system (ICS) and triage concepts, followed by a tabletop scenario with a map of a disaster scene or emergency department. Facilitators presented situational prompts of tasks for residents to address during the exercise. These exposed residents to challenges in disaster scenarios, such as surge and limited resources. The exercise concluded with a debrief and short lecture reviewing scenario-specific topics and challenges. Residents completed an online pre- and postexercise assessment, evaluating knowledge and perceptions of disaster scenario management. Results Eighteen residents participated in this exercise. The response rates to the pre- and postsurvey were 76% and 72% respectively. Using a Mann Whitney U test, no statistically significant difference was demonstrated on the medical knowledge component of the survey. There was, however, a statistically significant increase in perceived confidence of the residents' ability to manage disaster incidents. Discussion We developed a simple exercise that is an easily adaptable and practical option for introduction to disaster preparedness training. These concepts are difficult to teach and assess among learners, however it remains an important component of education for EM physicians-in-training.

Preparing medical first responders for crises: a systematic literature review of disaster training programs and their effectiveness

“…For the quasi-experimental studies, usually none ( k = 4), one question ( k = 23) or two questions ( k = 13) were answered with no . There was only one paper for which four out of nine questions were answered in the negative [ 46 ]. The higher risk of bias in the quasi-experimental studies was mainly based on question 4, which assesses the control group because a large part of the studies had a single group pre-post design ( k = 35).…”

“…All other studies measured individual performance only. Furthermore, several studies used self-reported measures, including preparedness/readiness [39,[41][42][43][44] and (self-)confidence [45][46][47][48][49][50].…”

Board Game: An Effective Way for Novice Trainees to Learn Incident Command System

“…Unlike lectures, disaster exercises may be a good method to help learners gain knowledge or skills. Tabletop exercises have been used to teach ICS effectively and at a low cost (Sena et al, 2021); however, learners may not feel the reality of the disaster or lack engagement in the disaster response in this type of exercise (Knight et al, 2010). By contrast, full-scale exercises can create an environment close to disaster but may require considerable funding and a large amount of educational resources (Hu, Liu and Li, 2020).…”

“…Because disasters do not usually happen frequently, many learners may lose their skills or knowledge due to a lack of exposure or practice (Sena et al, 2021). Therefore, disaster training should be repeated at regular intervals to prepare responders for unexpected events.…”

“…Therefore, disaster training should be repeated at regular intervals to prepare responders for unexpected events. However, while traditional lectures and disaster exercises require instructors, facilitators and/or evaluators, educational games require minimal or even no direction from the facilitator (Sena et al, 2021). Learners can repeat the games many times, allowing players to learn from the experience through the game mechanism of scoring (Charlier and De Fraine, 2013).…”