Teaching mass casualty triage skills using iterative multimanikin simulations

Area of Science:

• Medical Education
• Emergency Medicine
• Disaster Preparedness

Background:

• Effective mass casualty (MC) triage demands rapid, accurate decision-making from first responders.
• Traditional MC exercises offer limited opportunities for deliberate practice and individualized feedback in triage.
• Novice learners require structured training to enhance their skills in high-pressure scenarios.

Purpose of the Study:

• To evaluate the impact of deliberate practice using high-fidelity manikins on novice learners' triage speed, accuracy, and self-efficacy.
• To assess the effectiveness of iterative feedback in improving mass casualty triage performance.
• To determine if simulated mass casualty training enhances confidence in managing complex emergency situations.

Main Methods:

• Learners acquired baseline knowledge via podcasts and a written exam.
• Participants engaged in three sequential mass casualty (MC) scenarios with five manikin simulations each.
• Individualized feedback was provided after each scenario, with triage and intervention scores recorded.

Main Results:

• Triage and intervention scores significantly improved by the second scenario (p < 0.001).
• Scenario completion time decreased significantly from 8 min 27 sec to 6 min 19 sec (p < 0.001).
• Self-efficacy in prioritizing, identifying high-risk casualties, and overall responder effectiveness significantly increased.

Conclusions:

• Iterative, multimanikin mass casualty (MC) training significantly enhances novice learners' triage and intervention skills.
• The training approach improved both the speed and accuracy of triage decision-making.
• Learners reported substantial gains in self-efficacy, indicating greater confidence in managing mass casualty events.