A Simulated Mass Casualty Incident Triage Exercise: SimWars

Area of Science:

• Emergency Medicine
• Disaster Preparedness
• Medical Simulation

Background:

• Mass casualty incidents (MCIs) require rapid and accurate medical provider triage.
• Existing training methods may not fully prepare providers for the complexities of MCI patient management.
• A structured simulation can enhance the application of MCI triage principles.

Purpose of the Study:

• To evaluate a multipatient simulation exercise for hospital medical providers during a simulated mass casualty incident.
• To assess the impact of the simulation on participants' ability to rapidly classify and disposition MCI patients.
• To compare decision-making between two provider teams and an observing audience.

Main Methods:

• A SimWars format simulation involving two teams of provider pairs triaging 12 simulated patients within 8 minutes.
• Active audience observation with checklist completion for patient categorization and disposition.
• Facilitated group discussion comparing team decisions with observer self-assessments and expert panel insights.

Main Results:

• Team performances and audience responses showed similarities, facilitating robust discussion.
• Pre-exercise, 37% of participants felt confident in MCI triage; post-exercise, 100% reported good/excellent ability, a 63% increase.
• All respondents indicated the exercise would influence their clinical practice.

Conclusions:

• The two-team simulation with active observation effectively enhances MCI triage and disposition skills.
• This format provides a framework for real-time knowledge application and comparative decision-making analysis.
• The exercise significantly boosts provider confidence and preparedness for managing mass casualty incidents.