The Challenge of Mass Casualty Incident Response Simulation Exercise Design and Creation: A Modified Delphi Study

Area of Science:

• Translational science
• Emergency medicine
• Healthcare simulation

Background:

• Mass Casualty Incident (MCI) full-scale exercises (FSEx) are crucial for ensuring first responder (FR) competencies.
• Simulation and serious gaming platforms offer potential for achieving and maintaining these critical skills.
• The translational science T0 question explored how FRs can gain MCI competencies comparable to FSEx using simulation exercises.

Purpose of the Study:

• To determine if Mass Casualty Incident (MCI) simulation exercises can effectively develop first responder (FR) competencies equivalent to those achieved in full-scale exercises (FSEx).
• To identify key components and consensus-based statements for creating effective MCI simulation exercises.

Main Methods:

• A two-stage translational science (TS) approach was employed, starting with a scoping review (T1) following PRISMA-ScR guidelines.
• The scoping review informed a modified Delphi (mD) study (T2) involving expert ranking of 27 derived statements on a 7-point scale to reach consensus (SD ≤ 1.0).

Main Results:

• The scoping review (T1) identified 27 potential statements for developing MCI simulation exercises.
• Following three rounds of the modified Delphi study (T2), 19 statements achieved expert consensus, while 8 did not.

Conclusions:

• MCI simulation exercises can be designed to yield competencies similar to FSEx.
• Incorporating the 19 consensus statements into simulation exercises, followed by implementation (T3) and evaluation (T4) stages, is recommended for achieving comparable FR competencies.