A Low-Cost, Low-Tech Virtual Mass Casualty Training Simulation for Undergraduate Medical Education

Mass casualty incident (MCI) training effectively increases trainees' knowledge and confidence when implemented in a live, in-person setting. In-person MCI training is resource-intensive, but virtual MCI training models are an alternative with similar effectiveness at a lesser cost. However, most of these validated virtual options are based on high-tech virtual reality (VR) programs. We designed and implemented a low-tech, low-cost virtual MCI training model for third-year medical students, using Google Jamboard^TM (Google, Mountain View, CA) and Zoom^TM (Zoom Video Communications, Inc., San Jose, CA) as the primary technological platforms.

Learners were instructed on the adult simple triage and rapid treatment (START) and the pediatric JumpSTART triage algorithms over Zoom^TM. In small groups, students used a gameboard on Google Jamboard^TM to simulate a scene at an MCI where they were tasked with triaging 25 patients in 30 minutes, followed by a debriefing session. Students were surveyed on their perceived understanding of the triage algorithms and confidence before and after the event using a 5-point Likert scale (poor, fair, good, very good, and excellent). Pre- and post-event scores were compared using paired, two-sample, and two-tailed t-tests. We considered a p value of <0.01 significant to correct for multiplicity using the Bonferroni method.

Learners reported an increased understanding of the triage algorithms (adult and pediatric), scene setup, and understanding of emergency medical service training/transportation, as well as increased confidence in participating in an MCI (all p < 0.001).

Virtual MCI training can be used as an alternative or supplement to in-person MCI training. Low-tech virtual MCI training models can increase the accessibility of these valuable training activities without sacrificing the quality of learning. Areas for further investigation include low-tech virtual MCI training models' ability to effectively recreate situational and environmental distractions and other challenges better simulated by in-person and high-tech VR training events.