Triaging in Mass Casualty Incidents: A Simulation-Based Scenario Training for Emergency Care Senior Residents

Mass casualty incidents (MCIs) are events where the number of patients may exceed the resources available for emergency management. In emergency departments (ED), MCIs go along with high patient allocation in a short time period. For ED staff, simulation-based immersive scenario training can be an effective tool to develop communicative and leadership competencies to manage these situations.

A novel simulation-based immersion experience was developed for senior residents in emergency care. To our knowledge, this is the first scenario training focusing on in-hospital triage and management of MCI in an ED using simulated patients, visual tracking, bodycams and active participant location tracking as educational tools. The participants were either directly involved by managing triage and allocation of in-hospital resources for 14 patients or in remote observation of the running scenario on an audiovisual basis.

After implementation of the pilot MCI simulation-based scenario training, 13 participants completed surveys (48% response rate) including open-ended response items. Quantitative data and open-ended responses using an electronic response system were sequentially analysed to evaluate training feasibility and acceptability.

We designed a novel simulation-based MCI scenario training focusing on learning objectives involving confidence gain in ED triage. Although this format is extremely resource and time consuming, the highly positive evaluation (participants strongly agreed or agreed that the simulation scenario was suitable for in-hospital MCI triage training) implies that this innovative education technique should be considered for future emergency medical services (EMS) training sessions.