Simulated mass casualty events: Advocating real care for simulated victims

Mass casualty events (MCE; e.g., natural disasters, terror attacks) impose a great deal of stress on health care systems and professionals worldwide. To ensure their preparedness, large-scale simulations of such events (i.e., SMCE) involving simulated victims (SVs) have become a prominent tool. Although past research suggests SVs' symptoms during SMCE might be comparable to that of trauma victims, little research has investigated this proposition. This study first aims to quantitatively assess SVs' symptoms of acute stress (i.e., emotional distress and dissociation) in the context of SMCE. Second, we explore associations with various individual (e.g., gender), interpersonal (e.g., care appraisal), and organizational (e.g., role) factors.

After two separate SMCE following the same terror attack scenario, a questionnaire was completed by SVs (n = 90).

Results outline symptoms relating to distress (e.g., helplessness, 27%) or dissociation (e.g., disorientation, 19%). Satisfaction with care was highly dependent on reassurance (d = 1.34) and swiftness of care (d = 1.19). SVs playing psychological symptoms reported a globally worse experience: more acute stress symptoms (r = .23, p < .05), not receiving sufficient information (η² = .05), and other role-related issues (e.g., being shown less empathy).

Our study shows that SVs may experience symptoms of acute stress and provides actionable insights to prevent these symptoms. As simulation could pave the way for the development of new protocols regarding real victims, we advocate for all actors and institutions involved to take more interest in SVs' experience-that is, to provide them with real care. (PsycInfo Database Record (c) 2026 APA, all rights reserved).