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Building Trust and Confidence in Disaster Nursing: A Mixed-Methods Critical Inquiry
Jeanette Drake1, Adrianna Watson1, Matthew Anderson1
1College of Nursing, Brigham Young University, Provo, Utah, USA.
None:
Mass casualty incident simulations shape disaster nursing preparedness. In a mixed-methods analysis, quantitative analysis of 380 student nurses demonstrated significant increases in confidence across all measured domains (p < 0.001). Qualitative hermeneutic analysis of 251 student nurse reflections and 487 volunteer patient actor narratives revealed that readiness and composure, alongside compassionate, respectful, and attentive care, were central to trust-building in disaster response. Together, these findings disrupt the prevailing emphasis on technical mastery in simulation, highlighting that relational competence is not an incidental outcome but a fundamental dimension of preparedness. Policy and practice implications are clear. Disaster nursing curricula should mandate structured opportunities for trust-building, reflection, and ethical dialogue, positioning simulation not only as technical rehearsal but also as the origin of germinating relational courage and humanization in care. The use of volunteer patient actors (cost-effective and accessible) offers a scalable strategy to democratize simulation globally, particularly in resource-limited settings. Educational leaders and policymakers are called to prioritize funding, design, and accreditation standards that integrate relational and ethical competencies alongside technical skill, reframing disaster readiness as an inherently human, ethical, and political practice.
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