A Multiphase Disaster Training Exercise for Emergency Medicine Residents: Opportunity Knocks

Abstract

Disaster planning is a core curriculum requirement for emergency medicine (EM) residency programs. Few comprehensive training opportunities in disaster planning incorporating the appropriate competencies have been reported. To design, pilot, and evaluate a combination interactive Web-based disaster planning curriculum and real-time multidisciplinary full-scale disaster exercise. Residents were assigned to groups led by a faculty mentor. Each group used an Internet-based platform to review the literature pertaining to their component of a disaster plan. The groups then used the platform to redesign an existing institutional disaster plan. Finally, they implemented their disaster plan for 80 simulated casualties resulting from a police, fire department, and emergency medical services multiple-casualty rescue exercise. All health professions then participated in a joint debriefing session. All aspects of the program were supervised by specialty EM faculty, and the exercise was evaluated using a five-point Likert scale with specific anchored descriptors. Sixteen residents and 17 faculty members participated in the exercise. Trained volunteers and high-fidelity simulations represented casualties varying in age from 6 months to 65 years, and in severity from ambulatory to moribund. Residents found the exercise enjoyable (4.9/5), relevant (4.6/5), and educational (4.8/5). Emergency medicine residency programs can benefit from participating in high-quality medical disaster exercises coordinated with local disaster response agencies. Residents report high satisfaction and learning from realistic simulations of disasters, and from collaboration with other community services.