There is a need for high-quality disaster training in lower income communities that bear an increasing burden of MCIs. Tabletop exercises (TTX) are low-fidelity, low-cost training methods consisting of facilitator-moderated, discussion-based activities. Simulation education (SIM) is a high-fidelity modality mimicking psychological stress, muscle memory and cognitive load of an MCI. These represent economical training strategies which are standardizable across different regions, developing disaster management skills for first responders.

This study compares the effectiveness of TTX and SIM in building knowledge for Emergency Physicians (EPs) involved in MCIs and increasing comfort in managing disaster scenarios.

64 EPs were randomly assigned to a 1-hour session of TTX or SIM on MCIs and completed assessments testing knowledge and self-perceived comfort levels. Simulation and Disaster Medicine faculty members subsequently moderated debriefing sessions.

TTX participants (N=38) had median knowledge scores of 71% compared to 57% in SIM participants (N=25). TTX participants’ comfort level in dealing with MCIs after the education sessions showed a median comfort level of 5/5 compared to 3/5 in SIM participants. TTX showed an average change in comfort level of 2.13 (SD 1.53) pre- and post-education sessions compared to 1.68 (SD 1.38) in the SIM group, with no statistically significant difference between the groups.

Both modalities increased comfort level in managing MCIs, although participants in TTX performed better on the post-exercise assessment. This data suggests TTX may be an efficacious cost-effective strategy to increase knowledge and comfort in preparing staff for MCIs.