There is a lack of ethical triage and treatment guidelines for the entrapped and mangled extremity (E&ME) in resource scarce environments: mass casualty incidents, low- to middle- income countries, complex humanitarian emergencies including conflict, and prolonged transport times (RSE).

The aim of this study is to use a modified Delphi (mD) approach to produce statements to develop treatment guidelines of the E&ME in RSE to advance the 2021 WHO EMT Minimum Standards (EMT) treating the E&ME.

Experts rated their agreement with each statement on a 7- point linear numeric scale. Consensus amongst experts was defined as a standard deviation <= 1. Statements attaining consensus after the first round moved to the final report. Those not attaining consensus moved to the second round in which experts were shown the mean response of the expert panel and their own response for the opportunity to reconsider their rating for that round. Statements attaining consensus after the second round moved to the final report. This process repeated in the third round. Statements attaining consensus moved to the final report. The remaining statements did not attain consensus.

Seventy-seven experts participated in the first, 75 in the second, and 74 in the third round. Twenty-three statements attained consensus. Twenty-one statements did not attain consensus.

A Delphi technique was used to establish consensus regarding the numerous complex factors influencing treatment of the E&ME in RSEs. Twenty-three statements attained consensus and can be incorporated into guidelines to advance the EMT treating the E&ME.

The use of diagnostic technology at the bedside is increasingly common in hospitals and is spreading to EMS.

To detect the contexts in which the use of point-of-care blood test and ultrasound is feasible and provides benefit in an EMT1 fixed.

Review of the procedures of the SAMUR-Protección Civil and the bibliography that supports them. Summary of the publications carried out by our group.

The basic blood analysis with blood gases, biochemistry and electrolytes allows to detect electrolyte disturbances secondary to gastrointestinal infection, diabetic decompensation, and others, to estimate the severity of a trauma patient that is not clearly unstable, to guide resuscitation in shock, to study the patient with chest pain, to assess organic involvement in infectious conditions, etc.

The use of ultrasound at the bedside has shown to be a great diagnostic aid in many pathologies: trauma (frequent in the context of a catastrophe), COVID-19 (detection of infiltrates), cardiorespiratory arrest (reversible causes), pulmonary embolism (high risk in people trapped), study of collections and abscesses, heart disease, etc. and it is useful for multiple techniques such as vascular cannulations (peripheral and central), orotracheal intubation, and drainage.

The ESP EMT1 SAMUR-PC is equipped with ultrasound and point-of care blood analysis, as well as our ALS units in Madrid.

The inclusion of ultrasound and blood tests among the diagnostic capabilities of an EMT1 fixed can improve the ability to detect serious pathology and guide initial treatment.

In the event of CBRN mass casualty incidents, a specialized approach is essential that includes decontamination procedures. There are two types of decontamination systems most often used for CBRN incidents: wet and dry. While wet decontamination is more common, it can be problematic in cold weather or when logistical equipment is unavailable. This scoping review seeks to assess the effectiveness of dry decontamination.

Evaluating the effectiveness of dry decontamination methods for mass decontamination.

A scoping review was done on dry decontamination using various databases, including MEDLINE, CINAHL, Embase, Web of Science, and Scopus. Following the PRISMA approach, nine eligible articles were included in this scoping review. The methods of dry decontamination, types of decontamination materials, methods of analyzing decontamination, and the main conclusions from each study were extracted, summarized, and compared.

The review found that dry decontamination is an effective method (4 articles), particularly when dealing with liquid contaminants (1 article). However, its efficacy diminishes in cases of more hairy parts of the body (1 article) and when dealing with chemicals in particle form. Effectiveness of dry decontamination varies depending on the material used and the chemical agent involved (3 articles). Moreover, the technique of blotting and rubbing was found to increase effectiveness (1 article).

This scoping review found that dry decontamination can be effective and may be an alternative to wet decontamination in CBRN mass casualty incidents, particularly for liquid contaminants. Its effectiveness varies depending on factors such as the type of contaminants, and the decontaminant material used.

The Republic of Moldova needs a proactive approach in building their trauma and emergency care capacity given the neighboring conflict in Ukraine and inflow of refugees. The World Health Organization, in collaboration with local and international experts, has implemented a series of training programs to address the identified need for improved emergency and trauma care. These programs are critical for future EMT development.

Objectives of the training programs include:

1. 1. Strengthening emergency medicine and trauma expertise amongst interdisciplinary healthcare providers

2. 2. Improving trauma care through the development and implementation of a novel trauma team program

3. 3. Increasing capacity for mass casualty management

Emergency Care Systems Assessment and Hospital Emergency Unit Assessment Tool were used to identify gaps. Initial training focused on Basic Emergency Care, Advanced Trauma Life Support, and ultrasound courses led by WHO instructors in partnership with a local simulation center. A team of international experts, in partnership with local physicians, introduced trauma simulation sessions in the emergency department for multi-specialty teams to enhance their team communication and resuscitation skills. A training video was produced to improve dissemination of trauma care knowledge and instruction of an evidence-based pre-hospital handover tool. Finally, a table-top mass casualty simulation exercise was completed led by Emergo Train System instructors.

The Institutul de Medicină Urgentă launched the country’s first trauma team program on July 1, 2024 and neighboring regions will be replicating this approach.

A multi-faceted training approach allows for proactive strengthening of emergency and trauma care to improve local response capacity.

Papua New Guinea (PNG) faces significant challenges from recurring disasters and health emergencies. There are critical gaps in frontline staff knowledge, skills, and equipment for basic emergency care (BEC). The PNG EMT has delivered basic training to HCWs in provinces. Many deployed teams provided training to local HCWs.

PNG EMT strengthening Emergency Care Systems by;

1. 1. delivering accredited contextualized training during deployments, and

2. 2. maintaining standardized contextualized resources as an aid for international EMTs in PNG.

PNG EMT currently has trainers in IITT, BEC and Oxygen delivery training (OSCAR-O2). There are locally contextualized, standardized resources available for use on deployment to train local health workers. Experiences training local health workers is an essential part of a pre-deployment orientation.

Since PNG EMT inception, a total of 7 trainings have been completed during deployments to provinces. Currently, 177 healthcare received training in oxygen delivery.

For BEC in 2024, PNG has 3 master trainers and 30 trainers nationally. TOT done in April 2023 with 5 EMT team members.

For IITT in 2024, PNG has 2 trainers for each of the 22 provinces. TOT done in Dec 2024. PNG EMT has 3 experienced trainers.

Strengthening the EMT’s role as a delivery mechanism for “just-in-time” training further enhances national efforts in developing robust ECS. Contextualized standard teaching aids are essential for deployed teams.

To familiarize potential national EMT stakeholders with the concepts and objectives of the EMT initiative and to involve them in its implementation, an EMT awareness workshop has been developed as a global advocacy tool. The results of the workshop implementation in the WHO European Region indicated that a new approach is needed to address the specific learning needs of the different country contexts and target audiences, which vary in their level of EMT awareness.

To develop a novel workshop design, based on the experience of the EMT awareness workshops conducted in the WHO European Region and on the needs assessment, that addresses the following necessities:

• flexibility of the curriculum to suit the audience’s level of knowledge and time constraints;

• the context of the host country to ensure audience engagement.

A new workshop development process involved analysis of previous EMT awareness-raising activities, brainstorming by the working group, and experimentation with the delivery of the pilot workshops by REECH.

The new EMT awareness workshop has the following characteristics:

• modular structure of the curriculum, providing three levels of complexity and detail for of each module;

• the core interactive exercise using the national data of the host country on geographical, demographic, and epidemiological conditions, risks, and hazards of emergencies, and on capacity of health services.

The new EMT awareness workshop provides a flexible and targeted approach to consider the audience’s baseline level, the context of the host country, and time constraints, which also allows for the intermittent mode.

The WHO mentorship and assistance are crucial in ensuring the quality and reliability of internationally deployed EMTs assisting needy countries. The program is a comprehensive assessment that helps EMTs evaluate all elements and personnel of the team that must be rapidly deployed to aid a nation facing an emergency.

It encompasses logistical equipment, procedures, clinical capabilities, administration, and management. This procedure guarantees the team is completely autonomous and delivers patient care according to international benchmarks.

Indonesia has experienced civilian-military coordination in humanitarian aid efforts in such natural and non-natural tragedy in Indonesia.

Indonesia requires a dedicated training center to develop and deploy Emergency Medical Team (EMT) teams for effective response to diverse crises both within Indonesia and internationally.

The successful completion of the recognition of Multheor Indonesia by the South-East Asia Region and WHO EMT is a strategic measure to effectively address future disasters. We urge them to enhance their emergency preparedness and operational readiness by ensuring the verification of national EMTs.

The WHO’s prompt declaration of a Public Health Emergency of International Concern shepherded an effective coordinated response to contain the epidemic. In order to coordinate better the response to epidemics, outbreaks and disasters, the Niger Ministry of Health and the WHO Country Office established the Rapid Response team.

The aim of this study is to describe the experiences and challenges during the Implementation of Emergency Preparedness and Response-Rapid Response Team.

The study used a mixed methods approach with quantitative and qualitative data from a literature review of the WHO Country Office coordination mechanisms and the Niger Public Health Emergency Operational Centre (PHEOC). The study was conducted at the PHEOC of Niger during 12 months from September 2022 to September 2023.

The program began with the evaluation of Niger’s capacities and capacity building of teams to prepare, detect, and respond to public health emergencies within 24 hours of an alert. The team of multi-disciplinary and multi-sector experts was identified, selected, and trained using a series of training modules. The team was composed of a total of 50 experts from six sectoral ministries. The average age is 49.94 (±5.9) years with extremes ranging from 33 to 56 years. The sex ratio is 0.35. The team has acquired the experience of being deployed in four regions of the country and six districts as part of the response to six public health events.

The rapid response team has made it possible to acquire not only the technical and operational skills, but also financial, human, and logistical capacities to respond rapidly when a public health emergency occurs.

In the coming decades, the operational scenario will become more complex due to several changes (OCHA, 2022). With the global disasters increase, fatal victims and people subjected to emergency relief also increase, which reinforces World Health Organization’s (WHO) announcements for national and international development of capacities for emergencies and crisis responses. In Brazil, the Minas Gerais Military Fire Department (CBMMG), a state public institution, responds to incidents involved in emergencies and search and rescue, being a local response reference and a potential agent at national and international level.

In this global challenging context, CBMMG faces the need to expand and improve its operational capabilities. Thus, the study’s general objective was to verify organizational preparation for responses to local and external emergencies, integrating Emergency Medical Teams (EMT) guidelines into their operational practices.

This was an exploratory study and the methodology included literature review related to the responsibilities of firefighters in disaster response scenarios and their capacity to act in relation to pre-hospital care demands.

As a result, it was found that the institution invests in military personnel training in both pre-hospital care and disaster risk management, as well as in other auxiliary areas, effectively instructing them with applied technical and practical knowledge.

Thus, it is concluded that CBMMG military personnel are potential agents to compose an EMT, considering legal and regulatory aspects, their training, and the WHO prerequisites. In this way, they can contribute not only to the state citizens, but across the globe, in support of other teams and callings.

The Korean Disaster Relief Team (KDRT) plays a critical role in providing rapid and effective disaster response. However, past literature has highlighted the need for enhanced training and capacity-building programs.

This study aims to improve KDRT’s training and capacity-building programs to enhance disaster response preparedness and efficiency, addressing specific training needs and capacity gaps.

The study employed the PRISMA methodology to review international literature on training and capacity building, comparing findings with KDRT programs. Based on 2022 KOFIH report, surveys, and interviews with KDRT members identified specific training needs and gaps. A SWOT analysis evaluated the current state of KDRT’s training programs, incorporating insights from reviewed documents.

Ten reports were selected from an initial pool of 14,670 for final analysis. KDRT’s strengths include engaging learning methods and comprehensive, practical training. Weaknesses identified were high resource requirements and the need for extensive training. Opportunities include expanding training to other roles and regions, leveraging technology, and establishing global training standards. Threats comprise variability in training standards, funding limitations, and technological disparities. Findings highlighted the need for psychological preparedness modules, regular updates to training packages, standardized medical record-keeping, and simulation-based training.

To enhance KDRT’s programs, this study recommends establishing a robust governance structure, developing standardized SOPs, integrating advanced communication systems, and regularly evaluating training tools. Implementing comprehensive training programs with joint exercises focusing on real-life scenarios is crucial. Ensuring team proficiency, monitoring effectiveness, and analyzing data to improve practices are essential for continuous improvement of KDRT’s training programs, aligning them with global standards.

The World Health Organization established the Emergency Medical Team (EMT) initiative in 2013 to standardize disaster response, emphasizing robust education and training programs. The Canadian Medical Assistance Teams (CMAT), a volunteer-run NGO with over 1,000 members, struggles with logistical and financial constraints for in-person training.

This study evaluates the effectiveness of virtually delivered TEAMS 3.0 tabletop modules for training CMAT’s volunteers, hypothesizing that virtual training is effective and comparable to in-person training. Adapt TEAMS 3.0 tabletop exercises into a virtual format and assess their effectiveness. Compare the effectiveness of virtual and in-person training.

A quasi-experimental design with non-randomized groups was used. CMAT members were assigned to in-person or virtual training based on availability. Pre- and post-training surveys assessed self-efficacy, teamwork, and training quality. Statistical analysis using SPSS employed non-parametric tests to compare pre- and post-training scores and between-group differences. Qualitative feedback was collected via a post-training anonymous form.

Four TEAMS 3.0 exercises were adapted for virtual delivery using Google Meet and Google collaborative tools. Among 26 participants (10 in-person, 16 virtual), both formats showed no significant changes in self-efficacy or teamwork scores from pre- to post-training. In-person training received significantly higher quality ratings from trainees compared to virtual training (p=0.026). Trainers’ quality ratings also favored in-person training but were not statistically significant (p=0.091).

Virtual TEAMS 3.0 exercises yielded similar self-efficacy and teamwork results as in-person training, though in-person sessions were rated higher quality. This supports virtual training as a scalable, cost-effective alternative, though further research with larger samples is needed.

Effective disaster response requires standardized training of Emergency Medical Teams (EMTs). The TEAMS 3.0 training initiative, initially designed for in-person training, has been shown to significantly improve team efficacy. However, logistical challenges and the COVID-19 pandemic have prompted the need to develop and assess virtual training alternatives.

This study compares EMT trainee experiences in TEAMS 3.0 virtual and in-person programs using qualitative thematic analysis.

Sixteen Canadian EMT volunteers participated in a condensed, one-day TEAMS 3.0 program. Sessions were held in-person (6 trainees, 4 trainers) and virtually (10 trainees, 6 trainers). Each session included four exercises with 30-minute debriefs, which were recorded and transcribed. Thematic analysis of transcripts was done in NVivo version 14.

Thematic analysis revealed key components of effective training in both formats. Access to EMT-specific SOPs and documentation templates were identified as being crucial for learning and exercise success. However, the virtual format negatively impacted communication and team connection during training activities.

Both formats supported the development of team skills and sparked essential discussions for successful deployment. Despite challenges in virtual training, such as impaired communication and participant connection, converting TEAMS 3.0 to a virtual format is a viable method of EMT training.

In the face of increasing global crises and conflict, responding immediately to a disaster with life-saving interventions is an identified gap. Rapidly deployable, highly mobile surgical teams with prepared logistics and equipment is an identified solution to meet this need.

Develop a Mobile Surgical Theater (MST) that is adaptable to both sudden onset and conflict driven disasters. The MST should be immediately deployable on commercial aircraft. The team members will be trained not only on the clinical aspects but also the operational components of the MST. The MST should hold the ability to provide five major surgeries daily for the duration of response and be fully self-sufficient.

Subject Matter Experts (SME’s) in Mobile Surgical and Golden Hour Surgical teams were consulted throughout development. Thorough research, testing, and development was performed on all components to ensure good function and reliability. While developing training and objectives, SMEs were also consulted to ensure optimal learning. All aspects of development and training used a collaborative, team driven approach.

Samaritan’s Purse currently maintains two MST units, prepositioned and ready to deploy. This includes four trained teams with future trainings planned. Samaritan’s Purse maintains logistics and supply chain to ensure readiness for rapid deployment.

Samaritan’s Purse stands ready to deploy Mobile Surgical Teams into complex disaster scenarios. The rapid and nimble nature of the MST ensures delivery of quality lifesaving care into areas and timeframes previously unmet through traditional disaster response mechanisms.

In February 2022, Russia launched an offensive in Ukraine, resulting in significant casualties to civilians, including children. As part of an academic/NGO partnership, a novel pediatric trauma fundamentals course (PTF) was developed to provide pediatric trauma education to frontline healthcare providers across Ukraine.

The objective of the program was to develop, implement, and evaluate a novel PTF educational course in the active conflict zone of Ukraine.

A two-day PTF course was internally developed and implemented in Ukraine from November 2022 to December 2024. Training effectiveness was assessed using the RE-AIM framework. Participants completed pre- and post- assessments in knowledge and self-confidence and critical skills were assessed against objective skill checklists. Change in knowledge and self-confidence were analyzed, respectively, with the nonparametric Wilcoxon matched-pairs signed rank test and McNemar’s test for paired data. Anonymous course evaluations were solicited after each course. Six-week follow up surveys assessed skill utilization and stewardship.

446 Ukrainian healthcare providers were trained during 30 courses across eight oblasts in Ukraine during the intervention period. Aggregated knowledge and self-confidence significantly improved across all measures. Ukrainian instructors received higher scores on instructor evaluations compared to international instructors. Six-week follow-up surveys demonstrated participants had positive views of the training, used the training on patients, and taught the material to others.

Our PTF course implementation demonstrates a successful partnership-based model for implementing pediatric trauma education in an active conflict zone. Implementation challenges can be mitigated through partnership-based models between academic institutions and organizations with local implementation expertise.

Public education in effective interventions for external hemorrhage control for gunshot wounds has become a priority focus. There remains a gap in training programs of populations of non-medical bystanders who would be the first to stop this bleeding in a mass shooting.

To create a WHO EMT initiative community training program designed to close this gap in low-middle income countries, complex humanitarian events and in conflict zones.

This study is a factorial randomized control study, utilizing four cohort groups. Two comprised of bystanders with no previous medical training, and the remaining two comprised of first responders previously trained to control external hemorrhage. Each group was put through the same hemorrhage control simulation; one cohort of each bystander/first responder groups acted as a respective control group receiving only a tourniquet, whereas other cohorts of each group received Stop-the-Bleed® handouts to serve as the point-of-care instructional method of Just-in-Time training alongside the tourniquets.

Within the bystander’s cohort, 26.3% of the group who received JiT training applied the tourniquet correctly vs 6.3% of the control group.

Of the first responder’s cohort, 75% of those who received JiT training applied the tourniquet correctly vs 66.7% of the control group.

There was no statistically significant difference in the ability to correctly apply the tourniquet in the intervention vs control groups of either cohort.

The WHO EMT initiative has the opportunity to train non-medical bystanders to receive Just-in-Time training to effectively place a tourniquet to stop the bleeding after a mass shooting.

A CBRN event requires a conscious response from point of exposure to definitive hospital management. Being training a key element of healthcare system preparedness, the EMT2-ITA Regione Piemonte (EMT2-ITA) developed a new CBRN specific course including CBRN awareness, personal protective equipment, patient classification, and related treatment.

The current study aimed to assess the quality of this new model of training through the evaluation of the courses provided by the EMT2-ITA to professionals belonging to the EMT2 pool or to the regional healthcare system.

The survey study was based on a Likert-scale questionnaire specifically designed (Cronbach’s alpha: 0.9115). The overall Training Quality (TQ) index was calculated as the average value of the rating given by all the participants. Open text feedback was also collected.

An online survey was sent by email to all professionals (165 people) trained during the different course editions held between November 2023 and June 2024. The statistical analysis of the results was performed using Stata 15.1.

Ninety-nine people (response rate: 60%) completed the survey. The high value registered for TQ (4.58 ± 0.47) shows good appreciation by all the participants with different roles (62% nurses, 28% medical doctors, 10% others). Stratified analyses did not show a statistical significance, with the only exception of single questions analyses showing a P-value less than 0.05 for age and role categories.

The new EMT2-ITA CBRN training course has been evaluated by different groups of professionals, both healthcare and technical, as useful and complete to improve healthcare system preparedness.

Chemical, biological, radiological, and nuclear (CBRN) incidents pose increasing transborder risks globally, necessitating enhanced health sector preparedness.

This study aimed to develop a comprehensive CBRN preparedness assessment tool (PAT), operational response guidelines (ORG), and tabletop simulation scenarios for the health sectors of the Middle East and North Africa (MENA) region.

A mixed-methods approach comprised a systematic review of the literature up to 2022 in English and French, modified expert interviews (MIM), and an online Delphi questionnaire. Content analysis was performed on interview data. Using R-Studio™, consensus metrics and artificial intelligence techniques, including natural language processing, sentiment analysis, and unsupervised machine learning (ML) clustering algorithms, were deployed for advanced data analysis across all phases.

The literature review identified 63 relevant studies illustrating various preparedness strategies. The MIM’s thematic analysis, reinforced by AI-driven content analysis, emphasized the need for stronger inter-regional cooperation facilitated by organizations such as WHO and standardized tabletop simulation training. A robust consensus was achieved on the proposed assessment tool and operational response guidelines. ML analysis identified distinct expert clusters, providing additional consensus perspectives.

The study emphasized the urgency for collaborative CBRN response strategies within MENA, valuing the innovative aspect of our suggested PAT, ORG, and simulation scenarios. This work advocates a dynamic, resilient approach to disaster medicine preparedness, which is crucial for regional security and global health resilience, especially in the MENA. It also highlights the significant role of AI analysis methods in enriching analytical outcomes in disaster medicine research and promoting data-informed preparedness strategies.

Emergency Medical Teams (EMTs) face significant psychological stress due to their exposure to traumatic events and high-pressure situations. Addressing these psychological challenges is essential for maintaining EMTs’ mental health and enhancing their performance in emergency responses.

This study aims to develop a comprehensive psychological resilience training program for EMTs to improve their coping mechanisms, emotional regulation, and overall resilience.

A comprehensive literature review was conducted to identify evidence-based techniques for building psychological resilience, including cognitive-behavioral therapy (CBT), mindfulness, and stress inoculation training. Based on these findings, a structured resilience training program was developed, incorporating workshops, scenario-based training, peer support networks, and access to professional mental health resources.

The proposed framework outlines a structured approach to incorporating psychological resilience training into existing EMT training programs. While the program has not yet been implemented, the literature indicates that such a framework could significantly improve EMTs’ ability to manage stress, reduce burnout, and enhance job satisfaction.

Integrating psychological resilience training into EMT professional development is crucial for fostering a mentally healthy and resilient workforce. The proposed framework, based on a comprehensive literature review, demonstrates the potential for significantly improving EMTs’ psychological well-being and effectiveness in emergency responses. Future implementation and evaluation of this framework are necessary to validate its impact and facilitate broader adoption across EMS organizations.

The EMT-ATG achieved a significant milestone with its inaugural deployment during the SIDS4 Conference in Antigua. The EMT2030 strategy and Global Health Emergency Corps (GHEC) approach underscore the importance of collaborative leadership and joint efforts among all the networks to provide a comprehensive response.

The primary objective of the deployment was to ensure the health and safety of SIDS4 conference attendees through a coordinated and effective emergency medical response. It also aimed to demonstrate the capability of small island countries to establish and deploy fully operational and self-sufficient EMTs in coordination with other rapid response capacities, fostering a model of collaborative leadership.

Training programs, conducted in collaboration with PAHO, focused on disaster response, triage, and mass casualty management. PAHO capacity building included the procurement of medical equipment, establishment of mobile medical units, and enhancement of communication systems for seamless coordination.

In preparation for deployment, ATG-EMT conducted simulation exercises and drills which involved various stakeholders, including local health authorities, security agencies, prehospital EMS, public health rapid response teams, and community volunteers.

The successful deployment of ATG-EMT during the SIDS4 Conference demonstrated the team’s capability to provide high-quality medical care and support at a high-profile international event. This contributed to the health and safety of over 4,500 delegates.

The deployment highlights the importance of continuous training, robust capacity building, meticulous preparation in developing an effective emergency medical response system and serves as a model for small island countries aiming to enhance their disaster response capabilities.

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.