Impact of training in medical disaster management: a pilot study using a new tool for live simulation

Objective This study aims to test the new Disaster Simulation Suite (DSS) and to evaluate its use during the same full-scale exercise replicated in two different occasions where players (physicians) had a different educational background in disaster management: Trained (T) and Not Trained (NT). The DSS is a web-based instrument designed to enable a systematic, objective, and quantitative evaluation of health performance in dynamic and distributed environments, such as mass-casualty-incidents (MCI) exercises. The hypothesis was that the system could detect the difference in the events management. Methods A ceiling collapse over a crowded room was simulated. Using the DSS we electronically collected data about: Pre-hospital and hospital key times, Pre-hospital and hospital Triage accuracy, Pre-hospital and Hospital Command and Control and Pre-hospital Treatment Accuracy. Results Overall the average Length-of-Stay on the collapse scene was shorter in T than in NT. The average Length-of-Stay in the Emergency Department was shorter in NT than in T. No differences in Triage Accuracy between T and NT both in pre-hospital and in Hospital triage. Command and Control performance was better in T than in NT. No differences between T and NT in treatment correctness. Conclusion The use of DSS in two comparable scenarios allowed the identification of the difference in the response to MCI carried out by T versus NT personnel . These results may reflect the specific objectives of the disaster medicine training, which was mainly oriented to the organizational management of health crises rather than the clinical management of injuries.