# Learning Mass Casualty Triage via Role-Play Simulation

## TL;DR

This paper describes a role-play simulation designed to teach trainees how to handle mass casualty incidents using triage techniques like START.

## Contribution

The study introduces an innovative, hands-on educational intervention using role-play to teach MCI triage and disaster preparedness.

## Key findings

- 93% of participants felt better prepared to manage real-life mass casualty incidents after the simulation.
- 98% reported that the START triage method motivated them to learn more about disaster medicine.
- 96% found the activity more challenging and engaging than other learning methods.

## Abstract

Background

The purpose of this educational intervention was to introduce trainees to the core competencies of disaster preparedness/resource allocation/mass casualty incident (MCI) command and event medicine. This innovative learning activity involving trainees from different programs teaches effective techniques of how to apply triage algorithms, such as Simple Triage and Rapid Treatment (START), in a mass casualty event.

Educational objectives

After participation in this educational session, learners were expected to be able to define a mass casualty incident (MCI) and discuss the unique challenges inherent to mass casualty incidents and disaster/event medicine, differentiate between day-to-day triage and triage during a mass casualty incident, and apply the components of Simple Triage and Rapid Transport (START) for mass casualty incidents.

Curricular design

The scenario was a music festival. A group of residents were granted backstage access to tour the concert grounds and medical tent. During the facility tour, the operations director (Proctor #2) radios the tour guide (Proctor #1) to let them know of an emergency crowd stampede due to unapproved pyrotechnics causing a fire; the medical tent suddenly became flooded with patients. “Patients” were trainees who received a laminated card labeled with vital signs and mental status and were transported one at a time to the tent. Residents ran over to the tent, performed triage, and then selected two of the most critical patients for air transport. The station leader documented the accuracy of each team. Winners were selected based on time of completion and accuracy of correctly triaging patients. For every incorrect triage, a 30-second penalty was added. Incorrectly triaged patient cards were debriefed in detail.

Impact/effectiveness

This activity engages learners both physically and mentally, necessitating everyone to be active. The impact was measured by a post-activity survey, accessed via QR at the station. Of the participants, 93% reported feeling better prepared to manage a real-life MCI. Further, 98% reported that START triage better motivated them to learn. In addition, 96% reported that this activity challenged them more than other learning activities. Verbal feedback included appreciation for the innovative activity design and being able to get some exercise.