A Low-Cost, Low-Tech Virtual Mass Casualty Training Simulation for Undergraduate Medical Education

Samuel Kolb; Puja Patel; Vishnu Mudrakola; Dhimitri A Nikolla; Amanda Lee; Dusty Barbour; Kaitlin M Bowers

doi:10.7759/cureus.69603

A Low-Cost, Low-Tech Virtual Mass Casualty Training Simulation for Undergraduate Medical Education

Cureus. 2024 Sep 17;16(9):e69603. doi: 10.7759/cureus.69603. eCollection 2024 Sep.

Authors

Samuel Kolb¹, Puja Patel¹, Vishnu Mudrakola², Dhimitri A Nikolla^{3

4}, Amanda Lee¹, Dusty Barbour¹, Kaitlin M Bowers¹

Affiliations

¹ Department of Emergency Medicine, Jerry M. Wallace School of Osteopathic Medicine, Campbell University, Lillington, USA.
² Department of Emergency Medicine, Summa Health, Akron, USA.
³ Department of Internal Medicine/Emergency Medicine, Lake Erie College of Osteopathic Medicine, Erie, USA.
⁴ Department of Emergency Medicine, Allegheny Health Network, Erie, USA.

Abstract

Background: Mass casualty incident (MCI) training effectively increases trainees' knowledge and confidence when implemented in a live, in-person setting. In-person MCI training is resource-intensive, but virtual MCI training models are an alternative with similar effectiveness at a lesser cost. However, most of these validated virtual options are based on high-tech virtual reality (VR) programs. We designed and implemented a low-tech, low-cost virtual MCI training model for third-year medical students, using Google Jamboard^TM (Google, Mountain View, CA) and Zoom^TM (Zoom Video Communications, Inc., San Jose, CA) as the primary technological platforms.

Methods: Learners were instructed on the adult simple triage and rapid treatment (START) and the pediatric JumpSTART triage algorithms over Zoom^TM. In small groups, students used a gameboard on Google Jamboard^TM to simulate a scene at an MCI where they were tasked with triaging 25 patients in 30 minutes, followed by a debriefing session. Students were surveyed on their perceived understanding of the triage algorithms and confidence before and after the event using a 5-point Likert scale (poor, fair, good, very good, and excellent). Pre- and post-event scores were compared using paired, two-sample, and two-tailed t-tests. We considered a p value of <0.01 significant to correct for multiplicity using the Bonferroni method.

Results: Learners reported an increased understanding of the triage algorithms (adult and pediatric), scene setup, and understanding of emergency medical service training/transportation, as well as increased confidence in participating in an MCI (all p < 0.001).

Conclusions: Virtual MCI training can be used as an alternative or supplement to in-person MCI training. Low-tech virtual MCI training models can increase the accessibility of these valuable training activities without sacrificing the quality of learning. Areas for further investigation include low-tech virtual MCI training models' ability to effectively recreate situational and environmental distractions and other challenges better simulated by in-person and high-tech VR training events.

Keywords: disaster; disaster preparedness; disaster response and preparedness; field triage; mass casualty incident; multi-victim; simulation; triage; undergraduate medical education; virtual training models.