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Article contents
Comparing Tabletop and High-Fidelity Simulation for Disaster Medicine Training in Emergency Medicine Residents
Published online by Cambridge University Press: 06 October 2025
Abstract
Objectives
To compare the effectiveness of tabletop exercises (TTX) and high-fidelity in-person simulations (IPS) in improving knowledge, confidence, and perceived preparedness in disaster medicine among emergency medicine residents.
Methods
A prospective, randomized educational intervention was conducted across 2 urban emergency medicine residency programs. Sixty-three residents were randomized to TTX or IPS groups. Each group completed a preintervention knowledge and confidence assessment, participated in their assigned exercise based on a simulated mass casualty incident (MCI), and underwent a structured debrief. Postintervention surveys assessed change in knowledge and self-reported comfort levels. A paired 2-tailed Student’s t-test was utilized to compare results. Statistical significance was defined as P < 0.01.
Results
Both groups demonstrated increased self-reported confidence and knowledge regarding management of MCIs. TTX participants showed higher median post-test scores (77.4%, N = 38) compared to IPS participants (67.4%, N = 25). Results were not statistically significant (P = 0.079).
Conclusions
TTX is an effective modality for disaster medicine education, with outcomes comparable to IPS. While TTX may better align with knowledge-based assessments, IPS remains essential for practicing real-time decision-making under stress. Combining these 2 modalities may provide both the knowledge base and psychological duress required for robust disaster scenario training.
Keywords
Information
- Type
- Brief Report
- Information
- Copyright
- © The Author(s), 2025. Published by Cambridge University Press on behalf of Society for Disaster Medicine and Public Health, Inc
References
Sarpy, SA, Warren, CR, Kaplan, S, Bradley, J, Howe, R. Simulating public health response to a severe acute respiratory syndrome (SARS) event: a comprehensive and systematic approach to designing, implementing, and evaluating a tabletop exercise. J Public Health Manag Pract. 2005;Suppl:S75–82. doi: 10.1097/00124784-200511001-00013.CrossRefGoogle ScholarPubMed
Murray, V. Disaster risk reduction, health, and the post-2015 United Nations Landmark Agreements. Disaster Med Public Health Prep. 2014;8(4):283–287. doi:10.1017/dmp.2014.75CrossRefGoogle ScholarPubMed
Sarin, RR, Cattamanchi, S, Alqahtani, A, Aljohani, M, Keim, M, Ciottone, GR. Disaster education: a survey study to analyze disaster medicine training in emergency medicine residency programs in the United States. Prehosp Disaster Med. 2017;32(4):368–373. doi:10.1017/S1049023X17000267CrossRefGoogle Scholar
Sandifer, SP, Wexler, BJ, Flamm, A. Comparison of disaster medicine education in emergency medicine residency and emergency medical services fellowship in the United States. Prehosp Disaster Med. 2023;38(3):378–383. doi:10.1017/S1049023X23000407CrossRefGoogle Scholar
Mahdi, SS, Jafri, HA, Allana, R, et al. Systematic review on the current state of disaster preparation Simulation Exercises (SimEx). BMC Emerg Med. 2023;23(1). doi:10.1186/s12873-023-00824-8Google ScholarPubMed
Pek, JH, Quah, LJJ, Valente, M, Ragazzoni, L, Della Corte, F. Use of simulation in full-scale exercises for response to disasters and mass-casualty incidents: a scoping review. Prehosp Disaster Med. 2023;38(6):792–806. doi:10.1017/S1049023X2300660XCrossRefGoogle ScholarPubMed
Weinstein, ES, Bortolin, M, Lamine, H, et al. The challenge of mass casualty incident response simulation exercise design and creation: a modified Delphi study. Disaster Med Public Health Prep. 2023;17(5). doi:10.1017/dmp.2023.71CrossRefGoogle ScholarPubMed
Djalali, A, Carenzo, L, Ragazzoni, L, et al. Does hospital disaster preparedness predict response performance during a full-scale exercise? A pilot study. Prehosp Disaster Med. 2014;29(5):441–447. doi:10.1017/S1049023X1400082XCrossRefGoogle ScholarPubMed
Bentley, S, Iavicoli, L, Boehm, L, et al. A simulated mass casualty incident triage exercise: SimWars. MedEdPORTAL. 2019;15:10823. doi: 10.15766/mep_2374-8265.10823. Erratum in: MedEdPORTAL. 2019 Dec 06;15:10879. doi: 10.15766/mep_2374-8265.10879.CrossRefGoogle ScholarPubMed
Shrestha, R, Kanchan, T, Krishan, K. Simulation training and skill assessment in disaster. StatPearls. Published online 2023.Google ScholarPubMed
Ingrassia, PL, Pigozzi, L, Bono, M, Ragazzoni, L, Della Corte, F. Use of simulated patients in disaster medicine training: a systematic review. Disaster Med Public Health Prep. 2021;15(1):99–104. doi:10.1017/dmp.2019.111CrossRefGoogle ScholarPubMed
Sánchez-Marco, M, Escribano, S, Rubio-Aparicio, M, Juliá-Sanchis, R, Cabañero-Martínez, MJ. Effectiveness of nontechnical skills educational interventions in the context of emergencies: a systematic review and meta-analysis. Australian Critical Care. 2023;36(6):1159–1171. doi:10.1016/j.aucc.2023.01.007CrossRefGoogle ScholarPubMed
Hailey, C, Lei, C, Lawrence, L. In-flight emergency: a simulation case for emergency medicine residents. MedEdPORTAL. 2020;16:10949. doi:10.15766/mep_2374-8265.10949CrossRefGoogle ScholarPubMed
Gable, BD, Misra, A, Doos, DM, Hughes, PG, Clayton, LM, Ahmed, RA. Disaster day: a simulation-based disaster medicine curriculum for novice learners. J Med Educ Curric Dev. 2021;8:238212052110207. doi:10.1177/23821205211020751CrossRefGoogle Scholar
Alim, S, Kawabata, M, Nakazawa, M. Evaluation of disaster preparedness training and disaster drill for nursing students. Nurse Educ Today. 2015;35(1):25–31. doi:10.1016/j.nedt.2014.04.016CrossRefGoogle ScholarPubMed
Frégeau, A, Cournoyer, A, Maheu-Cadotte, MA, et al. Use of tabletop exercises for healthcare education: a scoping review protocol. BMJ Open. 2020;10(1). doi:10.1136/bmjopen-2019-032662CrossRefGoogle ScholarPubMed
Whitney, RE, Burke, R V, Lehman-Huskamp, K, Arora, G, Park, DB, Cicero, MX. On shaky ground learner response and confidence after tabletop earthquake simulation. Pediatric Emergency Care. 2016;32(8). www.pec-online.comCrossRefGoogle ScholarPubMed
Liu, J, Huang, Y, Li, B, Gui, L, Zhou, L. Development and evaluation of innovative and practical table-top exercises based on a real mass-casualty incident. Disaster Med Public Health Prep. 2023;17(11). doi:10.1017/dmp.2022.95CrossRefGoogle Scholar
Idrose, AM, Adnan, WAW, Villa, GF, Abdullah, AHA. The use of classroom training and simulation in the training of medical responders for airport disaster. Emergency Medicine Journal. 2007;24(1):7–11. doi:10.1136/emj.2006.036202CrossRefGoogle ScholarPubMed
Descatha, A, Loeb, T, Dolveck, F, Goddet, NS, Poirier, V, Baer, M. Use of tabletop in industrial training disaster. J Occup Environ Med. 2010;51(9):990–991.CrossRefGoogle Scholar
Nicolaides, M, Theodorou, E, Emin, EI, et al. Team performance training for medical students: low vs high fidelity simulation. Ann Med Surg. May 29, 2020 ;55:308–315. doi:10.1016/j.amsu.2020.05.042CrossRefGoogle ScholarPubMed
Massoth, C, Röder, H, Ohlenburg, H, et al. High-fidelity is not superior to low-fidelity simulation but leads to overconfidence in medical students. BMC Med Educ. 2019;19:29. doi:10.1186/s12909-019-1464-7CrossRefGoogle Scholar
Sarin, RR, Biddinger, P, Brown, J, et al. Core Disaster Medicine Education (CDME) for emergency medicine residents in the United States. Prehosp Disaster Med. 2019;34(5):473–480. doi:10.1017/S1049023X19004746CrossRefGoogle ScholarPubMed