Tabletop and Functional Exercises: Which Is Better for Hospital Mass Casualty Incident Preparedness?

Introduction: Mass casualty incidents (MCIs) are major emergencies in emergency departments, necessitating effective training for healthcare personnel. Tabletop exercises (TTx) and functional exercises (FE) are two non-disruptive training methods that can simulate MCI responses. However, little research has compared the effectiveness of these two methods. This study aims to evaluate the effectiveness of TTx and FE as training tools for MCI preparedness. Methods: Participants were divided into two groups: the T group (trained via TTx) and the F group (trained via FE). Both exercises simulated a train station explosion, requiring the hospital to manage 26 simulated casualties. TTx involved instructor-facilitated group discussions, while FE required role-playing in a simulated hospital setting. Participants were assessed before the exercise, immediately after, and six months post-exercise. Evaluations included confidence in MCI response, willingness to attend future training, willingness to participate in real MCIs, knowledge of disaster medicine, and familiarity with MCI response plans. Data were analyzed using ANOVA and paired t-tests to assess short- and long-term effects. Additionally, participants provided feedback on the factors that most contributed to their learning. Results: Both exercises significantly improved confidence in MCI response, with TTx having more sustained effects. FE increased willingness to attend future training and participate in real MCIs, though effects diminished after six months. Neither exercise significantly affected disaster medicine knowledge. Familiarity with MCI response plans improved in both groups but returned to baseline after six months. Participants rated both exercises as valuable learning tools, citing scenario-based learning, greater engagement, interactivity, and real-time feedback as key factors. Conclusion: TTx and FE are both valuable for hospital disaster preparedness, with each offering unique advantages. Hospitals should select the exercise format that best suits their staff and needs. Regular re-training within six months may be required to sustain preparedness.