Tale of two outbreaks: Contrasting table-top exercise designs and evaluation methods for cross-border public health emergency response training

This presentation describes the development and implementation of training evaluation methods for two cross-border public health emergency table-top exercises engaging public health leaders from the United States and Canada. The table-top exercises were planned and produced by a committee of federal, state, provincial, and local health care and public health leaders from both countries. One table-top exercise (conducted in September, 2005) had participants react to a pandemic flu outbreak and the response logistics at the Michigan-Ontario border. The second table-top exercise (conducted in August, 2006) had participants react to an outbreak of Lassa fever in Michigan, Ontario, New York, Minnesota, and Wisconsin. The deliberations about the scenario development and the evaluation methods revealed the tension between opposing goals for the exercises: testing the effectiveness of communication plans vs. guiding the participants in practicing communication plans. The evaluation methods for the pandemic flu exercise included intensive observations of small and diverse groups made up of representatives from different jurisdictions and different levels of government. The Lassa fever table-top exercise was designed for small groups of participants who work in the same jurisdiction, sometimes at different levels of government and health care services. The participants received instructions to form work groups, but to communicate with participants at other tables (i.e., other jurisdictions) during the exercise. Each work group conducted a self-evaluation based on the behavioral objectives designed for the exercise. The lessons learned from the evaluation results for the two table-top exercise formats and evaluation designs will be discussed.