A High-Fidelity Training Simulation in Disaster Triage for Undergraduate Community Health Nursing Students

Background

Nurses trained in traditional acute-care environments lack sufficient training and practice in making triage decisions following a disaster or crisis event.   Training in disaster-triage is typically accomplished via lectures.  We describe the pilot of a high-fidelity training simulation designed to teach START triage offered to senior-level baccalaureate nursing students enrolled in a community health course at a large, public research university with the assistance of a non-profit emergency management organization.

Description

Senior-level students completed an on-line course in START Triage developed by the Indiana Department of Homeland Security.  Following successful completion  students participated in a 6-hour, high-fidelity simulation conducted at the Muscatatuck Urban Training Center (MUTC).  MUTC is 1,000 acre facility managed by the Indiana Army National Guard and primarily used for training military and first responders.  The facility contains a four story hospital that was formerly a state developmental facility, as well as an underground subway.  A START triage training curriculum was developed that provided each student the opportunity to practice triaging up to 60 students at several times during the day. The scenarios included the use of noise and light stimulation and incorporated the natural structures, creating for a realistic training environment that students reported was highly effective.  

Lessons Learned

Students reported experiencing anticipated stress reactions during the event, to include feeling nervous and scared about making inappropriate triage decisions under stress.  The experience was positively reviewed by all students. 

Implications

Further research is needed to determine whether training in high-fidelity environments improves disaster triage skill-recall.