Disasters & Diseases: An Online Role-Playing Platform for Mass Casualty Incident Simulation and Education

Introduction: The COVID-19 pandemic caused residency programs to rapidly transition to using virtual learning for didactic education. A tabletop game-style simulation of a mass casualty incident (MCI) was planned for the summer of 2020; rather than cancel it, the authors developed a method to run the simulation utilizing an online gaming platform (Roll20) to create an MCI drill. This model of virtual, game-style simulation has implications for education across all levels of training, making large-scale MCI simulations available to groups that otherwise would not have the opportunity or resources to participate in person. Methods: This study utilized a cross-sectional survey of fifteen emergency medicine residents who participated in a virtual MCI simulation. The survey assessed learners’ perceptions of the simulation, focusing on preparedness, knowledge gained, impact on clinical practice, and utility and quality of the virtual tool. Survey items included Likert-scale and open-ended questions. Results: Seven individuals responded to the survey. 85.7% of respondents felt more prepared to deal with an MCI after the exercise and reported that this exercise was practice-changing. 85.7% reported that the virtual platform was a useful educational tool in disaster management and would be useful for other topics. Most participants (57.2%) felt that the pre-exercise instructions were challenging to understand, but 71.5% felt that, nonetheless, the learning objectives were achieved. Open-ended comments included a sense that this teaching method was “fun, innovative, and engaging,” but required more detailed pre-learning to ensure that all individuals could navigate the platform well. Conclusion: An online role-playing platform is an effective, engaging method of conducting MCI exercises that improves knowledge and changes practice. Remote learning methods have the potential to increase participation in MCI simulations. This study is limited by the small group that participated. A larger study with wider participation is a promising future avenue for research.