Educational effectiveness of scenario-based tabletop exercises for disaster preparedness among resident physicians in China

To evaluate the effects of implementing realistic, scenario-based disaster tabletop exercises(TTX) as a training strategy on a range of outcomes among resident physicians in China. In May 2025, a nationwide, single-group pre–post intervention study was conducted, 151 resident physicians were recruited through convenience and stratified sampling from nine tertiary A(Grade III, Class A) general hospitals located across eight provinces, encompassing the southern, eastern, northern, western, and central regions of China. A disaster-management–focused TTX was implemented. Participants’ perceived disaster management capability, self-confidence, satisfaction with learning, and critical thinking were evaluated both a week before and immediately following the exercise. In addition, instructors independently completed a surge-capacity assessment checklist during the training. Of 151 participants, 133(88.1%) completed both assessments. Previous disaster training and disaster response experience were reported by 7.52% and 0.75% of participants, respectively. Mean perceived disaster management capability increased from 51.06 ± 20.92 to 81.56 ± 11.98(Z = − 9.945, P < 0.001; r = 0.86). Perceived capability, self-confidence, satisfaction, and critical thinking all improved significantly(all P < 0.001). Self-confidence in learning(B = 9.385, β = 0.315, P = 0.003) and critical thinking(B = 4.142, β = 0.303, P = 0.001) were independently and positively associated with post-test perceived capability. Instructors rated a higher overall proportion of fully implemented items during the in-hospital than the prehospital phase(57.9% vs. 36.7%, P = 0.031). Among first-level dimensions, resource requirements remained significantly different after Holm adjustment(adjusted P = 0.047), whereas no second-level dimension remained significant after correction for multiple comparisons. Resident physicians had limited prior disaster training and response experience. Participation in a realistic, scenario-based TTX was associated with improvements in perceived disaster management capability, self-confidence, satisfaction, and critical thinking. The findings also highlight the need for greater emphasis on prehospital emergency response during disaster preparedness training.