Technology-enhanced training for prehospital mass-casualty incident preparedness: A scoping review

Background The use of technology-enhanced training for prehospital mass-casualty incident (MCI) preparedness has expanded rapidly, yet how these technologies function throughout the educational process and how competencies are evaluated remain systematically under-examined. This scoping review, conducted as part of the MCIPHER (Mass-Casualty Incident Prehospital Emergency Response) project, mapped the technological modalities, educational functions, and assessment frameworks used in prehospital disaster training. Methods Following Arksey and O’Malley’s framework with Levac refinements and PRISMA-ScR reporting, we searched seven databases and supplementary sources for English-language studies and protocols (2015–2025) on technology-enhanced prehospital MCI training for healthcare learners and professionals. Two reviewers independently screened and extracted data. Descriptive and narrative synthesis included modified Kirkpatrick outcome mapping for completed studies, incorporating L2+ (Applied Learning). Results Twenty-eight studies met the inclusion criteria. Virtual reality was the most common modality (43%, n = 12), followed by hybrid approaches (29%, n = 8) and screen-based simulations (21%, n = 6). Synthesis of the interventions revealed three consistent operational patterns: half of the studies (50%, n = 14) utilized dual-purpose platforms for both training delivery and automated assessment; embedded data collection was directly linked to achieving applied learning outcomes; and 75% (n = 21) lacked an explicit training design framework. Two additional patterns—a disconnect between immersion level and evaluation depth, and a tension between technological sophistication and scalability—emerged as areas needing future research. Furthermore, no studies originated from low- or lower-middle-income countries. Using the modified Kirkpatrick framework, 56% (n = 14 of 25 completed studies) demonstrated applied learning through embedded performance metrics. Only one study (4%) evaluated workplace behavior change (L3), and none (0%) assessed organizational impact (L4). Conclusions The educational value of technology in prehospital MCI training depends more on integrated performance measurement than on visual fidelity or surface immersion. Future investments should prioritize dual-use platforms with embedded assessment, improve pedagogical reporting transparency, and address geographic disparities in training access.