Identifying what components of full-scale emergency exercises improve disaster response learning: A rapid evidence assessment

To date, little systematic focus has been directed toward examining whether participating in full-scale exercises can develop knowledge and skills in emergency responders that are important for responding to disasters, nor what mechanisms facilitate this learning. This poses important implications for demonstrating whether full-scale exercises represent a wise resource investment and for improving exercise design and delivery to enhance emergency preparedness. Accordingly, this paper presents the findings of a rapid evidence assessment of 31 studies published since 2000, providing a balanced evaluation of what is currently known about the learning benefits of full-scale exercises, the mechanisms that facilitate this, and effects of methodological limitations on knowledge claims. Findings of literary synthesis highlight several learning benefits, including improved critical thinking, knowledge of roles and responsibilities, how to implement emergency plans, communication and collaboration, confidence in ability to respond, and reduced stress. These benefits are facilitated by exercise realism (realistic scenarios, timescales, equipment, and problems requiring inter-agency working, participation of relevant agencies), exercise duration (long enough to review actions and implement corrections), pre-exercise preparation activities (seminars and icebreakers to clarify aims, objectives, and exercise logistics), and debriefing (focusing post-incident reflections back to exercise aims). Findings are beneficial for i) researchers in highlighting knowledge gaps in need of further focus and developing data proformas to improve comparability of evidence, and ii) emergency planners to inform decisions about when to use full-scale exercises and how to improve design and delivery.