Comparison of the Three-Level Collaboration and Hybrid Simulation Training Comprising the Three-Level Collaboration and Tabletop Exercise: A Retrospective Cross-Sectional Study.

Introduction: In recent decades, disasters have increasingly impacted populations and public health systems, partly due to climate change, population growth, and infrastructure vulnerabilities. Effective emergency response requires robust preparedness through planning, training, and readiness assessments. The Three-Level Collaboration (3LC) exercise, focusing on local, regional, and national coordination, is a recognized approach to disaster preparedness. However, further empirical evidence is needed to assess the effectiveness of these training methods in strengthening disaster management capabilities. This study aims to evaluate their impact on enhancing these capabilities. Methods: This mixed-method retrospective study analyzed data collected from the training sessions through observation and self-assessment questionnaires. The effectiveness of the Three-Level Collaboration (3LC) and Hybrid Simulation Training was evaluated based on criteria such as coordination among different levels, response time, and overall performance in simulated disaster scenarios. Results: Participants included 120 medical personnel and staff from disaster response and disaster management organizations, including firefighters, NGOs, municipalities, and communities, participating in training programs (60 participants for the conventional method and 60 for the hybrid one). Participants’ median age was 38 (32,44), 68 of them were women (55.7%), and 79 of them were healthcare professionals (64.8%). Participants in the conventional training group demonstrated improvement in the CSCATTT approach (collaborative measures for disaster management) by 48.5% compared to participants in the hybrid exercise, which showed 75% improvement. Conclusion: The hybrid training method combining the Three-Level Collaboration and tabletop exercises proved more effective than the conventional method in enhancing participants’ collaborative disaster management skills, as evidenced by the higher improvement rate in the CSCATTT approach. This suggests that hybrid training could be a valuable strategy for strengthening disaster management capabilities.