Mass-Casualty Incident - Prehospital Emergency Response

NCT07838441 | Completed

• 2 other identifiers: MCIPHER 01MBRU/RGS/2024/L-51
• Study Type: interventional
• Target: 25
• Locations: 1 country
• Sites: 1

Brief Summary

The goal of this study was to learn whether the MCIPHER memory aid could help first-year resident doctors manage a simulated mass-casualty incident. MCIPHER organizes the response into five phases: command, triage, treatment, transport, and closure. Twenty-five postgraduate year-1 residents from emergency medicine, trauma surgery, general surgery, and anaesthesiology took part. All participants completed the same two-week course on mass-casualty incident response. Researchers then placed participants into one of two groups using a non-random method. The control group completed a three-dimensional tabletop simulation after the standard course. The MCIPHER group received an additional structured briefing on MCIPHER immediately before completing the same simulation. The main questions were: Did MCIPHER affect overall team performance? Did MCIPHER affect how quickly teams completed key actions? Did MCIPHER affect how accurately teams triaged simulated casualties? Researchers also measured participants' confidence, knowledge, attitudes, views of the debrief, and views of MCIPHER. Each team managed the same simulated incident involving 25 casualties. The exercise lasted about 60 minutes and was followed by a structured debrief lasting about 20 minutes.

Conditions

Mass Casualty Incident Preparedness; Simulation-Based Medical Education

Keywords

MCIPHER mnemonic framework; Mass casualty incident; Disaster medicine; Emergency preparedness; Tabletop simulation; Simulation-based medical education; Cognitive aid; Triage; Postgraduate medical education

Outcome Measures

Primary Outcomes (3)

• Percentage Team Performance Score During the First Tabletop Exercise

  Each team's performance was assessed across 20 predefined critical actions spanning command, triage, treatment, transport, and closure. Each action was scored as 1.0 for full completion in the correct sequence and within the timing window without prompting, 0.5 for partial, delayed, incomplete, or prompted completion, and 0.0 for an action that was not observed, incorrect, or out of sequence. Scores were summed, divided by 20, and multiplied by 100. Scores range from 0 to 100 percentage points; higher scores indicate better team performance.

  During the first tabletop exercise, approximately 60 minutes

• Percentage Operational Timeliness Index During the First Tabletop Exercise

  The number of 20 predefined critical actions completed within their benchmark timing windows, allowing a plus or minus 2-minute tolerance, was divided by 20 and multiplied by 100. Scores range from 0 to 100 percentage points; higher scores indicate that a larger proportion of critical actions were completed on time.

  During the first tabletop exercise, approximately 60 minutes

• Percentage Initial Triage Accuracy Score During the First Tabletop Exercise

  The number of 25 simulated casualties assigned the correct initial triage category compared with the predefined gold-standard category was divided by 25 and multiplied by 100. Scores range from 0 to 100 percentage points; higher scores indicate greater initial triage accuracy.

  At completion of initial triage during the first tabletop exercise, within approximately 60 minutes

Secondary Outcomes (5)

• Mean Change From Pre-training to Post-training in Composite Self-Reported Confidence Score

  Immediately before the tabletop simulation (Baseline) and immediately after the 20-minute post-simulation debrief, approximately 80 minutes after simulation start (Day 1)

• Change From Pre-training to Post-training in Mass-Casualty Incident Attitude Item Scores

  Immediately before the tabletop simulation (Baseline) and immediately after the 20-minute post-simulation debrief, approximately 80 minutes after simulation start (Day 1)

• Mean Post-training Debrief Experience Score

  Immediately after the 20-minute post-simulation debrief, approximately 80 minutes after simulation start (Day 1)

• Mean Post-training MCIPHER Perception Score

  Immediately after the 20-minute post-simulation debrief, approximately 80 minutes after simulation start (Day 1)

• Percentage Correct on the Post-training Knowledge Test

  Immediately after the 20-minute post-simulation debrief, approximately 80 minutes after simulation start (Day 1)

Other Outcomes (1)

• Percentage Secondary Triage Accuracy Score During the First Tabletop Exercise

  At completion of secondary triage during the first tabletop exercise, within approximately 60 minutes

Study Arms (2)

Standard MCI Training Plus MCIPHER

EXPERIMENTAL

Participants completed the standardized two-week mass-casualty incident curriculum and received an additional structured MCIPHER pre-brief immediately before completing the first three-dimensional tabletop exercise.

Other: Standard Mass-Casualty Incident Curriculum; Other: MCIPHER mnemonic pre-brief; Other: Tabletop Simulation

Standard MCI Training

ACTIVE COMPARATOR

Participants completed the standardized two-week mass-casualty incident curriculum and then completed the first three-dimensional tabletop exercise without MCIPHER. This arm served as the active control for the initial between-group comparison.

Other: Standard Mass-Casualty Incident Curriculum; Other: Tabletop Simulation

Interventions

Standard Mass-Casualty Incident Curriculum OTHER

All participants completed a standardized two-week didactic curriculum on mass-casualty incident response. The curriculum covered introduction to mass-casualty incident management, response activation and scene setup, triage and decision-making, treatment and resource allocation, evacuation and transport, and response conclusion and recovery.

Standard MCI Training; Standard MCI Training Plus MCIPHER

MCIPHER mnemonic pre-brief OTHER

Participants in the MCIPHER group received structured pre-brief immediately before the tabletop exercise. The pre-brief introduced MCIPHER as a cognitive roadmap for sequencing and prioritizing mass-casualty incident response. The framework consists of five sequential phases: C.O.M.M.A.N.D. for command and scene management, S.O.R.T. for triage, C.A.R.E. for treatment, M.O.V.E. for transport, and C.L.E.A.R. for closure and debrief.

Standard MCI Training Plus MCIPHER

Tabletop Simulation OTHER

Participants completed a standardized three-dimensional tabletop simulation involving 25 simulated casualties. The active exercise lasted approximately 60 minutes and was followed by an approximately 20-minute structured debrief.

Standard MCI Training; Standard MCI Training Plus MCIPHER

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Current postgraduate year-1 resident in emergency medicine, trauma surgery, general surgery, or anaesthesiology
• Able to provide informed consent
• Available to complete all study components on the simulation day

You may not qualify if:

• Previous exposure to MCIPHER-guided training
• Previous participation in a structured mass-casualty incident tabletop simulation
• Unable to complete the pre-training and post-training assessments

Sponsors & Collaborators

• Mohammed Bin Rashid University of Medicine and Health Sciences: lead
• Dubai Health: collaborator
• Vrije Universiteit Brussel: collaborator

Study Sites (1)

Mohammed Bin Rashid University of Medicine and Health Sciences (MBRU)

Dubai, 00000, United Arab Emirates

Location

Related Publications (1)

• 1. Suda AJ, Franke A, Hertwig M, Gooßen K. Management of mass casualty incidents: a systematic review and clinical practice guideline update. Eur J Trauma Emerg Surg [Internet]. 2025 Dec [cited 2025 Jul 24];51(1). Available from: https://link.springer.com/10.1007/s00068-024-02727-0 2. Tabletop Tests: Low-Cost, High-Impact Emergency Planning [Internet]. AlertMedia. [cited 2025 Jul 24]. Available from: https://www.alertmedia.com/blog/tabletop-test/ 3. On, Above, and Beyond: Taking Tabletops to the Third Dimension. In: Human-Computer Interaction Series [Internet]. London: Springer London; 2010 [cited 2025 Jul 24]. p. 277-99. Available from: http://link.springer.com/10.1007/978-1-84996-113-4_12 4. Chou WK, Lin CH. Teaching Senior Medical Students Mass Casualty Incident Management by 3D Tabletop Exercise without Lecture: Increase Students' Knowledge and Motivation. Prehosp Disaster med. 2023 May;38(S1):s22-3.

  BACKGROUND

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NON RANDOMIZED
• Masking: NONE
• Purpose: OTHER
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Dr

Model Details: Participants were assigned to one of two groups for the initial comparison. Group A received the shared curriculum and completed the first tabletop exercise without MCIPHER. Group B received the shared curriculum plus a structured MCIPHER pre-brief before the first exercise. Only each team's first tabletop performance was used for the between-group analysis to avoid carryover learning effects. Group A later received access to the MCIPHER educational content; later performance data were not included in the analysis reported in this record

Study Record Dates

• First Submitted: September 12, 2026
• First Posted: September 24, 2026
• Study Start: November 4, 2025
• Primary Completion: November 18, 2025
• Study Completion: November 18, 2025
• Last Updated: September 24, 2026

Record last verified: 2026-09

Data Sharing

• IPD Sharing: Will share
• Time Frame: Beginning after publication of the study results; no planned end date.
• Access Criteria: Requests should be submitted to the corresponding author at aoyousif@dubaihealth.ae. Requests will be considered on a reasonable-request basis and subject to applicable institutional, ethical, and participant-confidentiality requirements.

Locations

AE (1)