An elective, theory-informed four-week interprofessional disaster preparedness course using problem-based learning, repeated 3LC exercises and MRMI/MACSIM-informed simulation
This paper presents a theory-informed, four-week elective interprofessional course that utilizes problem-based learning, repeated tabletop exercises, and simulation to equip medical and paramedical students with essential disaster preparedness competencies.
Original paper licensed under CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). This is an AI-generated explanation of the paper below. It is not written or endorsed by the authors. For technical accuracy, refer to the original paper. Read full disclaimer
When a disaster strikes, whether it is a sudden earthquake, a spreading virus, or a chemical spill, the world does not pause to ask which hospital department a doctor belongs to or which agency a paramedic works for. The situation demands a unified response where medical staff, emergency responders, and public health officials must work together seamlessly, often under extreme pressure and with incomplete information. The challenge is not just knowing how to treat a patient, but understanding how to organize a chaotic scene, communicate clearly across different groups, and make difficult choices when resources are scarce. For decades, educators have debated how best to teach these skills to future health professionals. While some argue that disaster training should be a mandatory part of every medical student's education, the sheer volume of required coursework in modern medical schools often leaves little room for new, specialized topics. This creates a gap: students graduate with excellent clinical skills but may lack the specific training needed to function effectively when a crisis hits.
To address this, researchers at the University of Gothenburg have designed a new, optional course specifically for students who are eager to learn about disaster preparedness. Rather than trying to force this complex subject into an already crowded schedule, they created a focused, four-week intensive program that brings together medical and paramedical students to learn by doing. The course is built on the idea that you cannot learn to manage a crisis just by listening to lectures; you must practice making decisions in simulated scenarios that get progressively harder. The researchers combined several established teaching methods into a single, cohesive plan. They use problem-based learning, where students are given a messy, evolving situation and must figure out what is missing and what to do next. They incorporate repeated tabletop exercises, which are like detailed map-based simulations where teams discuss their strategy without needing a physical set. Finally, the course culminates in a large-scale simulation that mimics a real major incident, testing how well the students can coordinate treatment, transport, and command structures.
The course is structured to take students from a basic understanding of disaster risks to the ability to lead and collaborate in a complex emergency. It begins with online preparation and seminars that cover the fundamentals, such as how to assess a situation, how to prioritize patients when there are too many and too few resources, and how to communicate risks to the public and authorities. A key part of the training involves a framework known as CSCATTT, which stands for Command and control, Safety, Communication, Assessment, Triage, Treatment, and Transport. This is not a rigid checklist to be followed blindly, but a mental tool to help students organize their thinking during the chaos of an incident. Students learn that safety comes first, that clear communication is vital, and that triage—the process of sorting patients by the urgency of their needs—is a dynamic decision that changes as the situation evolves.
Throughout the first three weeks, students engage in six different tabletop exercises. These are not simple quizzes; they are collaborative problem-solving sessions where students from different backgrounds must work together to solve a specific crisis. One week might focus on a local mass-casualty event, while another might simulate a hospital evacuation or a hazardous material spill. The researchers designed these exercises to be repeated and varied so that students can see how their decisions ripple through the system. For instance, a choice made by a frontline medic about who to treat first will create a demand for resources at the coordination level, which in turn affects what the strategic leaders can do. By working through these scenarios again and again, students learn to anticipate these connections and communicate more effectively across professional boundaries.
The final week of the course brings everything together in a major simulation. This is an immersive exercise where students act out a realistic major incident, moving from the scene of the disaster to the hospital reception, coordinating transport and treatment in real time. Unlike the tabletop exercises, this simulation involves physical movement and role-playing, allowing students to experience the stress and complexity of a real-world event in a controlled environment. After the simulation, the group engages in a structured debriefing, a critical step where they reflect on what went well, what went wrong, and how they can improve. This process of doing, reflecting, and trying again is central to the course's design, helping students turn theoretical knowledge into practical skill.
In addition to the simulations, the course requires each student to write a short academic paper on a specific topic related to disaster preparedness. This assignment ensures that while the group exercises build teamwork and practical skills, each student also develops a deep, individual understanding of the subject. They might choose to research how social media influences crisis communication, the ethics of resource allocation, or the role of technology in modern disaster response. This written work forces them to connect the theories they learned in class with the realities they observed in the simulations, creating a more complete picture of the field.
The researchers are careful to note that this course is not intended to turn students into disaster experts in just four weeks. Instead, it aims to provide a strong foundation of disaster literacy, role awareness, and interprofessional collaboration. The goal is to ensure that when these students enter their professional lives, they understand the basics of how a system responds to a crisis and feel confident in their ability to work with others during an emergency. The course is designed to be flexible and scalable, meaning it can be adapted by other institutions with different resources. It does not require expensive, high-tech equipment; the core of the learning comes from the scenarios, the discussions, and the structured feedback.
This approach represents a shift in how disaster education is viewed. Rather than treating it as a collection of facts to be memorized, the course treats it as a set of skills to be practiced and refined. By using an elective format, the researchers have created a space where motivated learners can dive deep into the subject without disrupting the core curriculum of their medical or paramedical studies. The course serves as a bridge, connecting the basic education students receive in school with the advanced training they might pursue later in their careers. It acknowledges that while no single course can solve all the challenges of disaster preparedness, a well-structured, theory-informed program can equip future health professionals with the mindset and tools they need to respond effectively when the unexpected happens. The ultimate aim is to build a generation of health workers who are not only skilled clinicians but also capable, collaborative members of a larger emergency response system.
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