Interprofessional disaster exercises for undergraduate nursing students: a scoping review

Objective: The aim of this scoping review was to report on the planning and implementation of a disaster exercise for undergraduate nursing students, which included the participation of other health students, allied health students, or professionals, for the purpose of preparing them to respond to a disaster. 

Introduction: Recently, the world has witnessed an increasing frequency of natural disasters, emergencies, and public health events. These events often adversely influence many individuals' health, and as such, require health professionals to be prepared and ready to effectively respond. Health students, including nursing, medical, and allied health professionals, need to be provided with opportunities to learn about disasters and to practice responding to them within a team context. This scoping review examined the planning and implementation of disaster exercises that have conceptualized an interprofessional team approach inclusive of nursing students. 

Inclusion criteria: Quantitative studies, qualitative studies, mixed method studies, discussions, and text or opinion papers reporting a disaster simulation or drill, involving undergraduate nursing and other health students, allied health discipline students, practitioners, and non-health personnel were included. There was no limit on the publication period or languages. 

Methods: MEDLINE (EBSCOhost), CINAHL (EBSCOhost), ERIC (EBSCOhost), Embase (Ovid), Web of Science Core Collection, ProQuest Nursing and Allied Health (Ovid), and PsycINFO (Ovid) were searched for relevant reports. Titles and abstracts and then full texts were screened independently by 2 reviewers. A data extraction tool developed specifically for this review was used to chart evidence pertaining to planning and implementing a disaster exercise, nursing students' roles, and measured outcomes. 

Results: A total of 1429 titles were screened; 42 full texts were assessed against the eligibility criteria and 13 papers were selected for review. Nursing students had opportunities to practice performing a single role or a combined role as observers, triage nurses, direct care providers, or assisting health professionals, depending on their year level. Nursing students' roles were sometimes not well identified and not clearly communicated to them prior to the exercise, resulting in ambiguous expectations for some participants. By involving multiple health students and professionals, the nursing students had the opportunity to participate and perform tasks within their scope of practice while observing the roles of other disciplines. In a few studies, participants teamed up to triage, assess, and provide care for simulated patients. A variety of outcomes were categorized, such as students' knowledge, skills, attitudes, satisfaction with the learning experience, self-confidence, communication, collaboration, readiness for a disaster event, critical decision-making, and empathy. Important lessons regarding decision-making preparations (such as planning, coordinating, and implementing a disaster exercise), scheduling and sequencing for optimal times to ensure participating disciplines can attend, identification and effective communication of students' roles, plus ensuring manageable group sizes will optimize a more authentic learning opportunity for all involved in disaster exercises. 

Conclusions: Overall, the exercises were perceived as a positive learning opportunity for students to understand what is required in disaster responses and to practice their skills. Adequate preparation for a disaster exercise is crucial for a successful experience and should prepare nursing students and other participants for the roles they need to fulfill. 

Supplemental Digital Content: A Vietnamese-language version of the abstract of this review is available as Supplemental Digital Content http://links.lww.com/SRX/A24.