טכניון מכון טכנולוגי לישראל
הטכניון מכון טכנולוגי לישראל - בית הספר ללימודי מוסמכים  
M.Sc Thesis
M.Sc StudentSolomon Tal
SubjectSituational Awareness in Multi-Casualty Incidents:
Simulator-Based Training
DepartmentDepartment of Industrial Engineering and Management
Supervisor Professor Avi Parush
Full Thesis text - in Hebrew Full thesis text - Hebrew Version


Abstract

A Mass Casualty Incident (MCI) is an event in which first responders, such as the Emergency Medical Services (EMS), do not have sufficient resources to provide optimal care to casualties due to their high number. Rapid and accurate detection and diagnosis of wounded may be very hard due to the overload of information, which in turn is distributed among the various agencies operating within the MCI scene.  Therefore, the MCI manager is engaged in many physical and cognitive tasks in order to understand the dynamic situation in the MCI scene, and then make timely decisions.

The training program of MCI managers in Magen David Adom (MDA) in Israel is mostly frontal lectures, whereas practical exercises, which facilitate practicing the formation of situational picture and decision-making processes in a complex situation context, take place very rarely, mainly due to budgetary constraints. Consequently, only a few paramedics are trained to be an MCI manager making it difficult to track the trainees’ progress in protocol proficiency levels, situational picture forming abilities, and the validity of their decisions taken while managing an MCI .

The goal of this work was to explore a simulator-based solution which allows Israel’s MDA paramedics to practice MCI management regularly, while enhancing their abilities in constructing situational picture, decision making, and protocol practice . In addition, the solution also supports trainers in tracking trainee’s progress and provide proper feedback along their performances.

Israel’s MDA paramedic training program (regarding MCI’s protocol) has been studied, and the gaps between the existing program and the actual needs were derived. These needs were defined as the training objectives which were then implemented in the simulator-based solution. The simulator’s initial design phase included users and task analyses, an extended review of the relevant emergency medicine profession (Israel’s MDA), and deriving the functionality needed for the simulator in order to implement the training objectives and requirements .

The simulator is a scenario and event-based platform, designed as a three-dimensional perspective on the MCI scene, and provides trainees with the ability to manipulate resources (ambulances and paramedics) and perform various operations (set parking and treatment areas, survey the scene, perform triage and send casualties for evacuation). Trainees of an MDA paramedic course practiced several times with the simulator and then evaluated its effectiveness and usability in two steps: first, immediately after practicing with it; and second, prior to a filed practice of MCI management. The simulator was rated high as engaging and useful in helping practice understand the situation and make decisions. The usability of the simulator was rated lower which will lead to additional future re-design. In addition, the simulator was rated high in helping to prepare better for the field practice. It seems that the simulator will become part of MDA’s training paramedics to manage multi-casualty incidents.