When the Going Gets Tough, the Tough Get Going: Improving the Disaster Preparedness of Health Care Providers: A Single Center's 4-Year Experience

Emmanouil Pikoulis, Evika Karamagioli, Athanasios Kalogeropoulos*, Andreas Pikoulis, Panagis Lykoudis, Kyle Remick, Debra Malone, Adam Kushner, Bernd Domres, Ari Leppäniemi, Aristomenis Exadaktylos, Eric Elster, Norman Rich

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

4 Scopus citations


Objective: Operation based exercises represent simulation activities, which are of great importance for emergency preparedness, as they simulate real experiences in a guided manner. Whereas their primary purpose is to address the organizational emergency preparedness, little is known about the personal benefits of involved participants and whether these positive changes endure over time. Methods: Immediate and medium term assessment of the effectiveness on individual preparedness and benefits of participants, based on self-perception, after participating in a set of 4 interdisciplinary field exercises organized as part of the MSc in Global Health-Disaster Medicine of the Medical School of the National and Kapodistrian University of Athens, Greece. The field exercises were carried out yearly, from 2016 to 2019. Data were collected via questionnaires pre- and post-exercise (1 week and 10 months after participation). The sample size was 228 trainees, with a response rate of 88%. Results: The majority (95%) stated that Mass Casualty Incident (MCI) exercises are appropriate for disaster management training in terms of comprehending theory, and for team-building training. In the case of a real MCI, 22% of the participants declared themselves to be ready to respond prior to MCI exercises. Upon completion, the overall perception of readiness among the participants increased to 77%. Trainee feedback indicated enhancement of both technical and non-technical skills (87%), which were persistent over time, and revealed a high level of satisfaction with the training. Conclusion: This study shows a positive immediate and medium-term impact of operation-based exercises on technical, non-technical skills, and self-perception of participants.

Original languageEnglish
Pages (from-to)520-530
Number of pages11
JournalDisaster Medicine and Public Health Preparedness
Issue number2
StatePublished - 28 Apr 2022
Externally publishedYes


  • disaster preparedness
  • disaster training
  • non-technical skills
  • simulation exercise


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