Designing a disaster.

A mass casualty simulation was developed and implemented for senior-level nursing students in a large baccalaureate program. This simulation was developed to introduce students to rapid triage in an interactive and immersive experience. The purpose of the simulation was to provide students with a realistic, hands-on experience in a safe environment. Unlike other similar exercises, all students participated in the health care provider role rather than as observers or victims. Didactic content regarding triage and a short video preceded the surprise simulated "bus crash." The element of surprise was used to create the chaos and confusion that often accompanies these incidents. Fifteen victims were comprised of static manikins, high-fidelity human patient simulators, and live actors with various injuries. The students worked in small groups and assigned each victim an appropriate Simple Triage and Rapid Treatment triage category on the basis of what they learned in lecture. Participating students performed well on their final examinations on questions covering the triage content they learned in this unit and feedback regarding the simulated experience was overwhelmingly positive. This simulation could be adapted for the education of other health care providers who may be involved in a future mass casualty incident.