Using innovative simulation modalities for civilian-based, chemical, biological, radiological, nuclear, and explosive training in the acute management of terrorist victims: A pilot study

Italo Subbarao, William F. Bond, Christopher Johnson, Edbert B. Hsu, Thomas E. Wasser

Research output: Contribution to journalArticle


Objectives: Chemical, biological, radiological, nuclear, and explosive (CBRNE) incidents are low frequency, high impact events that require specialized train-ing outside of usual clinical practice. Educational modalities must recreate these clinical scenarios in order to provide realistic first responder/receiver training.Methods: High fidelity, mannequin-based (HFMB) simulation and video clinical vignettes were used to create a simulation-based CBRNE course directed at the recognition, triage, and resuscitation of contaminated victims. The course participants, who consisted of first responders and receivers, were evaluated using a 43-question pre- and post-test that employed 12 video clinical vignettes as scenarios for the test questions. The results of the pre-test were analyzed according to the various medical training backgrounds of the participants to identify differences in baseline performance. A Scheffe posthoc test and an ANOVA were used to determine differences between the medical training backgrounds of the participants. For those participants who completed both the pre-course and post-course test, the results were compared using a paired Student's t-test.Results: A total of 54 first responders/receivers including physicians, nurses, and paramedics completed the course. Pre-course and post-course test results are listed by learner category. For all participants who took the pre-course test (n = 67), the mean value of the test scores was 53.5 ±12.7%. For all participants who took the post-course test (n = 54), the mean value of the test scores was 78.3 ±10.9%. The change in score for those who took both the pre- and post-test (n = 54) achieved statistical significance at all levels of learner.Conclusions: The results suggest that video clinical vignettes and HFMB simulation are effective methods of CBRNE training and evaluation. Future studies should be conducted to determine the educational and cost-effectiveness of the use of these modalities.

Original languageEnglish (US)
Pages (from-to)272-275
Number of pages4
JournalPrehospital and disaster medicine
Issue number4
StatePublished - Jan 1 2006



  • CBRNE training
  • algorithm
  • and explosive (CBRNE)
  • biological
  • chemical
  • contamination
  • dirty resus-citation
  • nuclear
  • radiological
  • simulation
  • symptom-based
  • terror-ism
  • triage

ASJC Scopus subject areas

  • Emergency Medicine
  • Emergency

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