Electronic table top exercises for major incident training :from pragmatic pilot to multicentre controlled trial

Traditional emergency service major incident table top training exercises are presented via ‘low-technology’ means, such as plastic bricks and paper maps, or ‘front-loaded’ via slides presented by an instructor. The purpose of this research was to develop a new, electronic approach to table top delivery, to address issues with the existing approaches and provide a usable, more useful, streamlined user experience that was acceptable for major incident education.While the benefits of the existing paper-based approaches include their: affordability; reliability; portability; accessibility and acceptability, they do not permit the recording of exercise progress. Presentations by instructors can result in a lack of candidate participation and physical maps can become cluttered and cause a loss of data when disturbed. Additionally, supporting information required by participants during the scenario is presented as an adjunct to the exercise, necessitating supplementary display equipment.To address these issues, low-cost, bespoke, interactive software solutions for major incident training were created. The usability and acceptability of these products were tested within two populations routinely using table top exercises, via an experimentally-led ‘research in the wild’ approach. These were healthcare professionals, attending the international Major Incident Medical Management and Support (MIMMS) courses, and Greater Manchester Police (GMP) Officers. An experimental approach was adopted to attain realistic responses from the target audience regarding table top use. Given the nature of this form of incident response training, we were constrained to conducting experiments in a non-intrusive way, to neither interfere with, nor distract from, the participants’ learning experiences.Three experiments were designed to establish the viability of this development. Two one centre, one sample studies were conducted, followed by a multicentre controlled trial. The one sample studies consisted of a pilot that explored proof of concept, focussing on table top usability by non-computing expert users, and a second study which determined the validity of the pilot’s findings within a larger sample size. The multicentre controlled trial compared paper-based table top with electronic table top cohorts in terms of the participant learning experience and, thereby, fitness for purpose.6 candidates piloted the prototype MIMMS electronic exercise in February 2011. 114 Police Officers utilised the GMP table top during November and December 2011. The multicentre controlled MIMMS trial enrolled 23 candidates (n=11 electronic and n=12 paper-based table top cohorts) from courses held at 3 U.K. centres. Both the healthcare and policing trial participants evaluating the table top respectively rated significant levels of agreement with the software being fit for purpose and usable. Candidate results from the multicentre MIMMS trial indicated positive findings regarding the equivalency of the electronic with the existing, paper-based media.The MIMMS pilot trial was an acceptable proof of concept, justifying the further development of this work. The GMP study affirmed these findings for a larger sample size. The MIMMS multicentre controlled trial demonstrated the comparability of the electronic table top with its paper-based counterpart, in terms of the learning experience provided and affirmed this approach as fit for purpose. This work has changed major incident education practice by addressing real world training delivery issues, via the pertinent application of usable technology