Multispecialty resident physicians’ perceived preparedness for mass casualty events (MCEs) at an urban level I trauma center prior to the coronavirus disease 2019 (COVID-19) era

Abstract

Purpose Coronavirus disease 2019 (COVID-19) has underscored how ill-prepared healthcare systems are for mass casualty events (MCEs,) especially as MCEs increase worldwide. We hypothesized that resident physicians (RPs) across multiple specialties are underprepared for MCE. Methods Two similar surveys were conducted to assess awareness of disaster plans (DPs) and individual’s roles and responsibilities therein. Initially, we surveyed exclusively trainees who are trauma team members (TTMs,) including physician assistants (PAs), residents from emergency medicine (EMRs) and general surgery (GSRs.) Subsequently, we surveyed multi-specialty RPs, except GSRs and EMRs, and their program directors/associate program directors (PDs/APDs.) RPs’ awareness, knowledge of, and confidence in hospital MCE response plans were assessed, and barriers encountered were queried. Data were consolidated except with respect to PDs/APDs, who were queried only in the second survey. The Fisher exact test for multiple-group comparisons was used. Alpha = 0.05. Results For the first survey, the response rate was 74% (123/166), whereas 34% (129/380) responded to the second survey. Combined, the response rate was 46% (252/546.) Considering the RPs only for the two surveys combined, 103 (53%) respondents reported no awareness of institutional MCE response plans, 73% (n = 143) did not know/were unsure whether they were expected to contact someone, and 68% (n = 134) reported no formal MCE/disaster management (DM) training over the prior year. Additionally, the median response reported for level of knowledge of the MCE response plan among all RPs was “not at all,” with a significant difference observed between those aware of the plan and those who were not (p < 0.001). The median response reported for confidence level of RPs in MCE/DM training, excluding GSRs and EMRs (TTMs,) was “not at all,” with significant differences between surgical and non-surgical specialty RPs (p = 0.031), and between junior and senior RPs (p = 0.027). PDs/APDs (n = 12) reported “time” as the main barrier to implementation. Conclusions RPs across all surveyed specialties reported low levels of knowledge and minimal training regarding MCE/DM. Incorporation of MCE/DM preparedness into residency training in all specialties involving direct patient care is essential. Curricular restructuring will be required for meaningful participation of RPs in MCEs.