Self-assessment of learning outcomes in prehospital disaster response skills: instrument development and validation for mass casualty incident training.

Abstract

Measuring the effectiveness of mass casualty incident (MCI) scenario training is challenging due to simultaneously assessing individual skills, team dynamics, decision-making under pressure and adaptability. Existing instruments often focus too narrowly on individual skills, overlooking the comprehensive range of skills needed for effective prehospital disaster response. This study aims to develop and validate a comprehensive self-assessment tool for prehospital disaster response skills during initial MCI scenario training. The instrument was developed and validated using a comprehensive methodology. This included literature reviews to identify the construct, ensuring content validity through expert evaluation and conducting field trials in MCI scenario training to evaluate the instrument under simulated conditions that approximated real-life incidents. The instrument's psychometric properties were assessed using exploratory factor analysis (EFA) and Horn's parallel analysis, as well as Cronbach's α and item-total correlation analysis. Two field trials conducted with participants in Sweden during 2023 and 2024. 75 students from a bachelor's programme at a Swedish university were recruited to participate in the field trials. The programme featured one semester of comprehensive theoretical and practical training in disaster medicine, including MCI response and management. 88 instruments were collected during the field trials. Overall Cronbach's α score was 0.86, indicating high internal consistency for the instrument. EFA and Horn's parallel analysis revealed a five-factor model accounting for 52.3% of the total variance: <i>incident control and management; systematic examination procedures; risk assessment and management; stress response and impact</i>; and <i>triage procedures</i>. Cronbach's α for all factors indicated good internal consistency (range: 0.74-0.85). The instrument addresses a critical gap by offering a comprehensive self-evaluation tool for disaster response skills. The robust psychometric properties indicate its potential for practical implication. Future studies should explore its application in diverse training settings and populations to enhance its utility and generalisability.A comprehensive development and validation methodology ensured the high content validity of the instrument.