Making acute hospital exercises more realistic without impacting on healthcare delivery.

Exercises can suffer from a lack of realism that reduces the value of the exercise in terms of the positive experience of the participant and the possibility that outcomes are based on artificialities created by the exercise environment. It is important to minimise these so that participants actively engage and recommendations are based on robust observations. Field exercises provide the most realistic format in which to exercise but are disruptive to normal working and expensive. In a health environment, anything but the most minimal disruption to normal service would be considered unacceptable. This paper describes a possible alternative that combines different exercise formats with a simple, but well thought-out, patient simulation tool to explore the health response to two different mass casualty events. Key outcomes from these exercises are discussed to demonstrate the potential of this system when applied to the health community.