No CrossRef data available.
Article contents
Effects of Disaster Triage Training Program on Knowledge, Skills, and Resilience Among Nurses: A Randomized Controlled Trial
Published online by Cambridge University Press: 17 October 2025
Abstract
Objectives
This study aimed to develop a disaster triage training program designed to enhance knowledge, skills, and resilience for disasters among nurses.
Method
A randomized controlled trial was conducted at two government hospitals in Indonesia. One hundred and eight nurses were randomly assigned in equal numbers to the experimental and control groups. The experimental group received a 4-hour triage training focused on mass casualty incidents. Disaster triage knowledge, skills, and resilience were assessed at three time points: before, immediately after, and 1 month following the intervention. Generalized Estimating Equations were used to evaluate the effectiveness of the training program.
Results
The results of this study revealed that nurses in the experimental group showed significantly greater improvements in disaster triage knowledge, skills, and resilience compared to those in the control group at 2 post-test time points. In addition, feedback from trained nurses emphasized its relevance to local disaster scenarios, such as earthquakes and floods, and highlighted the value of hands-on practice and easily accessible learning materials.
Conclusions
The study demonstrates that disaster triage training can effectively enhance nurses’ preparedness for disasters. It is recommended that health care institutions integrate disaster-related content into regular on-the-job training programs for nurses and assess its effectiveness.
Information
- Type
- Original Research
- Information
- Copyright
- © The Author(s), 2025. Published by Cambridge University Press on behalf of Society for Disaster Medicine and Public Health, Inc
References
Farah, B, Pavlova, M, Groot, W. Hospital disaster preparedness in sub-Saharan Africa: a systematic review of English literature. BMC Emerg Med. 2023;23(1):71. doi:10.1186/s12873-023-00843-5CrossRefGoogle ScholarPubMed
ICN-International Council of Nurses. Core competences in disaster nursing version 2.0, https://www.icn.ch/sites/default/files/inline-files/ICN_Disaster-Comp-Report_WEB.pdf, 2019. Accessed April, 8, 2025.Google Scholar
Makwana, N. Disaster and its impact on mental health: A narrative review. J Family Med Prim Care. 2019;8(10):3090–3095. doi:10.4103/jfmpc.jfmpc_893_19CrossRefGoogle ScholarPubMed
Faheim, S, Ahmed, SS, Aly, EF, Hegazy, SM. Effect of triage education on nurses’ performance in diverse emergency departments, EBNR. 2019;1(2):53–63. doi:10.47104/ebnrojs3.v1i2.45CrossRefGoogle Scholar
Cui, Y, Shaw, R. Disaster law—implications to governance and implementation. Springer; 2025.10.1007/978-981-97-7374-9CrossRefGoogle Scholar
Christian, MD. Triage. Crit Care Clin. 2019; 35(4):575–589. doi:10.1016/j.ccc.2019.06.009CrossRefGoogle ScholarPubMed
Al Dhefeeri, AK, Aldhafeeri, AMB, Alsharari, GAS, et al. The importance of traige in the emergency department. Gland Surgery. 2024;9(2):285–291.Google Scholar
Bazyar, J, Farrokhi, M, Khankeh, H. Triage systems in mass casualty incidents and disasters: A review study with a worldwide approach. Maced J Med Sci. 2019;7(3):482–494. doi:10.3889/oamjms.2019.119CrossRefGoogle ScholarPubMed
Khorram-Manesh, A, Nordling, J, Carlström, E, Goniewicz, K, Faccincani, R, Burkle, FM. A translational triage research development tool: standardizing prehospital triage decision-making systems in mass casualty incidents. Scand J Trauma Resusc Emerg Med. 2021;29(1):119. doi:10.1186/s13049-021-00932-zCrossRefGoogle ScholarPubMed
Singh, P, Lamine, H, Sapkota, S, Bahattab, A, Eriksson, A. Management of mass-casualty incidents in Nepal: A qualitative case study of three district hospitals in Nepal. Prehosp Disaster Med. 2023;38(5):606–611. doi:10.1017/S1049023X23006209CrossRefGoogle Scholar
Reinhardt, MR. A Systematic approach to evaluation of performance deficiencies in ED triage. J Emerg Nurs. 2017;43(4):329–332. doi:10.1016/j.jen.2017.01.003CrossRefGoogle ScholarPubMed
ADRC- Asian Disaster Reduction Center. Natural disaster data book 2021, https://www.adrc.asia/publications/databook/DB2021_e.php. Accessed April 9, 2025.Google Scholar
United Nations Indonesia. Twenty years on: Indonesia’s disaster preparedness has much improved in the wake of the 21st century’s largest natural disaster. https://indonesia.un.org/en/281068-twenty-years-indonesia%E2%80%99s-disaster-preparedness-has-much-improved-wake-21st-century%E2%80%99s-largest, 2024. Accessed April 9, 2025.Google Scholar
Pertiwi, P, Llewellyn, G, Villeneuve, M. Disability representation in Indonesian disaster risk reduction regulatory frameworks. IJDRR. 2020;45(2020):101454. doi:10.1016/j.ijdrr.2019.101454Google Scholar
Setyawati, AD, Lu, YY, Liu, CY, Liang, SY. Disaster knowledge, skills, and preparedness among nurses in Bengkulu, Indonesia: A descriptive correlational survey study. J Emerg Nurs. 2020;46(5):633–641. doi:10.1016/j.jen.2020.04.004CrossRefGoogle ScholarPubMed
Chiang, HH, Ting, CW, Chao, E, Chen, KJ. Using tabletop exercises to evaluate nurses’ clinical performance of hazardous materials disaster management: A cross-sectional study. Nurse Educ Today. 2020;87:104358. doi:10.1016/j.nedt.2020.104358CrossRefGoogle ScholarPubMed
Said, NB, Chiang, VCL. The knowledge, skill competencies, and psychological preparedness of nurses for disasters: A systematic review. Int Emerg Nurs. 2020;48:100806. doi:10.1016/j.ienj.2019.100806CrossRefGoogle ScholarPubMed
Hopewell, S, Chan, AW, Collins, GS, et al. CONSORT 2025 statement: Updated guideline for reporting randomised trials. PLoS Med. 2025;22(4):e1004587. doi:10.1371/journal.pmed.1004587CrossRefGoogle ScholarPubMed
Faul, F, Erdfelder, E, Buchner, A, Lang, AG. Statistical power analyses using G*Power 3.1: tests for correlation and regression analyses. Behav Res Methods. 2009;41(4):1149–1160. doi:10.3758/BRM.41.4.1149CrossRefGoogle Scholar
Faul, F, Erdfelder, E, Lang, AG, Buchner, A. G*Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods. 2007;39(2):175–191. doi:10.3758/bf03193146CrossRefGoogle Scholar
Noh, J, Oh, EG, Kim, SS, Jang, YS, Chung, HS, Lee, O. Development and evaluation of a multimodality simulation disaster education and training program for hospital nurses. Int J Nurs Pract. 2020;26(3):e12810. doi:10.1111/ijn.12810CrossRefGoogle ScholarPubMed
Primasari, I, Hoeboer, CM, Bakker, A, Olff, M. Validation of the Indonesian resilience evaluation scale in an undergraduate student population. BMC Public Health. 2022;22(1):2410. doi:10.1186/s12889-022-14769-3CrossRefGoogle Scholar
Bell, R, Bell, H. Applying educational theory to develop a framework to support the delivery of experiential entrepreneurship education. JSBED. 2020;27(6):987–1004. doi:10.1108/JSBED-01-2020-0012CrossRefGoogle Scholar
Munna, AS, Kalam, MA. Teaching and learning process to enhance teaching effectiveness: a literature review. IJHI. 2021;4(1):1–4. doi:10.33750/ijhi.v4i1.10CrossRefGoogle Scholar
Brinjee, D, Al Thobaity, A, Almalki, M, Alahmari, W. Identify the disaster nursing training and education needs for nurses in Taif City, Saudi Arabia. Risk Manag Healthc Policy. 2021;14:2301–2310. doi:10.2147/RMHP.S312940CrossRefGoogle ScholarPubMed
Sarfati, L, Ranchon, F, Vantard, N, et al. Human-simulation-based learning to prevent medication error: A systematic review. J Eval Clin Pract. 2019;25(1):11–20. doi:10.1111/jep.12883CrossRefGoogle ScholarPubMed
Smith, S, Farra, SL, Hodgson, E. Evaluation of two simulation methods for teaching a disaster skill. BMJ Simul Technol Enhanc Learn. 2020;7(2):92–96. doi:10.1136/bmjstel-2019-000572CrossRefGoogle ScholarPubMed
Watson, AL, Drake, J, Anderson, M, et al. Triage ethics in mass casualty incident simulation: A phenomenological exploration. Nurs Ethics. 2025;32(4):1313–1326. doi:10.1177/09697330241299526CrossRefGoogle Scholar
Bhatia, V, Singh, AK, Giri, PP, Sahoo, DP. Effectiveness of a short-structured training programme on knowledge of healthcare providers and programme managers involved in maternal and child health programmes in Odisha, India: a quality improvement study. BMJ Open. 2021;11(8):e040841. doi:10.1136/bmjopen-2020-040841CrossRefGoogle ScholarPubMed
Farra, SL, Smith, S, Bashaw, MA. Learning outcome measurement in nurse participants after disaster training. Disaster Med Public Health Prep. 2016;10(5):728–733. doi:10.1017/dmp.2016.41CrossRefGoogle ScholarPubMed
Feng, Z, González, VA, Mutch, C, et al. Towards a customizable immersive virtual reality serious game for earthquake emergency training. Adv Eng Inform. 2020;46(2020):101134. doi:10.1016/j.aei.2020.101134CrossRefGoogle Scholar
Goniewicz, M, Khorram-Manesh, A, Timler, D, Al-Wathinani, AM, Goniewicz, K. Hospital disaster preparedness: A comprehensive evaluation using the hospital safety index. Sustainability. 2023;15(17):13197. doi:10.3390/su151713197CrossRefGoogle Scholar
Haritha, G, Rao, R. A holistic approach to professional development: Integrating Kolb’s experiential learning theory for soft skills mastery. JEET. 2024;37(Special Issue 2):415–424. doi:10.16920/jeet/2024/v37is2/24069CrossRefGoogle Scholar
Kolb, DA. Experiential learning: experience as the source of learning and development. FT Press; 2014.Google Scholar
Yang, J, Kim, KH. Effect of the strategic thinking, problem solving skills, and grit on the disaster triage ability of emergency room nurses. Int J Environ Res Public Health. 2022;19(2):987. doi:10.3390/ijerph19020987CrossRefGoogle ScholarPubMed
Kim, HW, Choi, YJ. A simulation-based nursing education of psychological first aid for adolescents exposed to hazardous chemical disasters. BMC Med Educ. 2022;22(1):93. doi:10.1186/s12909-022-03164-6CrossRefGoogle ScholarPubMed
Gros, A. The effects of knowledge retention, self-confidence, and anxiety levels associated with peer-assisted learning in a healthcare course. Doctoral dissertation: University of Louisiana at Monroe; 2021.Google Scholar
Madani, SMS, Bahramnejad, A, Farsi, Z, Alizadeh, A, Azizi, M. The effect of psychological first-aid virtual education on the communication skills of nurses in disasters: a randomized controlled trial. BMC Psychol. 2024;12(1):194. doi:10.1186/s40359-024-01682-0CrossRefGoogle ScholarPubMed
Tint, B, McWaters, V, Raymond, VD. Applied improvisation training for disaster readiness and response. JHLSCM. 2015;5(1):73–94. doi:10.1108/JHLSCM-12-2013-0043CrossRefGoogle Scholar
Albott, CS, Wozniak, JR, McGlinch, BP, Wall, MH, Gold, BS, Vinogradov, S. Battle buddies: Rapid deployment of a psychological resilience intervention for health care workers during the COVID-19 pandemic. Anesth Analg. 2020;131(1):43–54. doi:10.1213/ANE.0000000000004912CrossRefGoogle ScholarPubMed
Pouraghaei, M, Sadegh Tabrizi, J, Moharamzadeh, P, Rajaei Ghafori, R, Rahmani, F, Najafi Mirfakhraei, B. The effect of start triage education on knowledge and practice of emergency medical technicians in disasters. J Caring Sci. 2017;6(2):119–125. doi:10.15171/jcs.2017.012CrossRefGoogle ScholarPubMed
Kalanlar, B, Akkaya, G. Nursing student’s experiences of Role-Play Scenario-Based Disaster Triage (START) training: A qualitative research. Nurse Educ Today. 2024;141:106307. doi:10.1016/j.nedt.2024.106307CrossRefGoogle ScholarPubMed