Disaster management and emergency preparedness relies on the collaboration, communication, and expertise of a multidisciplinary team. Skills in preparation, communication, and management of disasters are core competencies of an emergency physician. To learn the principles of disaster management, simulations are critical as mass casualty/rapid surge events seldom occur. The COVID-19 pandemic resulted in the cancellation of in-person events. In response to these restrictions, the University of Toronto, EM Program developed a successful virtual interprofessional mass casualty simulation.

The novel online simulation event was piloted in 2021 and ran for three-hours. The exercise focused on developing soft skills (e.g., communication, team-work, and debriefing) and hard skills (e.g., triage, casualty distribution, and activation of plans). Groups were composed of members of each post-graduate year to facilitate near-peer learning. A total of six groups were formed: Adult, Children, Community Hospitals, EMS, Government, and Media. Each Team used multiple communication tools (i.e., Whatsapp groups, Zoom breakout rooms, Shared Google Documents) to swiftly pivot and manage a mass casualty event. Post-exercise debriefing and anonymous evaluations were gathered.

A total of 28-residents (nine PGY1, ten PGY2, and eight PGY3 learners) and 11-staff observers participated (25-respondents). Nineteen participants rated the simulation exercise as excellent and six as “very good”. Twenty participants rated the workshop as “very useful” and five as “useful”. Positive feedback centered around content applicability, exercise creativity, level of engagement, and learning value. Constructive feedback included the need for more pre-exercise orientation time, increasing disaster management time, and inviting allied-health staff.

There is a clear need for EM residents to learn and develop skills related to disaster management and emergency preparedness. This exercise showed that disaster management and emergency preparedness competencies can be learned in a virtual format. This virtual format has encouraged its continuation and further inspired the curation of a four-year program.

In Canada, access to health care is considered a universal right, however, many Indigenous communities exist in austere settings and the major health care provided is through a nursing station. As a result, they are vulnerable to developing acute staff shortages during COVID-19 outbreaks.

Trial the effectiveness of a Nomadic Medical Assistance Team (NoMAT) to mitigate sudden staff shortages caused by a COVID-19 outbreak in a remote Indigenous community served only by a nursing station.

Indigenous Services Canada funded a pilot and NoMAT was deployed from March 13 through April 2, 2022 to a small Indigenous community in remote Northern Ontario, Canada.

The team consisted of up to seven personnel: MD, Nurse, Nurse Practitioner, Physician Assistant, Paramedic, Data Support, and Logistics. Individuals served from one-to-two weeks of a three-week deployment. If there was a shortage, the MD could be virtual. Local health resources were used and the team resided at the local school.

The NoMAT rapidly: (1) worked with the local team to co-develop outbreak management; (2) identified high-risk patients for treatment; (3) supported non-COVID-19 patient care; and (4) reduced a backlog of care.

The NoMAT strategy is highly effective and efficient in mitigating the impact of both COVID-19 surges and reducing backlogs of care. The next step is developing a proposal for full-time teams.