Joint North Atlantic Treaty Organization Mass Casualty Incident Simulation Exercise: Evaluation of Interprofessional Collaboration, Communication, Teamwork, and Prehospital Clinical Competence Among Reserve Health Care Providers.
Military medicine · 2026-08-01 · Quasi-experimental
Abstract
BACKGROUND: Trauma-related injuries remain a major global health challenge, especially in military and austere environments. Joint interprofessional clinical simulation training is a key strategy to enhance the skills and readiness of healthcare providers across North Atlantic Treaty Organization (NATO) nations. However, formal evaluations of its impact on collaboration, teamwork, satisfaction, and clinical competency are limited. This study assessed the effects of a joint casualty care simulation on the prehospital clinical competency, teamwork, and satisfaction of Canadian and American reserve military medical personnel. MATERIALS AND METHODS: A cross-sectional pre-post study was conducted in April 2025, involving reserve military medical personnel partici-pating in a mass casualty simulation. Data were collected using validated survey instruments assessing interprofessional collaboration and teamwork as well as satisfaction with current learning, self-confidence in learning and overall simulation experience. Facilitators also used a standardized tool to evaluate clinical competence. Quantitative data were analyzed using descriptive and inferential statistics (SPSS Version 29.0). RESULTS: Thirty-five personnel participated: 57% from 25 (Toronto) Field Ambulance and 43% from 329 Ground Ambulance. Statistically significant improvements (P < .05) were observed in participants' perceptions of simulation-based learning and interprofessional education and collaborative practice. Post-exercise, participants reported high satisfaction with current learning, self-confidence in learning and overall simulation experience. However, competence assessments showed variability across scenarios, with poly-trauma management identified as a key area for improvement. CONCLUSIONS: Joint international medical simulation training may improve competence, teamwork, and satisfaction among military medical personnel. These findings offer evidence-based guidance for future training initiatives, particularly in strengthening trauma management skills to ensure teams are prepared to deliver coordinated, high-quality care in diverse operational environments alongside NATO partners.