Simulation tests students in high-stakes emergency care

(Photo by UTHealth Houston)

Panic rippled through the Cooley University Life Center courtyard as injured victims called for help and students rushed in from all directions, scanning the scene and making split-second decisions. The intentional chaos was part of a large-scale simulation designed to prepare future health professionals for the realities of mass casualty events.

More than 400 students from McGovern Medical School at UTHealth Houston, Cizik School of Nursing at UTHealth Houston, UTHealth Houston School of Dentistry, and Texas Southern University social work programs participated in the mass casualty simulation, hosted twice a year by the Center for Interprofessional Collaboration.

The exercise recreated the aftermath of a fictional mass shooting, with faculty and staff portraying victims with varying degrees of injury. Students were tasked with assessing wounds, administering care, and coordinating as teams in a fast-moving, high-stress environment.

From chaos to coordination

The simulation began in the courtyard, where students responded to victims in the field before transitioning into a hospital-based scenario that mirrored an already strained emergency room.

Each phase was followed by a structured debrief, allowing students to reflect and refine their approach before applying those lessons in the next scenario.

According to Ann Marshburn, MD, associate professor of pediatrics at McGovern Medical School and lead faculty for the simulation, the immersive nature of the exercise plays a key role in preparing students for real-world situations.

“Today is all about the experiential learning,” Marshburn said. “It’s when you have the learning happening in a stressful situation where it’s somewhat ill-defined that usually cements that experience and the lessons into their psyche even better. They’re going to be able to access this and bring it up even faster and know the skills with both communication and triage.”

Rachel Jantea, MD, MS, associate professor of internal medicine at the medical school and director of education at the Center for Interprofessional Collaboration, emphasized how hands-on learning strengthens retention and confidence.

“Experiential applied learning like this creates an environment that ensures better knowledge retention,” Jantea said. “By experiencing the stress and emotions and building confidence in rising to the occasion, students will be more prepared to respond to a mass casualty scenario in real life.”

Learning to lead and collaborate

A central goal of the simulation is teaching students how to function as part of a multidisciplinary team, often with individuals they have never worked with before.

“One of their main objectives is figuring out how to communicate with each other when you don’t know each other’s backgrounds,” Marshburn said. “They need to understand how to figure out their own strength, voice their own strength, and then find out what other people’s strengths are so that they can form teams within this larger team.”

Jantea emphasized that teamwork is essential in transforming a chaotic situation into an organized response.

“In a mass casualty, team structure and process are paramount to creating order from chaos. In this mass casualty simulation, students learn how to work effectively in teams by assigning roles, engaging in clear communication, and applying evidence-based strategies for collaboration in the field.”

For students, the experience highlighted both the challenges and the importance of collaboration.

“I knew coming into this it would probably be chaotic, but I didn’t know that it can be this chaotic,” said Yunyan Cheng, a fourth-year student at Cizik School of Nursing. “We needed to quickly form a team, identify the leaders, and assign roles.”

Cheng added that working with students from other disciplines quickly became a strength.

“In the beginning it was kind of awkward, but we warmed up pretty fast because we have the same goal, to take care of the patients.”

Adapting in real time

As the scenarios unfolded, students were challenged to think critically and adapt as conditions changed.

“I think the simulation today was a good reminder that your knowledge, your capability, and your effort are going to be helpful in an emergency context or in any context,” said Mara Eccles, a fourth-year student at McGovern Medical School.

Eccles said the experience reinforced the importance of flexibility in patient care.

“I do feel more capable of being able to adapt to a changing situation.”

Students also observed how individuals stepped into roles beyond their expected scope, underscoring the value of teamwork across disciplines.

“I think everyone did really well,” Eccles said. “Everyone did a great job of rising to meet the needs of the occasion.”

Preparing the next generation

The simulation reflects a broader commitment by UTHealth Houston to prepare students not only as clinicians, but as collaborative leaders in health care.

“Our responsibility is to graduate health profession students not only competent in their own fields, but also able to engage in effective health care teams that provide high quality patient care,” Jantea said. “As a result of interprofessional simulations like this one, UTHealth Houston students are set up to graduate as health care team leaders.”

For Marshburn, the experience extends beyond students to faculty as well.

“Watching us work as multidisciplinary mentors and role models is helpful and shows them that we all are able to work together when it’s needed.”