ArticleInternational journal of emergency medicine2026
Cluster analysis of participants' self-reported emotional and organizational responses during a large-scale disaster simulation exercise at a level 1 trauma center.
Article in International journal of emergency medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundHospital-based simulations are vital for disaster preparedness. Anxiety and other emotions may affect hospital staff by influencing non-technical skills. We investigated self-reported emotional and organizational factors among hospital professionals during a large-scale disaster simulation.
methodsWe conducted a cross-sectional study using a self-reported web survey administered after a large-scale in-hospital fire simulation at a level 1 trauma center. The primary outcome was self-reported anxiety intensity during the exercise on a 0 to 10 numerical rating scale. We compared anxiety levels between staff working in emergency versus non-emergency settings and performed a cluster analysis to identify participant profiles based on emotional and organizational perceptions.
resultsOf 89 participants, 72 (80.9%) completed the survey. Emergency professionals reported significantly higher anxiety during the exercise (median 3 [1-5] versus 1.5 [0-3] for non-emergency professionals; p = 0.01). Exploratory cluster analysis suggested three distinct professional profiles: Cluster 1 (n = 19; 26.4%) included non-emergency staff with limited experience, characterized by lower enthusiasm and increased communication difficulty; Cluster 2 (n = 28; 38.9%) comprised experienced emergency professionals with high enthusiasm and low negative emotions; and Cluster 3 (n = 25; 34.7%) was composed predominantly of non-emergency staff with general but limited large-scale simulation experience and reported higher negative emotions despite a high level of preparedness. Perceived safety was significantly associated with increased odds of institutional trust (OR = 1.55; 95% CI [1.11-2.16]; p = 0.009).
conclusionsEmergency professionals reported higher anxiety levels during the simulation than professionals working in non-emergency settings, although absolute anxiety levels remained low overall. Exploratory cluster analysis suggested heterogeneous emotional and organizational response profiles, particularly among less experienced and non-clinical staff. These findings support the development of role-specific disaster training and simulation designs that reinforce perceived safety.
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