Development and evaluation of scenario-based e-simulation for humanitarian health training: A mixed-methods action research study

Objectives This study aimed to develop and evaluate a scenario-based e-simulation (SBES) to address the limited avilability of accessible and practical training for humanitarian public health responders. The objectives included SBES customisation, effectiveness evaluation, and identifying learning-enhancing design elements. Design A university-based, mixed-methods action research design. Setting The study was conducted at an international university's academic centre in Italy, and at a university-based master's programme in Yemen. Participants The study involved 20 multidisciplinary global health and education experts and 66 international medical and health sciences students. Results Between September 2020 and July 2022, four SBES modules were developed, implemented and evaluated using a rapid prototype model. The modules, which targeted health professionals new to or with limited experience in the humanitarian field, included health needs assessment, essential health services, communicable diseases and health system. Formative evaluation improved the design and implementation of the SBES, which was found to be effective in the summative evaluation, evident from positive student reactions (the overall mean satisfaction rate was 6.03 out of 7, 95% CI 5.95 to 6.47) and the significant improvement in knowledge scores (p<0.001, effect size: 1.179). The identified effective design of SBES includes overlapping elements among content, strategy and technology. Poor internet access was recognised as a potential barrier to delivering the training in the humanitarian context, highlighting the need to develop an offline version in the next phase. Conclusion The developed SBES met the training needs of the academic institution involved. The study findings will contribute to advancing future SBES training initiatives for disaster medicine and global health. Further studies are recommended to evaluate and address the challenges associated with SBES implementation beyond the study setting.