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Cost Effectiveness of Videogame vs. Live Simulation for Pediatric Disaster Triage Training
Maria Carmen G. Diaz, MD, FAAP, FACEP1; Travis Whitfill, MPH2; Marc Auerbach, MD2; Mark Cicero, MD2
1Nemours/Alfred I. duPont Hospital for Children, Wilmington, DE; 2Yale, New Haven, CT

Introduction: Pediatric disaster triage (PDT) training for emergency medical service (EMS) providers is not standardized. Live simulation training is costly and time-consuming; educational video games enable low-cost and more time-efficient standardized training. We hypothesized that the PDT video game 60 Seconds to Survival (60S) would be a cost-effective alternative to live simulation-based PDT training.

Methods: This study was part of a randomized controlled trial that compared triage accuracy between EMS providers exposed to 60S versus learners who completed a live simulation with in-person debriefing. Baseline triage accuracy scores were measured for each participant at the onset of the study and then compared to final triage accuracy using the same scenario and compared between both groups. Cost-effectiveness was assessed using a net benefit regression model at various willingness-to-pay (WTP) values and a cost-effectiveness acceptability curve to identify the more cost-effective training program.

Results: The total cost for the live simulation PDT training program was $83,747 and for 60S was $67,822. Incremental net benefit values at WTP values from ranges $0 to $100,000 revealed positive incremental net benefit values, indicating that the video game is more cost-effective compared to live simulation and feedback. Moreover, the cost-effectiveness acceptability curve revealed a high probability (>0.93) at WTP values ≤$100,000 that the videogame is more cost-effective.

Conclusions: A video game-based PDT training program could be a simple, scalable, and sustainable solution to training EMS providers. Future studies are needed to better measure the effectiveness of this type of program.


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