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Purpose This paper aims to discuss the experiences designing and conducting an experiential learning virtual incident response tabletop exercise (VIRTTX) to review a business's security posture as it adapts to remote working because of the Coronavirus 2019 (COVID-19). The pandemic forced businesses to move operations from offices to remote working. Given that this happened quickly for many, some firms had little time to factor in appropriate cyber-hygiene and incident prevention measures, thereby exposing themselves to vulnerabilities such as phishing and other scams. Design/methodology/approach The exercise was designed and facilitated through Microsoft Teams. The approach used included a literature review and an experiential learning method that used scenario-based, active pedagogical strategies such as case studies, simulations, role-playing and discussion-focused techniques to develop and evaluate processes and procedures used in preventing, detecting, mitigating, responding and recovering from cyber incidents. Findings The exercise highlighted the value of using scenario-based exercises in cyber security training. It elaborated that scenario-based incident response (IR) exercises are beneficial because well-crafted and well-executed exercises raise cyber security awareness among managers and IT professionals. Such activities with integrated operational and decision-making components enable businesses to evaluate IR and disaster recovery (DR) procedures, including communication flows, to improve decision-making at strategic levels and enhance the technical skills of cyber security personnel. Practical implications It maintained that the primary implication for practice is that they enhance security awareness through practical experiential, hands-on exercises such as this VIRTTX. These exercises bring together staff from across a business to evaluate existing IR/DR processes to determine if they are fit for purpose, establish existing gaps and identify strategies to prevent future threats, including during challenging circumstances such as the COVID-19 outbreak. Furthermore, the use of TTXs or TTEs for scenario-based incident response exercises was extremely useful for cyber security practice because well-crafted and well-executed exercises have been found to serve as valuable and effective tools for raising cyber security awareness among senior leadership, managers and IT professionals (Ulmanová, 2020). Originality/value This paper underlines the importance of practical, scenario-based cyber-IR training and reports on the experience of conducting a virtual IR/DR tabletop exercise within a large organisation.

Background Disaster preparedness is one of the critical strategies for effectively managing disasters and has been an area of high focus in the healthcare sector over the past few decades. The current Indian medical undergraduate curriculum does not describe any novel methods for disaster preparedness training. There is a need for a better understanding of novel teaching-learning methods and modes for administering disaster preparedness training among Indian medical students. Objectives Describe the undergraduate medical students’ baseline knowledge and confidence level of disaster preparedness. Compare undergraduate medical students’ knowledge scores and confidence levels on disaster preparedness after online and onsite delivery of the disaster preparedness module. Methods In this educational interventional study, 103 medical students were divided into two groups and subjected to an online or onsite session of the validated disaster preparedness module (based on the COVID-19 pandemic), encompassing a simulation-based tabletop exercise. Baseline testing was done for 52 participants in the online group and 51 in the onsite group of the study. Post-intervention, they were assessed with single-response type MCQs for knowledge and Likert scale-based questions for confidence scores. The pretest and posttest scores were collected, and the data were analysed using two-tailed t-tests for paired analysis of within-group (online group or onsite group) and heteroscedastic analysis of between-group datasets. Results One hundred and three participants completed the exercise—52 participants were from the online group, and 51 were from the onsite group. After the intervention, there was a statistically significant increase in knowledge and confidence in both online and onsite groups. There is, however, no significant difference in the ‘percentage change’ in ‘knowledge’ or ‘confidence’ between the groups. Conclusions Our study indicates that the disaster preparedness module, delivered online and onsite, improves knowledge and confidence among undergraduate medical students. However, there is no superiority between one mode of delivery and the other. We conclude that online training can facilitate disaster preparedness training as a corollary to the prescribed traditional training methods for undergraduate medical students in India.

This research aims to test several tools for assessing workload and performance during a tabletop cybersecurity exercise. We have administered two such exercises in order to collect and analyse data regarding the participants’ behavioural characteristics, their knowledge of cybersecurity, and four sets of questions assessing how they performed their tasks and how they handled the workload. Furthermore, we have also looked for statistical associations with independent expert evaluation of their performance, their mutual assessments of their team colleagues, their professional background and the potential influence of repeated assessment delayed by 2 weeks. We have found that performance was most strongly correlated with a lack of perceived stress caused by the workload, knowledge of cybersecurity, good communication and, unexpectedly, a low openness score. The repeated delayed assessment yielded only data consistent with a regression towards the mean. A comparison between technical and non-technical professionals showed little difference in their self-assessment but showed differences in how they were perceived and assessed by their teammates. Given the importance of this topic, we suggest this area needs further research.

Background Traditional methods of teaching mass casualty incident (MCI) management often lack engagement, particularly for senior medical students. Lectures may be uninspiring, and tabletop exercises (TTX) may not fully captivate participants. This study proposes the use of three-dimensional (3D) models in TTX as a solution to these challenges. Methods A TTX focusing on MCI in the emergency room was developed for senior medical students, centered on five core competencies of MCI management. 3D models representing the emergency room, hospital staff, patients, and other personnel were utilized. No lectures were given; instead, students engaged in discussions and demonstrated responses using 3D models. Immediate feedback was provided by the instructor, and knowledge was tested through multiple-choice questions and questionnaires. Results Between September 2018 and May 2022, 326 students completed pre- and post-exercise evaluations. Significant improvements were observed in test scores for all core competencies, as well as increased interest in learning and willingness to participate. Students found the exercise engaging and expressed a desire for further training. Conclusions A TTX using 3D models is proving to be an effective alternative of teaching MCI management and disaster medicine to senior medical students, while increasing interest and participation.

Emergency preparedness is a critical component of patient safety in outpatient dialysis settings, where patients rely on life-sustaining treatments multiple times each week. Disruptions caused by natural disasters, infrastructure failures, or other emergencies can threaten the continuity of dialysis care and place this vulnerable population at significant risk. Tabletop exercises have emerged as an effective strategy for strengthening emergency readiness by allowing health care teams to rehearse response procedures in a structured, low-risk environment. These scenario-based simulations promote active engagement, interdisciplinary communication, and real-time problem-solving, while helping organizations identify operational gaps in existing emergency protocols. This article describes the creation and implementation of a tabletop exercise for a rapidly escalating emergency - a hurricane with a changing path and rapid intensification.

This study investigated the crucial role of formulating and applying standard operating procedures (SOPs) in the context of emergency planning and response. The effective application of SOPs during operations is essential in order to address challenges that surpass individual organizational capacities. A specific focus on fostering efficient information sharing and executing specified actions maximizes the prospect of success. To explore the collective functionality of SOPs across organizations, we conducted a comprehensive tabletop exercise involving 10 organizations spanning tactical, operational, and strategic levels. Our analysis identified six key challenges, primarily related to the structures for information sharing, communication pathways, and the complex integration and application of common SOPs within these diverse organizational contexts. This research contributes insights into the use of SOPs in large-scale, cross-organizational scenarios.

Objectives: Virtual tabletop exercises (VTTXs) simulate disaster scenarios to help participants improve their emergency-planning capacity. The objectives of our study were to (1) evaluate the effectiveness of a VTTX in improving preparedness capabilities specific to children’s needs among pediatricians and public health practitioners, (2) document follow-up actions, and (3) identify exercise strengths and weaknesses. Methods: In February 2017, we conducted and evaluated a VTTX facilitated via videoconferencing among 26 pediatricians and public health practitioners from 4 states. Using a mixed-methods design, we assessed participants’ knowledge and confidence to fulfill targeted federal preparedness capabilities immediately before and after the exercise. We also evaluated the degree to which participants made progress on actions through surveys 1 month (n = 14) and 6 months (n = 14) after the exercise. Results: Participants reported a greater ability to identify their state’s pediatric emergency preparedness strengths and weaknesses after the exercise (16 of 18) compared with before the exercise (10 of 18). We also observed increases in (1) knowledge of and confidence in performing most pediatric emergency preparedness capabilities and (2) most dimensions of interprofessional collaboration. From 1 month to 6 months after the exercise, participants (n = 14) self-reported making progress in increasing awareness for potential preparedness partners and in conducting similar pediatric exercises (from 4-7 for both). Conclusions: Participants viewed the VTTX positively and indicated increased pediatric emergency preparedness knowledge and confidence. Addressing barriers to improving local pediatric emergency preparedness—particularly long term—is an important target for future tabletop exercises.

During health emergencies, such as the COVID-19 pandemic, systematic evaluation of capabilities, and multisector coordination are challenging while operating in triage mode. During Action Review and Tabletop (DART) identifies recommendations for strengthening readiness and resiliency by creating a single methodology integrating retrospective analysis of the response to date with a prospective analysis of future scenarios. DART utilizes a role-based questionnaire and participant-led discussion for retrospective response review and identification of future scenarios of concern. Tabletop exercises exploring those future scenarios are conducted in a multi-role format to assess readiness and resiliency. Participants evaluate findings to determine recommended actions to improve response capabilities. 3 COVID-19 focused DARTs demonstrated the ability of this participant-led approach to systematically assess, not only readiness for today, but also resiliency to future complications. While demonstrating its usefulness during COVID-19, DART’s flexible and modular design promises to be an effective for any ongoing health emergency.

Despite noble intentions, new technologies may have adverse effects on the resilience of the sociotechnical systems into which they are integrated. Our objective was to develop a lightweight method to elicit requirements that, if implemented, would support sociotechnical system resilience. We developed and piloted the Resilience-Aware Development Exercise Protocol (RAD-XP), a method to generate tabletop exercises (TTXs) to elicit resilience requirements. In the pilot study, this approach generated 15 requirements from a one-hour TTX, where the majority of requirements were found to support resilience. Participants indicated via survey that RAD-XP was effective and efficient, and that they would want to use RAD-XP regularly throughout the agile development process. We discuss future research and development to refine this approach to eliciting resilience requirements.

In the wake of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, rapid identification of pediatric mental health risk is extremely important. The Western Regional Alliance for Pediatric Emergency Management held an integrated, interdisciplinary national tabletop exercise to familiarize mental health and non-mental health professionals with Psychological Simple Triage and Rapid Treatment (PsySTART), an evidence-based triage and incident management system used to evaluate new mental health risk impacts following exposure to traumatic events, such as coronavirus disease (COVID-19). Participants Participants were exposed to 3 practice cases that reflected a combination of \"all hazards\" scenarios and were asked to triage each case using PsySTART. Participants were asked to interpret results at both an individual site and aggregate county and/or state level. The exercise had a total of 115 participants with a total of 156 discrete triage encounters. A user-defined operating picture was created with graphs of aggregate mental health risk data, generating cross-regional, real-time situational awareness. After the exercise, a vast majority of the participants reported confidence in their ability to use PsySTART in their practices. Participants are now better equipped with tools to perform mental health triage for early intervention during COVID-19 and other disasters and understand risk on a population level.